A&T Burkina Faso Maternal Nutrition Endline Survey 2021: Nurse-Midwife

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 and infant and young child 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 endline 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 endline survey was conducted in January-March 2021 by Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), the in-country research collaborator for the survey. The endline 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 nurse-midwife interviews were conducted using pretested, structured questionnaires. Information was collected on Nurse-midwife’s responsibilities, capacity, knowledge, motivation, and ANC service provision at the health center.

茁壮成长计划（Alive & Thrive，简称A&T）是一项旨在通过优化孕产妇营养与婴幼儿喂养实践，推广营养干预措施以挽救生命、预防疾病、助力健康成长与发育的倡议。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方案，计划将其融入政府卫生机构提供的现有产前保健（Antenatal Care，简称ANC）服务中。该方案涵盖孕期饮食多样性与质量的强化咨询与指导、叶酸铁（Iron-Folic Acid，简称IFA）补充剂服用指导、产前保健的重要性与增加产检次数的宣教、规范体重增长监测，以及早开奶与纯母乳喂养指导。本数据集是为收集该干预措施影响评估的终线调研数据而开展的调研的一部分。本研究的总体目标为：评估将符合当地实际的孕产妇营养干预措施融入政府卫生系统提供的产前保健服务的可行性，以及这些措施对孕期饮食质量、摄入量与营养干预措施使用情况的影响。研究问题如下：1）本项目对孕产妇营养行为的影响具体为何：（1）与推荐摄入量相比，多样化食物摄入情况及微量营养素、蛋白质与能量的充足摄入情况；（2）孕期叶酸铁补充剂的服用情况；（3）早泌乳相关行为？2）通过强化卫生系统与以营养为核心的社会行为改变沟通（Social and Behavior Change Communication，简称SBCC，含人际沟通与社区动员）手段，能否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）的覆盖范围与使用情况，以及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融入并强化至政府产前保健服务提供平台的进程？本次评估采用双臂整群随机、非设盲试验设计，包含基线与终线两次横断面调研。随机分组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。本次终线调研于2021年1月至3月由调研的本地合作方——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。本次终线调研涵盖以下内容：1）孕产妇调查问卷；2）近期分娩妇女调查问卷；3）近期分娩妇女配偶调查问卷；4）助产士调查问卷；5）社区卫生员（agent de santé communautaire，简称ASBCs）调查问卷；6）卫生机构观察清单；7）产前保健服务观察与就诊后访谈。助产士访谈采用经过预测试的结构化问卷开展，收集的信息包括助产士的工作职责、能力水平、专业知识、工作动机，以及卫生机构内的产前保健服务提供情况。