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The Journal of Health, Population and Nutrition
icddr,b
ISSN: 1606-0997
EISSN: 1606-0997
Vol. 24, No. 4, 2006, pp. 498 - 507
Bioline Code: hn06059
Full paper language: English
Document type: Research Article
Document available free of charge

The Journal of Health, Population and Nutrition, Vol. 24, No. 4, 2006, pp. 498 - 507

 en A Positive Deviance-based Antenatal Nutrition Project Improves Birth-weight in Upper Egypt
Ahrari, Mahshid; Houser, Robert F.; Yassin, Siham; Mogheez, Mona; Hussaini, Y.; Crump, Patrick; Darmstadt, Gary L.; Marsh, David & Levinson, F. James

Abstract

The positive deviance approach identifies and promotes existing uncommon healthy behaviours. A positive deviance-informed antenatal project was pilot-tested in Al-Minia Governorate, Upper Egypt, during 2003-2004, after a positive deviance study in 2000 found that successful pregnancies had in­creased consumption of meat and vegetables, daytime rest, and antenatal care; less second-hand smoke exposure; and symptoms of no urinary tract infection. Accordingly, health facilities were upgraded in target and comparison areas to provide quality antenatal care, including treatment of urinary tract in­fection. Additionally, in the target villages, women at-risk of delivering low-birth-weight infants were enrolled in weekly 'IMPRESS' (improved pregnancy through education and supplementation) ses­sions with counselling and supplemental food. In total, 519 women (344 target, 175 comparison) were enrolled in the third or fourth month of pregnancy and were followed through delivery. Birth-weights of the target mothers increased 2.2 times more than birth-weights of the comparison mothers over baseline (mean increase: 0.58 vs 0.26 g respectively, p<0.01). Similarly, the decrease in prevalence of low birth-weight from baseline was greater in the target villages than in the comparison mothers (% of decrease: 26.9 vs 11.9 respectively, p<0.01). The target at-risk women were far more likely than their counterparts to report eating more food (54.9% vs 10.6%), more meat (57.1% vs 4.2%), more vegeta­bles (66.9% vs 5.3%), increasing daytime rest (64.1% vs 11.7%), and avoiding second-hand smoke (91.3% vs 51.6%) during pregnancy. The cost per 100 g of improvement in birth-weight was US$ 3.98. The Government of Egypt and partners are scaling up the elements of the project.

Keywords
Positive deviance; Pregnancy outcomes; Birth-weight; Pregnancy weight gain; First preg­nancies; Antenatal care; Urinary tract infections; Daytime rest; Second-hand smoke; Be­haviour change; Egypt

 
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