Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger

Hampshire, Rachel; Aguayo, Víctor M.; Hamani, Harouna; Roley, Julie A.; Tarini, Ann; Baker, Shawn K.

doi:10.1079/phn2004641

Cited by 18 publications

(17 citation statements)

References 5 publications

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“…In this population, poor iron status and anemia was observed in the context of a national policy for IFA supplementation among pregnant women. Continuation of this routine supplementation program, as currently implemented [15,21], is unlikely to be effective in ensuring adequate micronutrient status and improving pregnancy outcomes in this population. Considering the high prevalence of iron, zinc, vitamin A, B 12 , and folate deficiencies, and previously presented results on iodine deficiency in this study population [63], interventions to promote the strengthening of ANC, and access and adherence to nutrition and health interventions are urgently needed [64,65].…”

Section: Discussionmentioning

confidence: 99%

“…In Niger, iron and folic acid (IFA) supplements are almost exclusively available to pregnant women through antenatal care (ANC) at governmental health clinics, and policies issued by the Ministry of Public Health are in line with WHO guidelines [14]. However, a previous survey of nutrition services provided during ANC revealed that health care providers’ adherence to guidelines is inadequate, and knowledge transfer to pregnant women is limited [15]. In observed ANC consultations, only 57% of pregnant women received IFA supplements, and 38% received counseling on pregnancy-related dietary improvements [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, a previous survey of nutrition services provided during ANC revealed that health care providers’ adherence to guidelines is inadequate, and knowledge transfer to pregnant women is limited [15]. In observed ANC consultations, only 57% of pregnant women received IFA supplements, and 38% received counseling on pregnancy-related dietary improvements [15]. In the 2012 Demographic and Health Survey (DHS), 81% of women reported IFA consumption at any point during their last pregnancy, yet only 29% of women consumed supplements for at least 90 days [9].…”

Section: Introductionmentioning

confidence: 99%

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Micronutrient Status among Pregnant Women in Zinder, Niger and Risk Factors Associated with Deficiency

et al. 2017

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Anemia and micronutrient (MN) deficiencies in pregnant women are associated with adverse pregnancy outcomes. In Niger, 58.6% of pregnant women are anemic; however, MN statuses are unknown. The study objectives were to estimate the prevalence of MN deficiencies among pregnant women in Zinder, Niger and explore associated risk factors. Pregnant women living in randomly selected rural villages (n = 88) were included. Capillary and venous blood samples (n = 770) were analyzed for hemoglobin (Hb) and plasma ferritin, soluble transferrin receptor (sTfR), zinc (pZn), retinol binding protein (RBP), folate and vitamin B12. C-reactive protein and alpha-1-acid glycoprotein were measured to adjust for inflammation. The prevalence of MN deficiencies in pregnant woman was high, indicative of a severe public health problem. Prevalence of iron deficiency was 20.7% and 35.7%, by ferritin (<15 µg/L) and sTfR (>8.3 mg/L), respectively. In total, 40.7% of women had low pZn (<50 µg/dL), 79.7% had marginal RBP (<1.32 µmol/L), 44.3% of women had low folate (<10 nmol/L) and 34.8% had low B12 concentrations (<148 pmol/L). Common risk factors associated with MN status included gravidity, mid-upper-arm circumference, geophagy, malaria, and result of the woman’s last pregnancy. Interventions to promote the strengthening of antenatal care, and access and adherence to nutrition and health interventions are critical among pregnant women in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Micronutrient Status among Pregnant Women in Zinder, Niger and Risk Factors Associated with Deficiency

et al. 2017

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“…Finally, we suggest that the existence of poor quality training programmes and academic curricula in nutrition in regions of poor quality service delivery is not a coincidence. [150][151][152][153] Many of these studies are from high-burden regions and they fi nd the training and curricula to be outdated, impractical, and misaligned with local nutrition priorities. We reiterate the conclusion of the 2008 Series that much more needs to be done to strengthen strategic and operational capacity.…”

Section: Capacity For Scale Upmentioning

confidence: 99%

The politics of reducing malnutrition: building commitment and accelerating progress

et al. 2013

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In the past 5 years, political discourse about the challenge of undernutrition has increased substantially at national and international levels and has led to stated commitments from many national governments, international organisations, and donors. The Scaling Up Nutrition movement has both driven, and been driven by, this developing momentum. Harmonisation has increased among stakeholders, with regard to their understanding of the main causes of malnutrition and to the various options for addressing it. The main challenges are to enhance and expand the quality and coverage of nutrition-specifi c interventions, and to maximise the nutrition sensitivity of more distal interventions, such as agriculture, social protection, and water and sanitation. But a crucial third level of action exists, which relates to the environments and processes that underpin and shape political and policy processes. We focus on this neglected level. We address several fundamental questions: how can enabling environments and processes be cultivated, sustained, and ultimately translated into results on the ground? How has high-level political momentum been generated? What needs to happen to turn this momentum into results? How can we ensure that high-quality, well-resourced interventions for nutrition are available to those who need them, and that agriculture, social protection, and water and sanitation systems and programmes are proactively reoriented to support nutrition goals? We use a six-cell framework to discuss the ways in which three domains (knowledge and evidence, politics and governance, and capacity and resources) are pivotal to create and sustain political momentum, and to translate momentum into results in high-burden countries.

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“…In Burkina Faso, Niger and Mozambique, fewer than 30% of mothers were counseled (Hampshire et al. ). Reasons cited included lack of health personnel to provide the service, inaccessible child health services and poor attendance by caregivers.…”

Section: Introductionmentioning

confidence: 99%

Impact of type of child growth intervention program on caregivers’ child feeding knowledge and practices: a comparative study in Ga West Municipality, Ghana

Agbozo

Colecraft

Ellahi

2015

Food Science & Nutrition

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Community‐based growth promotion (CBGP) delivered by community volunteers aims at enhancing the traditional growth monitoring and promotion (GMP) program delivered by community health nurses through the promotion of optimum infant and young child feeding (IYCF) leading to improved child growth. This study compared IYCF knowledge and practices among caregiver–child pairs (0–24 months) receiving child welfare services from CBGP (n = 124) and GMP (n = 108) programs. Semistructured questionnaires were used to interview caregivers on IYCF knowledge/practices and validated food frequency questionnaire used to record infants’ food intakes. Group differences were determined using Chi‐square and independent samples t‐tests (P < 0.05; 95% confidence interval [CI]). Mean IYCF knowledge scores were similar (CBGP: 10.84 ± 1.69 vs. GMP: 10.23 ± 1.38, P = 0.062). However, more CBGP caregivers (17%) were highly knowledgeable than their GMP counterparts (5%) (P = 0.011). Early breastfeeding initiation (CBGP: 54% vs. GMP: 28%, P < 0.0001), exclusive breastfeeding (CBGP: 73% vs. GMP: 56%, P = 0.001), and timely complementary feeding (CBGP: 72% vs. GMP: 49%, P = 0.014) were reportedly higher among CBGP caregivers. Underweight was 11% (CBGP: 8% vs. GMP: 14%, P = 0.154). Mean dietary diversity scores (10 food groups) were similar (CBGP: 4.49 ± 1.89 vs. GMP: 3.87 ± 1.89, P = 0.057) but more CBGP caregivers (77%) achieved minimum dietary diversity than their GMP counterparts (61%) (P = 0.035). Few caregivers achieved minimum meal frequency (CBGP: 31% vs. GMP: 29%, P = 0.486) and minimum acceptable diet (CBGP: 23% vs. GMP: 21%, P = 0.464) indicators. Number of children under 5 years owned by caregiver (adjusted odds ratio [AOR]: 0.405; 95% CI: 1.13–78.53, P = 0.038), her educational level (AOR: 0.112; 95% CI: 0.02–0.90, P = 0.040), and IYCF knowledge (AOR: 0.140; 95% CI: 0.03–0.79, P = 0.026) significantly predicted optimum child feeding. Nutrition education on optimum complementary feeding and birth spacing strategies should intensify.

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Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger

Cited by 18 publications

References 5 publications

Micronutrient Status among Pregnant Women in Zinder, Niger and Risk Factors Associated with Deficiency

Micronutrient Status among Pregnant Women in Zinder, Niger and Risk Factors Associated with Deficiency

The politics of reducing malnutrition: building commitment and accelerating progress

Impact of type of child growth intervention program on caregivers’ child feeding knowledge and practices: a comparative study in Ga West Municipality, Ghana

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