Assessing the Feasibility of Integrating a Package of Maternal Nutrition Interventions Into Antenatal Care Services in Burkina Faso

Summary

Alive \& Thrive (A\&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A\&T developed an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities that align with the latest global evidence. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys of pregnant and recently delivered women (i.e. with a child under 6 months of age) in 2019 and 2021.

Conditions

• Maternal Dietary Diversity
• Iron-Folic Acid Supplementation
• Early Initiation of Breastfeeding

Interventions

BEHAVIORAL

Health Facility Level Interventions

* Intensified counseling on maternal dietary diversity and quality using job aids * Counseling on purpose of IFA supplementation, managing side effects, and importance of adherence to daily consumption * Distribution/prescription of IFA tablets at each ANC visit * Use of pill card/reminders for pregnant women and their spouses * Monthly IFA tablet stock monitoring to assure sufficient supplies * Measurement of weight gain during each ANC visit and advise on healthy weight gain * Checks for functioning scales and use of monitoring sheets * Intensified counseling on early initiation of breastfeeding and exclusive breastfeeding using job aids * Reminder on importance of early ANC attendance and 4+ visits

BEHAVIORAL

Community Level Interventions

* Advocacy among community leaders (traditional and religious leaders, local associations, etc.) about ANC * Gatherings among grandmothers, husbands, and other influencers about ANC and their roles * Promotion of ANC service utilisation and the importance of early ANC visit during the first trimester. * Early identification of pregnant women * Support women's group discussions * 2-3 home visits per pregnant woman by community health workers (Agent de santé a base communautaire; ASBC) which will include counseling on diet quality, breastfeeding, importance on adherence to daily IFA consumption and side effect management, etc.

BEHAVIORAL

Health System Level Interventions

* Training on nutrition interventions during ANC for all ANC providers and community health workers * Semi-annual supervision by the Regional Health Directorate (Direction Regionale de la Santé; DRS) * Quarterly supportive supervision of health facility staff by the health district management team * Monthly supportive supervision of ASBCs * Monthly review between health facilities and ASBCs * Training and use of data registers * Training and use of mother's cards to record up to 8 ANC visits and nutrition services * Training on data utilization to improve coverage and quality

Sponsors & Collaborators

• AFRICSanté

  collaborator OTHER

• FHI 360

  collaborator OTHER

• International Food Policy Research Institute

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

15 Years

Max Age

49 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-11-06

Primary Completion

2021-03-05

Completion

2021-03-05

Countries

• United States

Study Locations