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

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 ANC observations and exit interviews were conducted using pretested, structured questionnaires. A direct observation checklist of ANC sessions was used to document services provided, and an in-person interview collected information on perceptions of counseling received and patient satisfaction.

“茁壮成长（Alive & Thrive，下称A&T）是一项致力于推广营养干预措施的倡议，旨在通过优化孕产妇营养、母乳喂养与辅食喂养实践，挽救生命、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方案，计划将其整合至政府卫生机构提供的现有产前保健（Antenatal Care，简称ANC）服务中。方案内容涵盖孕期饮食多样性与质量的强化咨询与支持、铁叶酸（Iron-Folic Acid，简称IFA）补充剂的规范服用、产前保健的重要性及增加产检次数的倡导、合理体重增长监测，以及母乳喂养的尽早启动与纯母乳喂养。本数据集是为该干预措施的影响评估收集基线数据而开展的调查的一部分。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整合至政府卫生系统产前保健服务中的可行性，及其对孕期饮食质量、摄入量与营养干预措施利用情况的影响。研究问题包括：1）该项目对孕产妇营养实践的影响：（1）与推荐摄入量相比，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）孕期铁叶酸补充剂的服用依从性；（3）早期母乳喂养实践情况？2）能否通过强化卫生系统及以营养为核心的社会与行为改变沟通（Social and Behavior Change Communication，简称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、铁叶酸补充剂发放与咨询、母乳喂养咨询）的覆盖范围与利用率，同时增加产前保健随访次数？3）哪些因素影响了孕产妇营养干预措施在政府产前保健服务提供平台中的整合与强化？本次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。随机分组的单位为卫生与社会促进中心（Centre de Santé et de Promotion Social，法语缩写CSPS）的服务覆盖区域。本次基线调查于2019年11-12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，该机构为本调查的本土研究合作方。本次基线调查涵盖以下内容：1）孕妇问卷；2）近期分娩产妇问卷；3）近期分娩产妇丈夫问卷；4）护士-助产士问卷；5）社区卫生员（agent de santé communautaire，简称ASBCs）问卷；6）卫生机构观察清单；7）产前保健观察与离院访谈。产前保健观察与离院访谈均采用经过预测试的结构化问卷开展。研究使用产前保健服务直接观察清单记录所提供的服务，并通过面对面访谈收集受访者对所接受咨询的认知及患者满意度相关信息。