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Maternal, Infant and Young Child Nutrition, Effectiveness of Personalized Home based Nutritional counselling on Infant feeding practices in Urban Informal Settlements, Nairobi, Kenya

KENYA, 2012 - 2015
Health and Well-Being (HaW)
African Population and Health Reseach Center
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Identification

IDNO
APHRC-MIYCN-2014-1.1
Title
Maternal, Infant and Young Child Nutrition, Effectiveness of Personalized Home based Nutritional counselling on Infant feeding practices in Urban Informal Settlements, Nairobi, Kenya
Subtitle
Effectiveness of Personalized Home based Nutritional counselling on Infant feeding practices in Urban Informal Settlements, Nairobi, Kenya
Country
Name Country code
KENYA KEN
Abstract
The WHO recommends exclusive breastfeeding in the first six months of an infant's life, to meet their nutritional requirements and achieve optimal growth, development and health. The WHO also recommends introducing appropriate complementary feeds at six months, with continued breastfeeding up to two years or beyond. Poor infant and young child feeding (IYCF) practices are widely documented in developing countries including Kenya, where only one-third of children are exclusively breastfed for six months. The Kenyan government developed a strategy to promote optimal IYCF practices in 2007, actualized mainly through the baby-friendly hospital initiative (BFHI) in public health facilities. Urban informal settlements, where most urban residents in Kenya live, present unique challenges to actualizing the strategy. The near absence of public facilities in these settlements means they are systematically excluded from such initiatives. Very poor IYCF practices and high levels of malnutrition characterize these settings; for example only 2% of infants under six months are exclusively breastfed, while 40% of children 0-42 months are malnourished. Innovative strategies to reach residents of urban informal settlements are therefore needed. We propose to assess the effectiveness of a community-based intervention on IYCF practices and nutritional status of Kenyan children living in two urban informal settlements in Nairobi: Korogocho and Viwandani. The study, funded by the Wellcome Trust will run for a period of three years, starting March 2012.

Version

Version Date
2015-09-03
Version Notes
Version 1.0 (September 2015): Datasets edited and anonymised.

Scope

Keywords
Keyword
KAPs
Breastfeeding
Exclusive Breastfeeding
Complementary Feeding
Vaccination
Child Growth

Coverage

Geographic Coverage
Korogocho and Viwandani, the Nairobi Urban Health and Demographic Surveillance Study Site in Nairobi County
Unit of Analysis
Household, Woman and child
Universe
The study will recruit pregnant women aged 12-49 years and follow them up to the point of giving birth and follow the mother/child pair until the end of infancy. Data on food security and SES will also be collected from the households they are part of.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
African Population and Health Reseach Center APHRC
Producers
Name Affiliation Role
Dr. Elizabeth Kimani-Murage African Population and Health Reseach Center Primary Investigator
Dr. Alex Ezeh African Population and Health Reseach Center
Dr. Catherine Kyobutungi African Population and Health Reseach Center
Dr. Nyovani Madise University of Southampton, UK
Paula Griffiths Loughborough University, UK
Prof Rachel Musoke University of Nairobi, Kenya
Victor Owino UC-Davis, Kenya
Shane Norris University of the Witwatersrand, South Africa
Fredrick Wekesah African Population and Health Reseach Center
Nelson Muhia African Population and Health Reseach Center
Milka Njeri African Population and Health Reseach Center
Thaddaeus Egondi African Population and Health Reseach Center
Funding Agency/Sponsor
Name Abbreviation Role
Wellcome Trust WT Funder
Other Identifications/Acknowledgments
Name Role
The William and Flora Hewlett Foundation Core funding for APHRC
The Swedish International Cooperation Agency (SIDA) Core funding for APHRC
The Bill and Melinda Gates Foundation Funding for the NUHDSS
The Division of Nutrition and the Division of Community Health Services of the Ministry of Health, Kenya Guidance in the design of the intervention and support of the implementation
UNICEF Guidance in the design of this study
Urban Nutrition Working Group in Kenya Guidance in the design of this study
The APHRC Research Staff Offer technical support in the design of the study

Sampling

Sampling Procedure
The study adopts a cluster-randomized trial design, with block randomization at village level, with half of the villages in Korogocho and Viwandani allocated to the intervention and the other half to the control arm. Block randomization is preferred over individual-level randomization to minimize contamination. Recruitment of participants is done through routine NUHDSS rounds whereby pregnancy registration is done for female residents aged 12-49 years in each household. This will be complimented by community informants to ensure high coverage. All pregnant women in each village in the two study slums will be recruited to the study until the desired sample size of 800 (approx. 400 in each site and in each arm) is achieved.
Deviations from the Sample Design
No deviation
Weighting
None

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2012-09-04 2015-02-02
Mode of data collection
Face-to-face [f2f]
Supervision
The Project Manager is in charge of overall supervision. The Research officer managed the whole process of data collection and supervision of data collectors assisted by a research assistant. The field data collectors were led by a team leader who was in charge of planning, allocating workload and checking data quality issues as well as reporting in the progress of data collection and issues affecting the team and the process of data collection. The research assistant assisted the data collector is addressing data issues that required clarifications by liaising with the field team through their team leader.
Type of Research Instrument
All questionnaires (including on household characteristics and food security and hygiene) are administered to the mother being followed up.

Baseline Questionnaire - socio-demographic characteristics, KAPs on MIYCN Pre-birth questionnaire - Maternal nutrition, KAPs on MIYCN, ANC attendance Post birth 1 questionnaire - Initiation of BF, birth weight, Post natal care Post birth 2 questionnaire - exclusive breastfeeding, baby milestones, vaccination Post birth 3 questionnaire - exclusive breastfeeding, continued breastfeeding, complementary feeding, vaccination Post birth 4 questionnaire (end line) questionnaire - recap of the infancy period, BF, CF and vaccination, contraceptive use Post infancy questionnaire - continued breastfeeding, complementary feeding Household food security - food security Household hygiene questionnaire - WASH and feeding environment Anthropometric questionnaire - height, length, weight and BP readings for mother and child

Data Processing

Cleaning Operations
Data was collected using electronic programs in netbooks that had internal constraints which helped in data consistency and accuracy. The field team leader reviewed all records collected by the data collectors immediately following the completion of the data collection of the records and raised issues with the data collectors for clarification. The research assistant reviewed 5% of records submitted and raised emerging issues for clarification by the team leader. In case an issue was not clear, call backs were made to the respondents to confirm the information.

Data access

Contact
Name Affiliation Email URI
Head, Statistics and Survey Unit APHRC datarequests@aphrc.org www.aphrc.org
Conditions
All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained (as outlined on this form) and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:

"This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City."

Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
African Population and Health Research Center, Maternal, Infant and Young Child Nutrition. Effectiveness of Personalized Home based Nutritional counselling on Infant feeding practices in Urban Informal Settlements - Nairobi, Kenya, June 2014. APHRC, Nairobi - Kenya. doi:11239/176-2015-034-1.0

Metadata production

Document ID
APHRC-MIYCN-2014-1.1
Producers
Name Abbreviation Role
African Population and Health Research Center APHRC Metadata Producer
Date of Production
2014-12-12
Document version
Version 1.1