Effectiveness of Integrated Maternal Nutrition Intervention Package on Birth Weight in Rwanda

Abstract

Inadequate maternal nutrition before and during pregnancy is a principal risk factor for poor fetal development, resulting in low birth weight (LBW) and subsequently, poor child growth. Most studies focus on the impact of nutritional interventions after birth while only a few interventions consider integrated nutrition service packages. Therefore, there is limited evidence on whether integrated maternal nutrition interventions have a positive effect on birthweight. Thus, a post-program quasi-experimental study was carried out to determine the effectiveness of the integrated maternal nutrition intervention package on low birth weight in Rwanda. A total of 551 mother–baby pairs from the intervention and 545 controls were included in the analysis. Data regarding socio-demographic, maternal anthropometric parameters, and dietary diversity were collected using a structured questionnaire. Birth weight was assessed right after delivery, within 24 h. Logistic regression, linear regression, and path analysis were fitted to determine the effectiveness of the intervention on birth weight. The study found that the intervention reduced LBW by 66.99% (p < 0.001) and increased average birth weight by 219 g (p < 0.001). Logistic regression identified reduced risk of LBW among the intervention group (AOR = 0.23; 95%CI = 0.12–0.43; p < 0.001). It was also observed that the direct effect of the intervention on birth weight was 0.17 (β = 0.17; p < 0.001) and the main indirect mediator was maternal MUAC (β = 0.05; p < 0.001). Moreover, maternal passive smoking exposure and MUAC < 23 cm were found as risk factors for LBW. This study has demonstrated that an integrated maternal nutritional intervention package can significantly reduce LBW in low-income settings and should, therefore, be considered to improve birth weight.

Effect of nutrition assessment, counselling and support integration on mother- infant nutritional status, practices and health in Tororo and Butaleja districts, Uganda: A comparative non equivalent quasi experimental study

“…This implies that nutrition integration had a potential benefit of on the foetal and infant growth and development. Our findings concur with; Veeena et al [34] M Barker et al [8], Von Salmuth et al [10], Olutayo et al [11], Micheal Habtu etal [35] on the effectiveness of a holistic approach to improving the nutritional status of children.…”

Effect and Challenges of an Integrated Nutrition-Intervention Package Utilization among Pregnant Women and Lactating Mothers in Rwanda: An Exploratory Qualitative Study

“…All these improved knowledge and skills; in addition, a changed positive mindset regarding nutrition and women empowerment could have affected on the perceived improved nutritional status by addressing both immediate and underlying causes of malnutrition as highly expressed by many of the key informants and FGDs participants in the study. This is supported by quasi-experimental studies conducted by the same authors, which found that the Gikuriro intervention was associated with a significant reduction of low birth weight and maternal undernutrition [ 12 , 13 ].…”

“…Recent quantitative studies have been performed to evaluate the effect of the Gikuriro program on maternal nutritional status and birth weight. Both postprogram quasi-experiments revealed that the intervention led to significant reduction of low birth weight and maternal undernutrition [ 12 , 13 ]. The main success factor having been attributed to the integration of nutrition-specific and nutrition-sensitive intervention package.…”

Low birth weight among infants and pregnancy outcomes among women living with HIV and HIV-negative women in Rwanda

“…It is well known that maternal nutrition during pregnancy has a pivotal role in the regulation of placental-fetal development, that suboptimal maternal nutrition yields LBW [ 46 – 48 ] and nutritional interventions during pregnancy have been shown to positively affect LBW [ 49 , 50 ]. Thus, the strong association between maternal underweight and LBW that we observed could serve as evidence to support such interventions particularly for WLHIV and primigravidae women.…”