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Adetutu OM, Oyinlola FF, Oyelakin TE, Ofili FL. Influence of intimate partner violence and male involvement on maternal healthcare services utilisation in Nigeria. Front Glob Womens Health 2024; 5:1353117. [PMID: 38559815 PMCID: PMC10978718 DOI: 10.3389/fgwh.2024.1353117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Low maternal health care services utilisation, especially antenatal care attendance and skilled birth attendance, has been documented to be responsible for maternal mortality and morbidity in Nigeria. While available evidence suggests mixed findings on uptake of maternal health care services in the context of abusive spousal relationships, male involvement in household and health decision-making has been established to promote uptake of maternal health care services. Yet, studies which consider mediating influence of intimate partner violence on male involvement and maternal health care services uptake are sorely missing in Nigeria. We hypothesised that maternal health care services uptake in abusive marital unions has implications for male involvement in pregnancy care and this has been largely overlooked in Nigeria. Materials and methods This study extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The 2018 NDHS is a nationally representative secondary data which collected population, demographic and health information on women, men and households in Nigeria. The secondary data used a two-stage stratified and multistage sampling technique to collect information from the respondents. In this study, data were extracted for women who were sexually active, within the reproductive age (15-49 years) and not pregnant in five years prior the survey (n = 7,847). Results The results indicated (77%) antenatal care attendance and (47%) skilled delivery. The mediating influence of IPV on male involvement resulted in women who experienced sexual violence more likely to use heath facility for antenatal care (OR = 3.20; C.I: 1.20-8.50). Women whose partners were involved in health decision making had lower odds of antenatal care attendance (OR = 0.64; C.I: 0.44-0.94). Also, women whose partners were involved in spending their earnings had lower probability of antenatal care attendance (OR = 0.72; C.I: 0.55-0.96). Yet, the mediating influence of intimate partner violence on male involvement resulted in a lower likelihood of use of skilled delivery for emotionally abused women (OR = 0.58; C.I: 0.39-0.85). Women whose partners were involved in spending their earnings had higher odds of using skilled delivery (OR = 2.15; C.I: 1.79-2.56). Yet, women whose partners were involved in their health decision-making had lower odds of using skilled delivery (OR = 0.46; C.I: 0.34-0.62). Conclusion This study held the philosophical stance that intimate partner violence mediated the influence of male involvement on maternal health care uptake while intimate partner violence had an inconsistent influence on maternal health care uptake. Policies and interventions should aim at addressing deep-rooted gender norms which promote IPV and limit male involvement in pregnancy care in Nigeria. Programme and policy interventions should focus on enhancing socioeconomic status of women.
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Affiliation(s)
- O. M. Adetutu
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Komakech JJ, Emerson SR, Cole KL, Walters CN, Rakotomanana H, Kabahenda MK, Hildebrand DA, Stoecker BJ. Care groups in an integrated nutrition education intervention improved infant growth among South Sudanese refugees in Uganda's West Nile post-emergency settlements: A cluster randomized trial. PLoS One 2024; 19:e0300334. [PMID: 38489346 PMCID: PMC10942045 DOI: 10.1371/journal.pone.0300334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE This study examined the effects of a peer-led integrated nutrition education intervention with maternal social support using Care Groups on infant growth among South Sudanese refugees in Uganda. METHODS A community-based cluster-randomized trial (RCT) was conducted among 390 pregnant women (third trimester). Two intervention study arms were Mothers-only(n = 131) and Parents-combined (n = 142) with a Control (n = 117). WHO infant growth standards defined length-for-age z-scores (LAZ) for stunting, weight-for-age z-scores (WAZ) for underweight and weight-for-length z-scores (WLZ) for wasting. The Medical Outcomes Study (MOS) social support index was a proxy measure for social support. A split-plot ANOVA tested the interaction effects of social support, intervention, and time on infant growth after adjusting for covariates. Further, pairwise comparisons explained mean differences in infant growth among the study arms. RESULTS The mean infant birth weight was 3.1 ± 0.5 kg. Over the study period, infant stunting was most prevalent in the Control (≥ 14%) compared to Mothers-only (< 9.5%) and Parents-combined (< 7.4%) arms. There were significant interaction effects of the Care Group intervention and social support by time on infant mean LAZ (F (6, 560) = 28.91, p < 0.001), WAZ (F (5.8, 539.4) = 12.70, p = < 0.001) and WLZ (F (5.3, 492.5) = 3.38, p = 0.004). Simple main effects by the end of the study showed that the intervention improved infant mean LAZ (Mothers-only vs. Control (mean difference, MD) = 2.05, p < 0.001; Parents-combined vs. Control, MD = 2.00, p < 0.001) and WAZ (Mothers-only vs. Control, MD = 1.27, p < 0.001; Parents-combined vs. Control, MD = 1.28, p < 0.001). CONCLUSION Maternal social support with an integrated nutrition education intervention significantly improved infant stunting and underweight. Nutrition-sensitive approaches focused on reducing child undernutrition among post-emergency refugees may benefit from using Care Groups in programs. TRIAL REGISTRATION Clinicaltrials.gov, NCT05584969.
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Affiliation(s)
- Joel J. Komakech
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Starkville, Mississippi, United States of America
| | - Sam R. Emerson
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | - Ki L. Cole
- Research, Evaluation, Measurement, and Statistics Department, Oklahoma State University, Stillwater, OK, United States of America
| | - Christine N. Walters
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | - Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | | | - Deana A. Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
| | - Barbara J. Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States of America
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Schnefke CH, Flax VL, Ubanmhen F, Alayon S, Bose S, Daniel O, Grimes KEL, Allotey D, Seiger ER, Arije O. Attitudes, beliefs and social norms regarding infant and young child feeding among Nigerian mothers, fathers and grandmothers across time. MATERNAL & CHILD NUTRITION 2023; 19:e13524. [PMID: 37173816 PMCID: PMC10483957 DOI: 10.1111/mcn.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
Infant and young child feeding (IYCF) interventions in low-resource countries mainly target pregnant women and mothers of young children; however, fathers and grandmothers also influence IYCF practices. We conducted focus group discussions with mothers, fathers and grandmothers of young children across three time points in areas where an IYCF social and behaviour change intervention was implemented in Nigeria to explore differences by participant type and shifts over time in attitudes, beliefs and social norms related to breastfeeding and dietary diversity (DD). Overall, across time points, we found more discrepancies in attitudes, beliefs and social norms for early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) among different participant types than for DD. Although most participants agreed EIBF and EBF are good practices, mothers believed this more strongly than fathers and grandmothers; however, at endline, a shift towards acceptance of EIBF and EBF appeared among fathers and grandmothers. Across time points, all participant types acknowledged the nutritional and health benefits of green leafy vegetables and animal-source foods but described various barriers to feeding them to children. Across time points, all participant types also highlighted the importance of health workers and antenatal visits as important sources of IYCF knowledge and facilitators to following recommended practices. Insights from this study highlight the importance of including key influencers of IYCF practices in qualitative research.
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Affiliation(s)
- Courtney H. Schnefke
- Public Health Research DivisionRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Valerie L. Flax
- Public Health Research DivisionRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | | | - Silvia Alayon
- Department of Global HealthSave the ChildrenWashingtonDistrict of ColumbiaUSA
| | - Sujata Bose
- FHI Solutions, MonitoringLearning and EvaluationDurhamNorth CarolinaUSA
| | - Obinna Daniel
- Public Health Research DivisionRTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | | | - Diana Allotey
- Department of NutritionUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Emily R. Seiger
- Department of NutritionUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Olujide Arije
- Institute of Public HealthObafemi Awolowo UniversityIle‐IfeOsun StateNigeria
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Jeong J, Sullivan EF, McCann JK. Effectiveness of father-inclusive interventions on maternal, paternal, couples, and early child outcomes in low- and middle-income countries: A systematic review. Soc Sci Med 2023; 328:115971. [PMID: 37224703 PMCID: PMC10330563 DOI: 10.1016/j.socscimed.2023.115971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/17/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
Most caregiving interventions for young children are directed to female caregivers. Relatively few have included male caregivers as program participants especially in low- and middle-income countries (LMICs). The range of potential benefits that can be achieved through the engagement of fathers and male caregivers has not been adequately explored from a family systems perspective. We reviewed interventions that engaged male caregivers to support young children in LMICs and summarized impacts on maternal, paternal, couples, and child outcomes. We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Global Health Library for quantitative evaluation studies of social and behavioral interventions that included fathers or other male caregivers to improve nurturing care for young children under 5 years of age in LMICs. Three authors independently extracted data using a structured form. Forty-four articles, representing 33 intervention evaluations, were included. The most common type of intervention targeted fathers along with their female partners and primarily to address child nutrition and health. Across interventions, maternal outcomes were the most evaluated outcomes (82%), followed by paternal (58%), couple's relationship (48%) and child-level outcomes (45%). Overall, father-inclusive interventions had positive impacts on maternal, paternal and couples' relationship outcomes. Although there was greater variation in the degree of supportive evidence for child outcomes compared to maternal, paternal, and couples outcomes, findings suggested mostly positive effects across all outcomes. Limitations included relatively weak study designs and heterogeneity across interventions, outcome types, and measurement tools. Interventions that include fathers and other male caregivers have potential to improve maternal and paternal caregiving, couple's relationships dynamics, and early child outcomes in LMICs. More evaluation studies, using rigorous methods and robust measurement frameworks, is needed to bolster this evidence-base about the effect of fathers' engagement for young children, caregivers, and families in LMICs.
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Affiliation(s)
- Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | | | - Juliet K McCann
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Bayati M, Biabanakigoortani A, Changiz T, Namnabati M. The impact of a three-phase education-support-follow-up program on the mothers' perceptions of the needs of their multiple infants: A protocol study for a clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:110. [PMID: 37288409 PMCID: PMC10243459 DOI: 10.4103/jehp.jehp_46_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/18/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Infertility, a problematic issue to the newly married couples, should be treated as no couple should be deprived of having children. The treatment, however, poses new challenges to the multiples and subsequent preterm births, health system, and families. Therefore, the aim of this study is to investigate the effect of an education-support-follow-up program on the mothers' perceptions of their multiples' needs. MATERIALS AND METHODS This research is a three-phase interventional study. The first phase develops an educational program through review of the literature and using the opinions of experts. In the second phase, the developed program will be implemented in the neonatal intensive care unit (NICU) for the mothers of multiples. In the third phase, based on the developed plan, the required support will be applied and followed up. The data collection tool is a researcher-made questionnaire which is completed by the mothers (N = 30) before and after the intervention. Convenience sampling method will be used, and the mothers will be allocated randomly. Data gathering started from September 2020 and would continue until the sample collection is completed. Data will be analyzed through the descriptive and analytical statistics with Statistical Package for the Social Sciences (SPSS) version 21. RESULTS The present study can address the needs of the multiple infants based on the implementation of an education-support-follow-up program for mothers and their families. CONCLUSION The mothers of multiple infants are required to specify unique physical and developmental needs of their infants, while their perceptions of these needs may be different based on the education-support-follow-up program. The researchers designed the program to help them define highly specialized needs of multiples and also examined their perceptions of these needs.
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Affiliation(s)
- Masumeh Bayati
- Department of Pediatric and Neonates, Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Tahereh Changiz
- Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Namnabati
- Departments of Pediatric and Neonates, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Dagla C, Antoniou E, Sarantaki A, Iliadou M, Mrvoljak-Theodoropoulou I, Andersson E, Dagla M. The Effect of Antenatal Education on Expectant Fathers' Attitudes toward Breastfeeding and Attachment to the Fetus. NURSING REPORTS 2023; 13:243-254. [PMID: 36810274 PMCID: PMC9944450 DOI: 10.3390/nursrep13010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND This study explores the effect of antenatal education on fathers' attitudes toward: (i) breastfeeding and (ii) attachment to the fetus. A secondary aim is to explore the relationship of fathers' demographic and the psycho-emotional characteristics that come with breastfeeding and attachment. METHODS This is a longitudinal study involving a group of 216 Greek expectant fathers who participated with their partners in an antenatal educational program performed by midwives in Athens, Greece (September 2020-November 2021). The Iowa Infant Feeding Attitudes Scale (IIFAS) and Paternal Antenatal Attachment Scale (PAAS) were administered at two time points: (a) 24th-28th gestation week and (b) 34th-38th gestation week. The T-test and Univariate Analyses of Variance (ANOVA) were performed. RESULTS The expectant fathers' scores show that breastfeeding intention/exclusivity and prenatal attachment to the fetus were higher after their participation in the antenatal education program, but the difference was not statistically insignificant. Expectant fathers with a cohabitation agreement (p = 0.026), who felt very much supported by their partners (p = 0.001) and had no relationship difficulties with their partners (p < 0.001), as well as those who reported being very happy during pregnancy (p < 0.001), showed greater paternal antenatal attachment to the fetus. CONCLUSIONS Although the difference was statistically insignificant, antenatal education appears to have an impact on paternal breastfeeding attitudes and antenatal attachment to the fetus. Additionally, several paternal characteristics were associated with greater antenatal attachment. Future research should be directed toward the investigation of additional factors that impact antenatal-paternal attachment and breastfeeding attitudes so that effective education programs can be designed.
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Affiliation(s)
- Calliope Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence: ; Tel.: +30-6984493365
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Antigoni Sarantaki
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | | | - Ewa Andersson
- Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
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Jeong J, Sullivan EF, McCann JK, McCoy DC, Yousafzai AK. Implementation characteristics of father-inclusive interventions in low- and middle-income countries: A systematic review. Ann N Y Acad Sci 2023; 1520:34-52. [PMID: 36482863 PMCID: PMC9974925 DOI: 10.1111/nyas.14941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although prior reviews have documented the effectiveness of engaging male caregivers in early childhood interventions, little is known about how these interventions have been designed and implemented to reach, engage, and support male caregivers in low-resource global settings. We searched five bibliographic databases for intervention studies that engaged male caregivers to improve nurturing care for children under 5 years of age in low- and middle-income countries. Forty-four articles met the inclusion criteria, which represented 33 interventions. Fathers specifically were the most common type of male caregivers targeted in these interventions. The majority of interventions invited fathers to participate alongside their female partners. Community-based peer-groups were the most common delivery model. Most interventions used the same program structure for fathers as applied to mothers, with few considering whether implementation adaptations were needed for men. Intervention curricula were multicomponent and largely targeted child nutrition, health, and couples' relationships. A minority of programs addressed parenting, psychosocial wellbeing, violence prevention, gender attitudes, or economic support. Behavior change techniques were limited to interactive counseling and peer learning. Male caregivers remain missing from caregiving interventions for young children. A greater focus on implementation research can inform better inclusion, engagement, and support for male caregivers in nurturing care interventions.
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Affiliation(s)
- Joshua Jeong
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Juliet K McCann
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Dana C McCoy
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Agrawal J, Chakole S, Sachdev C. The Role of Fathers in Promoting Exclusive Breastfeeding. Cureus 2022; 14:e30363. [PMID: 36407167 PMCID: PMC9665906 DOI: 10.7759/cureus.30363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023] Open
Abstract
The cornerstone of a newborn's nutrition is breastfeeding. Due to its well-known benefits for mothers, children, and society in the short and long term, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) recommend it as the best way of feeding the baby during the first six months of life. The family, particularly the spouse, may significantly influence the baby's quality of nursing. On a global scale, previous studies have demonstrated that family members (such as a mother's spouse, partner, or grandmother) not only affect her choice to start and endure breastfeeding but also significantly contribute to the early postnatal period's cessation of appropriate breastfeeding. A father's knowledge and attitude are fundamental in this regard, as he has the most critical role in helping women with parenting and feeding their babies. Furthermore, because the father's role is considered important in a family, the partner's or wife's perception of the father's attitude may alter her subjective criteria about exclusive breastfeeding (EBF). Future initiatives should target new mothers and their spouses to see how they may provide the most beneficial assistance to new mothers. The main focus should be on targeting newly married couples. The father's lack of involvement may be due to the hierarchical structure of power within households. Because of this hierarchical aspect, partners or fathers may significantly influence a mother's choice to nurse their child correctly. Household chores, childcare for grown-up children, guaranteeing the well-being of their spouse, preparing meals, recognizing a newborn's hunger cues, burping, and changing the infant's diaper after feedings, all these factors indirectly support the mother in initiating and enduring the nursing of a child.
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Affiliation(s)
- Jayesh Agrawal
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Chetna Sachdev
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Aghababaei S, Khodakarami B, Farhadian M, Kamali M. Promoting maternal self efficacy and paternal attitudes towards breastfeeding: a randomized controlled trial. Glob Health Promot 2022; 29:17579759221091194. [PMID: 35723044 DOI: 10.1177/17579759221091194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Counseling is one of the ways to improve the quantity and quality of breastfeeding. The present study was conducted to investigate the effect of couple-centered counseling on fathers' attitudes and mothers' self-efficacy towards breastfeeding. METHODS This randomized controlled trial study was conducted on 60 primigravida pregnant women and their spouses who were randomly selected among the pregnant women referred to the two maternity hospitals of Malayer City, a city in the province Hamadan in western Iran. Data collection tools included the demographic characteristics questionnaire, Breastfeeding Self-Efficacy Questionnaire, and Iowa Infant Feeding Attitude Scale. The intervention was performed according to the principles of GATHER counseling (Greet, Ask, Tell, Help, Explain, and Return). Mothers' self-efficacy and fathers' attitudes toward breastfeeding were assessed before the intervention and 4 weeks after birth in both groups. Data were analyzed with SPSS version 23 software and using a significance level of p = 0.05. RESULTS The participants of the control and test groups were homogeneous in terms of demographic characteristics. The change in mothers' breastfeeding self-efficacy score after intervention in the test group had a statistically significant difference compared to the control group (30.43 ± 2.53; 95%CI: 25.41,35.44), and the change in the score of fathers' attitude towards breastfeeding had a statistically significant difference after the intervention in the test group compared to the control group (19.3 ± 2.05; 95%CI: -23.36, -15.23). In the test group, the change in fathers' attitude towards breastfeeding after the intervention was significant compared to before the intervention (30.36 ± 2.38; 95%CI: 25.43, 35.25). CONCLUSIONS Appropriate counseling programs can change fathers' attitudes toward breastfeeding and increase mothers' breastfeeding self-efficacy, so couples' presence in breastfeeding counseling is recommended.
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Affiliation(s)
- Soodabeh Aghababaei
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Batoul Khodakarami
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health, Research Center for Health Sciences, Hamadan University of Medical Science, Hamadan, Iran
| | - Marziyeh Kamali
- Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
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Panahi F, Rashidi Fakari F, Nazarpour S, Lotfi R, Rahimizadeh M, Nasiri M, Simbar M. Educating fathers to improve exclusive breastfeeding practices: a randomized controlled trial. BMC Health Serv Res 2022; 22:554. [PMID: 35468827 PMCID: PMC9040207 DOI: 10.1186/s12913-022-07966-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 04/20/2022] [Indexed: 02/08/2023] Open
Abstract
Background Fathers’ involvement is crucial for promoting breastfeeding. There are a few studies on the effectiveness of fathers’ educational programs to promote exclusive breastfeeding. This study aims to assess the effectiveness of a fathers’ educational program on their support for breastfeeding, mothers’ breastfeeding practice, and exclusive breastfeeding status. Methods This was a randomized controlled trial on 76 fathers who were randomly assigned to two groups of intervention and control, in a selected health center in Iran, 2018. The tools for data collection were: 1) a questionnaire for “Demographic and Maternal-Infant Information”; 2) a questionnaire to assess “Fathers’ support for Breastfeeding”, and 3) an observational checklist to assess “Mothers’ Breastfeeding Practice”; and 4) a questionnaire to assess “Exclusive Breastfeeding Status”. The questionnaires were filled up through an interview. The checklist was completed through observation by the researcher. The fathers (with the mothers) of the intervention group were educated using individual face-to-face education and counseling, in two sessions, with the duration of about 40 min and one-week interval, whereas, the fathers of the control group did not receive any education and only mothers were educated with the same instruction. The content of the education was: fathers’ education about “benefits of breast milk” and “the supporting ways for breastfeeding including the women encouragement”. Then, the scores of “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” were compared before and after 4 months of intervention in each group, and also between groups. Data were analyzed using SPPS-23, and t- and paired-tests, Chi-square, and Generalized-Estimating-Equations (GEE) tests. Results The results showed two groups were not significantly different regarding the demographic and any other possible confounding variables before the intervention (P < 0.05). The before and after comparisons also demonstrated significant improvements in the two variables including “father’s support for breastfeeding”, and “mothers’ breastfeeding practice after 4 months, in the intervention group (Paired t-test: P<0.001 and P<0.0001, respectively) however, there was a significant decrease in “father’s support for breastfeeding” and no improvement in “mothers’ breastfeeding practice” after 4 months in the control group (Paired t-test: P < 0.001 and P = 0.07, respectively). Between groups comparison showed also significant higher scores for “father’s support for breastfeeding”, “mothers’ breastfeeding practice” and “exclusive breastfeeding status” in the intervention group comparing to the control group, after 4 months (T-test: P < 0.001 and P < 0.0001; Chi2: P < 0.001, respectively). The interaction effects of time and group were significant in the GEE test for the fathers’ support for breastfeeding (B-group = 31.93, B-time = 22.15, p < 0.001) and mothers’ breastfeeding practice (B-group = 26.32, B-time = 12.86, p < 0.0). Conclusion The results showed that the father’s education improves mothers’ breastfeeding practice and increases the rate and continuity of exclusive breastfeeding. Trial registration IRCT201508248801N10. “31/08/2016”. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07966-8.
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Affiliation(s)
- Farideh Panahi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences-Bojnurd, Bojnurd, Iran
| | - Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Razieh Lotfi
- Department of Midwifery, School of Nursing and Midwifery, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Mitra Rahimizadeh
- Department of Biostatistics, Social Determinant of Health Research Center, Alborz University of Medical Sciences-Karaj, Karaj, Iran
| | - Maliheh Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences Tehran, Tehran, Iran
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr and Hashemi Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran.
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Mabele OM, Benedict MOA, Steinberg WJ, Reji E, Van Rooyen C, Adefuye AO. Knowledge, attitudes and practices of men in a South African rural community in relation to exclusive breastfeeding. S Afr Fam Pract (2004) 2022; 64:e1-e8. [PMID: 35144460 PMCID: PMC8905419 DOI: 10.4102/safp.v64i1.5366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/18/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background Several lifelong maternal, child and societal health benefits have been associated with exclusive breastfeeding (EBF). However, despite all the potential advantages, EBF rates have been consistently low in developing countries, including South Africa. It has been suggested that the knowledge, attitudes and practices of male partners in relation to EBF are amongst the important factors that contribute to the success of EBF practices. Hence, the aim of this study was to determine the knowledge, attitudes and practices of men in Botshabelo, Free State province, South Africa, regarding EBF. Methods This study was designed as a cross-sectional analytical study that utilised a structured questionnaire administered to 200 adult men attending the outpatient department of a district hospital, in the Free State province, South Africa. Results The majority (n = 83; 41.5%) of participants had poor knowledge of EBF but reported positive attitudes (n = 153, 76.5%) and good practices (n = 151, 75.5%) towards EBF, respectively. Age, levels of education, employment status, marital status and whether the participant accompanied his partner to the antenatal clinic were associated with adequate knowledge, positive attitudes and good practices in relation to EBF (p < 0.05). Conclusion The study revealed a suboptimal level of knowledge on EBF in men in Botshabelo. Most men had positive attitudes and reported good practices in relation to EBF. Our findings highlight the need for targeted community-based intervention programmes directed to educating and promoting positive social and cultural change in relation to EBF amongst men in Botshabelo.
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Affiliation(s)
- Oscar M Mabele
- Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein.
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Rajan P, Hiller C, Lin J, Refshauge K, Lincoln M, Leaver A. Community-based interventions for chronic musculoskeletal health conditions in rural and remote populations: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1621-1631. [PMID: 33368791 DOI: 10.1111/hsc.13263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/15/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Chronic musculoskeletal health conditions are highly prevalent in rural and remote areas, globally. It is unknown, however, whether interventions shown to be effective for urban populations are also effective for rural and remote populations. The purpose of the review was to evaluate the effectiveness of community-based interventions for management of chronic musculoskeletal health conditions in rural and remote populations. A systematic review was undertaken of the major databases: Medline, Scopus, Web of Science, Rural and Remote Health, Embase and PEDro to April 2020 with no restrictions on language or publication date. Odds Ratios were calculated to report differences between intervention and control groups. Risk of bias was assessed using the PEDro scale. Meta-analysis was not conducted, given the high heterogeneity among studies. From a total of 3,219 articles identified from the title search, five studies were eligible, with a total of 2,831 participants. Interventions evaluated included education alone, exercise with education and ergonomic modifications. Community-based education and exercise led to significantly reduced chronic musculoskeletal pain [OR = 1.85 (95% CI 1.22, 2.82)] compared with controls. Ergonomic stove installation significantly reduced average prevalence of back pain (0.25% reduction in pain prevalence; p < .05); however, no significant effect [OR = 1.02 (0.63, 1.65)] was found when transformed to Odds Ratio. There were divergent findings for education programmes alone: one study reported a positive effect [OR = 1.78 (1.27, 2.49)], while another reported no significant effect [delivered either in home [OR: 1.21 (0.78, 1.86)] or in small groups [OR = 0.95 (0.60, 1.51)]. A significant improvement in knowledge was found with community-based education delivered in participants' homes [SMD: 1.27 (1.01, 1.54)], in small groups [SMD: 0.79 (0.53, 1.06)], using traditional puppetry [SMD: 4.79 (4.51, 5.06)], and with education and exercise [SMD: 0.29 (0.06, 0.52)]. There is low quality evidence that education and/or exercise improves knowledge of arthritis, and the effectiveness of ergonomic interventions on pain was unclear.
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Affiliation(s)
- Pavithra Rajan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Claire Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jianhua Lin
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Kathryn Refshauge
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Lincoln
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Andrew Leaver
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Radwan H, Fakhry R, Metheny N, Baniissa W, Faris MAIE, Obaid RS, Al Marzooqi S, Al Ghazal H, ElHalik M, Dennis CL. Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study. Int Breastfeed J 2021; 16:79. [PMID: 34641934 PMCID: PMC8507212 DOI: 10.1186/s13006-021-00428-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite considerable policy actions at the national and hospital levels, rates of breastfeeding in the Middle East and North Africa (MENA) region remain below the global average. There is a need to explore the modifiable factors of breastfeeding such as maternal breastfeeding self-efficacy (BSE), support, and mental health among women in this region to guide interventions in the United Arab Emirates (UAE). The aim of this study was to examine the maternal predictors of any and exclusive breastfeeding in a cohort of Emirati and expatriate women residing in the UAE with a specific focus on modifiable factors. METHODS Using a prospective cohort design, Emirati and expatriate women were recruited in the immediate postpartum period (N = 374) and followed at three and 6 months postpartum between February 2018 and July 2019. Questionnaires with validated tools were used to collect information on sociodemographic characteristics, breastfeeding practices, BSE, postnatal depression, and anxiety. The main outcomes in the study were Any Breastfeeding and exclusivity practices, which were assessed at three and 6 months postpartum by asking the mother about her breastfeeding behaviour during the past 7 days. Multilevel, multivariate logistic regression was used to estimate the association of different variables with breastfeeding outcomes. RESULTS Almost all women reported initiating breastfeeding during their stay at the hospital (n = 357), while only 263 (70.3%) initiated breastfeeding within the first hour of delivery. At 6 months postpartum, 301 (81.5%) women continued to breastfeed of whom 100 (26.7%) were doing so exclusively. Older mothers who initiated breastfeeding within 1 h of birth and were satisfied with the breastfeeding support they received from family and friends had significantly greater odds of any breastfeeding at 6 months. Whereas a clinically significant Edinburgh Postnatal Depression Scale (EPDS) score, low BSE score as well as employment outside the home were associated with significantly lower odds of exclusive breastfeeding and any breastfeeding at 6 months postpartum. CONCLUSION This study highlights the need to develop effective education strategies and support programs targeting these modifiable variables to improve breastfeeding outcomes among women in the UAE.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Miami, USA
| | - Wegdan Baniissa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Moez Al Islam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Mahmoud ElHalik
- Department of Neonatology, Latifa Women and Children Hospital, Dubai, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Engaging family members in maternal, infant and young child nutrition activities in low- and middle-income countries: A systematic scoping review. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13158. [PMID: 34241961 PMCID: PMC8269148 DOI: 10.1111/mcn.13158] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 12/20/2022]
Abstract
The influence of fathers, grandmothers and other family members on maternal, infant and young child nutrition practices has been well documented for decades, yet many social and behavioural interventions continue to reach only mothers. While recent guidelines recommend involving fathers, grandmothers and other family members in maternal and child nutrition, we lack a comprehensive review of interventions that have engaged them. This scoping review aimed to address this gap by describing social and behavioural interventions to engage family members in maternal and child nutrition in low- and middle-income countries. We systematically searched PubMed, Scopus, Web of Science, Global Health and CINAHL for peer-reviewed studies meeting inclusion criteria. We screened 6,570 abstracts, evaluated 179 full-text articles, and included 87 articles from 63 studies. Studies reported a broad range of approaches to engage fathers, grandmothers and other family members to support maternal nutrition (n = 6); breastfeeding (n = 32); complementary feeding (n = 6) and multiple maternal and child nutrition practices (n = 19). Interventions were facility and community based; included individual and group-based interpersonal communication, community mobilization, mass media and mHealth; and reached mothers and family members together or separately. Most interventions were located within the health sector; rare exceptions included nutrition-sensitive agriculture, social protection, early child development and community development interventions. Few interventions addressed gender norms, decision-making, and family dynamics or described formative research or theories informing intervention design. These diverse studies can shed light on innovative programme approaches to increase family support for maternal and child nutrition.
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Affiliation(s)
- Stephanie L. Martin
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Juliet K. McCann
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Emily Gascoigne
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Diana Allotey
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Dadirai Fundira
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Katherine L. Dickin
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
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Father's Knowledge, Attitude and Support to Mother's Exclusive Breastfeeding Practices in Bangladesh: A Multi-Group Structural Equations Model Analysis. Healthcare (Basel) 2021; 9:healthcare9030276. [PMID: 33802555 PMCID: PMC7998803 DOI: 10.3390/healthcare9030276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/28/2022] Open
Abstract
Despite worldwide initiatives, the exclusive breastfeeding (EBF) rate is low. The study aims to investigate the role of fathers’ knowledge, attitude and support in formulating mothers’ practice of breastfeeding taking Bangladeshi parental cases as a sample. The study uses a standard survey instrument following the theory of planned behavior (TPB). Responses from 332 couples are accepted following a standard criteria and used for analysis. The sample is divided into sub-groups based on delivery mode—vaginal (n = 211, 64%) and cesarean section (n = 121, 36%). Based on the sub-groups, a multi-group structural equation modelling (SEM) is applied to analyze the phenomena. The study finds that a father’s knowledge in EBF can, in one way, significantly enhance mother’s knowledge by sharing and, in another way, can enhance his own attitude to offer different support to his partner/wife which induces the chances of EBF practices by mothers. The enhanced EBF knowledge of a mother raises her attitude to practice EBF, which is also positively affected by the father’s attitude. Thus, fathers’ support, coupled with mothers’ positive attitude, the mother’s intention to practice EBF as per standard guidelines.
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Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review. Nutrients 2021; 13:nu13020681. [PMID: 33672692 PMCID: PMC7924359 DOI: 10.3390/nu13020681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers'/healthcare staffs' knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother-infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers' knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).
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Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Mixed-Methods Systematic Review of Behavioral Interventions in Low- and Middle-Income Countries to Increase Family Support for Maternal, Infant, and Young Child Nutrition during the First 1000 Days. Curr Dev Nutr 2020; 4:nzaa085. [PMID: 32607463 PMCID: PMC7311193 DOI: 10.1093/cdn/nzaa085] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
Fathers, grandmothers, and other family members' influence on maternal, infant, and young child nutrition (MIYCN) is widely recognized, yet synthesis of the effectiveness of engaging them to improve nutrition practices during the first 1000 d is lacking. We examined the impact of behavioral interventions to engage family members in MIYCN in low- and middle-income countries through a mixed-methods systematic review. We screened 5733 abstracts and included 35 peer-reviewed articles on 25 studies (16 with quantitative and 13 with qualitative data). Most quantitative studies focused on early breastfeeding, primarily engaging fathers or, less often, grandmothers. Most found positive impacts on exclusive breastfeeding rates and family members' knowledge and support. The few quantitative studies on complementary feeding, maternal nutrition, and multiple outcomes also suggested benefits. Qualitative themes included improved nutrition behaviors, enhanced relationships, and challenges due to social norms. Interventions engaging family members can increase awareness and build support for MIYCN, but more rigorous study designs are needed. This systematic review is registered at PROSPERO as CRD42018090273, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=90273.
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Affiliation(s)
- Stephanie L Martin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Juliet K McCann
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Emily Gascoigne
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diana Allotey
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dadirai Fundira
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Katherine L Dickin
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Cardenas SD, Puello SDCP, Montes LAB. Breastfeeding and Related Factors in Afrodescendant Women From Cartagena, Colombia. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Leng RNW, Shorey S, Yin SLK, Chan CPP, He HG. Fathers' Involvement in Their Wives'/Partners' Breastfeeding: A Descriptive Correlational Study. J Hum Lact 2019; 35:801-812. [PMID: 30991006 DOI: 10.1177/0890334419830988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fathers' involvement has been identified as a significant predictor in maternal breastfeeding outcomes. Its benefits have been well-documented, but limited studies have examined its influencing factors. RESEARCH AIM To investigate factors influencing fathers' involvement in their partners' breastfeeding. METHODS A descriptive correlational design was used. Data were collected from 151 fathers from four obstetrics wards of a public hospital in Singapore from October 2016 to December 2016. Self-administered questionnaires were used to examine factors such as fathers' knowledge and involvement in breastfeeding, attitudes towards breastfeeding, and perceived improvements of knowledge and attitudes for fathers' involvement in breastfeeding on the discharge day of their partners' and 2 weeks post-birth. Data were analyzed using IBMSPSS24.0. RESULTS Fathers' involvement in their partners' breastfeeding yielded a moderate to high mean score. The multiple linear regression analysis showed that five independent factors significantly influenced fathers' involvement in their partners' breastfeeding: (1) perceived approval of family members and friends in fathers' breastfeeding involvement; (2) knowledge regarding breastfeeding and their involvement; (3) perceived behavioral control for fathers' breastfeeding involvement; (4)marital relationship; and (5) perceived improvements of knowledge and attitudes 2 weeks post-birth. CONCLUSIONS The study provided evidence on the significant factors that influenced fathers' involvement in their partners' breastfeeding, which can be used to guide healthcare professionals when providing appropriate support to facilitate fathers' involvement. Future studies should continue to evaluate fathers' involvement in breastfeeding longitudinally so that relevant support can be rendered.
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Affiliation(s)
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore
| | | | | | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore; National University Health System, Singapore
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Bich TH, Long TK, Hoa DP. Community-based father education intervention on breastfeeding practice-Results of a quasi-experimental study. MATERNAL AND CHILD NUTRITION 2019; 15 Suppl 1:e12705. [PMID: 30748110 DOI: 10.1111/mcn.12705] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/12/2018] [Accepted: 09/19/2018] [Indexed: 12/17/2022]
Abstract
Although the benefits of breastfeeding are well-documented, little is known about how best to encourage fathers to support breastfeeding. A quasi-experimental study of a community-based intervention was designed to examine whether health education to promote fathers' involvement in supporting women is associated with early initiation and exclusive breastfeeding practices. At baseline, 802 couples of fathers with pregnant wives from 12 to 27 weeks of gestational age were recruited to either the intervention group (n = 390) or a control group (n = 412) consisting of couples seeking care through routine maternal and child health services. Fathers in the intervention area received breastfeeding education and counselling services in health facilities and at home visits during the antenatal, delivery, and post-partum periods. Peer education and social exchange concerning breastfeeding were organized in fathers' clubs. After 1 year of the intervention, mothers in the intervention group were more likely to initiate early breastfeeding 49.2 and 35.8% in the intervention and control group respectively, P < 0.001. At 1, 4, and 6 months after birth, 34.8, 18.7, and 1.9% of the mothers in the intervention group were exclusively breastfeeding their children because of birth, respectively, compared with 5.7, 4.0, and 0.0% of those in the control group (P < 0.001). Those practices were associated with the intervention in bivariate and multivariate logistic and Cox regression analyses. Intervention targeting fathers at antenatal and postnatal periods may positively influence the breastfeeding practices of mothers, and it should be an important component of breastfeeding programs.
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Flax VL, Chapola J, Mokiwa L, Mofolo I, Swira H, Hosseinipour MC, Maman S. Infant and young child feeding learning sessions during savings groups are feasible and acceptable for HIV-positive and HIV-negative women in Malawi. MATERNAL & CHILD NUTRITION 2019; 15:e12765. [PMID: 30516880 PMCID: PMC7198955 DOI: 10.1111/mcn.12765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/11/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022]
Abstract
Based on formative research, HIV-positive women in Lilongwe District, Malawi receive little infant and young child feeding (IYCF) counselling postpartum and want more support for IYCF from their husbands. To address these gaps, we implemented a behaviour change communication intervention promoting IYCF in village savings and loan associations (VSLAs) that included HIV-positive and HIV-negative women. The intervention consisted of 15 IYCF learning sessions facilitated by VSLA volunteers during regular VSLA meetings and included four sessions to which husbands were invited. We assessed the feasibility and acceptability of the intervention through learning session participation logs, structured observations of learning sessions, and in-depth interviews with HIV-positive and HIV-negative VSLA members, husbands of members, and VSLA volunteers. Nine VSLA volunteers conducted learning sessions with approximately 300-400 women, about one quarter of whom were lactating, and 25-35 men. VSLA volunteers consistently communicated technical information correctly, followed the learning session steps, and used visual aids. Sessions averaged 46 min, with <20% of observed sessions completed within the recommended time (20-25 min). Key themes from interviews were the following: (a) learning sessions were useful; (b) including HIV-positive and HIV-negative women in the sessions was acceptable; (c) information learned during sessions encouraged families to change IYCF practices; (d) IYCF messages were shared with others in the community; and (e) male participation was low because men considered VSLAs and IYCF to be women's activities. In conclusion, integrating IYCF learning sessions into VLSAs was feasible and acceptable for mixed groups of HIV-positive and HIV-negative women. Future research should test other strategies for involving men in IYCF.
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Affiliation(s)
- Valerie L. Flax
- Food, Nutrition, and Obesity Policy Research Program, RTI International, Research Triangle ParkNorth CarolinaUSA
| | | | - Lemekeza Mokiwa
- Food and Nutrition Security Department, CARE MalawiLilongweMalawi
| | | | - Henry Swira
- Food and Nutrition Security Team, CARE USAAtlantaGeorgiaUSA
| | - Mina C. Hosseinipour
- UNC Project‐MalawiLilongweMalawi
- Department of Medicine, School of MedicineUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Suzanne Maman
- Department of Health Behavior, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Abbass-Dick J, Brown HK, Jackson KT, Rempel L, Dennis CL. Perinatal breastfeeding interventions including fathers/partners: A systematic review of the literature. Midwifery 2019; 75:41-51. [PMID: 30999255 DOI: 10.1016/j.midw.2019.04.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/23/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Support from fathers is consistently associated with improved breastfeeding duration and exclusivity rates. Additionally, there is growing evidence that fathers want to be included in breastfeeding interventions provided by health care professionals. The objective of this review was to determine the effect of partner-inclusive educational and psychosocial interventions on breastfeeding initiation, duration, and exclusivity. DESIGN A systematic review was conducted using a search strategy developed with an expert health sciences librarian. Electronic databases MEDLINE, EMBASE, CINAHL, and PsycINFO were systematically searched for randomized controlled trials and quasi-experimental studies from inception to August 4, 2018. Independent data extraction and quality assessments were conducted by authors using Cochrane Collaboration tools. Due to significant heterogeneity in intervention content, outcome measures, and follow-up time points, data were synthesized qualitatively. FINDINGS 3982 articles were identified, of which 12 studies in 15 publications met the inclusion criteria and were included. All of the studies improved at least one breastfeeding outcome, including duration (n = 5/9) and exclusivity (n = 8/10) up to 24 weeks postpartum. Six studies examined increasing paternal breastfeeding support and all found beneficial effects. Biases were identified in the studies with the most common bias relating to the randomization process and the blinding of outcome assessors. IMPLICATIONS FOR PRACTICE The inclusion of fathers/partners in breastfeeding interventions improves breastfeeding initiation, duration, and exclusivity rates. Interventions that include face-to-face information delivery, are designed in a culturally appropriate manner, and provide information on how partners can support breastfeeding are more likely to have a beneficial effect. Research is warranted to examine the underlying intervention mechanisms.
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Ng RWL, Shorey S, He HG. Integrative Review of the Factors That Influence Fathers’ Involvement in the Breastfeeding of Their Infants. J Obstet Gynecol Neonatal Nurs 2019; 48:16-26. [DOI: 10.1016/j.jogn.2018.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2018] [Indexed: 11/26/2022] Open
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Tadesse K, Zelenko O, Mulugeta A, Gallegos D. Effectiveness of breastfeeding interventions delivered to fathers in low- and middle-income countries: A systematic review. MATERNAL AND CHILD NUTRITION 2018; 14:e12612. [PMID: 29740958 DOI: 10.1111/mcn.12612] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/09/2018] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Abstract
Adequate support for lactating mothers is crucial to improve the rates of early initiation, exclusive, and continued breastfeeding. Maternal breastfeeding intention and ongoing breastfeeding duration are strongly predicted by their partners' breastfeeding beliefs. Partner support has a significant effect on improving rates of any and exclusive breastfeeding, when compared with professional support, particularly in low-income populations. This systematic review investigates the effectiveness of breastfeeding interventions targeting fathers in low- and middle-income countries (LMIC). A systematic literature search was undertaken on Medline (EBSCOhost), PsycInfo, CINAHL, and Scopus databases and via manual searching. Inclusion criteria were experimental or quasiexperimental designs targeting fathers from LMIC, which measured either breastfeeding initiation, breastfeeding exclusivity, or duration of breastfeeding as the main outcomes. No time restriction was put in place, and all articles were published in English. The quality of selected papers was assessed using the Joanna Briggs Institute tool. A total of 8 articles were included from 6 interventions: 2 quasiexperimental and 4 randomized control trials. All interventions involved breastfeeding education targeting fathers; 2 were given only to fathers, and 4 delivered to both fathers and mothers. Among these interventions, 2 measured both early initiation and exclusive breastfeeding; one exclusive breastfeeding only; one exclusive breastfeeding, knowledge, and attitudes; one exclusive breastfeeding and knowledge; and one breastfeeding, continued breastfeeding, and awareness. Across all interventions, breastfeeding education showed significant improvement in breastfeeding outcomes in the intervention compared with the control groups. In summary, breastfeeding education interventions targeting fathers in LMIC are effective in improving early initiation of breastfeeding, exclusive breastfeeding, and continued breastfeeding. Thus, breastfeeding promotion should consider the education and involvement of fathers in the intervention.
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Affiliation(s)
- Kidane Tadesse
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queesnland, Australia.,School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Oksana Zelenko
- School of Design, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queesnland, Australia
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Mesters I, Gijsbers B, Bartholomew LK. Promoting Sustained Breastfeeding of Infants at Risk for Asthma: Explaining the "Active Ingredients" of an Effective Program Using Intervention Mapping. Front Public Health 2018; 6:87. [PMID: 29616209 PMCID: PMC5869925 DOI: 10.3389/fpubh.2018.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/05/2018] [Indexed: 12/01/2022] Open
Abstract
Infants whose parents and/or siblings have a history of asthma or allergy may profit from receiving exclusive breastfeeding during the first 6 months of life. This is expected to diminish the chance of developing childhood asthma and/or atopic disease. Ongoing breastfeeding for 6 months seems challenging for many women. An educational program was developed using Intervention Mapping as a logic model to guide development and was found successful in improving breastfeeding rates at 6 months postpartum, improving knowledge and beliefs about breastfeeding for 6 months, after exposure to the program compared to controls. Intervention elements included an evidence- and theory-based booklet addressed during pre- and postnatal home visits by trained assistants. This paper elucidates the inner workings of the program by systematically describing and illustrating the steps for intervention development.
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Affiliation(s)
- Ilse Mesters
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Barbara Gijsbers
- Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - L Kay Bartholomew
- Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, United States
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Abbass-Dick J, Xie F, Koroluk J, Alcock Brillinger S, Huizinga J, Newport A, Goodman WM, Dennis CL. The Development and piloting of an eHealth breastfeeding resource targeting fathers and partners as co-parents. Midwifery 2017; 50:139-147. [DOI: 10.1016/j.midw.2017.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/22/2017] [Accepted: 04/16/2017] [Indexed: 12/01/2022]
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Health and social determinants of health in Vietnam: local evidence and international implications. Int J Public Health 2016; 62:1-2. [PMID: 27942742 DOI: 10.1007/s00038-016-0932-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022] Open
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