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A positive deviance-based antenatal nutrition project improves birth-weight in Upper Egypt
Mahshid Ahrari1, Robert F Houser, Siham Yassin
1Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
Journal of Health, Population, and Nutrition
|June 27, 2007
Summary
This study used the positive deviance approach to improve pregnancy outcomes in Egypt. The intervention significantly increased birth-weights and reduced low birth-weight infants by promoting healthy maternal behaviors.
Area of Science:
- Maternal and Child Health
- Public Health Interventions
- Nutritional Epidemiology
Background:
- The positive deviance approach identifies and promotes uncommon healthy behaviors within a community.
- A prior study in Al-Minia Governorate, Egypt, identified key positive deviance behaviors associated with successful pregnancies.
- These behaviors included increased consumption of meat and vegetables, daytime rest, antenatal care, reduced second-hand smoke exposure, and absence of urinary tract infection symptoms.
Purpose of the Study:
- To pilot-test a positive deviance-informed antenatal project to improve pregnancy outcomes, specifically birth-weight and low birth-weight prevalence.
- To evaluate the effectiveness of enhanced antenatal care and the 'IMPRESS' (improved pregnancy through education and supplementation) program.
Main Methods:
- A pilot project was implemented in Al-Minia Governorate, Egypt (2003-2004).
- Health facilities were upgraded for quality antenatal care, including urinary tract infection treatment.
- At-risk pregnant women in target villages attended weekly 'IMPRESS' sessions with counseling and supplemental food.
Main Results:
- Birth-weights of target mothers increased 2.2 times more than comparison mothers (mean increase: 0.58g vs 0.26g, p<0.01).
- The decrease in low birth-weight prevalence was greater in target villages (26.9% decrease) compared to comparison areas (11.9% decrease, p<0.01).
- Target women significantly increased intake of meat, vegetables, and food overall, increased daytime rest, and avoided second-hand smoke more than comparison women.
Conclusions:
- The positive deviance-informed antenatal project effectively improved birth-weights and reduced low birth-weight infants.
- The 'IMPRESS' program and enhanced antenatal care demonstrated positive impacts on maternal behaviors and infant outcomes.
- The intervention's success is leading to a scale-up by the Government of Egypt and partners.
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