Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation
Background: Alive & Thrive supported the Government of Burkina Faso to strengthen the provision of iron-folic acid (IFA) supplementation and interpersonal counseling on maternal nutrition and breastfeeding through antenatal care (ANC) services and community-based contacts in two regions. Objectives:...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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Elsevier
2023
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| Online Access: | https://hdl.handle.net/10568/139976 |
| _version_ | 1855539537218895872 |
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| author | Kim, Sunny S. Zagré, Rock Romaric Ouédraogo, Césaire T. Sununtnasuk, Celeste Ganaba, Rasmané Zafimanjaka, Maurice G. Tharaney, Manisha Sanghvi, Tina Menon, Purnima |
| author_browse | Ganaba, Rasmané Kim, Sunny S. Menon, Purnima Ouédraogo, Césaire T. Sanghvi, Tina Sununtnasuk, Celeste Tharaney, Manisha Zafimanjaka, Maurice G. Zagré, Rock Romaric |
| author_facet | Kim, Sunny S. Zagré, Rock Romaric Ouédraogo, Césaire T. Sununtnasuk, Celeste Ganaba, Rasmané Zafimanjaka, Maurice G. Tharaney, Manisha Sanghvi, Tina Menon, Purnima |
| author_sort | Kim, Sunny S. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Alive & Thrive supported the Government of Burkina Faso to strengthen the provision of iron-folic acid (IFA) supplementation and interpersonal counseling on maternal nutrition and breastfeeding through antenatal care (ANC) services and community-based contacts in two regions. Objectives: We assessed the impacts of intensified nutrition interventions during ANC compared with standard ANC services on intervention coverage and maternal nutrition practices. Methods: A cluster-randomized evaluation compared 40 health center catchment areas in intervention areas to 40 in control areas. Repeated cross-sectional surveys in 2019 and 2021 (960 pregnant women and 1920 women with children 0-5 months of age per survey round) provided data on impact indicators, intervention exposure and other factors. We derived difference-in-difference effect estimates (DID), adjusted for geographical clustering, for maternal dietary diversity, IFA consumption, and early breastfeeding practices. Results: More women in intervention areas had 4+ ANC visits (DID: 8.3 percentage points [pp]) and started ANC during the first trimester (DID: 10.5 pp), compared to control areas. Improvements were achieved in exposure to nutrition counseling on dietary diversity (DID: 44.4 pp), food quantity (DID: 42.9 pp), adequate weight gain (DID: 35.1 pp), and breastfeeding (DID: 25.9 pp). Women in intervention areas consumed more IFA supplements during pregnancy (DID: 21 tablets). Early initiation of and exclusive breastfeeding also improved (DID: 17.0 pp and 8.3 pp, respectively). However, dietary diversity (4 out of 10 food groups) and mean probability of adequacy of micronutrient intake (14%) among pregnant women remained low in both areas. Conclusions: Strengthening maternal nutrition interventions delivered through government ANC services was feasible and effective in improving maternal nutrition practices. Continued efforts to strengthen the delivery and use of maternal nutrition services may be required for greater behavior changes, and to address family support, social norms, and other factors to improve women’s diet during pregnancy. |
| format | Journal Article |
| id | CGSpace139976 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| record_format | dspace |
| spelling | CGSpace1399762025-12-02T10:59:51Z Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation Kim, Sunny S. Zagré, Rock Romaric Ouédraogo, Césaire T. Sununtnasuk, Celeste Ganaba, Rasmané Zafimanjaka, Maurice G. Tharaney, Manisha Sanghvi, Tina Menon, Purnima foods pregnancy weight micronutrient deficiencies iron breastfeeding diet maternal nutrition folic acid health care perinatal period dietary diversity Background: Alive & Thrive supported the Government of Burkina Faso to strengthen the provision of iron-folic acid (IFA) supplementation and interpersonal counseling on maternal nutrition and breastfeeding through antenatal care (ANC) services and community-based contacts in two regions. Objectives: We assessed the impacts of intensified nutrition interventions during ANC compared with standard ANC services on intervention coverage and maternal nutrition practices. Methods: A cluster-randomized evaluation compared 40 health center catchment areas in intervention areas to 40 in control areas. Repeated cross-sectional surveys in 2019 and 2021 (960 pregnant women and 1920 women with children 0-5 months of age per survey round) provided data on impact indicators, intervention exposure and other factors. We derived difference-in-difference effect estimates (DID), adjusted for geographical clustering, for maternal dietary diversity, IFA consumption, and early breastfeeding practices. Results: More women in intervention areas had 4+ ANC visits (DID: 8.3 percentage points [pp]) and started ANC during the first trimester (DID: 10.5 pp), compared to control areas. Improvements were achieved in exposure to nutrition counseling on dietary diversity (DID: 44.4 pp), food quantity (DID: 42.9 pp), adequate weight gain (DID: 35.1 pp), and breastfeeding (DID: 25.9 pp). Women in intervention areas consumed more IFA supplements during pregnancy (DID: 21 tablets). Early initiation of and exclusive breastfeeding also improved (DID: 17.0 pp and 8.3 pp, respectively). However, dietary diversity (4 out of 10 food groups) and mean probability of adequacy of micronutrient intake (14%) among pregnant women remained low in both areas. Conclusions: Strengthening maternal nutrition interventions delivered through government ANC services was feasible and effective in improving maternal nutrition practices. Continued efforts to strengthen the delivery and use of maternal nutrition services may be required for greater behavior changes, and to address family support, social norms, and other factors to improve women’s diet during pregnancy. 2023-10 2024-03-14T12:08:47Z 2024-03-14T12:08:47Z Journal Article https://hdl.handle.net/10568/139976 en https://doi.org/10.1093/cdn/nzaa054_127 https://www.aliveandthrive.org/sites/default/files/alive_thrive_-_endline_-_maternal_nutrition_burkina_faso_v9.pdf https://www.aliveandthrive.org/sites/default/files/burkina-faso-maternal-nutrition-final.pdf Open Access Elsevier Kim, Sunny S.; Zagré, Rock R.; Ouédraogo, Césaire T.; Sununtnasuk, Celeste; Ganaba, Rasmané; Menon, Purnima; et al. 2024. Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation. Journal of Nutrition 153(10): 3058-3067. https://doi.org/10.1016/j.tjnut.2023.06.016 |
| spellingShingle | foods pregnancy weight micronutrient deficiencies iron breastfeeding diet maternal nutrition folic acid health care perinatal period dietary diversity Kim, Sunny S. Zagré, Rock Romaric Ouédraogo, Césaire T. Sununtnasuk, Celeste Ganaba, Rasmané Zafimanjaka, Maurice G. Tharaney, Manisha Sanghvi, Tina Menon, Purnima Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title | Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title_full | Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title_fullStr | Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title_full_unstemmed | Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title_short | Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation |
| title_sort | intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in burkina faso results of a cluster randomized program evaluation |
| topic | foods pregnancy weight micronutrient deficiencies iron breastfeeding diet maternal nutrition folic acid health care perinatal period dietary diversity |
| url | https://hdl.handle.net/10568/139976 |
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