Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi

BackgroundInadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes. ObjectivesTo improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi. MethodsWe performed a 2-arm...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Kamudoni, Penjani Rhoda (author)
مؤلفون آخرون: Kaunda, Lillian (author), Tharrey, Marion (author), Mphande, Maggie (author), Chithambo, Shyreen (author), Ferguson, Elaine (author), Shi, Zumin (author), Mdala, Ibrahimu (author), Maleta, Kenneth (author), Munthali, Alister (author), Holmboe-Ottesen, Gerd (author), Iversen, Per Ole (author)
التنسيق: article
منشور في: 2024
الموضوعات:
الوصول للمادة أونلاين:http://dx.doi.org/10.1016/j.cdnut.2024.104506
https://www.sciencedirect.com/science/article/pii/S2475299124024405
http://hdl.handle.net/10576/64496
الوسوم: إضافة وسم
لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!
_version_ 1857415084509233152
author Kamudoni, Penjani Rhoda
author2 Kaunda, Lillian
Tharrey, Marion
Mphande, Maggie
Chithambo, Shyreen
Ferguson, Elaine
Shi, Zumin
Mdala, Ibrahimu
Maleta, Kenneth
Munthali, Alister
Holmboe-Ottesen, Gerd
Iversen, Per Ole
author2_role author
author
author
author
author
author
author
author
author
author
author
author_facet Kamudoni, Penjani Rhoda
Kaunda, Lillian
Tharrey, Marion
Mphande, Maggie
Chithambo, Shyreen
Ferguson, Elaine
Shi, Zumin
Mdala, Ibrahimu
Maleta, Kenneth
Munthali, Alister
Holmboe-Ottesen, Gerd
Iversen, Per Ole
author_role author
dc.creator.none.fl_str_mv Kamudoni, Penjani Rhoda
Kaunda, Lillian
Tharrey, Marion
Mphande, Maggie
Chithambo, Shyreen
Ferguson, Elaine
Shi, Zumin
Mdala, Ibrahimu
Maleta, Kenneth
Munthali, Alister
Holmboe-Ottesen, Gerd
Iversen, Per Ole
dc.date.none.fl_str_mv 2024-12-31
2025-04-27T10:33:34Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://dx.doi.org/10.1016/j.cdnut.2024.104506
24752991
https://www.sciencedirect.com/science/article/pii/S2475299124024405
http://hdl.handle.net/10576/64496
12
8
dc.language.none.fl_str_mv en
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv dietary intakes
infants
low birth weight
Malawi
mothers
nutrition education counseling
dc.title.none.fl_str_mv Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description BackgroundInadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes. ObjectivesTo improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi. MethodsWe performed a 2-armed (1:1) cluster-randomized controlled trial in Southern Malawi, enrolling pregnant women at gestational age 12–18 wk. Twenty villages (clusters) were randomly assigned to an intervention or a control group. A nutrition education and counseling (NEC) intervention consisted of education sessions followed by cooking demonstrations and counseling sessions. The women were encouraged to use locally available nutrient-dense foods to enhance dietary adequacy and -diversity. We applied linear programming to identify food combinations that could increase micronutrient intakes. The control group received standard antenatal health education. ResultsAmong the 311 women recruited, 187 (60%) completed the trial. We found no significant difference in mean birth weights recorded within 1 or 24 h of birth between the intervention and control groups. Intervention infants had greater birth length (P = 0.043) and abdominal circumference (P = 0.007) compared to controls, whereas other birth outcomes did not differ significantly. Notably, a quantile analysis revealed that the NEC intervention favored birth weight among mothers with a height below the mean height of the participant sample (156 cm) (P-interaction = 0.043). ConclusionsTailoring NEC in food-insecure communities did not result in a significant difference in birth weight among infants of the participating mothers, but mean birth length and abdominal circumference were greater in the intervention group compared to controls. We noted that the NEC intervention favored birth weight among mothers with a lower height than the mean sample height. Our results warrant further investigation into offering tailored NEC early in pregnancy and on a larger scale.This trial was registered at clinicaltrials.gov as NCT03136393.
eu_rights_str_mv openAccess
format article
id qu_58718373b3909ffc3d43c1e0b53a5b40
identifier_str_mv 24752991
12
8
language_invalid_str_mv en
network_acronym_str qu
network_name_str Qatar University repository
oai_identifier_str oai:qspace.qu.edu.qa:10576/64496
publishDate 2024
publisher.none.fl_str_mv Elsevier
repository.mail.fl_str_mv
repository.name.fl_str_mv
repository_id_str
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
spelling Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural MalawiKamudoni, Penjani RhodaKaunda, LillianTharrey, MarionMphande, MaggieChithambo, ShyreenFerguson, ElaineShi, ZuminMdala, IbrahimuMaleta, KennethMunthali, AlisterHolmboe-Ottesen, GerdIversen, Per Oledietary intakesinfantslow birth weightMalawimothersnutrition education counselingBackgroundInadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes. ObjectivesTo improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi. MethodsWe performed a 2-armed (1:1) cluster-randomized controlled trial in Southern Malawi, enrolling pregnant women at gestational age 12–18 wk. Twenty villages (clusters) were randomly assigned to an intervention or a control group. A nutrition education and counseling (NEC) intervention consisted of education sessions followed by cooking demonstrations and counseling sessions. The women were encouraged to use locally available nutrient-dense foods to enhance dietary adequacy and -diversity. We applied linear programming to identify food combinations that could increase micronutrient intakes. The control group received standard antenatal health education. ResultsAmong the 311 women recruited, 187 (60%) completed the trial. We found no significant difference in mean birth weights recorded within 1 or 24 h of birth between the intervention and control groups. Intervention infants had greater birth length (P = 0.043) and abdominal circumference (P = 0.007) compared to controls, whereas other birth outcomes did not differ significantly. Notably, a quantile analysis revealed that the NEC intervention favored birth weight among mothers with a height below the mean height of the participant sample (156 cm) (P-interaction = 0.043). ConclusionsTailoring NEC in food-insecure communities did not result in a significant difference in birth weight among infants of the participating mothers, but mean birth length and abdominal circumference were greater in the intervention group compared to controls. We noted that the NEC intervention favored birth weight among mothers with a lower height than the mean sample height. Our results warrant further investigation into offering tailored NEC early in pregnancy and on a larger scale.This trial was registered at clinicaltrials.gov as NCT03136393.This project was partly funded by the Research Council of Norway, the University of Oslo, and Direktør Throne Holsts Fond for Ernæringsforskning, Norway. The funders had no role in the design, implementation, analysis, or interpretation of the data.Elsevier2025-04-27T10:33:34Z2024-12-31Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.cdnut.2024.10450624752991https://www.sciencedirect.com/science/article/pii/S2475299124024405http://hdl.handle.net/10576/64496128enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/644962025-04-27T19:09:56Z
spellingShingle Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
Kamudoni, Penjani Rhoda
dietary intakes
infants
low birth weight
Malawi
mothers
nutrition education counseling
status_str publishedVersion
title Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
title_full Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
title_fullStr Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
title_full_unstemmed Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
title_short Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
title_sort Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi
topic dietary intakes
infants
low birth weight
Malawi
mothers
nutrition education counseling
url http://dx.doi.org/10.1016/j.cdnut.2024.104506
https://www.sciencedirect.com/science/article/pii/S2475299124024405
http://hdl.handle.net/10576/64496