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Implementing a Novel Facility-Community Intervention for Strengthening Integration of Infant Nutrition and Family Planning in Mara and Kagera, Tanzania

Author

Listed:
  • Chelsea M. Cooper

    (USAID’s Maternal and Child Survival Program/Jhpiego, Washington, DC 20036, USA
    Co-lead authors.)

  • Mary Drake

    (Jhpiego, Baltimore, MD 21231, USA
    University Medical Centre Groningen, Department of Health Sciences, Global Health, University of Groningen, 9713 GZ Groningen, The Netherlands
    Co-lead authors.)

  • Justine A. Kavle

    (Kavle Consulting, LLC, Washington, DC 20001, USA)

  • Joyce Nyoni

    (Institute of Social Work, University of Dar es Salaam, Dar es Salaam, Tanzania)

  • Ruth Lemwayi

    (Jhpiego, Dar es Salaam, Tanzania)

  • Lemmy Mabuga

    (USAID’s Maternal and Child Survival Program/Jhpiego, Dar es Salaam, Tanzania)

  • Anne Pfitzer

    (USAID’s Maternal and Child Survival Program/Jhpiego, Washington, DC 20036, USA)

  • Mary Makungu

    (Government of Tanzania, Musoma, Mara Region, Tanzania)

  • Elizabeth Massawe

    (Bukoba Referral Hospital, Government of Tanzania, Bukoba, Kagera Region, Tanzania)

  • John George

    (UNICEF, Dar es Salaam, Tanzania)

Abstract

Tanzania has high fertility, low contraceptive prevalence and low exclusive breastfeeding (EBF). The Lake Zone, including Mara and Kagera regions, leads the country in total fertility; use of the lactational amenorrhea method (LAM) is negligible. This pre-/post-study explored the effects of a multi-level facility and community intervention (service delivery support, community engagement, media and LAM tracking) to integrate maternal and infant nutrition and postpartum family planning (FP) within existing health contacts. Mixed methods were used, including service statistics, exit interviews, patient-tracking tools for community health workers, client self-tracking tools, supervision data, focus group discussions and in-depth interviews. Results are presented using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) implementation science framework. The intervention reached primarily the second and fourth wealth quintiles, increased FP and EBF at six weeks postpartum. LAM was very acceptable, provided an entry point for FP conversations and for addressing misconceptions, and reinforced EBF practices. Partners felt encouraged to support spousal nutrition, breastfeeding and FP. Higher adoption in Kagera may be influenced by performance-based financing. The intervention was implemented with generally high fidelity. Maintenance data reflected stakeholder interest in continuing the intervention. A multi-level facility and community intervention was feasible to implement and likely contributed to improved EBF practices and FP uptake, including LAM use.

Suggested Citation

  • Chelsea M. Cooper & Mary Drake & Justine A. Kavle & Joyce Nyoni & Ruth Lemwayi & Lemmy Mabuga & Anne Pfitzer & Mary Makungu & Elizabeth Massawe & John George, 2021. "Implementing a Novel Facility-Community Intervention for Strengthening Integration of Infant Nutrition and Family Planning in Mara and Kagera, Tanzania," IJERPH, MDPI, vol. 18(8), pages 1-21, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:8:p:4105-:d:535342
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    References listed on IDEAS

    as
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