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...
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| مؤلفون آخرون: | , , , , , , , , , , |
| التنسيق: | article |
| منشور في: |
2024
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| 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 |
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| _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 |