“它改变了我的生活”:无条件现金转移和个性化婴儿喂养支持——在肯尼亚西部感染艾滋病毒的妇女中进行的可行性干预试验。

IF 2.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Emily L Tuthill, Ann E Maltby, Belinda C Odhiambo, Thomas J Hoffmann, Maureen Nyaura, Rosemary Shikari, Craig R Cohen, Sheri D Weiser
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引用次数: 0

摘要

背景:包括通过联合国可持续发展目标1、2和3,贫穷、粮食不安全和感染艾滋病毒的综合影响被确认为全球卫生优先事项。今天,在包括肯尼亚在内的东部和南部非洲,妇女和女孩占所有新感染艾滋病毒的63%。在这种情况下,感染艾滋病毒的孕妇和产后妇女面临着独特的挑战,包括随着妇女离开工作岗位照顾新生儿而增加的经济不安全感。这加剧了贫困、粮食短缺和压力。方法:为了解决这种情况下艾滋病毒感染母亲的经济不安全感,改善婴儿喂养和减轻压力,我们制定了一项多层次干预措施,支持健康母亲,包括10个月无条件现金转移(10,000 KES, ~ 75美元/月)和个性化婴儿喂养支持,从怀孕到产后7个月。我们在肯尼亚基苏木从事艾滋病护理的妇女中进行了一项非随机可行性试验。从2022年2月23日至2022年3月23日,我们共招募了40名怀孕20-35周的妇女,其中20名妇女在一家公立诊所作为干预组,20名妇女在一家类似诊所作为对照组。我们的目的是评估干预的可行性、可接受性以及对食品安全、婴儿喂养和母亲心理健康的潜在影响。结果:分析所有40名参与者的数据,我们发现,与对照组相比,干预组在产后6周和6个月的食物不安全评分从基线显著降低(p = 0.0008和p)。“支持健康母亲”干预措施有可能通过增加经济保障和支持妇女克服婴儿喂养挑战,在整个围产期及以后对妇女产生积极影响,应在更大规模的试验中进行评估。试验注册:支持健康母亲已在ClinicalTrials.gov协议注册和结果系统中注册,最初于2022年2月1日发布。临床试验:gov ID: NCT05219552协议ID: K23MH116807。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"It has changed my life": unconditional cash transfers and personalized infant feeding support- a feasibility intervention trial among women living with HIV in western Kenya.

Background: The syndemic effects of poverty, food insecurity and living with HIV are recognized as global health priorities, including through the United Nations Sustainability Goals 1, 2 and 3. Today, women and girls account for 63% of all new HIV infections in eastern and southern Africa, including Kenya. Pregnant and postpartum women living with HIV in this setting face unique challenges including increased financial insecurity as women leave the work force to care for their newborn infants. This contributes to poverty, food scarcity and stress.

Methods: To address financial insecurity, improve infant feeding and reduce stress among mothers living with HIV in this setting, we developed a multilevel intervention, Supporting Healthy Mothers, consisting of 10 monthly unconditional cash transfers (10,000 KES, ~$75 USD/month) and personalized infant feeding support from pregnancy to 7 months postpartum. We conducted a non-randomized feasibility trial of this intervention among women engaged in HIV care in Kisumu, Kenya. From February 23, 2022 to March 23, 2022, we enrolled a total of 40 women who were 20-35 weeks pregnant-20 women to the intervention group at a public clinic, and 20 women to the control group at a similar clinic. Our aim was to assess feasibility, acceptability, and the potential impact of the intervention on food security, infant feeding and maternal mental health.

Results: Analyzing data from all 40 participants, we found a significant reduction in food insecurity scores from baseline for the intervention group when compared to the control group at 6 weeks and 6 months postpartum (p = 0.0008 and p < 0.0001, respectively). Qualitative exit interviews with intervention group participants confirmed women felt more financially secure and had newly acquired practical knowledge and skills related to infant feeding. Women found the two intervention components highly acceptable and described an overall positive impact on wellbeing.

Conclusions: The Supporting Healthy Mothers intervention has potential to positively impact women across the perinatal period and beyond by increasing financial security and supporting women to overcome infant feeding challenges and should be assessed in larger trials.

Trial registration: Supporting Healthy Mothers was registered with ClinicalTrials.gov Protocol Registration and Results System, initially published on February 1, 2022.

Clinicaltrials: gov ID: NCT05219552 Protocol ID: K23MH116807.

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来源期刊
International Breastfeeding Journal
International Breastfeeding Journal Medicine-Obstetrics and Gynecology
CiteScore
6.30
自引率
11.40%
发文量
76
审稿时长
32 weeks
期刊介绍: Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.
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