The University of Southampton
University of Southampton Institutional Repository

Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial

Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial
Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial
Background
Nutrition in the first 1,000 days of life (during pregnancy and the first two years) is critical for child growth and survival. Poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Kenya, with potential detrimental effects on child growth and survival. This is particularly a problem in slums, where most urban residents live. For example, exclusive breastfeeding for the first six months is only about two per cent. Innovative strategies to reach slum residents are therefore needed. Strategies like the Baby Friendly Hospital Initiative have proven effective in some settings but their effectiveness in resource-limited settings, including slums where many women do not deliver in hospital, is questionable. We propose to test the effectiveness of a home-based intervention on infant feeding practices, nutrition and health outcomes of infants born in two slums in Nairobi, Kenya.

Methods/Design
The study, employing a cluster-randomised study design, will be conducted in two slums in Nairobi: Korogocho and Viwandani where 14 community units (defined by the Government’s health care system) will form the unit of randomization. A total of 780 pregnant women and their respective child will be recruited into the study. The mother-child pair will be followed up until the child is one year old. Recruitment will last approximately one year and three months from September 2012 to December 2013. The mothers will receive regular, personalised, home-based counselling by trained Community Health Workers on MIYCN. Regular assessment of knowledge, attitudes and practices on MIYCN will be done, coupled with assessments of nutritional status of the mother-child pairs and diarrhea morbidity for the children. Statistical methods will include analysis of covariance and multinomial logistic regression. Additionally, cost-effectiveness analysis will be done.The study is funded by the Wellcome Trust and will run from March 2012 to February 2015.
Discussion
Interventions aimed at promoting optimal breastfeeding and complementary feeding practices are considered to have high impact and could prevent a fifth of the under-five deaths in countries with high mortality rates. This study will inform policy and practice in Kenya and similar settings regarding delivery mechanisms for such high-impact interventions, particularly among urban poor populations


breastfeeding, infant feeding practices, child nutrition, cluster randomised controlled trials, kenya, sub-saharan africa, urban slums
1745-6215
Kimani-Murage, Elizabeth
620a17ef-d4ad-45d1-bc7a-002e533ed8f9
Kyobutungi, Catherine
dc9572b9-0eb2-4688-9101-d73ce9ebcd0a
Ezeh, Alex C
e621da98-54f7-4d5e-90b9-864599beeb3b
Wekesah, Frederick
1c1a5b85-2bd6-4517-8443-45337bff07bd
Wanjohi, Milka
80cca192-0081-49a9-8fbe-7be9abd7ab3c
Muriuki, Peterrock
15b6ba63-c59b-4186-9d92-c29d18d1223d
Musoke, Rachel N
b843cc2b-e941-4414-86f4-1defa22f6af0
Norris, Shane A
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Griffiths, Paula
1e42c8d2-e67f-4825-a800-9721d427e8c7
Madise, Nyovani J.
2ea2fbcc-50da-4696-a0a5-2fe01db63d8c
Kimani-Murage, Elizabeth
620a17ef-d4ad-45d1-bc7a-002e533ed8f9
Kyobutungi, Catherine
dc9572b9-0eb2-4688-9101-d73ce9ebcd0a
Ezeh, Alex C
e621da98-54f7-4d5e-90b9-864599beeb3b
Wekesah, Frederick
1c1a5b85-2bd6-4517-8443-45337bff07bd
Wanjohi, Milka
80cca192-0081-49a9-8fbe-7be9abd7ab3c
Muriuki, Peterrock
15b6ba63-c59b-4186-9d92-c29d18d1223d
Musoke, Rachel N
b843cc2b-e941-4414-86f4-1defa22f6af0
Norris, Shane A
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Griffiths, Paula
1e42c8d2-e67f-4825-a800-9721d427e8c7
Madise, Nyovani J.
2ea2fbcc-50da-4696-a0a5-2fe01db63d8c

Kimani-Murage, Elizabeth, Kyobutungi, Catherine, Ezeh, Alex C, Wekesah, Frederick, Wanjohi, Milka, Muriuki, Peterrock, Musoke, Rachel N, Norris, Shane A, Griffiths, Paula and Madise, Nyovani J. (2013) Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial. Trials, 14 (445). (doi:10.1186/1745-6215-14-445).

Record type: Article

Abstract

Background
Nutrition in the first 1,000 days of life (during pregnancy and the first two years) is critical for child growth and survival. Poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Kenya, with potential detrimental effects on child growth and survival. This is particularly a problem in slums, where most urban residents live. For example, exclusive breastfeeding for the first six months is only about two per cent. Innovative strategies to reach slum residents are therefore needed. Strategies like the Baby Friendly Hospital Initiative have proven effective in some settings but their effectiveness in resource-limited settings, including slums where many women do not deliver in hospital, is questionable. We propose to test the effectiveness of a home-based intervention on infant feeding practices, nutrition and health outcomes of infants born in two slums in Nairobi, Kenya.

Methods/Design
The study, employing a cluster-randomised study design, will be conducted in two slums in Nairobi: Korogocho and Viwandani where 14 community units (defined by the Government’s health care system) will form the unit of randomization. A total of 780 pregnant women and their respective child will be recruited into the study. The mother-child pair will be followed up until the child is one year old. Recruitment will last approximately one year and three months from September 2012 to December 2013. The mothers will receive regular, personalised, home-based counselling by trained Community Health Workers on MIYCN. Regular assessment of knowledge, attitudes and practices on MIYCN will be done, coupled with assessments of nutritional status of the mother-child pairs and diarrhea morbidity for the children. Statistical methods will include analysis of covariance and multinomial logistic regression. Additionally, cost-effectiveness analysis will be done.The study is funded by the Wellcome Trust and will run from March 2012 to February 2015.
Discussion
Interventions aimed at promoting optimal breastfeeding and complementary feeding practices are considered to have high impact and could prevent a fifth of the under-five deaths in countries with high mortality rates. This study will inform policy and practice in Kenya and similar settings regarding delivery mechanisms for such high-impact interventions, particularly among urban poor populations


This record has no associated files available for download.

More information

Published date: 27 December 2013
Keywords: breastfeeding, infant feeding practices, child nutrition, cluster randomised controlled trials, kenya, sub-saharan africa, urban slums
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 366949
URI: http://eprints.soton.ac.uk/id/eprint/366949
ISSN: 1745-6215
PURE UUID: 420fad7b-322a-465e-9fe9-e490d80f8bd8
ORCID for Shane A Norris: ORCID iD orcid.org/0000-0001-7124-3788
ORCID for Nyovani J. Madise: ORCID iD orcid.org/0000-0002-2813-5295

Catalogue record

Date deposited: 21 Jul 2014 08:52
Last modified: 15 Mar 2024 04:05

Export record

Altmetrics

Contributors

Author: Elizabeth Kimani-Murage
Author: Catherine Kyobutungi
Author: Alex C Ezeh
Author: Frederick Wekesah
Author: Milka Wanjohi
Author: Peterrock Muriuki
Author: Rachel N Musoke
Author: Shane A Norris ORCID iD
Author: Paula Griffiths
Author: Nyovani J. Madise ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×