Maternal and Child Nutrition最新文献

{"title":"The Association Between Urbanisation and Household Food Security in Nigeria","authors":"Joseph B. Ajefu,&nbsp;Michael Henry,&nbsp;Sabastine U. Ugbaje","doi":"10.1111/mcn.70044","DOIUrl":"10.1111/mcn.70044","url":null,"abstract":"<p>A growing number of studies have shown that urbanisation is commonly associated with a change in dietary or consumption patterns towards more expensive and exotic foods. Previous attempts to investigate the implications of urbanisation on household food security have commonly employed dichotomous or binary indicators of urbanisation. Unlike previous studies, we employ satellite-based night-time light intensity data from the US Air Force Defense Meteorological Satellites Programme and use it as a proxy for different stages or degrees of urbanisation. The night-time light data provide a continuous, spatially explicit, and objective proxy for urbanisation. The data are measured with consistent quality across countries, regardless of the different institutional capacities, allowing for consistent measurement of urban growth across various communities and regions. In our analysis, we explore the impact of variations in nightlight intensity on household food security in Nigeria. Our results show that night-time light is positively associated with household food security. However, we find that higher polynomial terms of night-time light intensity exhibit a nonlinear relationship between urbanisation and household food security. Based on the results, our findings will advance the current understanding of the relationship between urbanisation and household food security, which could have implications on maternal and child wellbeing.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Family MUAC Utilization in Identifying Severity of Acute Malnutrition at Admission to Nutrition Programs Among Children Aged 6–59 Months Ethiopia","authors":"Meron Tamirat,&nbsp;Alinoor Mohammed Farah,&nbsp;Gudina Egeta,&nbsp;Aweke kebede,&nbsp;Samson Gebremedhin,&nbsp;Seifu Hagos Gebreyesus","doi":"10.1111/mcn.70054","DOIUrl":"10.1111/mcn.70054","url":null,"abstract":"<p>Mid-upper arm circumference (MUAC) screening is a simple community-level method for detecting acute malnutrition. The Family MUAC approach, which trains caregivers to measure their children's MUAC and refer them for treatment, has shown promise, but evidence regarding its impact on malnutrition severity at admission is limited. To address this gap, we conducted a longitudinal study from March to May 2024 in two districts in Eastern Ethiopia, enrolling 360 children aged 6–59 months. We compared children referred by their mothers or caregivers using the Family MUAC (<i>n</i> = 180) with those referred by Health Extension Workers (HEWs) (<i>n</i> = 180). We found that the median MUAC at admission was 119 mm (IQR 116–120) in the mother-referral group versus 116 mm (IQR 115–119) in the HEWs-referral group, and the proportion of severe acute malnutrition (MUAC &lt; 115 mm) was lower among caregiver-referred children (4.2% vs. 18.4%). Multivariable regression analysis showed that mother/caregiver-referred children had an 80.5% lower risk of severe MUAC at admission [ARR 0.195(0.06, 0.59)] and a 75% reduced likelihood of SAM admission compared to the HEWs-Referral group (ARR 0.25; 95% CI, 0.148–0.448). The Family MUAC approach significantly reduced the severity of malnutrition at admission. Consequently, this strategy should be expanded and prioritized in national screening programs.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpregnancy Weight Change and Adverse Birth Outcomes: Cohort Study Using Brazil's Routine Register-Based Linked Data","authors":"Aline S. Rocha,&nbsp;Thais Rangel Bousquet Carrilho,&nbsp;Priscila R. F. Costa,&nbsp;Enny S. Paixao,&nbsp;Natanael J. Silva,&nbsp;Helena B. M. da Silva,&nbsp;Ila R. Falcão,&nbsp;Rosemeire L. Fiaccone,&nbsp;Mauricio L. Barreto,&nbsp;Rita de Cássia Ribeiro-Silva","doi":"10.1111/mcn.70052","DOIUrl":"10.1111/mcn.70052","url":null,"abstract":"<p>The effects of interpregnancy weight change (IPWC) on the risk of adverse birth outcomes in subsequent pregnancies are still not fully understood. Existing studies present conflicting results regarding the association between IPWC and preterm birth, while evidence of its relationship with low birth weight (LBW) or macrosomia is limited, particularly in low- and middle-income countries. This population-based longitudinal study used Brazil's routine register-based linked data from 2008 to 2015 to evaluate the association between IPWC and adverse birth outcomes in a subsequent pregnancy. Preterm birth, LBW, and macrosomia were compared across categories of IPWC between pregnancies (including changes in BMI unit, changes in BMI category, and percentage of weight change). Logistic and multinomial logistic regressions were used to estimate the association between IPWC and adverse birth outcomes. We analysed 15,570 live births from 7785 multiparous women. Women who reduced their BMI between pregnancies had an increased chance of delivering preterm neonates (OR 1.27; 95% CI 1.01–1.60) and those who increased their BMI by ≥ 4 units between pregnancies had an increased chance of macrosomia (OR 1.60; 95% CI 1.21–2.12) compared to those who maintained their BMI. Similar results were observed when IPWC was defined as changes in BMI categories and percentage changes in weight. The results of this study show that IPCW were associated with changes in both the newborn's maturity and size in a subsequent pregnancy. These findings support the need to develop experimental studies on the effects of maternal weight management within and between pregnancies to improve outcomes for both mothers and babies.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Scoping Review on Alternative Ready-to-Use Therapeutic Foods","authors":"Patrizia Pajak,&nbsp;Sebsibie Teshome,&nbsp;Anne Berton,&nbsp;Heather Stobaugh,&nbsp;Alison Fleet,&nbsp;Durga Khatiwada,&nbsp;Bernardette Cichon","doi":"10.1111/mcn.70035","DOIUrl":"10.1111/mcn.70035","url":null,"abstract":"<p>Alternative ready-to-use therapeutic foods (RUTF) formulations provide an opportunity to lower costs, facilitate local or national ingredient use, and enhance the availability and acceptability of RUTF. This scoping review aimed to identify and categorise the available evidence on alternative RUTF formulations developed and tested globally, assess their compliance with international standards and summarise evidence on acceptability, cost, effectiveness, cost-effectiveness and adverse events, highlighting evidence gaps to guide future research. Searches of three databases and extensive grey literature were conducted covering the period from 1999 to June 2023. Fifty-four articles, 42 peer-reviewed articles and 12 grey literature sources were included. Fifty-three RUTF formulations at various development stages for the treatment of severe acute malnutrition (SAM) without medical complications in children 6–59 months were identified. Numerous ingredients have undergone testing to replace primarily peanuts and/or milk, demonstrating consistent acceptance and promising results in terms of effectiveness. Evidence on outcomes beyond anthropometric recovery, such as higher iron status, and effects on cognitive and developmental outcomes or gut microbiome, is also limited. Few studies evaluated the cost implications, revealing potential savings in production costs while no significant differences were found in terms of safety. Additional evidence is required on how reduced or milk-free formulations within the innovation and novel categories can achieve compliance with the required protein digestibility-corrected amino acid score (PDCAAS) recommendations. Further research is also needed with specific focus on outcomes beyond anthropometric recovery such as cost-effectiveness, accessibility, macro and micronutrient deficiencies, sustainability of recovery and longer term health outcomes.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Maternal Education and Household Wealth on Double Burden of Malnutrition in South and Southeast Asia","authors":"Ashis Talukder,&nbsp;Matthew Kelly,&nbsp;Darren Gray,&nbsp;Haribondhu Sarma","doi":"10.1111/mcn.70049","DOIUrl":"10.1111/mcn.70049","url":null,"abstract":"<p>The double burden of malnutrition (DBM), defined by the coexistence of undernutrition and overnutrition within households, poses significant public health challenges in South and Southeast Asia. While previous studies have examined the individual effects of maternal education and household wealth on DBM, findings remain inconsistent, and little is known about how these factors interact across different contexts. To address this gap, we used nationally representative Demographic and Health Survey (DHS) data from Bangladesh (2017–2018), Cambodia (2022), Nepal (2022) and Timor-Leste (2016) to analyse the interaction between maternal education and household wealth in shaping DBM risk. These countries were selected due to their ongoing nutritional transition, which has contributed to the increasing prevalence of DBM. For the analysis, we used DHS data, which employs a standardised multistage cluster sampling method and probabilistic methods to ensure representativeness. In this study, we selected mother–child pairs from the DHS survey, focusing on children aged 0–59 months and nonpregnant mothers at the time of the survey. We included those pairs for which both the mother and child had valid weight and height measurements. Maternal education and household wealth were identified as the primary exposures. To examine their interaction and the impact of other covariates on DBM, we employed multivariable logistic regression models. Our study found that DBM prevalence was higher in urban and wealthier households, with the highest rates observed in Timor-Leste and Cambodia. Multivariable logistic regression indicated that lower maternal education increased DBM risk, especially in affluent households (OR 2.07–3.29). Conversely, higher maternal education was associated with lower DBM prevalence. Additionally, breastfeeding and antenatal care visits emerged as protective factors. These findings indicate the necessity for specific interventions aimed at enhancing maternal education and promoting healthy dietary practices, particularly in rich households. Additionally, reinforcing breastfeeding practices and increasing antenatal care visits are essential strategies to mitigate the risks associated with DBM.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient Powders Combined With Malaria Chemoprevention to Improve Anaemia and Cognitive Function in Early Childhood in Mali: A Cluster-Randomised Trial","authors":"Niélé H. Diarra,&nbsp;Yahia Dicko,&nbsp;Natalie Roschnik,&nbsp;Modibo Bamadio,&nbsp;Michael Boivin,&nbsp;Yvonne Griffiths,&nbsp;Rebecca Jones,&nbsp;Sham Lal,&nbsp;Helen Moestue,&nbsp;Hamidou Niangaly,&nbsp;Lauren Pisani,&nbsp;Renion Saye,&nbsp;Kalifa Sidibe,&nbsp;Karla Smuts,&nbsp;Nia-An Philippe Thera,&nbsp;Josselin Thuilliez,&nbsp;Hans Verhoef,&nbsp;Moussa Sacko,&nbsp;Siân E. Clarke","doi":"10.1111/mcn.70033","DOIUrl":"10.1111/mcn.70033","url":null,"abstract":"<p>A cluster-randomised controlled trial was conducted in 60 communities in southern Mali to evaluate the impact of micronutrient powders (MNP) combined with seasonal malaria chemoprevention (SMC) on anaemia (primary endpoint), <i>Plasmodium</i> infection, stunting and cognitive function in children &lt; 5 years. The 60 communities were randomly allocated to the intervention or control arm, and cross-sectional biomedical and cognitive surveys were conducted after 1 and 3 years in a random sample of 3 and 5 years olds (1052 and 1081 children, respectively). All children aged 3–59 m in intervention and control communities received two rounds of SMC each year during the peak malaria season, and in intervention communities, all children aged 6–59 m additionally received 4 months of daily MNP after the peak malaria season. Despite a high baseline prevalence of anaemia and good fidelity to intervention, this trial found no evidence of impact on study outcomes. The prevalence of anaemia was similar in both arms for both age groups after 1 and 3 years of intervention—after 3 years, the prevalence of anaemia amongst 3-year olds was 57.6% in the intervention arm versus 60.1% in the control group (<i>p</i> = 0.352). For 5-year olds, it was 51.3% and 53.0%, respectively (<i>p</i> = 0.607). No effect was observed on stunting or cognitive function either.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaching Priority Populations When Scaling Up: A Qualitative Study of Practitioners' Experiences of Implementing Early Childhood Health Interventions in Victoria, Australia","authors":"Sarah Marshall,&nbsp;Penelope Love,&nbsp;Konsita Kuswara,&nbsp;Karen Lee,&nbsp;Hannah Downes,&nbsp;Rachel Laws","doi":"10.1111/mcn.70046","DOIUrl":"10.1111/mcn.70046","url":null,"abstract":"<p>Implementing evidence-based health promotion programmes at scale is important for achieving population-level health outcomes. However, achieving equitable reach can be challenging. An evidence-based early-life nutrition and movement intervention (INFANT) is currently being implemented at scale in Australia. This study explored practitioners' perceptions about reaching priority population groups through INFANT or similar universal preventive health programmes and services implemented at scale. Fifteen semi-structured online interviews were conducted with purposively selected experienced practitioners. Interviews were transcribed and analysed using reflexive thematic analysis. Two main themes were developed, representing the complexities of reaching priority population groups through universal health programmes and services in early childhood. Theme 1: <i>“We're not hitting the mark”—Underlying issues influence universal healthcare access</i>, highlighted (a) the perception that parents felt out of place through a sense of not belonging or being unfamiliar with universal services and (b) that practical constraints and pressing priorities impacted access. Theme 2: <i>“There are no easy answers”—Varied approaches can enhance engagement, but the path is not straightforward</i>, encompassed (a) the importance of trust and familiarity with providers, (b) the suitability of programmes and services for target communities, and (c) factors such as practitioner uncertainty regarding approaches that could address the needs of families from priority populations and resourcing that can limit targeted efforts. Our findings highlight the complexities of achieving equitable reach during scale-up and the varied decision-making and resourcing for addressing inequity in a local context. While our findings identify local-level strategies to address equitable reach during scale-up, we emphasise that striving to achieve health equity should be embedded and prioritised in scale-up efforts.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of a Homestead Food Production Intervention on Anaemia and Micronutrient Deficiencies Among Women and Children in Rural Bangladesh: A Cluster-Randomized Controlled Trial","authors":"Amanda S. Wendt,&nbsp;Jillian L. Waid,&nbsp;Anna A. Müller-Hauser,&nbsp;Nathalie J. Lambrecht,&nbsp;Tarique Md. Nurul Huda,&nbsp;Nicholas N. A. Kyei,&nbsp;Sabine Gabrysch","doi":"10.1111/mcn.70043","DOIUrl":"10.1111/mcn.70043","url":null,"abstract":"<p>Micronutrient deficiencies affect over half of young children and two-thirds of reproductive-aged women worldwide. Nutrition-sensitive agriculture interventions have the potential to increase nutrient-dense food intake and thus improve micronutrient status. We evaluated the impact of a homestead food production (HFP) programme on micronutrient status and anaemia of women and their children (registered secondary outcomes) in the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial, additionally assessing its impact on inflammation. We conducted a 1:1 parallel two-arm cluster-randomized controlled trial in Sylhet, Bangladesh, with 96 clusters. The 3-year HFP intervention included gardening, poultry, nutrition, and hygiene components. In 2015, we conducted the baseline survey. We enrolled 2705 women and their children up to 3 years of age, and in 2019, we evaluated impacts on anaemia, iron, vitamin A, zinc and inflammation status through blood measures of these women (aged 19–44 years) and their 6- to 37-month-old children, using multilevel regression. Anaemia was common (nonpregnant women: 20%, pregnant women: 35%, children: 16%), while iron deficiency was rare among nonpregnant women (3%), 12% among pregnant women and 20% among children. Vitamin A deficiency ranged from 1% to 5%, and zinc deficiency was very common (nonpregnant women: 43%, pregnant women: 69%, children: 25%). We found no evidence of an intervention impact on micronutrient status, anaemia or inflammation among the 2483 women and 930 children measured. The moderate improvements in dietary intake achieved by the intervention were thus not sufficient, and more substantial hygiene improvements and targeted dietary changes may be needed to improve micronutrient status. This trial was registered at Clinicaltrials.gov (NCT02505711).</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer Support and Community Interventions Targeting Breastfeeding in the UK: Systematic Review of Qualitative Evidence to Identify Inequities in Participants' Experiences","authors":"Rhiannon Evans,&nbsp;Caitlyn Donaldson,&nbsp;Rabeea'h Aslam,&nbsp;Joelle Kirby,&nbsp;Sophie Robinson,&nbsp;Joanne Clarke,&nbsp;Stephanie J. Hanley,&nbsp;Siang Ing Lee,&nbsp;Joht Singh Chandan,&nbsp;Ruth Garside,&nbsp;Jo Thompson-Coon,&nbsp;Kate Jolly,&nbsp;Kath Maguire,&nbsp;Sean Harrison,&nbsp;G. J. Melendez-Torres","doi":"10.1111/mcn.70041","DOIUrl":"10.1111/mcn.70041","url":null,"abstract":"<p>Rates of breastfeeding remain low in the UK, with variations between population groups. Peer support and community interventions are intended to increase breastfeeding, but there is limited understanding if they cause inequities in participants' experiences. We conducted a systematic review synthesising qualitative evidence from the UK to understand: (1) what social characteristics are relevant to participants' experiences of interventions? and (2) how are participants' experiences influenced by different social characteristics? The scope of the review was informed through stakeholder consultation with women (<i>n</i> = 7) and peer supporters (<i>n</i> = 6). Searches of nine databases updated an existing systematic review. We screened relevant systematic reviews and undertook citation tracking. We conducted framework synthesis and assessed certainty of evidence with GRADE-CERQual. Fifty-five studies, with 68 linked reports, were included. Inequity generating experiences were identified across the course of intervention participation: (1) lack of information about intervention eligibility and culturally appropriate recruitment procedures; (2) limited accessible provision for continued attendance; (3) inadequate consideration of participation needs related to socioeconomic status, socio-cultural background, physical characteristics, and individuals' breastfeeding journeys; and (4) enduring structural barriers (e.g. community norms) to breastfeeding inhibiting sustained behaviour post-intervention. Evidence suggests that differential intervention experiences may lead to inequities in outcomes, particularly among individuals from different socioeconomic and ethnic backgrounds. Peer and community provision needs to be tailored to the social characteristics of different populations. Future qualitative research needs to move beyond participants' general intervention experiences and consider specific issues pertaining to recruitment, drop-out and post-intervention behavioural maintenance.</p><p><b>Systematic Reveiw Registration:</b> PROSPERO CRD42024537108.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I Am Going to Take It Up”: Implementing Skin-to-Skin Contact in Uganda","authors":"Karin Cadwell,&nbsp;Anna Blair,&nbsp;Kajsa Brimdyr,&nbsp;Kristin Svensson,&nbsp;Melissa Reyes,&nbsp;Mike Kagawa,&nbsp;Louise Racine Bastarache,&nbsp;Scovia Nalugo Mbalinda","doi":"10.1111/mcn.70047","DOIUrl":"10.1111/mcn.70047","url":null,"abstract":"<p>Timely and prolonged skin-to-skin contact (SSC) immediately after birth is recommended in the Ugandan Clinical Guideline, the 2023 International Research and Practice Guideline on SSC and by the WHO/UNICEF Baby-Friendly Hospital Initiative. Skin-to-skin contact is safe, low-resource, evidence-based and contributes to short- and long-term health outcomes. However, practice is inconsistent. A rapid-change intervention, PRECESS (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success), encouraged adaptation of the SSC Guideline protocol in a regional referral hospital in Uganda. Fifteen key informants, including leadership and staff members, were interviewed before and after the practice change about perceived barriers and solutions for implementing SSC. The semi-structured pre- and post-intervention interviews were recorded, transcribed and analyzed for meaningful units and themes. Three themes emerged: (1) Commitment to consistent, evidence-based care within constraints; (2) Addressing knowledge and skill regarding the optimal practice of SSC; and (3) Willingness to “take-up” the practice change for the benefit of mothers and babies. Our findings support the experiential method of practice change PRECESS to implement immediate, continuous, uninterrupted SSC for at least the first hour after birth. Despite the challenges and barriers identified in key informant interviews, significant progress was made in increasing the duration of SSC for both vaginal and cesarean births. The identified themes provide insight for future implementation of skin-to-skin contact.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}