Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study

Mukuria, Altrena; Sl, Martin; Egondi, Thaddeus; Bingham, Allison; Thuita, Faith

doi:10.9745/ghsp-d-15-00197

Cited by 104 publications

(151 citation statements)

References 38 publications

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“…The outcomes of this study were similar to those reported in an intervention in Western Kenya that aimed at providing social support to the mother by enlisting fathers and grandmothers in encouraging specific practices for infant feeding. Significant improvements were reported for minimum meal frequency (OR 1.14, 95% CI:1.00–1.30, p = 0.047) and minimum dietary diversity (OR 1.19, 95%CI:1.01–1.40, p = 0.04) [22]. …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study

2018

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BackgroundAppropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6–23 months, by comparing intervention and control groups.MethodsThis was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires.ResultsA statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44–10.03, p = < 0.001; OR: 14.84; 95%CI 2.75–79.9, p = 0.002; OR: 4.61; 95%CI 2.17–9.78, p = < 0.001 respectively).ConclusionThe BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya.Trial registrationISRCTN03467700. Registration 24 September 2014. Retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study

2018

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“…Our findings underscore the importance of women's social support for promoting the adoption of healthy IYCF practices, with significant positive associations for each of the IYCF indicators assessed and is consistent with a growing literature examines various dimensions of maternal well‐being with IYCF and nutritional status. Social support has been demonstrated to be associated with improved breastfeeding and complementary feeding (Bosire et al, ; Mukuria, Martin, Egondi, Bingham, & Thuita, ), and a review of women's empowerment and child nutritional status in South Asia concluded that social support is a relatively understudied construct in relation to nutritional status (Cunningham, Reul, et al, ). Social support can create an enabled environment for child feeding and access to knowledge and skills for child feeding but may also complicate women's feeding abilities through trade‐offs in workload and time for childcare (Cunningham, Ruel, et al, ).…”

Section: Discussionmentioning

confidence: 99%

Associations between social support, psychological well‐being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months

Ickes

Mandel

et al. 2017

Maternal & Child Nutrition

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Maternal capabilities-qualities of mothers that enable them to leverage skills and resources into child health-hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey (n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval The majority of essential public health interventions that are necessary to support child survival in low-income countries, including those aimed at improving child feeding and hygiene practices, target mothers Matare et al., 2015). Caregiver feeding practices of infants and young children present one important set of modifiable behaviours among mothers and are a common target in behaviour change communication interventions. When effectively delivered, appropriate child feeding can reduce undernutrition, mortality, disruption of cognitive development, and earning losses later in life (Stewart, Ionnotti, Dewey, Michaelsen, & Onyango, 2013).Effective child feeding and nutrition depends on a variety of influences at the societal, household, and individual levels World Bank-UNICEF Nutrition, 2002). Although each of these levels exerts some influence over the available resources for feeding, adequate child feeding requires caregivers to execute a set of complex behaviours (e.g., preparing frequent age-appropriate complementary foods and feeding a child responsively) that need to be sustained over List of abbreviations: IYCF, infant and young child feeding; LAZ, length-for-age z-score; WAZ, weight-for-age z-score; WLZ, weight-for-length z-score; WEAI, Women's Empowerment in Agriculture Index; BMI, body mass index Establishing methods for measuring maternal factors, including caregiver capabilities, and documenting associations between these capabilities are important for at least two reasons. First, it allows us to understand where constraints among caregivers may impair intervention impact; for example, if low decision-making capabilities limit the dietary diversity a mother is able to provide, this factor can be strengthened through interventions. Second, we can identify vulnerabilities in caregivers that can benefit from intervention supportive.This study aimed to expand our understanding of the associations between multiple dimensions of caregiver capabilities and child feeding and nutritional status. Using a tool that was developed using formative research in the specific study context, this study ( | Survey developmentThe survey (Data S1) was developed through formative research conducted in...

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“…Our data suggest that if facility‐ and community‐based health workers and volunteers provide more information and support to mothers and other family members during the antenatal and post‐natal periods, support for EBF may increase. Our data also showed that mothers were not receiving the desired Emotional or Instrumental support that suggests the need for interventions to increase support for recommended infant feeding practices (Alive & Thrive, ; Aubel, ; Flax et al, ; Mukuria, Martin, Egondi, Bingham, & Thuita, ). Programmatically, when administered before delivery, the scale could help to identify mothers who may have challenges with EBF.…”

Section: Discussionmentioning

confidence: 61%

Measuring exclusive breastfeeding social support: Scale development and validation in Uganda

Boateng

Collins

et al. 2018

Maternal & Child Nutrition

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The World Health Organization recommends exclusive breastfeeding (EBF) for 6 months and continued breastfeeding for at least 2 years. Social support has been widely recognized to influence breastfeeding practices. However, existing scales do not measure exclusive breastfeeding social support (EBFSS), rather they assess social support for any breastfeeding. Further, they are tailored towards high-income settings. Therefore, our objectives were to develop and validate a tool to measure EBFSS in low-income settings. To develop the scale, local and international breastfeeding experts were consulted on modifications to the Hughes' Breastfeeding Social Support Scale. It was then implemented in an observational cohort in Gulu, Uganda, at 1 (n = 238) and 3 (n = 237) months post-partum (NCT02925429). We performed polychoric and polyserial correlations to remove redundant items and exploratory factor analysis at 1 month post-partum to determine the latent factor structure of EBFSS. We further applied confirmatory factor analysis to assess dimensionality of the scale at 3 months post-partum. We then conducted tests of predictive, convergent, and discriminant validity against EBF, self-efficacy, general social support, and depression. The modification of the Hughes' scale resulted in 18 items, which were reduced to 16 after examining variances and factor loadings. Three dimensions of support emerged: Instrumental, Emotional, and Informational, with alpha coefficients of 0.79, 0.85, and 0.83, respectively. Predictive, convergent, and discriminant validity of the resultant EBFSS scale was supported. The EBFSS scale is valid and reliable for measuring EBFSS in northern Uganda and may be of use in other low-income settings to assess determinants of EBF.

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Role of Social Support in Improving Infant Feeding Practices in Western Kenya: A Quasi-Experimental Study

Cited by 104 publications

References 38 publications

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study

Associations between social support, psychological well‐being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months

Measuring exclusive breastfeeding social support: Scale development and validation in Uganda

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