Suchergebnisse

OBJECTIVES: Routine antenatal care (ANC) offers opportunities to receive a broad range of services including support for adequate nutritional care for pregnant women and their newborns. Alive & Thrive (A&T) aimed to strengthen provision of iron-folic acid (IFA) supplementation and interpersonal counseling on maternal nutrition and breastfeeding through government ANC services and community-based contacts in two regions in Burkina Faso. We assessed the impacts of intensified nutrition interventions during ANC (A&T) and standard ANC services (control) on intervention coverage and maternal nutrition practices. METHODS: A cluster-randomized design compared 40 health center catchment areas in A&T 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 and intervention exposure. 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 A&T areas had 4 + ANC visits (DID: 8.5 percentage points [pp]) and 4 + community-based contacts during their last pregnancy (DID: 14.7 pp) and started ANC during the first trimester (DID: 11.3 pp), compared to control areas. A larger improvement in exposure to nutrition counseling during ANC was achieved in A&T areas than in control areas (DID: 39.5 pp). Women in A&T areas consumed more IFA supplements during pregnancy than in control areas (DID: 21 tablets). Both early initiation of breastfeeding and exclusive breastfeeding also improved (DID: 17.1 pp and 8.3 pp, respectively). However, dietary diversity (4 out of 10 food groups) and mean probability of adequacy of micronutrients 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 ...

OBJECTIVES: High coverage of any antenatal care (ANC) and near-universal coverage of iron-folic acid (IFA) supplementation is reported by nationally representative surveys in Burkina Faso. We examined the coverage of maternal nutrition interventions during ANC to assess gaps and missed opportunities in achieving global and national recommendations. METHODS: We used household survey data among 1920 mothers with children <6 months of age in 2 regions in Burkina Faso, collected in November-December 2019. Descriptive statistics were used to examine exposure to nutrition interventions during antenatal care throughout pregnancy and equity analyses were conducted to assess differences in exposure by maternal age (adolescents 15–19 y of age and older mothers) and education (none vs. any schooling). RESULTS: All mothers reported having attended at least one ANC visit at a health facility (mostly government health centers) during last pregnancy, but only 66.6% reported attending at least 4 visits. All consumed IFA tablets, but reported consuming 109 tablets on average during pregnancy, which was short of the recommended 180 tablets over 6 months. Only 42.7% reported receiving any nutrition counseling during ANC, with the most common messages reported on consuming one IFA tablet daily (93.4%) and eating a variety of foods (68.8%). While nearly all mothers were weighed during ANC, very few reported receiving information about weight gain. Among mothers, 14% were adolescents below 20 y, and 66.1% never attended school. For all indicators related to exposure to ANC or maternal nutrition intervention, we observed no differences by maternal age, education or other subgroups such as religion, parity or household composition. CONCLUSIONS: The government health system in Burkina Faso with its widespread and uniform reach provides an opportunity for improving the low coverage of maternal nutrition interventions during ANC. Doing so will require efforts both to improve the coverage of 4 or more ANC visits and the effective ...