Evaluating the effect of the initiative ‘Caring for the Newborn and the Mother at Home’ in Mexico

Abstract

Objective: The WHO and UNICEF recommend home visits to improve health outcomes for mothers and newborns. We evaluated the effect of home visits by community volunteers during pregnancy and postpartum on breastfeeding practices, women´s knowledge about benefits, beliefs and myths of breastfeeding, obstetric and neonatal warning signs, preparation for childbirth and initial care for newborns, and diarrhea and respiratory diseases in children. Design: Community quasi-experimental design. We estimated difference-in-difference models with fixed effects at the community level weighted by propensity score and investigated implementation barriers through focus groups and semi-structured interviews. Setting: Poor rural communities in Mexico; 48 intervention and 29 control. Participants: Baseline and follow-up information were reported from two independent cross-sectional samples of women with babies aged between six and 18 months (baseline: 292 control, 320 intervention, follow-up: 292 control, 294 intervention). Results The intervention increased reports of exclusive breastfeeding in the first six months by 24.4 percentage points (pp) (95% CI 13.4, 35.4), mothers’ knowledge of obstetric warning signs by 23.4 pp (95% CI 9.2, 37.5), and neonatal warning signs by 26.2 pp (95% CI 15.2, 37.2) compared to the control group. A non-linear dose-response relation with the number of home visits was found. Diarrhea and respiratory diseases among children decreased in the intervention vs control group, but were not statistically significant. Conclusions: Home visits should be implemented as a complementary strategy to the provision of prenatal and postnatal care in rural communities due to their potential positive effects on the health of mothers and their children.

Breastfeeding practices in Mexico: Results from the National Demographic Dynamic Survey 2006–2018

“…Similar results were documented in a meta‐analysis, which found that counselling is effective at increasing rates of any breastfeeding and EB < 6mo, especially if delivered postnatally (McFadden et al, 2019). The same way, recent evidence shows that breastfeeding counselling through home visits by community health workers in rural communities in the South of Mexico improved breastfeeding practices (Unar‐Munguía et al, 2020). Also, health professionals should be trained with tools for adequate individual counselling, promotion and effective communication (Bonvecchio, Perichart, Reyes, & Rodríguez, 2018).…”

Construction and validation of an educational video on the newborn immersion bath

“…In the pregnancy-puerperal cycle, actions are concentrated on mothers and are fragmented, mostly focused on breast feeding (21) . After training for the first bath, the mother, father and family will have to perform this care without assistance at home (22) . Doubts about the proper way to bathe or hold the newborn baby, the ideal water temperature and the number of baths are frequent (1,10) .…”

“…Doubts about the proper way to bathe or hold the newborn baby, the ideal water temperature and the number of baths are frequent (1,10) . Studies highlight the importance of baby care programs starting from prenatal care for better planning of the new routine and point out the impact of these actions for the prevention of neonatal mortality, especially where access to health services is limited (1,21,22) .…”

Construção e validação de um vídeo educativo sobre o banho de imersão do recém-nascido

“…No ciclo grávido-puerperal as ações são concentradas nas mães e fragmentadas com foco principalmente no aleitamento materno (21) . O banho do RN é visto como um cuidado pouco debatido, é realizado treinamento no primeiro banho e depois a mãe, pai e família se depara no domicílio sozinhos para realizá-lo (22) . Dúvidas quanto a forma adequada de dar o banho ou segurar o bebê, temperatura ideal da água e quantidade de banhos são frequentes (1,10) .…”