Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India

OBJECTIVES: Breastfeeding and complementary feeding practices in India do not meet recommendations. Community health care workers (CHWs) are often the primary source of information for pregnant and postpartum women about Infant and Young Child Feeding (IYCF) practices. While existing research has ev...

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Autores principales: Diamond-Smith, Nadia, Gopalakrishnan, Lakshmi, Walker, Dilys, Fernald, Lia, Menon, Purnima, Patil, Sumeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783456/
https://www.ncbi.nlm.nih.gov/pubmed/35062930
http://dx.doi.org/10.1186/s12913-021-07352-w
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author Diamond-Smith, Nadia
Gopalakrishnan, Lakshmi
Walker, Dilys
Fernald, Lia
Menon, Purnima
Patil, Sumeet
author_facet Diamond-Smith, Nadia
Gopalakrishnan, Lakshmi
Walker, Dilys
Fernald, Lia
Menon, Purnima
Patil, Sumeet
author_sort Diamond-Smith, Nadia
collection PubMed
description OBJECTIVES: Breastfeeding and complementary feeding practices in India do not meet recommendations. Community health care workers (CHWs) are often the primary source of information for pregnant and postpartum women about Infant and Young Child Feeding (IYCF) practices. While existing research has evaluated the effectiveness of content and delivery of information through CHWs, little is known about the quality of the interpersonal communication (respectful care). We analyzed the effect of respectful interactions on recommended IYCF practices. METHODS: We use data from evaluation of an at-scale mHealth intervention in India that serves as a job aid to the CHWs (n = 3266 mothers of children < 12 m from 841 villages in 2 Indian states). The binary indicator variable for respectful care is constructed using a set of 7 questions related to trust, respect, friendliness during these interactions. The binary outcomes variables are exclusive breastfeeding, timely introduction of complimentary feeding, and minimum diet diversity for infants. We also explore if most of the pathway from respectful care to improved behaviors is through better recall of messages (mediation analysis). All models controlled for socio-economic-demographic characteristics and number of interactions with the CHW. RESULTS: About half of women reported positive, respectful interactions with CHWs. Interactions that are more respectful were associated with better recall of appropriate health messages. Interactions that are more respectful were associated with a greater likelihood of adopting all child-feeding behaviors except timely initiation of breastfeeding. After including recall in the model, the effect of respectful interactions alone reduced. CONCLUSIONS: Respectful care from CHWs appears to be significantly associated with some behaviors around infant feeding, with the primary pathway being through better recall of messages. Focusing on improving social and soft skills of CHWs that can translate into better CHW-beneficiary interactions can pay rich dividends. FUNDING: This study is funded by Grant No. OPP1158231 from Bill and Melinda Gates Foundation. Trial registration number: 10.1186/ISRCTN83902145
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spelling pubmed-87834562022-01-24 Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India Diamond-Smith, Nadia Gopalakrishnan, Lakshmi Walker, Dilys Fernald, Lia Menon, Purnima Patil, Sumeet BMC Health Serv Res Research OBJECTIVES: Breastfeeding and complementary feeding practices in India do not meet recommendations. Community health care workers (CHWs) are often the primary source of information for pregnant and postpartum women about Infant and Young Child Feeding (IYCF) practices. While existing research has evaluated the effectiveness of content and delivery of information through CHWs, little is known about the quality of the interpersonal communication (respectful care). We analyzed the effect of respectful interactions on recommended IYCF practices. METHODS: We use data from evaluation of an at-scale mHealth intervention in India that serves as a job aid to the CHWs (n = 3266 mothers of children < 12 m from 841 villages in 2 Indian states). The binary indicator variable for respectful care is constructed using a set of 7 questions related to trust, respect, friendliness during these interactions. The binary outcomes variables are exclusive breastfeeding, timely introduction of complimentary feeding, and minimum diet diversity for infants. We also explore if most of the pathway from respectful care to improved behaviors is through better recall of messages (mediation analysis). All models controlled for socio-economic-demographic characteristics and number of interactions with the CHW. RESULTS: About half of women reported positive, respectful interactions with CHWs. Interactions that are more respectful were associated with better recall of appropriate health messages. Interactions that are more respectful were associated with a greater likelihood of adopting all child-feeding behaviors except timely initiation of breastfeeding. After including recall in the model, the effect of respectful interactions alone reduced. CONCLUSIONS: Respectful care from CHWs appears to be significantly associated with some behaviors around infant feeding, with the primary pathway being through better recall of messages. Focusing on improving social and soft skills of CHWs that can translate into better CHW-beneficiary interactions can pay rich dividends. FUNDING: This study is funded by Grant No. OPP1158231 from Bill and Melinda Gates Foundation. Trial registration number: 10.1186/ISRCTN83902145 BioMed Central 2022-01-22 /pmc/articles/PMC8783456/ /pubmed/35062930 http://dx.doi.org/10.1186/s12913-021-07352-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Diamond-Smith, Nadia
Gopalakrishnan, Lakshmi
Walker, Dilys
Fernald, Lia
Menon, Purnima
Patil, Sumeet
Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title_full Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title_fullStr Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title_full_unstemmed Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title_short Is respectful care provided by community health workers associated with infant feeding practices? A cross sectional analysis from India
title_sort is respectful care provided by community health workers associated with infant feeding practices? a cross sectional analysis from india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783456/
https://www.ncbi.nlm.nih.gov/pubmed/35062930
http://dx.doi.org/10.1186/s12913-021-07352-w
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