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

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 government ANC service delivery platform? The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys at baseline and endline. The unit of randomization was the health and social promotion center (CSPS, Centre de Santé et de Promotion Social in French) catchment area. The baseline survey was conducted in November-December 2019 by Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), the in-country research collaborator for the survey. The baseline survey included the following: 1) Pregnant women questionnaire, 2) Recently delivered women questionnaire, 3) Husbands of recently delivered women questionnaire, 4), Nurse-midwife questionnaire, 5) Community health agents (agent de santé communautaire, ASBCs) questionnaire, 6) Health facility observation checklist, and 7) ANC observation and exit interview. The recently delivered women interviews were conducted using pretested, structured questionnaires. Information was collected on household composition, household socioeconomic status, obstetric history, use of ANC, exposure to ANC, maternal nutrition and breastfeeding knowledge and practices, pregnancy and postnatal care, household food security, social desirability, decision-making power, mental health, and anthropometry.

生存与繁荣（Alive & Thrive，简称A&T）是一项致力于规模化推广营养干预措施的倡议，旨在通过改善孕产妇营养、母乳喂养及辅食喂养实践，拯救生命、预防疾病并促进健康成长与发育。在布基纳法索，A&T开发并测试了一套强化型孕产妇营养干预包，将其整合至政府卫生机构提供的现有产前保健（Antenatal Care，ANC）服务中。该干预包涵盖孕期饮食多样性与质量强化咨询支持、叶酸铁（Iron-Folic Acid，IFA）补充剂服用指导、产前保健重要性宣讲及就诊次数提升建议、合理体重增长监测，以及早启动纯母乳喂养等内容。
本数据集是为评估上述干预措施影响而开展调查的基线数据组成部分。本研究的总体目标为：评估将符合当地需求的孕产妇营养干预措施整合至政府卫生系统提供的产前保健服务中的可行性，及其对孕期饮食质与量、营养干预措施利用情况的影响。
研究问题具体包括：1） 该方案对孕产妇营养实践产生了哪些影响：（1）相较于推荐摄入量，多样化食物摄入及微量营养素、蛋白质与能量的充足摄入情况；（2）孕期叶酸铁补充剂服用情况；（3）早期母乳喂养实践情况？2） 能否通过加强卫生系统建设及以营养为核心的社会与行为改变沟通（Social and Behavior Change Communication，SBCC，即人际沟通与社区动员）手段，提升关键营养干预措施（孕产妇营养咨询、体重增长监测、叶酸铁补充剂发放与咨询、母乳喂养咨询）的覆盖范围与利用效率，同时增加产前保健就诊次数？3） 哪些因素会影响孕产妇营养干预措施整合至政府产前保健服务提供平台的进程？
本评估采用双臂整群随机非盲试验设计，包含基线与终末两次横断面调查。随机化单位为卫生与社会促进中心（Centre de Santé et de Promotion Social，简称CSPS）的服务覆盖区域。基线调查于2019年11月至12月由非洲卫生培训研究与专业机构（Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique，简称AFRICSanté）开展，该机构为本项目的国内研究合作方。
基线调查内容涵盖：1） 孕产妇问卷；2） 近期分娩妇女问卷；3） 近期分娩妇女丈夫问卷；4） 护士-助产士问卷；5） 社区卫生员（agent de santé communautaire，简称ASBCs）问卷；6） 卫生设施观察清单；7） 产前保健观察与离院访谈。
近期分娩妇女访谈采用经过预试验的结构化问卷开展，收集的信息包括家庭构成、家庭社会经济地位、产科病史、产前保健使用情况、产前保健接触经历、孕产妇营养与母乳喂养知识及实践、妊娠与产后护理情况、家庭粮食安全状况、社会期许偏差、决策权力、心理健康状况及人体测量学指标。