Alive & Thrive Evaluation in Burkina Faso

The time between birth and age 24 months provides a unique opportunity to impact the long-term health and development of children through improved infant and young child feeding practices. In Burkina Faso, the prevalence of exclusive breastfeeding is currently around 25% in infants younger than six months.

The purpose of this study is to evaluate whether the Alive & Thrive intervention package, consisting of interpersonal counselling and community mobilisation activities, can increase the exclusive breastfeeding rate among infants younger than six months to at least 50% using a cluster randomised design.

Study Overview

• Status: Completed
• Conditions: Breast Feeding; Breast Feeding, Exclusive
• Intervention / Treatment: Behavioral: A&T infant and young child feeding intervention

• Study Type: Interventional
• Enrollment (Actual): 4541
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Burkina Faso
  • Bobo-Dioulasso, Burkina Faso, 01 BP 298
    • AFRICSanté
  • Bobo-Dioulasso, Burkina Faso
    • Centre Muraz Research Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 15 years to 49 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Gives informed consent
• Being aged from 15 to 49 years old (women of reproductive age)
• Has at least one infant less than 12 months old who is currently alive and lives with her.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: A&T Intervention Communes	Behavioral: A&T infant and young child feeding intervention; Interpersonal communication delivered by community workers and volunteers during home visits and at monthly mother's group meetings to:Increase mother's knowledge about optimal breastfeeding and its benefitsIncrease mother's self-efficacy related to breastfeedingImprove mother's perceptions about social norms relating to breastfeeding; Community mobilisation activities to:- Raise awareness of the benefits of optimal breastfeeding among opinion leaders, and family members, and increase the support they provide to breastfeeding mothers; Enhanced training of government health workers in infant and young child feeding to:Improve their ability to support mothers and provide timely information about infant feeding
No Intervention: Control Communes

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exclusive Breastfeeding on the Day Preceding the Interview as Assessed by Cross Sectional Survey	The percentage of infants aged less than 6 months who were exclusively breastfed on the day preceding the interview.	Infants up to 6 months in a cross-sectional endline survey scheduled for April - July 2017

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding Within 1 Hour of Birth as Assessed by Cross Sectional Survey	The proportion of newborns aged less than 6 months who were breastfed within 1 hour of birth.	Infants up to 6 months in a cross-sectional endline survey scheduled for April - July 2017
Colostrum Given as Assessed by Cross Sectional Survey	The proportion of newborns aged less than 6 months who were given colostrum.	Infants up to 6 months in a cross-sectional endline survey scheduled for April - July 2017
Pre-lacteal Feeds as Assessed by Cross Sectional Survey	The proportion of newborns aged less than 6 months who received no pre-lacteal feeds before breastfeeding was established	Infants up to 6 months in a cross-sectional endline survey scheduled for April - July 2017
Semi-solid, Solid or Soft Foods Consumed in the Previous Day as Assessed by Cross Sectional Survey	The proportion of infants age 6 to 8 months who received semi-solid, solid or soft foods in the previous day.	Infants age 6-8 months in a cross-sectional endline survey scheduled for April - July 2017
Minimum Acceptable Diet (Apart From Breast Milk) on the Day Preceding Interview as Assessed by Cross Sectional Survey	The proportion of infants aged 6 to 11.9 months who received a minimum acceptable diet (apart from breast milk) on the day preceding interview.	Infants age 6-11.9 months in a cross-sectional endline survey scheduled for April - July 2017
Dietary Diversity as Assessed by Cross Sectional Survey	Dietary diversity among infants age 6 to 11.9 months.	Infants age 6-11.9 months in a cross-sectional endline survey scheduled for April - July 2017
Breast Milk on the Day Preceding the Interview as Assessed by Cross Sectional Survey	The proportion of children aged 6 to 11.9 months who were fed breast milk on the day preceding the interview.	Infants age 6-11.9 months in a cross-sectional endline survey scheduled for April - July 2017
Mother's Accurate Knowledge of Good Breastfeeding Practice as Assessed by Cross Sectional Survey	Mother's accurate knowledge of: Optimal timing of breastfeeding initiation; Optimal duration of exclusive breastfeeding; Benefits of optimal breastfeeding practices for the infant; Solutions to common difficulties, for example engorgement, cracked and sore nipples; Optimal timing to introduce complementary feeding; Optimal dietary diversity and frequency of complementary feeding up to 12 months	Mothers of infants aged up to 12 months in a cross-sectional endline survey scheduled for April - July 2017
Mother's Self-reported Breastfeeding Practices as Assessed by Cross Sectional Survey	Mother's self-reported breastfeeding practices, including asking her if she experiences any barriers or difficulties with breastfeeding such as engorgement, cracked and sore nipples, or breastfeeding when working outside of the home.	Mothers of infants aged up to 12 months in a cross-sectional endline survey scheduled for April - July 2017
Mother's Perceptions and Beliefs Surrounding Breastfeeding	Mother's perceptions and beliefs about breastfeeding (qualitative component).	Mothers of infants aged up to 12 months in a cross-sectional endline survey scheduled for April - July 2017
Knowledge, Beliefs and Perceptions Surrounding Breastfeeding of Family Members	Knowledge, beliefs and perceptions of family members, such as mothers or mothers in law, community opinion leaders towards optimal infant and child feeding practices (qualitative component).	Family members of infants aged up to 12 months in a cross-sectional endline survey scheduled for April - July 2017

Collaborators and Investigators

• Sponsor: London School of Hygiene and Tropical Medicine
• Collaborators: FHI 360; AFRICSanté; Centre Muraz
• Investigators: Principal Investigator: Veronique Filippi, London School of Hygiene and Tropical Medicine

Publications and helpful links

General Publications

• Cresswell JA, Ganaba R, Sarrassat S, Some H, Diallo AH, Cousens S, Filippi V. The effect of the Alive & Thrive initiative on exclusive breastfeeding in rural Burkina Faso: a repeated cross-sectional cluster randomised controlled trial. Lancet Glob Health. 2019 Mar;7(3):e357-e365. doi: 10.1016/S2214-109X(18)30494-7.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2015
• Primary Completion (Actual): August 1, 2017
• Study Completion (Actual): August 1, 2017

Study Registration Dates

• First Submitted: April 22, 2015
• First Submitted That Met QC Criteria: May 1, 2015
• First Posted (Estimate): May 6, 2015

Study Record Updates

• Last Update Posted (Actual): December 4, 2018
• Last Update Submitted That Met QC Criteria: December 3, 2018
• Last Verified: August 1, 2017

More Information

Terms related to this study

• Keywords: Burkina Faso; Infant Nutrition; Breast Feeding, Exclusive
• Other Study ID Numbers: 9066 (Minnesota Medical Foundataion)