Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: A quasi-experimental study

  • Journal of Developmental Origins of Health and Disease, Volume 7, No. 2, Year 2015

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Study Justification:
– Early nutrition is crucial for long-term health and sustainable development.
– Exclusive breastfeeding (EBF) is an important component of early nutrition.
– The study aims to determine the potential effectiveness of the Kenyan Community Health Strategy in promoting EBF in urban poor settings in Nairobi, Kenya.
Study Highlights:
– Quasi-experimental study design based on three studies: Pre-intervention, Intervention, and Comparison.
– Longitudinal follow-up of mother-child pairs to establish EBF rates from 0 to 6 months.
– Cluster randomized trial with two study arms: MIYCN-Intervention and MIYCN-Control.
– MIYCN-Intervention arm received standard care and regular MIYCN counseling by trained community health workers (CHWs).
– MIYCN-Control arm received standard care involving CHWs visits for counseling on antenatal and postnatal care.
– Both groups received MIYCN information materials.
– Significant differences in EBF rates at 6 months among the study groups.
– Odds ratios for EBF from birth to 6 months were calculated for each study group.
Study Recommendations:
– The Kenyan Community Health Strategy shows potential effectiveness in promoting EBF in urban poor settings.
– Implementation of the Community Health Strategy should be considered to improve EBF rates.
– Training and support for community health workers in providing MIYCN counseling is crucial.
– Access to MIYCN information materials should be ensured for all mothers.
Key Role Players:
– Community health workers (CHWs): Trained CHWs play a vital role in providing MIYCN counseling.
– Health care providers: Collaborating with CHWs to support EBF promotion.
– Policy makers: Responsible for implementing and supporting the Community Health Strategy.
– Non-governmental organizations (NGOs): May provide resources and support for training and materials.
Cost Items for Planning Recommendations:
– Training programs for community health workers.
– Development and distribution of MIYCN information materials.
– Monitoring and evaluation of the Community Health Strategy implementation.
– Collaboration and coordination efforts between health care providers and CHWs.
– Potential costs associated with scaling up the intervention to reach a larger population.
Please note that the provided information is based on the given description and may not include all details from the original study.

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Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007-2011; n=5824), Intervention (2012-2015; n=1110) and Comparison (2012-2014; n=487)], which followed mother-child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ 2 test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4-96.4), 84.3 (95% CI 40.7-174.6) and 3.9 (95% CI 1.8-8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited.

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The study recommends implementing the Kenyan Community Health Strategy to promote exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. The intervention group, which received regular Maternal, Infant and Young Child Nutrition (MIYCN) counseling by trained community health workers (CHWs), had significantly higher rates of EBF compared to the pre-intervention group and the control group. The prevalence of EBF at 6 months was 55% in both the MIYCN-Intervention and MIYCN-Control groups, compared to only 2% in the pre-intervention group.

The study suggests that the Community Health Strategy, which involves CHWs providing counseling on antenatal and postnatal care, along with the distribution of MIYCN information materials, can effectively improve access to maternal health services and promote EBF in urban poor settings where healthcare access is limited. This strategy can be implemented in similar settings to improve maternal and child health outcomes.
AI Innovations Description
The recommendation from the study is to implement the Kenyan Community Health Strategy to promote exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. The study found that the intervention group, which received regular MIYCN counseling by trained community health workers (CHWs), had significantly higher rates of EBF compared to the pre-intervention group and the control group. The prevalence of EBF at 6 months was 55% in both the MIYCN-Intervention and MIYCN-Control groups, compared to only 2% in the pre-intervention group.

The study suggests that the Community Health Strategy, which involves CHWs providing counseling on antenatal and postnatal care, along with the distribution of MIYCN information materials, can effectively improve access to maternal health services and promote EBF in urban poor settings where healthcare access is limited. This strategy can be implemented in similar settings to improve maternal and child health outcomes.
AI Innovations Methodology
To simulate the impact of implementing the Kenyan Community Health Strategy on improving access to maternal health, you could consider the following methodology:

1. Study Design: Conduct a quasi-experimental study design similar to the one described in the abstract. This design allows for a comparison between different groups to assess the impact of the intervention.

2. Selection of Study Population: Identify urban poor settings in Nairobi, Kenya, where healthcare access is limited. Randomly select a sample of mother-child pairs from these settings to participate in the study.

3. Intervention Group: Implement the Kenyan Community Health Strategy in the intervention group. This involves training community health workers (CHWs) to provide regular Maternal, Infant and Young Child Nutrition (MIYCN) counseling to mothers on antenatal and postnatal care. Additionally, distribute MIYCN information materials to the intervention group.

4. Control Group: The control group should receive standard care involving CHW visits for counseling on antenatal and postnatal care, similar to the MIYCN-Control group in the original study.

5. Data Collection: Follow mother-child pairs longitudinally from birth to 6 months to establish exclusive breastfeeding (EBF) rates. Collect data on EBF rates at regular intervals using standardized methods, similar to the original study.

6. Statistical Analysis: Use appropriate statistical tests, such as chi-square tests and logistic regression, to compare EBF rates among the different study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control, and Comparison). Adjust for baseline characteristics to account for any potential confounding factors.

7. Interpretation of Results: Analyze the data to determine the impact of the Kenyan Community Health Strategy on improving access to maternal health. Compare the EBF rates in the intervention group (MIYCN-Intervention) with the pre-intervention group, control group, and comparison group to assess the effectiveness of the intervention.

8. Conclusion: Based on the results, draw conclusions about the potential effectiveness of implementing the Kenyan Community Health Strategy in promoting exclusive breastfeeding and improving access to maternal health in urban poor settings.

It is important to note that this is a general methodology suggestion based on the information provided in the abstract. The actual implementation of the study may require further considerations and adjustments based on the specific context and resources available.


Statistics:
Citations: 17
Identifiers:
DOI: 10.1017/S2040174415007941
ISSN: 20401744
Research Areas:
Community Interventions, Food Security, Health System and Policy, Maternal Access, Maternal and Child Health, Workforce
Study Countries:
Kenya
Study Design:
Case-Control Study, Cross Sectional Study, Quasi Experimental Study, randomised-control-trial
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