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2. Out-of-pocket costs and time spent attending antenatal care services: a case study of pregnant women in selected rural communities in Zinder, Niger

Author

Ouédraogo, Césaire T, Vosti, Stephen A, Wessells, K Ryan, Arnold, Charles D, Faye, M Thierno, and Hess, Sonja Y

Subjects
Midwifery, Health Sciences, Clinical Research, Reproductive health and childbirth, Good Health and Well Being, Cross-Sectional Studies, Female, Health Expenditures, Humans, Niger, Patient Acceptance of Health Care, Pregnancy, Pregnant Women, Prenatal Care, Rural Population, Out-of-pocket costs, Antenatal care, Opportunity cost of time, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health
Abstract

BackgroundDespite an official policy of exemption from health care costs, pregnant women in Niger still face some out-of-pocket costs (OPC) in addition to time costs when they attend antenatal care (ANC) services. We aimed to: 1) assess the OPC for pregnant woman attending ANC, 2) estimate the time spent to attend ANC and the opportunity cost of that time, and 3) assess how OPC and time spent to attend ANC affected ANC attendance.MethodsData were obtained from a quasi-experimental descriptive study carried out in the region of Zinder, Niger, which compared pre- and post-intervention cohorts of pregnant women (n = 1736 women who reported attending ANC during their current pregnancy). An ANC attendance score was developed to describe the timing of ANC attendance in regard to the WHO recommendation of attending 4 ANC sessions. OPC and time spent were evaluated separately for associations with ANC attendance using Spearman correlations.ResultsThe mean (±SD) age of pregnant women was 25.0 ± 6.4 yr, 19.0% were ≤ 19 yr and 99.7% were in their second or third trimester of gestation at the time of the interview. Among those who were > 13 weeks and > 27 weeks of gestation, 4.0 and 74.4% had attended ANC during their first and second trimesters, respectively. The median (1st quartile (Q1), 3rd quartile (Q3)) ANC score was 0 (- 1, 0), reflecting that the majority of women failed to follow the WHO recommendation. More than half of the women (72.5%) experienced OPC related to ANC. The majority of women (> 80%) reported spending ~ 3 h for an ANC visit, including travel and waiting time. Time spent to attend ANC was not associated with ANC attendance score. Women who experienced OPC, and those who received iron folic acid (IFA) or long-lasting insecticide-treated bednets during an ANC visit, were more likely to have a higher ANC attendance score compared to those who did not.ConclusionOPC and time spent were not identified as barriers to ANC visits, and IFA and long-lasting insecticide-treated bednets distribution could be used to motivate pregnant women to attend ANC.Trial registrationThe NiMaNu project was registered at www.clinicaltrials.gov as NCT01832688 . Registered 16 April 2013.

Published
2021

3. A multicenter analytical performance evaluation of a multiplexed immunoarray for the simultaneous measurement of biomarkers of micronutrient deficiency, inflammation and malarial antigenemia

Author

Brindle, Eleanor, Lillis, Lorraine, Barney, Rebecca, Bansil, Pooja, Hess, Sonja Y, Wessells, K Ryan, Ouédraogo, Césaire T, Arredondo, Francisco, Barker, Mikaela K, Craft, Neal E, Fischer, Christina, Graham, James L, Havel, Peter J, Karakochuk, Crystal D, Zhang, Mindy, Mussai, Ei-Xia, Mapango, Carine, Randolph, Jody M, Wander, Katherine, Pfeiffer, Christine M, Murphy, Eileen, and Boyle, David S

Subjects
Clinical Research, Good Health and Well Being, C-Reactive Protein, Ferritins, Immunoassay, Inflammation, Multicenter Studies as Topic, Proteins, Software, General Science & Technology
Abstract

A lack of comparative data across laboratories is often a barrier to the uptake and adoption of new technologies. Furthermore, data generated by different immunoassay methods may be incomparable due to a lack of harmonization. In this multicenter study, we describe validation experiments conducted in a single lab and cross-lab comparisons of assay results to assess the performance characteristics of the Q-plex™ 7-plex Human Micronutrient Array (7-plex), an immunoassay that simultaneously quantifies seven biomarkers associated with micronutrient (MN) deficiencies, inflammation and malarial antigenemia using plasma or serum; alpha-1-acid glycoprotein, C-reactive protein, ferritin, histidine-rich protein 2, retinol binding protein 4, soluble transferrin receptor, and thyroglobulin. Validations included repeated testing (n = 20 separately prepared experiments on 10 assay plates) in a single lab to assess precision and linearity. Seven independent laboratories tested 76 identical heparin plasma samples collected from a cohort of pregnant women in Niger using the same 7-plex assay to assess differences in results across laboratories. In the analytical validation experiments, intra- and inter-assay coefficients of variation were acceptable at

Published
2021

5. Assessment of Dietary Intake and Nutrient Gaps, and Development of Food-Based Recommendations, among Pregnant and Lactating Women in Zinder, Niger: An Optifood Linear Programming Analysis

Author

Wessells, K Ryan, Young, Rebecca R, Ferguson, Elaine L, Ouédraogo, Césaire T, Faye, M Thierno, and Hess, Sonja Y

Subjects
Public Health, Biomedical and Clinical Sciences, Nutrition and Dietetics, Health Sciences, Nutrition, Complementary and Integrative Health, Prevention, 3.3 Nutrition and chemoprevention, Prevention of disease and conditions, and promotion of well-being, Cardiovascular, Metabolic and endocrine, Diet, Energy Intake, Feeding Behavior, Female, Humans, Lactation, Maternal Nutritional Physiological Phenomena, Micronutrients, Niger, Nutritional Status, Pregnancy, Programming, Linear, Recommended Dietary Allowances, linear programming, food-based recommendations, Optifood, micronutrient, deficiency, dietary intake, pregnant, lactation, women, Food Sciences, Clinical sciences, Nutrition and dietetics, Public health
Abstract

Pregnant and lactating women in rural Niger are at high risk for inadequate intakes of multiple micronutrients. Thus, 24 h dietary recalls were conducted and analyzed for dietary intakes in this population (n = 202). Using linear programming analyses, micronutrient gaps in women's diets were identified, food-based recommendations (FBR) to improve dietary micronutrient adequacy were developed, and various supplementation strategies were modelled. Energy intakes were below estimated requirements, and, for most micronutrients, >50% of women were at risk of inadequate intakes. Linear programming analyses indicated it would be difficult to select a diet that achieved recommended dietary allowances for all but three (vitamin B₆, iron and zinc) of 11 modeled micronutrients. Consumption of one additional meal per day, and adherence to the selected FBR (daily consumption of dark green leafy vegetables, fermented milk, millet, pulses, and vitamin A fortified oil), would result in a low percentage of women at risk of inadequate intakes for eight modeled micronutrients (vitamin A, riboflavin, thiamin, B6, folate, iron, zinc, and calcium). Because the promotion of realistic FBRs likely will not ensure that a low percentage of women are at risk of inadequate intakes for all modeled micronutrients, multiple micronutrient supplementation or provision of nutrient-dense foods should be prioritized.

Published
2019

6. The relationship between energy provided and growth during severe wasting treatment.

Author

Potani, Isabel, Tausanovitch, Zachary, Ritz, Christian, Briend, André, Coulibaly, Issa Niamanto, Ouédraogo, Césaire T., Manda, Geoffrey, and Kangas, Suvi T.

Subjects
MALNUTRITION treatment, ARM circumference, FOOD consumption, WASTING syndrome, RESEARCH funding, MALNUTRITION, INFANT development, HUMAN growth, CHILD nutrition, DESCRIPTIVE statistics, ELEMENTAL diet, NUTRITIONAL status, RESEARCH, CHILD development, CONFIDENCE intervals, REGRESSION analysis, WEIGHT gain, CHILDREN
Abstract

Treatment of severe acute malnutrition aims at producing quick catch‐up growth in children to decrease their short‐term mortality risk. The extent to which catch‐up growth is influenced by the amount of energy provided is unclear. This study assessed whether energy provided at admission is associated with catch‐up ponderal growth among children with mid‐upper arm circumference (MUAC) < 115 mm at admission. We conducted a secondary data analysis an operational cohort in Mali. The children were treated with a simplified protocol providing 1000 kcal/day of therapeutic food until MUAC ≥ 115 mm was achieved for two consecutive weeks and 500 kcal/day thereafter until discharge with MUAC ≥ 125 mm for two consecutive weeks. Linear mixed‐effects regression models were fitted to assess the relationship between energy provided at admission (kcal/kg/day) with weight gain velocity (g/kg/day) (primary outcome), change in MUAC ‐for‐age z‐score and change in weight‐for‐age z‐score. Unadjusted models and models adjusted for sex, age, seasonality and MUAC at admission were fitted. Both models included the study site as a random effect. A 10 kcal/kg/day increase in energy provided at admission was associated with increments in all outcomes; for weight gain velocity, the mean (95% CI) increment was 0.340 [0.326, 0.354] g/kg/day and 0.466 [0.446, 0.485] g/kg/day in the unadjusted and adjusted analysis, respectively. A positive relationship exists between energy provided at admission and catch‐up ponderal growth in children with MUAC < 115 mm treated using a simplified protocol. Determining the ideal weight gain rate remains essential for assessing the benefits and risks of increased energy intake during treatment. Key messages: Among children diagnosed with severe wasting (MUAC < 115 mm), higher provisions of energy at admission (kcal/kg/day) are associated with a higher rate of weight gain, higher changes in weight‐for‐age and MUAC‐for‐age z‐scores.Children treated for severe wasting (MUAC < 115 mm) receiving Ready‐to‐use therapeutic foods (RUTFs) at a dose higher at admission than the WHO 2023 recommendation of 150–185 kcal/kg/day experience higher rates of weight gain and higher changes in weight‐for‐age and MUAC‐for‐age z‐scores.The optimal rate of weight gain in children treated for severe wasting (MUAC < 115 mm) using RUTF remains unknown. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS)

Author

Hess, Sonja Y, Peerson, Janet M, Becquey, Elodie, Abbeddou, Souheila, Ouédraogo, Césaire T, Somé, Jérôme W, Jimenez, Elizabeth Yakes, Ouédraogo, Jean-Bosco, Vosti, Stephen A, Rouamba, Noël, and Brown, Kenneth H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Nutrition, Clinical Research, Good Health and Well Being, Age Factors, Burkina Faso, Child, Preschool, Dietary Supplements, Female, Growth and Development, Health, Humans, Lipids, Male, Residence Characteristics, Zinc, General Science & Technology
Abstract

BackgroundOf two community-based trials among young children in neighboring health districts of Burkina Faso, one found that small-quantity lipid-based nutrient supplements (LNS) increased child growth compared with a non-intervention control group, but zinc supplementation did not in the second study.ObjectivesWe explored whether the disparate growth outcomes were associated with differences in intervention components, household demographic variables, and/or children's morbidity.MethodsChildren in the LNS study received 20g LNS daily containing different amounts of zinc (LNS). Children in the zinc supplementation study received different zinc supplementation regimens (Z-Suppl). Children in both studies were visited weekly for morbidity surveillance. Free malaria and diarrhea treatment was provided by the field worker in the LNS study, and by a village-based community-health worker in the zinc study. Anthropometric assessments were repeated every 13-16 weeks. For the present analyses, study intervals of the two studies were matched by child age and month of enrollment. The changes in length-for-age z-score (LAZ) per interval were compared between LNS and Z-Suppl groups using mixed model ANOVA or ANCOVA. Covariates were added to the model in blocks, and adjusted differences between group means were estimated.ResultsMean ages at enrollment of LNS (n = 1716) and Z-Suppl (n = 1720) were 9.4±0.4 and 10.1±2.7 months, respectively. The age-adjusted change in mean LAZ per interval declined less with LNS (-0.07±0.44) versus Z-Suppl (-0.21±0.43; p

Published
2017

8. Micronutrient Status among Pregnant Women in Zinder, Niger and Risk Factors Associated with Deficiency

Author

Wessells, K Ryan, Ouédraogo, Césaire T, Young, Rebecca R, Faye, M Thierno, Brito, Alex, and Hess, Sonja Y

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Health Sciences, Prevention, Nutrition, Hematology, Clinical Research, Reproductive health and childbirth, Good Health and Well Being, Adult, Female, Humans, Maternal Nutritional Physiological Phenomena, Micronutrients, Niger, Nutritional Status, Pregnancy, Pregnancy Outcome, Risk Factors, Rural Population, micronutrient, deficiency, anemia, pregnancy, antenatal care, iron, zinc, vitamin, Food Sciences, Clinical sciences, Nutrition and dietetics, Public health
Abstract

Anemia and micronutrient (MN) deficiencies in pregnant women are associated with adverse pregnancy outcomes. In Niger, 58.6% of pregnant women are anemic; however, MN statuses are unknown. The study objectives were to estimate the prevalence of MN deficiencies among pregnant women in Zinder, Niger and explore associated risk factors. Pregnant women living in randomly selected rural villages (n = 88) were included. Capillary and venous blood samples (n = 770) were analyzed for hemoglobin (Hb) and plasma ferritin, soluble transferrin receptor (sTfR), zinc (pZn), retinol binding protein (RBP), folate and vitamin B12. C-reactive protein and alpha-1-acid glycoprotein were measured to adjust for inflammation. The prevalence of MN deficiencies in pregnant woman was high, indicative of a severe public health problem. Prevalence of iron deficiency was 20.7% and 35.7%, by ferritin (8.3 mg/L), respectively. In total, 40.7% of women had low pZn (

Published
2017

9. Nutritional treatment of children 6–59 months with severely low weight-for-age z-score:a study protocol for a 3-arm randomized controlled trial

Author

Kangas, Suvi T., Ouédraogo, Césaire T., Tounkara, Moctar, Ouoluoguem, Bareye, Coulibaly, Issa Niamanto, Haidara, Alhousseyni, Diarra, Niele Hawa, Diassana, Koniba, Tausanovitch, Zachary, Ritz, Christian, Wells, Jonathan C., Briend, André, Myatt, Mark, Radin, Elizabeth, Bailey, Jeanette, Kangas, Suvi T., Ouédraogo, Césaire T., Tounkara, Moctar, Ouoluoguem, Bareye, Coulibaly, Issa Niamanto, Haidara, Alhousseyni, Diarra, Niele Hawa, Diassana, Koniba, Tausanovitch, Zachary, Ritz, Christian, Wells, Jonathan C., Briend, André, Myatt, Mark, Radin, Elizabeth, and Bailey, Jeanette

Abstract

Background: Admission criteria that treat children with low mid-upper-arm circumference (MUAC), and low weight-for-height z-score (WHZ) are not aligned with the evidence on which children are at risk of mortality. An analysis of community-based cohort data from Senegal found that a combination of weight-for-age (WAZ) and MUAC criteria identified all children at risk of near-term death associated with severe anthropometric deficits. This study will address whether children with WAZ <−3 but MUAC ≥125 mm benefit from therapeutic feeding with ready-to-use therapeutic foods (RUTF) and whether a simplified protocol is non-inferior to the weight-based standard protocol. Methods: This is a prospective individually randomized controlled 3-arm trial conducted in the Nara health district in Mali. Children aged 6–59 months presenting with MUAC ≥125 mm and WAZ <−3 will be randomized to (1) control group receiving no treatment, (2) simplified treatment receiving 1 sachet of RUTF daily until WAZ ≥−3 for 2 visits, (3) standard treatment receiving RUTF according to WHZ category: (a) WHZ <−3 receive 200 kcal/kg/day until WHZ ≥−2 for 2 visits, (b) WHZ ≥−3 but <−2 receive 1 sachet daily until WHZ ≥−2 for 2 visits or (c) WHZ ≥−2 receive no treatment. All children will be followed up first fortnightly for 12 weeks and then monthly until 6 months post-enrolment. The primary endpoint will be measured at 2 months with the primary outcome being WAZ as a continuous measure. Other outcomes include other anthropometric measurements and a secondary endpoint will be observed at 6 months. A total of 1397 children will be recruited including 209 in the control and 594 in both the simplified and standard arms. The sample size should enable us to conclude on the superiority of the simplified treatment compared to no treatment and on the non-inferiority of the simplified treatment versus standard treatment with a margin of non-inferiority of 0.2 WAZ. Discussion: This trial aims to gener

Published
2024

10. A Comparative Analysis of Maternal Nutrition Decision-Making Autonomy During Pregnancy—An Application of the Food Choice Process Model in Burkina Faso and Madagascar

Author

Ngoutane, Raphia M., primary, Murray-Kolb, Laura E., additional, Zoma, Ramakwende, additional, Ouédraogo, Césaire T., additional, van Zutphen, Kesso Gabrielle, additional, Bruning, Rachel, additional, Razakandrainy, Andry, additional, Ransom, Elizabeth, additional, Dalmiya, Nita, additional, Kraemer, Klaus, additional, and Kodish, Stephen R., additional

Published
2023
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11. A Comparative Analysis of Maternal Nutrition Decision-Making Autonomy During Pregnancy—An Application of the Food Choice Process Model in Burkina Faso and Madagascar.

Author

Ngoutane, Raphia M., Murray-Kolb, Laura E., Zoma, Ramakwende, Ouédraogo, Césaire T., van Zutphen, Kesso Gabrielle, Bruning, Rachel, Razakandrainy, Andry, Ransom, Elizabeth, Dalmiya, Nita, Kraemer, Klaus, and Kodish, Stephen R.

Abstract

Background: Adequate nutrition has been cited as one of the most critical components for optimal health outcomes during pregnancy. Women in Burkina Faso and Madagascar experience high rates of undernutrition due to lack of knowledge, finances, cultural norms, and autonomy. Therefore, this study aimed (1) to describe typical maternal diets during pregnancy in Burkina Faso and Madagascar, (2) to understand the multilevel factors that influence women's nutrition decision-making, and (3) to explore the extent to which women have nutrition decision-making autonomy during pregnancy. Methods: This study was conducted between October 2020 and February 2021 in Burkina Faso and Madagascar. Semi-structured interviews, focus group interviews, and free lists were conducted among women of reproductive age and pregnant and lactating women. Textual data from interviews were recorded and translated verbatim from local languages into French. The Food Choice Process Model guided textual content analysis using Dedoose software. Free list data were analyzed using cultural domain analysis approaches. Results: In Burkina Faso and Madagascar, women primarily consumed staple foods such as rice and tô during pregnancy. Participants cited eating fruits and vegetables when available, while the animal source foods were rarely consumed. Across both contexts, nutrition during pregnancy was influenced by factors that impact food choices, such as social factors, resources, ideals, and personal factors. While women and men in Madagascar had more shared decision-making on critical domains such as finances, men were the primary decision-makers in most areas of inquiry (eg, finances) in Burkina Faso. Conclusions: The lack of adequate diverse diet consumed during pregnancy is primarily due to important factors including social factors and resources. Understanding the ability for women to consume optimal diets during pregnancy is needed to target behavioral change in maternal nutrition programming. Plain language title: A comparison of How Pregnant Women Make Decisions About What to Eat in Burkina Faso and Madagascar Using a Model Called the Food Choice Process Model Plain language summary: Having a proper diet is very important for the health of pregnant women. In Burkina Faso and Madagascar, many women do not get enough nutritious food due to lack of knowledge on what to eat, lack of money, cultural traditions, and not having control over their own choices. This study wants to find out (1) what women eat during pregnancy in Burkina Faso and Madagascar, (2) what influences the decisions women make about what to eat during pregnancy, and (3) explore how women had decision-making autonomy during pregnancy. The study took place in Burkina Faso and Madagascar. The researchers talked to women who could have babies and women who were already pregnant or breastfeeding. They used different methods like focus group discussions and semi-structured interviews to gather information. They recorded and translated everything that was said from the local languages to French. They used special software to analyze the information from the interviews. They also used a free list to understand the things women mentioned most often when talking about food. In Burkina Faso and Madagascar, women mostly ate basic foods like rice and tô during pregnancy. Sometimes they ate fruits and vegetables when they were available, but they did not eat much meat or other foods from animals. In both places, the women's food choices during pregnancy were influenced by different things like what their friends and family thought, how much money they had, their personal preferences, and other factors. In Madagascar, men and women made decisions together about important things like money, but in Burkina Faso, men were usually the ones making the decisions. The lack of a proper diverse diet during pregnancy in Burkina Faso and Madagascar is primarily caused by social factors and resources. To help women make better food choices during pregnancy, it's important to understand what affects their ability to have a healthy diet. This can help programs that aim to improve the nutrition of pregnant women by encouraging them to change their behavior. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Post-Recovery Relapse of Children Treated with a Simplified, Combined Nutrition Treatment Protocol in Mali: A Prospective Cohort Study

Author

Kangas, Suvi T., primary, Coulibaly, Issa Niamanto, additional, Tausanovitch, Zachary, additional, Ouologuem, Bareye, additional, Marron, Bethany, additional, Radin, Elizabeth, additional, Ritz, Christian, additional, Dembele, Salimou, additional, Ouédraogo, Césaire T., additional, and Bailey, Jeanette, additional

Published
2023
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13. Simplified treatment of children 6-59 months with severely low weight-for-age z-score: a study protocol for a 3-arm randomized controlled trial

Author

Kangas, Suvi T., primary, Ouédraogo, Césaire T, additional, Tounkara, Moctar, additional, Ouoluoguem, Bareye, additional, Coulibaly, Issa Niamanto, additional, Haidara, Alhousseyni, additional, Diarra, Niele Hawa, additional, Diassana, Koniba, additional, Tausanovitch, Zachary, additional, Ritz, Christian, additional, Wells, Jonathan C, additional, Briend, André, additional, Myatt, Mark, additional, Radin, Elizabeth, additional, and Bailey, Jeanette, additional

Published
2023
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16. Intensified nutrition interventions in antenatal care services increased consumption of iron and folic acid supplements and early breastfeeding practices in Burkina Faso: Results of a cluster-randomized program evaluation

Author

Kim, Sunny S.; Zagré, Rock R.; Ouédraogo, Césaire T.; Sununtnasuk, Celeste; Ganaba, Rasmané; Zafimanjaka, Maurice G.; Tharaney, Manisha; Sanghvi, Tina; Menon, Purnima, http://orcid.org/0000-0003-3960-3354 Kim, Sunny; https://orcid.org/0000-0003-4125-6566 Zagre, Rock; http://orcid.org/0000-0002-2332-7386 Sununtnasuk, Celeste; http://orcid.org/0000-0001-5988-2894 Menon, Purnima, Kim, Sunny S.; Zagré, Rock R.; Ouédraogo, Césaire T.; Sununtnasuk, Celeste; Ganaba, Rasmané; Zafimanjaka, Maurice G.; Tharaney, Manisha; Sanghvi, Tina; Menon, Purnima, and http://orcid.org/0000-0003-3960-3354 Kim, Sunny; https://orcid.org/0000-0003-4125-6566 Zagre, Rock; http://orcid.org/0000-0002-2332-7386 Sununtnasuk, Celeste; http://orcid.org/0000-0001-5988-2894 Menon, Purnima

Abstract

PR, IFPRI3; ISI; DCA; CRP4; 2 Promoting Healthy Diets and Nutrition for all; IFPRIOA; Alive and Thrive, Nutrition, Diets, and Health (NDH); Food and Nutrition Policy; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Background: Alive & Thrive supported the Government of Burkina Faso to strengthen the provision of iron-folic acid (IFA) supplementation and interpersonal counseling on maternal nutrition and breastfeeding through antenatal care (ANC) services and community-based contacts in two regions. Objectives: We assessed the impacts of intensified nutrition interventions during ANC compared with standard ANC services on intervention coverage and maternal nutrition practices. Methods: A cluster-randomized evaluation compared 40 health center catchment areas in intervention areas to 40 in control areas. Repeated cross-sectional surveys in 2019 and 2021 (960 pregnant women and 1920 women with children 0-5 months of age per survey round) provided data on impact indicators, intervention exposure and other factors. We derived difference-in-difference effect estimates (DID), adjusted for geographical clustering, for maternal dietary diversity, IFA consumption, and early breastfeeding practices. Results: More women in intervention areas had 4+ ANC visits (DID: 8.3 percentage points [pp]) and started ANC during the first trimester (DID: 10.5 pp), compared to control areas. Improvements were achieved in exposure to nutrition counseling on dietary diversity (DID: 44.4 pp), food quantity (DID: 42.9 pp), adequate weight gain (DID: 35.1 pp), and breastfeeding (DID: 25.9 pp). Women in intervention areas consumed more IFA supplements during pregnancy (DID: 21 tablets). Early initiation of and exclusive breastfeeding also improved (DID: 17.0 pp and 8.3 pp, respectively). However, dietary diversity (4 out of 10 food groups) and mean probability of adequacy of micronutrient intake (14%) among pregnant women remained low in both areas. Conclusions: Strengthening maternal nutrition interventions delivered through government ANC services was feasible and effective in improving maternal nutrition practices. Continued efforts to strengthen the delivery and use of maternal nutrition services may be r

Published
2023

17. Effectiveness of Acute Malnutrition Treatment at Health Center and Community Levels with a Simplified, Combined Protocol in Mali: An Observational Cohort Study

Author

Kangas, Suvi T., primary, Marron, Bethany, additional, Tausanovitch, Zachary, additional, Radin, Elizabeth, additional, Andrianarisoa, Josiane, additional, Dembele, Salimou, additional, Ouédraogo, Césaire T., additional, Coulibaly, Issa Niamanto, additional, Biotteau, Marie, additional, Ouologuem, Bareye, additional, Daou, Soumaila, additional, Traoré, Fatoumata, additional, Traoré, Issiaka, additional, Nene, Marc, additional, and Bailey, Jeanette, additional

Published
2022
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19. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Nurse-Midwife

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventions into the gover

Published
2022

20. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Health Facility

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing antenatal care (ANC) services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventio

Published
2022

21. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Antenatal Care (ANC) Observation

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventions into the gover

Published
2022

22. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Households - Recently Delivered Women

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventions into the gover

Published
2022

23. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Agent de santé Communautaire (ASBC)

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing antenatal care (ANC) services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventio

Published
2022

24. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Households - Husbands

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventions into the gover

Published
2022

25. A&T Burkina Faso Maternal Nutrition Baseline Survey 2019: Households - Pregnant Women

Author

Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, International Food Policy Research Institute (IFPRI), Addis Continental Institute of Public Health (ACIPH); Kim, Sunny S.; Ouédraogo, Césaire T; Zagré, Rock; Sununtnasuk, Celeste; Ganaba, Rasmané; FHI Solutions, and International Food Policy Research Institute (IFPRI)

Abstract

2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive; IFPRI1; Open Access, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Burkina Faso, A&T developed and tested an intensive package of maternal nutrition interventions to be integrated into existing ANC services delivered through government health facilities. These included intensified counseling and support on dietary diversity and quality during pregnancy, iron-folic acid (IFA) supplements consumption, importance of ANC and increasing the number of visits, adequate weight-gain monitoring, and early initiation of and exclusive breastfeeding. This dataset is part of a survey that was conducted to gather baseline data for the impact evaluation of the interventions. The overall study objective was to evaluate the feasibility of integrating locally relevant maternal nutrition interventions into ANC services provided by the government health system and their impact on diet quality and quantity and utilization of nutrition interventions during pregnancy. Research questions include: 1) What are the program impacts on maternal nutrition practices: (1) consumption of diversified foods and adequate intake of micronutrient, protein and energy compared to recommended intakes; (2) consumption of IFA supplements during pregnancy; and (3) early breastfeeding practices? 2) Can the coverage and utilization of key nutrition interventions (maternal nutrition counseling, weight gain monitoring, distribution of and counseling on IFA supplementation, and breastfeeding counseling) and number of ANC contacts be improved through health system strengthening and nutrition-focused social and behavior change communication (SBCC; interpersonal communication and community mobilization) approaches? 3) What factors influenced integration and strengthening of maternal nutrition interventions into the gover

Published
2022

26. Multiple modifiable maternal, household and health service factors are associated with maternal nutrition and early breastfeeding practices in Burkina Faso

Author

Kim, Sunny S.; Ouédraogo, Césaire T.; Zagré, Rock; Ganaba, Rasmané; Zafimanjaka, Maurice G.; Tharaney, Manisha; Menon, Purnima, http://orcid.org/0000-0003-3960-3354 Kim, Sunny; https://orcid.org/0000-0003-4125-6566 Zagre, Rock; http://orcid.org/0000-0001-5988-2894 Menon, Purnima, Kim, Sunny S.; Ouédraogo, Césaire T.; Zagré, Rock; Ganaba, Rasmané; Zafimanjaka, Maurice G.; Tharaney, Manisha; Menon, Purnima, and http://orcid.org/0000-0003-3960-3354 Kim, Sunny; https://orcid.org/0000-0003-4125-6566 Zagre, Rock; http://orcid.org/0000-0001-5988-2894 Menon, Purnima

Abstract

PR, IFPRI3; ISI; DCA; CRP4; 2 Promoting Healthy Diets and Nutrition for all; Alive and Thrive, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Low coverage of effective nutrition interventions in many high-burden countries, due to service provision and demand factors, result in poor uptake of recommended practices and nutrition outcomes. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. We used household survey data among pregnant (n = 920) and recently delivered women (n = 1840). Multivariable regression analyses were conducted to identify the determinants of a diverse diet and iron-folic acid (IFA) supplement consumption, weight monitoring during pregnancy and early initiation of breastfeeding (EIBF). Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal conditions of interventions that address the modifiable determinants. During pregnancy, 21% of women achieved minimum diet diversity (MDD-W), 70% consumed 90+ IFA tablets and 65% were weighed 4+ times; EIBF was 40%. Nutrition knowledge was associated with MDD-W (odds ratio [OR]: 3.2), 90+ IFA (OR: 1.5) and EIBF (OR: 1.9). Positive social norms and family support were associated with 90+ IFA (OR: 1.5). Early and 4+ ANC visits were associated with 90+ IFA (OR: 1.5 and 10) and 4+ weight monitoring (OR: 6.2). Nutrition counselling was associated with 90+ IFA (OR: 2.5) and EIBF (OR: 1.5). Under optimal programme conditions, 41% of women would achieve MDD-W, 93% would consume 90+ IFA, 93% would be weighed 4+ times and 57% would practice EIBF. Strengthening the delivery and uptake of interventions targeted at these modifiable factors has the potential to improve maternal nutrition practices.

Published
2022

27. Multiple modifiable maternal, household and health service factors are associated with maternal nutrition and early breastfeeding practices in Burkina Faso.

Author

Kim, Sunny S., Ouédraogo, Césaire T., Zagré, Rock R., Ganaba, Rasmané, Zafimanjaka, Maurice G., Tharaney, Manisha, and Menon, Purnima

Subjects
*MOTHERS, *REGULATION of body weight, *TIME, *MULTIPLE regression analysis, *IRON, *SOCIAL norms, *PREGNANT women, *IRON in the body, *NUTRITION counseling, *DIETARY supplements, *BREASTFEEDING, *DESCRIPTIVE statistics, *RESEARCH funding, *FOLIC acid, *ODDS ratio, *NUTRITIONAL status, *PREGNANCY
Abstract

Low coverage of effective nutrition interventions in many high‐burden countries, due to service provision and demand factors, result in poor uptake of recommended practices and nutrition outcomes. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. We used household survey data among pregnant (n = 920) and recently delivered women (n = 1840). Multivariable regression analyses were conducted to identify the determinants of a diverse diet and iron‐folic acid (IFA) supplement consumption, weight monitoring during pregnancy and early initiation of breastfeeding (EIBF). Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal conditions of interventions that address the modifiable determinants. During pregnancy, 21% of women achieved minimum diet diversity (MDD‐W), 70% consumed 90+ IFA tablets and 65% were weighed 4+ times; EIBF was 40%. Nutrition knowledge was associated with MDD‐W (odds ratio [OR]: 3.2), 90+ IFA (OR: 1.5) and EIBF (OR: 1.9). Positive social norms and family support were associated with 90+ IFA (OR: 1.5). Early and 4+ ANC visits were associated with 90+ IFA (OR: 1.5 and 10) and 4+ weight monitoring (OR: 6.2). Nutrition counselling was associated with 90+ IFA (OR: 2.5) and EIBF (OR: 1.5). Under optimal programme conditions, 41% of women would achieve MDD‐W, 93% would consume 90+ IFA, 93% would be weighed 4+ times and 57% would practice EIBF. Strengthening the delivery and uptake of interventions targeted at these modifiable factors has the potential to improve maternal nutrition practices. Key messages: In our Burkina Faso study, maternal nutrition practices were low to moderate, with 21% of pregnant women consuming at least 5 food groups, 70% of women consuming at least 90 daily iron and folic acid (IFA) tablets and 65% weighed at least 4 times during their last pregnancy, and 40% of women initiating breastfeeding within 1 h after birth.Various individual, household and health service level factors were modifiable through interventions for improving maternal nutrition and breastfeeding practices, but practices were associated with different combinations of factors.Under optimal conditions of interventions that address the modifiable determinants, we estimated that nearly all women would be able to achieve consumption of 90+ IFA tablets and receipt of weight monitoring 4+ times, and nearly half or more of the women would be able to achieve minimum dietary diversity and early initiation of breastfeeding. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Missed opportunities for maternal nutrition interventions during antenatal care visits persist in Burkina Faso

Author

Ouédraogo, Césaire T.; Kim, Sunny S.; Zagre, Rock; Ganaba, Rasmané; Zafimanjaka, Maurice; Sawadogo, Ramatou; Combassere, Roland; Menon, Purmina, http://orcid.org/0000-0003-3960-3354 Kim, Sunny; http://orcid.org/0000-0001-5988-2894 Menon, Purnima, Ouédraogo, Césaire T.; Kim, Sunny S.; Zagre, Rock; Ganaba, Rasmané; Zafimanjaka, Maurice; Sawadogo, Ramatou; Combassere, Roland; Menon, Purmina, and http://orcid.org/0000-0003-3960-3354 Kim, Sunny; http://orcid.org/0000-0001-5988-2894 Menon, Purnima

Abstract

Non-PR, IFPRI5; CRP4; Alive and Thrive, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), High coverage of any antenatal care (ANC) and near-universal coverage of iron-folic acid (IFA) supplementation is reported by nationally representative surveys in Burkina Faso. We examined the coverage of maternal nutrition interventions during ANC to assess gaps and missed opportunities in achieving global and national recommendations.

Published
2020

31. Urinary iodine concentration identifies pregnant women as iodine deficient yet school-aged children as iodine sufficient in rural Niger.

Author

Hess, Sonja Y, Ouédraogo, Césaire T, Young, Rebecca R, Bamba, Ibrahim F, Stinca, Sara, Zimmermann, Michael B, Wessells, K Ryan, and Ouédraogo, Césaire T

Subjects
*NUTRITION in pregnancy, *URINALYSIS, *IODINE deficiency, *CHILD nutrition, *PUBLIC health
Abstract

ObjectiveTo assess iodine status among pregnant women in rural Zinder, Niger and to compare their status with the iodine status of school-aged children from the same households.DesignSeventy-three villages in the catchment area of sixteen health centres were randomly selected to participate in the cross-sectional survey.SettingSalt iodization is mandatory in Niger, requiring 20–60 ppm iodine at the retail level.SubjectsA spot urine sample was collected from randomly selected pregnant women (n 662) and one school-aged child from the same household (n 373). Urinary iodine concentration (UIC) was assessed as an indicator of iodine status in both groups. Dried blood spots (DBS) were collected from venous blood samples of pregnant women and thyroglobulin (Tg), thyroid-stimulating hormone and total thyroxine were measured. Iodine content of household salt samples (n 108) was assessed by titration.ResultsMedian iodine content of salt samples was 5·5 ppm (range 0–41 ppm), 98 % had an iodine content <20 ppm. Median (interquartile range) UIC of pregnant women and school-aged children was 69·0 (38·1–114·3) and 100·9 (61·2–163·2) µg/l, respectively. Although nearly all pregnant women were euthyroid, their median (interquartile range) DBS-Tg was 34·6 (23·9–49·7) µg/l and 38·4 % had DBS-Tg>40 µg/l.ConclusionsIn this region of Niger, most salt is inadequately iodized. UIC in pregnant women indicated iodine deficiency, whereas UIC of school-aged children indicated marginally adequate iodine status. Thus, estimating population iodine status based solely on monitoring of UIC among school-aged children may underestimate the risk of iodine deficiency in pregnant women. [ABSTRACT FROM PUBLISHER]

Published
2017
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32. Simultaneous assessment of iodine, iron, vitamin A, malarial antigenemia, and inflammation status biomarkers via a multiplex immunoassay method on a population of pregnant women from Niger

Author

Brindle, Eleanor, primary, Lillis, Lorraine, additional, Barney, Rebecca, additional, Hess, Sonja Y., additional, Wessells, K. Ryan, additional, Ouédraogo, Césaire T., additional, Stinca, Sara, additional, Kalnoky, Michael, additional, Peck, Roger, additional, Tyler, Abby, additional, Lyman, Christopher, additional, and Boyle, David S., additional

Published
2017
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34. Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS)

Author

Hess, Sonja Y.; Peerson, Janet M.; Becquey, Elodie; Abbeddou, Souheila; Ouédraogo, Césaire T.; Somé, Jérôme W.; Yakes Jimenez, Elizabeth; Ouédraogo, Jean-Bosco; Vosti, Stephen A.; Rouamba, Noël; Brown, Kenneth H., http://orcid.org/0000-0002-8748-7637 Becquey, Elodie, Hess, Sonja Y.; Peerson, Janet M.; Becquey, Elodie; Abbeddou, Souheila; Ouédraogo, Césaire T.; Somé, Jérôme W.; Yakes Jimenez, Elizabeth; Ouédraogo, Jean-Bosco; Vosti, Stephen A.; Rouamba, Noël; Brown, Kenneth H., and http://orcid.org/0000-0002-8748-7637 Becquey, Elodie

Abstract

PR, IFPRI3; ISI; DCA; CRP4; B Promoting healthy food systems, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Published
2017

35. Factors affecting the validity of coverage survey reports of receipt of Vitamin A supplements during child health days in southwestern Burkina Faso

Author

Ouédraogo, Césaire T; Becquey, Elodie; Wilson, Shelby E; Prince, Lea; Ouédraogo, Amadou; Rouamba, Noël; Ouédraogo, Jean-Bosco; Vosti, Stephen A; Brown, Kenneth H; Hess, Sonja Y, http://orcid.org/0000-0002-8748-7637 Becquey, Elodie, Ouédraogo, Césaire T; Becquey, Elodie; Wilson, Shelby E; Prince, Lea; Ouédraogo, Amadou; Rouamba, Noël; Ouédraogo, Jean-Bosco; Vosti, Stephen A; Brown, Kenneth H; Hess, Sonja Y, and http://orcid.org/0000-0002-8748-7637 Becquey, Elodie

Abstract

PR, IFPRI3; ISI; B Promoting Healthy Food Systems, PHND

Published
2016

37. Factors Affecting the Validity of Coverage Survey Reports of Receipt of Vitamin A Supplements During Child Health Days in Southwestern Burkina Faso

Author

Ouédraogo, Césaire T., primary, Becquey, Elodie, additional, Wilson, Shelby E., additional, Prince, Lea, additional, Ouédraogo, Amadou, additional, Rouamba, Noël, additional, Ouédraogo, Jean-Bosco, additional, Vosti, Stephen A., additional, Brown, Kenneth H., additional, and Hess, Sonja Y., additional

Published
2016
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38. Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger.

Author

Hess, Sonja Y., Wessells, K. Ryan, Ouédraogo, Césaire T., Bamba, Ibrahim F., Faye, Thierno, Keith, Nancy, Ndiaye, Banda, Doudou, Maimouna, and Nielsen, Jennifer

Subjects
FOCUS groups, FOLIC acid, INTERVIEWING, IRON, PRENATAL care
Abstract

Abstract: In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in‐home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder. ANC consultations (n = 33) were observed in 5 randomly selected health centres, and exit interviews were conducted with all pregnant women and seven health agents following these observations. During workshops with stakeholders, results of the formative research were interpreted, and programmatic interventions were developed. In home interviews, 72% of women reported having attended at least one ANC visit. They also reported husbands (71%), mothers (40%), and friends (33%) supporting ANC attendance. Among those having attended ANC, only 65% reported taking IFA the day prior to the interview. Three of five health centres visited had IFA in stock. Health staff did not provide IFA supplements during 18 of 33 observed ANC consultations of which only 7 cases could be explained by the lack of IFA supplements in stock. Findings were used to design a 3‐pronged intervention: (a) behaviour change communication activities in communities; (b) quality improvement activities in health centres to strengthen ANC; and (c) provision of key supplies required for ANC. [ABSTRACT FROM AUTHOR]

Published
2018
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40. Prevalence and determinants of gestational weight gain among pregnant women in Niger.

Author

Ouédraogo, Césaire T., Wessells, K. Ryan, Young, Rebecca R., Faye, M. Thierno, and Hess, Sonja Y.

Subjects
*MALNUTRITION, *ANTHROPOMETRY, *C-reactive protein, *COMMUNITY health services, *COMPARATIVE studies, *CONFIDENCE intervals, *GLYCOPROTEINS, *HEALTH service areas, *HEMOGLOBINS, *INTEGRATED health care delivery, *INTERVIEWING, *RESEARCH methodology, *MEDICAL protocols, *MOTHERS, *NUTRITIONAL assessment, *NUTRITIONAL requirements, *PREGNANT women, *WEIGHT gain in pregnancy, *PRENATAL care, *RESEARCH funding, *RURAL health, *STATISTICAL sampling, *MICRONUTRIENTS, *LOGISTIC regression analysis, *PRE-tests & post-tests, *DISEASE prevalence, *ARM circumference, *DATA analysis software, *HEALTH & social status, *DESCRIPTIVE statistics, *MIDDLE-income countries, *LOW-income countries, *NUTRITIONAL status, *ODDS ratio
Abstract

Low gestational weight gain (GWG) and low mid‐upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community‐based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in‐home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH‐21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH‐21st centile, respectively; 24.9% had low MUAC. Higher α‐1‐acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C‐reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socio‐economic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG. [ABSTRACT FROM AUTHOR]

Published
2020
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