Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial

Elizabeth W. Kimani-Murage; Judith Kimiywe; Mark Kabue; Frederick Wekesah; Evelyn Matiri; Nelson Muhia; Milka Wanjohi; Peterrock Muriuki; Betty Samburu; James N. Kanyuira; Sera L. Young; Paula L. Griffiths; Nyovani J. Madise; Stephen T. McGarvey

doi:10.1186/s13063-015-0935-3

Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial

Elizabeth W. Kimani-Murage^*, Judith Kimiywe, Mark Kabue, Frederick Wekesah, Evelyn Matiri, Nelson Muhia, Milka Wanjohi, Peterrock Muriuki, Betty Samburu, James N. Kanyuira, Sera L. Young, Paula L. Griffiths, Nyovani J. Madise, Stephen T. McGarvey

^*Corresponding author for this work

Anthropology

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health. Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.

Original language	English (US)
Article number	431
Journal	Trials
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s13063-015-0935-3
State	Published - Sep 28 2015

Funding

This study is funded by the NIH and the USAID through the Partnership for Enhanced Engagement in Research (PEER) Health Program, administered by the National Academy of Sciences (NAS). EWK-M was a Wellcome Trust Fellow during the development of this manuscript, Grant # 097146/Z/11/Z. PG is supported by a British Academy mid-career fellowship (Ref: MD120048). We acknowledge Dr. Catherine Kyobutungi of APHRC, Drs. Muthoni Magu-Kariuki and Linda H Archer of Jhpiego for their contribution to the design of the study. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government’s Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health.

Keywords

Breastfeeding
Child nutrition
Cluster randomized controlled trials
Infant feeding practices
Kenya
Rural
sub-Saharan Africa

ASJC Scopus subject areas

Medicine (miscellaneous)
Pharmacology (medical)

Access to Document

10.1186/s13063-015-0935-3

Cite this

Kimani-Murage, E. W., Kimiywe, J., Kabue, M., Wekesah, F., Matiri, E., Muhia, N., Wanjohi, M., Muriuki, P., Samburu, B., Kanyuira, J. N., Young, S. L., Griffiths, P. L., Madise, N. J., & McGarvey, S. T. (2015). Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial. Trials, 16(1), Article 431. https://doi.org/10.1186/s13063-015-0935-3

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abstract = "Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health. Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.",

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author = "Kimani-Murage, {Elizabeth W.} and Judith Kimiywe and Mark Kabue and Frederick Wekesah and Evelyn Matiri and Nelson Muhia and Milka Wanjohi and Peterrock Muriuki and Betty Samburu and Kanyuira, {James N.} and Young, {Sera L.} and Griffiths, {Paula L.} and Madise, {Nyovani J.} and McGarvey, {Stephen T.}",

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Kimani-Murage, EW, Kimiywe, J, Kabue, M, Wekesah, F, Matiri, E, Muhia, N, Wanjohi, M, Muriuki, P, Samburu, B, Kanyuira, JN, Young, SL, Griffiths, PL, Madise, NJ & McGarvey, ST 2015, 'Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial', Trials, vol. 16, no. 1, 431. https://doi.org/10.1186/s13063-015-0935-3

TY - JOUR

T1 - Feasibility and effectiveness of the baby friendly community initiative in rural Kenya

T2 - Study protocol for a randomized controlled trial

AU - Kimani-Murage, Elizabeth W.

AU - Kimiywe, Judith

AU - Kabue, Mark

AU - Wekesah, Frederick

AU - Matiri, Evelyn

AU - Muhia, Nelson

AU - Wanjohi, Milka

AU - Muriuki, Peterrock

AU - Samburu, Betty

AU - Kanyuira, James N.

AU - Young, Sera L.

AU - Griffiths, Paula L.

AU - Madise, Nyovani J.

AU - McGarvey, Stephen T.

PY - 2015/9/28

Y1 - 2015/9/28

N2 - Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health. Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.

AB - Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health. Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative.

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KW - Child nutrition

KW - Cluster randomized controlled trials

KW - Infant feeding practices

KW - Kenya

KW - Rural

KW - sub-Saharan Africa

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Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: Study protocol for a randomized controlled trial

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