Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study
Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study
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DOI：
10.1017/s2040174415007941
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发表时间：
2016-04-01
影响因子：
1.7
通讯作者：
Griffiths, P. L.
中科院分区：
文献类型：
--
作者：
Kimani-Murage, E. W.;Norris, S. A.;Griffiths, P. L.
早期营养对以后的健康和可持续发展至关重要。我们确定了肯尼亚社区卫生战略在肯尼亚内罗毕城市贫困地区促进纯母乳喂养（EBF）的潜在有效性。我们使用了一种准实验研究设计，基于三项研究[干预前（2007-2011; n = 5824），干预（2012-2015; n = 1110）和比较（2012-2014; n = 487）]，这些研究纵向跟踪母婴对，以确定0至6个月的EBF率。母婴和幼儿营养（MIYCN）研究是一项随机分组试验;对照组（MIYCN-对照）接受标准护理，包括社区卫生工作者（CHW）访视，以获得产前和产后护理咨询。干预组（MIYCN-干预）接受标准护理，并由受过培训的CHW定期提供MIYCN咨询。这两个小组都收到了MIYCN的宣传材料。我们使用卡方检验和逻辑回归检验了4个研究组（干预前、MIYCN干预组、MIYCN对照组和比较组）0 - 6个月的EBF率差异。6个月时，干预前组的EBF患病率为2%，MIYCN干预组为55%，MIYCN对照组为55%，对照组为3%（P< 0.05）。校正基线特征后，与干预前组相比，MIYCN干预组、MIYCN对照组和比较组从出生至6个月的EBF比值比分别为66.9（95% CI 45.4-96.4）、84.3（95% CI 40.7-174.6）和3.9（95% CI 1.8-8.4）。肯尼亚国家社区卫生战略在卫生保健机会有限的城市贫困地区促进EBF方面具有潜在的有效性。
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 chi(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.