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Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: study protocol for a randomized controlled trial.

Kimani-Murage EW, Kimiywe J, Kabue M, Wekesah F, Matiri E, Muhia N, Wanjohi M, Muriuki P, Samburu B, Kanyuira JN, Young SL, Griffiths PL, Madise NJ, McGarvey ST - Trials (2015)

Bottom Line: The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health.The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.ISRCTN03467700 ; Date of Registration: 24 September 2014.

View Article: PubMed Central - PubMed

Affiliation: African Population and Health Research Centre (APHRC), APHRC Campus, Kirawa Road, Off PeponiRoad, P.O. Box 10787, 00100, Nairobi, Kenya. ekimani@aphrc.org.

ABSTRACT

Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya.

Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health.

Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.

Trial registration: ISRCTN03467700 ; Date of Registration: 24 September 2014.

No MeSH data available.


Related in: MedlinePlus

Schematic of the study design
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Fig1: Schematic of the study design

Mentions: The study will adopt a cluster-randomized trial design [18, 19]. For pragmatic purposes, community units (CUs), as defined by the government’s Community Health Strategy [20] will be used as the clusters. Thirteen CUs have been defined in the study areas. Twelve of the CUs will be randomized with half allocated to the intervention and the other half to the control arm without matching. The random sequence of allocation of the CUs to the intervention or control arm will be computer-generated. Cluster randomization is preferred over individual-level randomization to minimize contamination and for pragmatic purposes in case of future scale-up of the intervention. Randomization will be done by a data analyst who is not a primary member of the study team. Fig. 1 shows the study design schematically.Fig. 1


Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: study protocol for a randomized controlled trial.

Kimani-Murage EW, Kimiywe J, Kabue M, Wekesah F, Matiri E, Muhia N, Wanjohi M, Muriuki P, Samburu B, Kanyuira JN, Young SL, Griffiths PL, Madise NJ, McGarvey ST - Trials (2015)

Schematic of the study design
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4587817&req=5

Fig1: Schematic of the study design
Mentions: The study will adopt a cluster-randomized trial design [18, 19]. For pragmatic purposes, community units (CUs), as defined by the government’s Community Health Strategy [20] will be used as the clusters. Thirteen CUs have been defined in the study areas. Twelve of the CUs will be randomized with half allocated to the intervention and the other half to the control arm without matching. The random sequence of allocation of the CUs to the intervention or control arm will be computer-generated. Cluster randomization is preferred over individual-level randomization to minimize contamination and for pragmatic purposes in case of future scale-up of the intervention. Randomization will be done by a data analyst who is not a primary member of the study team. Fig. 1 shows the study design schematically.Fig. 1

Bottom Line: The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health.The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.ISRCTN03467700 ; Date of Registration: 24 September 2014.

View Article: PubMed Central - PubMed

Affiliation: African Population and Health Research Centre (APHRC), APHRC Campus, Kirawa Road, Off PeponiRoad, P.O. Box 10787, 00100, Nairobi, Kenya. ekimani@aphrc.org.

ABSTRACT

Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya.

Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health.

Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.

Trial registration: ISRCTN03467700 ; Date of Registration: 24 September 2014.

No MeSH data available.


Related in: MedlinePlus