Nourishing networks: A social-ecological analysis of a network intervention for improving household nutrition in Western Kenya

L., DeLorme, Autumn; Gavenus, Erika R.; Salmen, Charles R.; Benard, Gor Ouma; Mattah, Brian; Bukusi, Elizabeth A.; Fiorella, Kathryn J.

doi:10.1016/j.socscimed.2017.11.023

Cited by 25 publications

(28 citation statements)

References 44 publications

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“…A social support intervention alone may be insufficient to surmount barriers to enacting nutrition knowledge. In addition to our quantitative findings regarding increased nutrition knowledge, a qualitative evaluation of the Kanyakla Nutrition Program demonstrated improvements in programme participants' knowledge and confidence regarding nutrition behaviour and feeding young children (DeLorme et al, ). The programme also engaged male caregivers, and both male and female participants identified structural barriers to food access (e.g., income and limited access to irrigation) that prevented them from fully enacting their knowledge (DeLorme et al, ).…”

Section: Discussionsupporting

confidence: 54%

“…In addition to our quantitative findings regarding increased nutrition knowledge, a qualitative evaluation of the Kanyakla Nutrition Program demonstrated improvements in programme participants' knowledge and confidence regarding nutrition behaviour and feeding young children (DeLorme et al, ). The programme also engaged male caregivers, and both male and female participants identified structural barriers to food access (e.g., income and limited access to irrigation) that prevented them from fully enacting their knowledge (DeLorme et al, ). Despite the inclusion of the social network component, the findings of this study are similar to studies evaluating maternal education programmes that improved maternal knowledge and attitudes towards appropriate feeding practices but did not significantly improve actual dietary diversity and meal frequency (Agbozo, Colecraft, & Ellahi, ; Christian et al, ; Gyampoh, Otoo, & Aryeetey, ).…”

Section: Discussionsupporting

confidence: 54%

“…The programme aimed to engage social support networks, including fathers, grandparents, and other community members, and strengthen relationships with CHWs to drive sustainable behaviour changes. The objectives of the intervention were to improve IYCF practices and establish social network support for access to nutritious foods (DeLorme et al, ).…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of a social network intervention on child feeding practices and caregiver knowledge

Fiorella

Gavenus

Milner

et al. 2019

Maternal & Child Nutrition

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Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasiexperimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionsupporting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of a social network intervention on child feeding practices and caregiver knowledge

Fiorella

Gavenus

Milner

et al. 2019

Maternal & Child Nutrition

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“…As shown in Table , one identified need is ensuring sufficient master trainers are available to meet the demand, alongside training and social and behaviour change counselling materials, to build nutrition competencies of health providers (De Lorme et al, ; Wainaina, Wanjohi, Wekesah, Woolhead, & Kimani‐Murage, ).…”

Section: Discussionmentioning

confidence: 99%

Baby‐Friendly Community Initiative—From national guidelines to implementation: A multisectoral platform for improving infant and young child feeding practices and integrated health services

Kavle

Ahoya²,

Kiige³

et al. 2019

Maternal & Child Nutrition

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The Baby‐Friendly Community Initiative (BFCI) is an extension of the 10th step of the Ten Steps of Successful Breastfeeding and the Baby‐Friendly Hospital Initiative (BFHI) and provides continued breastfeeding support to communities upon facility discharge after birth. BFCI creates a comprehensive support system at the community level through the establishment of mother‐to‐mother and community support groups to improve breastfeeding. The Government of Kenya has prioritized community‐based programming in the country, including the development of the first national BFCI guidelines, which inform national and subnational level implementation. This paper describes the process of BFCI implementation within the Kenyan health system, as well as successes, challenges, and opportunities for integration of BFCI into health and other sectors. In Maternal and Child Survival Program (MCSP) and UNICEF areas, 685 community leaders were oriented to BFCI, 475 health providers trained, 249 support groups established, and 3,065 children 0–12 months of age reached (MCSP only). Though difficult to attribute to our programme, improvements in infant and young child feeding practices were observed from routine health data following the programme, with dramatic declines in prelacteal feeding (19% to 11%) in Kisumu County and (37.6% to 5.1%) in Migori County from 2016 to 2017. Improvements in initiation and exclusive breastfeeding in Migori were also noted—from 85.9% to 89.3% and 75.2% to 92.3%, respectively. Large gains in consumption of iron‐rich complementary foods were also seen (69.6% to 90.0% in Migori, 78% to 90.9% in Kisumu) as well as introduction of complementary foods (42.0–83.3% in Migori). Coverage for BFCI activities varied across counties, from 20% to 60% throughout programme implementation and were largely sustained 3 months postimplementation in Migori, whereas coverage declined in Kisumu. BFCI is a promising platform to integrate into other sectors, such as early child development, agriculture, and water, sanitation, and hygiene.

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“…[25][26][27][28] At the same time, an approach centering on mothers can drive feelings of frustration, alienation and even helplessness among fathers and others who support mothers. [29][30][31][32] Further, a tendency to zero-in on individual parentsto-be may pull policy attention away from some of the larger structures (e.g. those involved in employment, in wealth distribution, and in food production and distribution) [33][34][35] well-situated to improve children's early life environmental conditions.…”

Section: Introductionmentioning

confidence: 99%

Translating the Developmental Origins of Health and Disease concept to improve the nutritional environment for our next generations: a call for a reflexive, positive, multi-level approach

McKerracher

Moffat

Barker

et al. 2018

J Dev Orig Health Dis

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Evidence supporting the Developmental Origins of Health and Disease (DOHaD) hypothesis indicates that improving early life environments can reduce non-communicable disease risks and improve health over the lifecourse. A widespread understanding of this evidence may help to reshape structures, guidelines and individual behaviors to better the developmental conditions for the next generations. Yet, few efforts have yet been made to translate the DOHaD concept beyond the research community. To understand why, and to identify priorities for DOHaD Knowledge Translation (KT) programs, we review here a portion of published descriptions of DOHaD KT efforts and critiques thereof. We focus on KT targeting people equipped to apply DOHaD knowledge to their everyday home or work lives. We identified 17 reports of direct-to-public DOHaD KT that met our inclusion criteria. Relevant KT programs have been or are being initiated in nine countries, most focusing on secondary school students or care-workers-in-training; few target parents-to-be. Early indicators suggest that such programs can empower participants. Main critiques of DOHaD KT suggest it may overburden mothers with responsibility for children’s health and health environments, minimizing the roles of other people and institutions. Simultaneously, though, many mothers-to-be seek reliable guidance on prenatal health and nutrition, and would likely benefit from engagement with DOHaD KT. We thus recommend emphasizing solidarity, and bringing together people likely to one day become parents (youth), people planning pregnancies, expecting couples, care workers and policymakers into empowering conversation about DOHaD and about the importance and complexity of early life environments.

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Nourishing networks: A social-ecological analysis of a network intervention for improving household nutrition in Western Kenya

Cited by 25 publications

References 44 publications

Evaluation of a social network intervention on child feeding practices and caregiver knowledge

Evaluation of a social network intervention on child feeding practices and caregiver knowledge

Baby‐Friendly Community Initiative—From national guidelines to implementation: A multisectoral platform for improving infant and young child feeding practices and integrated health services

Translating the Developmental Origins of Health and Disease concept to improve the nutritional environment for our next generations: a call for a reflexive, positive, multi-level approach

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