Implementing a Novel Facility-Community Intervention for Strengthening Integration of Infant Nutrition and Family Planning in Mara and Kagera, Tanzania

Autor: Joyce Nyoni, Mary Drake, Chelsea M. Cooper, Anne Pfitzer, John George, Mary Makungu, Justine A. Kavle, Ruth Lemwayi, Elizabeth Massawe, Lemmy Mabuga
Rok vydání: 2021
Předmět:
lactational amenorrhea method
Service delivery framework
Health
Toxicology and Mutagenesis
Total fertility rate
METHOD LAM
Breastfeeding
lcsh:Medicine
family planning
Tanzania
Article
03 medical and health sciences
0302 clinical medicine
Environmental health
parasitic diseases
Humans
Lactation
030212 general & internal medicine
postpartum family planning
Infant Nutritional Physiological Phenomena
male engagement
Amenorrhea
community health
implementation science
030219 obstetrics & reproductive medicine
biology
Community engagement
lcsh:R
Public Health
Environmental and Occupational Health
Infant
biology.organism_classification
Focus group
service integration
Breast Feeding
Family planning
Family Planning Services
exclusive breastfeeding
Community health
maternal infant nutrition
Female
Psychology
Zdroj: International Journal of Environmental Research and Public Health, Vol 18, Iss 4105, p 4105 (2021)
International Journal of Environmental Research and Public Health
Volume 18
Issue 8
International Journal of Environmental Research and Public Health, 18(8):4105. MDPI AG
ISSN: 1660-4601
1661-7827
Popis: Tanzania has high fertility, low contraceptive prevalence and low exclusive breastfeeding (EBF). The Lake Zone, including Mara and Kagera regions, leads the country in total fertility
use of the lactational amenorrhea method (LAM) is negligible. This pre-/post-study explored the effects of a multi-level facility and community intervention (service delivery support, community engagement, media and LAM tracking) to integrate maternal and infant nutrition and postpartum family planning (FP) within existing health contacts. Mixed methods were used, including service statistics, exit interviews, patient-tracking tools for community health workers, client self-tracking tools, supervision data, focus group discussions and in-depth interviews. Results are presented using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) implementation science framework. The intervention reached primarily the second and fourth wealth quintiles, increased FP and EBF at six weeks postpartum. LAM was very acceptable, provided an entry point for FP conversations and for addressing misconceptions, and reinforced EBF practices. Partners felt encouraged to support spousal nutrition, breastfeeding and FP. Higher adoption in Kagera may be influenced by performance-based financing. The intervention was implemented with generally high fidelity. Maintenance data reflected stakeholder interest in continuing the intervention. A multi-level facility and community intervention was feasible to implement and likely contributed to improved EBF practices and FP uptake, including LAM use.
Databáze: OpenAIRE
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