Mother-to-Mother Support Groups
- Conditions
- Nutritional, Metabolic, Endocrine
- Registration Number
- PACTR201910846018049
- Lead Sponsor
- Kenyatta University Kenya
- Brief Summary
Exclusive breast-feeding (EBF) is recognized globally as the best way of ensuring child survival, growth and development because it reduces infant morbidity, mortality and ensures better nutrition outcomes. The major challenge has been the low rates of EBF globally (36%) despite the gradual increase in EBF rates in recent years. Prevalence of EBF is 32% and 18.6% in Kenya and Igembe District the study site, respectively. Mother-to-mother support groups (MTMSGs) is a strategy used in Kenya and other countries in the promotion of EBF. There is scarcity of data on the effectiveness of MTMSGs in promotion of EBF in Kenya. The aim of this study was to assess the effectiveness of MTMSGs in promoting EBF in Igembe District, in Meru County, Kenya. The study adopted a cluster randomized controlled trial design in which 3 health centres were randomly allocated on a 1:1:1 ratio to 3 study groups; 2 treatment groups and one control group. In one treatment group (MES), the mothers in the MTMSGs received education support whereas in the second treatment group (MESIGA) the mothers were engaged in an income generating activity in addition to receiving education support. In both groups, the mothers held 7 monthly meetings, one pre-natally and six post-natally. The mothers in the control group received no education support from the research team but followed the usual standard nutrition/health education at the health centre. The sample sizes for each group were: MES 88; MESIGA 82; and the control group 79 mothers. The determination of infant feeding practices was done on a monthly basis from months 1 to 6. Observations of infant feeding practices were carried out on a10% of the study sample to verify maternal self-reported information at the interviews. Data on infant morbidity and weight measurements was collected on a monthly basis. Six focus group discussions were held to collect in-depth information on the rationale for maternal choices of infant feeding methods. The study outcome was EBF prevalence at 6 months as defined by cross-sectional data based on 24-hour recall and cumulative or continuous EBF. Data was analysed using SPSS software Version 17.0 and SAS 9.3 software. Mothers in MESIGA and MES were two times more likely to be exclusively breastfed at 6 months compared to mothers in Control Group {RR=2.42;CI(1.36-4.28);(p=0.004}and {RR=1.89; CI(1.02-3.49);(p=0.033)} respectively using cross-sectional 24-hr recall data. There was no significant difference between EBF rates at 6 months in MES and MESIGA. The median duration of cumulative EBF for the CG was significantly lower at 0.68 months as compared with MES at 2.8 months and MESIGA at 3.36 months (p=0.001). IGAs had significant (p<0.001) effect on rates of attendance to MTMSG meeting. The predictors of EBF were: not giving infants post-lacteal feeds (OR=0.17(0.05-0.55); (p=0.003)}, lack of infants’ illness {OR=0.27(0.12-0.63); (p=0.002) and receiving breastfeeding information from a health facility {OR=2.45(1.24-4.87); (p=0.010)}. The major barriers to EBF were: pressure from partners/relatives, cultural infant feeding practices such as giving of pre- and post-lacteal feeds, heavy maternal workload, and maternal separation from infants for long periods. The study findings show that MTMSGs, a community based intervention is an effective strategy in promoting EBF and should therefore be strengthened in the promotion of EBF programmes.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 222
Mothers who were in their third trimester of pregnancy (33-37 weeks gestation) and HIV negative were included in the study. The gestation age and HIV status were determined from their mother and child health booklets and hospital records respectively.
Another inclusion criterion was that one ought to have been resident in the study areas for at least six months before the study and planned to stay in the study site for at least seven months from the time of recruitment into the study.
Mothers with a history of pregnancy complications such as diabetes, eclampsia, hypertension or hyperemesis based on medical records were excluded from the study.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method ?Exclusive breast-feeding on monthly basis during the first six months as determined by 24-hour <br>recall on a monthly basis.
- Secondary Outcome Measures
Name Time Method Cumulative EBF from birth at 6 months