Improving maternal, infant and young child nutrition in Nepal via peer mobilization

Singh, Akriti; Klemm, Rolf; Mundy, Gary; Rana, Pooja; Pun, Bhim Kumari; Cunningham, Kenda

doi:10.1017/s1368980017002993

Cited by 12 publications

(21 citation statements)

References 16 publications

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“…However, these same family and peer networks could also be leveraged to support behaviour change interventions to improve breastfeeding. Meetings with trained peer facilitators have been shown to modestly improve infant and young child feeding knowledge and practices among mothers in rural areas of Nepal (Singh, Klemm, Mundy, Rana, & Pun, ). The relationship between peer recommendations and BMS use was not found in Phnom Penh, further suggesting that the factors that influence newborn feeding are variable and context specific.…”

Section: Discussionmentioning

confidence: 99%

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Champeny

Pries

Kroeun

et al. 2019

Maternal & Child Nutrition

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Introducing breast milk substitutes (BMS) in the first days after birth can increase infant morbidity and reduce duration and exclusivity of breastfeeding. This study assessed determinants of BMS feeding among newborns in delivery facilities in Phnom Penh, Cambodia, and Kathmandu Valley, Nepal. Cross‐sectional surveys were conducted among mothers upon discharge from health facilities after delivery: 304 mothers in Kathmandu Valley and 306 mothers in Phnom Penh participated. On the basis of a conceptual framework for prelacteal feeding, multivariable logistic regression was used to identify factors associated with BMS feeding prior to facility discharge. In both Phnom Penh and Kathmandu Valley, feeds of BMS were reported by over half of mothers (56.9% and 55.9%, respectively). Receiving a health professional's recommendation to use BMS increased the odds of BMS feeding in both Kathmandu Valley and Phnom Penh (odds ratio: 24.87; confidence interval [6.05, 102.29]; odds ratio: 2.42; CI [1.20, 4.91], respectively). In Kathmandu Valley, recommendations from friends/family and caesarean delivery were also associated with BMS use among mothers. Early initiation of breastfeeding and higher parity were protective against the use of BMS in Kathmandu Valley. Breastfeeding support from a health professional lowered the odds of BMS feeding among newborns. Exposure to BMS promotions outside the health system was prevalent in Phnom Penh (84.6%) and Kathmandu Valley (27.0%) but was not associated with BMS feeds among newborns. Establishment of successful breastfeeding should be prioritized before discharging mothers from delivery facilities, and health professionals should be equipped to support and encourage breastfeeding among all new mothers.

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Section: Discussionmentioning

confidence: 99%

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Champeny

Pries

Kroeun

et al. 2019

Maternal & Child Nutrition

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“…More importantly, cultural practices such as eating less during pregnancy, poor food diversity need to be addressed by targeting pregnant women, families, and communities in behavior change communication activities ( 45 ). Mass media mobilization, distribution of IEC/BCC materials as per local context, counseling through peer mobilization ( 46 ), or involvement of mother-in-law in prenatal care ( 47 ) could be potential strategies to reduce such contextual barriers.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Underweight among Under-Five Children in Eastern Nepal: Community-Based Cross-sectional Study

Adhikari

Khatri

Paudel

et al. 2017

Front. Public Health

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BackgroundUndernutrition is a leading cause of morbidity and mortality in children in developing countries including Nepal. This study aimed to identify sociodemographic, environmental, and maternal and child health (MCH) factors associated with objectively assessed underweight among children aged under 5 years in Ilam district of eastern Nepal.MethodsA community-based cross-sectional study of 300 mothers of children under 5 years was conducted using interviewer-administered questionnaires from July to August 2012. The sample was derived by randomly selecting three village development committees (VDCs), then three wards from each of these three VDCs were selected making a total sample of nine wards. Finally, individuals were selected from the nine wards using systematic random sampling. Chi-square tests were used to identify factors associated with childhood underweight. Logistic regression analyses were conducted to determine odds ratios for the factors associated with underweight.ResultsThe prevalence of underweight was 37% [95% confidence interval (CI): 33–43%]. Children who were more than 24 months of age were more likely to be underweight (adjusted odds ratio (aOR) = 2.72; 95% CI: 1.57, 4.70) than children aged less than 24 months. Children of families who consumed water without treatment had higher odds of being underweight (aOR = 2.48; 95% CI: 1.28, 4.78) than those who used water after boiling. Children whose mother perceived their size at birth as normal were more likely to be normal weight (aOR = 0.40; 95% CI: 0.16, 0.99) compared to a smaller size at birth. Children whose growth was monitored had a low chance of being underweight (aOR = 0.35, 95% CI: 0.15, 0.97).ConclusionNearly two-fifth of under-five children were found to be underweight. The age of children, drinking water purification practices, growth monitoring, and mother’s perception of size at birth were significantly associated with childhood underweight. These findings suggest that interventions focusing on access to child growth monitoring, and water and sanitation practices may reduce the childhood underweight.

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“…The positive association between social participation and exposure to IYCF information is consistent previous findings. Group membership in nutrition education or mother‐to‐mother support groups is shown to have a positive relationship with maternal information and knowledge (Lutter et al, ; Nair et al, ; Singh et al, ). Group‐based approaches are increasingly seen as an important strategy to improve maternal and child nutrition outcomes through multiple social, economic and agricultural paths (Brody, De Hoop, Vojtkova, Warnock, & Dunbar, ; Kumar et al, ).…”

Section: Discussionmentioning

confidence: 99%

Women's bargaining power and child feeding in Nepal: Linkages through nutrition information

Kulkarni

Frongillo

Cunningham

et al. 2019

Maternal & Child Nutrition

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Women's intra-household bargaining power is an important determinant of child nutritional status, but there is limited evidence on how it relates to infant and young child feeding (IYCF) practices. We conducted a cross-sectional analysis using 2012 baseline data from the impact evaluation of Suaahara, a multisectoral programme in Nepal, focusing on households with children 0-23 months (n = 1787). We examined if women's bargaining power was related to exposure to IYCF information and if exposure to IYCF information was in turn associated with improved IYCF practices: early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency and dietary diversity. Bargaining power consisted of four domains: (i) ownership and control of assets; (ii) social participation; (iii) workload; and (iv) household decision-making control and were primarily measured using additive scales. We used generalized structural equation modelling to examine if exposure to IYCF information mediated the relationship between the bargaining domains and the four IYCF practices, separately. Social participation was positively associated with exposure to IYCF information (β = 0.266, P < .001), which in turn was related to early initiation (β = 0.241, P = .001). We obtained similar results for the relationship between social participation and dietary diversity. Decision-making control was directly associated with exclusive breastfeeding (β = 0.350, P = .036). No domains were associated with minimum meal frequency. Different domains of women's bargaining power may relate to exposure to nutrition information and IYCF behaviours. Understanding specific domains of bargaining power is critical to developing interventions that can effectively address gender-related issues that underlie child nutrition outcomes.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Improving maternal, infant and young child nutrition in Nepal via peer mobilization

Abstract: Peer mobilization is a potential approach for improving health- and nutrition-related knowledge and behaviours among women in hard-to-reach communities of Nepal.

Cited by 12 publications

References 16 publications

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Factors Associated with Underweight among Under-Five Children in Eastern Nepal: Community-Based Cross-sectional Study

Women's bargaining power and child feeding in Nepal: Linkages through nutrition information

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