Tuan T Nguyen1, Nemat Hajeebhoy2,3, Jia Li4, Chung T Do2, Roger Mathisen2, Edward A Frongillo5. 1. Alive & Thrive, FHI 360, Hanoi, Vietnam. tnguyen@fhi360.org. 2. Alive & Thrive, FHI 360, Hanoi, Vietnam. 3. Nutrition Section, UNICEF Nigeria, Abuja, Nigeria. 4. School of Business, Nanjing University of Information Science & Technology, Nanjing, China. 5. Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Abstract
BACKGROUND: Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam. OBJECTIVE: This study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices. METHODS: To evaluate the model's implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model's effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0-23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559). FINDINGS: Coverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0-23 months in intervention villages. COSTS: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes was associated with higher odds of early initiation of breastfeeding (OR: 1.7; 95% CI: 1.1, 2.7), exclusive breastfeeding from 0 to 5 months (OR: 12.5; 95% CI: 6.7, 23.4), no bottle feeding (OR: 2.69; 95% CI: 1.82, 3.99), and minimum acceptable diet (OR: 1.51; 95% CI: 0.98, 2.33) compared to those living in comparison communes. CONCLUSION: The IYCF support group model was effective in reaching populations residing in remote areas and likely contributed to improved IYCF practices. The study suggests that the model could be scaled up to promote equity in breastfeeding support.
BACKGROUND: Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam. OBJECTIVE: This study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices. METHODS: To evaluate the model's implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model's effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0-23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559). FINDINGS: Coverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0-23 months in intervention villages. COSTS: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes was associated with higher odds of early initiation of breastfeeding (OR: 1.7; 95% CI: 1.1, 2.7), exclusive breastfeeding from 0 to 5 months (OR: 12.5; 95% CI: 6.7, 23.4), no bottle feeding (OR: 2.69; 95% CI: 1.82, 3.99), and minimum acceptable diet (OR: 1.51; 95% CI: 0.98, 2.33) compared to those living in comparison communes. CONCLUSION: The IYCF support group model was effective in reaching populations residing in remote areas and likely contributed to improved IYCF practices. The study suggests that the model could be scaled up to promote equity in breastfeeding support.
Entities:
Keywords:
Breastfeeding; Community outreach; Community support groups; Complementary feeding; Infant and young child feeding; Nutrition training; Vietnam
Authors: Anthony D Harris; Jessina C McGregor; Eli N Perencevich; Jon P Furuno; Jingkun Zhu; Dan E Peterson; Joseph Finkelstein Journal: J Am Med Inform Assoc Date: 2005-10-12 Impact factor: 4.497
Authors: Ty Beal; Danh Tuyen Le; Thi Huong Trinh; Dharani Dhar Burra; Tuyen Huynh; Thanh Thi Duong; Tuyet Mai Truong; Duy Son Nguyen; Kien Tri Nguyen; Stef de Haan; Andrew D Jones Journal: Matern Child Nutr Date: 2019-05-02 Impact factor: 3.092
Authors: Nigel C Rollins; Nita Bhandari; Nemat Hajeebhoy; Susan Horton; Chessa K Lutter; Jose C Martines; Ellen G Piwoz; Linda M Richter; Cesar G Victora Journal: Lancet Date: 2016-01-30 Impact factor: 202.731
Authors: Marleen E Hendriks; Piyali Kundu; Alexander C Boers; Oladimeji A Bolarinwa; Mark J Te Pas; Tanimola M Akande; Kayode Agbede; Gabriella B Gomez; William K Redekop; Constance Schultsz; Siok Swan Tan Journal: Glob Health Action Date: 2014-03-28 Impact factor: 2.640