No abstract

IntroductionChildhood obesity has been associated with the intake of energy-dense foods and sedentary lifestyle, and with mental health indicators such as anxiety and perception of body image. In Mexico it has not been studied the relationship between these variables in children.

Objective: The WHO and UNICEF recommend home visits to improve health outcomes for mothers and newborns. We evaluated the effect of home visits by community volunteers during pregnancy and postpartum on breastfeeding practices, women´s knowledge about benefits, beliefs and myths of breastfeeding, obstetric and neonatal warning signs, preparation for childbirth and initial care for newborns, and diarrhea and respiratory diseases in children. Design: Community quasi-experimental design. We estimated difference-in-difference models with fixed effects at the community level weighted by propensity score and investigated implementation barriers through focus groups and semi-structured interviews. Setting: Poor rural communities in Mexico; 48 intervention and 29 control. Participants: Baseline and follow-up information were reported from two independent cross-sectional samples of women with babies aged between six and 18 months (baseline: 292 control, 320 intervention, follow-up: 292 control, 294 intervention). Results The intervention increased reports of exclusive breastfeeding in the first six months by 24.4 percentage points (pp) (95% CI 13.4, 35.4), mothers’ knowledge of obstetric warning signs by 23.4 pp (95% CI 9.2, 37.5), and neonatal warning signs by 26.2 pp (95% CI 15.2, 37.2) compared to the control group. A non-linear dose-response relation with the number of home visits was found. Diarrhea and respiratory diseases among children decreased in the intervention vs control group, but were not statistically significant. Conclusions: Home visits should be implemented as a complementary strategy to the provision of prenatal and postnatal care in rural communities due to their potential positive effects on the health of mothers and their children.

Results shows the incongruence between the Programs recommendations and the preferences and practices of the target population and provides important elements to be considered in the promotion of the NS .