EVALUATION OF FAITH-BASED COMMUNICATION APPROACH TO IMPROVE UPTAKE OF NUTRITION SERVICES AMONG CAREGIVERS IN AKWA IBOM STATE, NIGERIA

Abstract

Infant and child malnutrition remains a public health problem in Nigeria with increasing prevalence of underweight and wasting. Appreciation of nutritional services and its utilisation in Nigeria are very low. Utilisation of nutritional services is known to improve with effective communication. However, potentials of faith-based communication approach in enhancing utilisation remain unexplored in Nigeria. This study was designed to evaluate the impact of faith-based communication (Bible based health messages communicated through churches) on nutritional practices and service uptake among caregivers in Akwa Ibom State. This quasi-experimental study involved a multi-stage sampling technique to select 1,284 mother-child dyads from communities in Akwa Ibom State, randomly assigned to experimental (642) and control (642) groups. A faith-based nutritional communication guide was used to train mothers for four days in the experimental group. Socio-demographic characteristics of respondents were obtained using a semi-structured questionnaire. Data were collected on practice of exclusive breastfeeding (EBF), intention to continue breastfeeding up to 24 months, food groups used for complementary feeding (CF), intake of micronutrient fortified foods/supplements (MI). Knowledge and intention to practice recommended infant feeding behaviours (EBF, CF, MI) as well as growth monitoring (GMP) were assessed. Mean scores were calculated at pre-intervention and 12 weeks post intervention. Change in utilization of nutrition services was assessed from hospital attendance records on GMP. Data were analysed using descriptive statistics, Chi-square and student t-test. Test of significance was determined at p=0.05. A total of 1,065 mother-child dyads completed the study, with a response rate of 83.0% (541) and 82% (524) in the study and control groups, respectively. Most respondents were Christians (95.8%), married (87.1%), and had at least primary education (83.9%). Mothers were aged 27±7 years while index child age was 15±9 months. There was a significant difference in EBF rate at pre-intervention assessment among mothers with children >6 months in control groups (CGPr), 13.0% and experimental groups (EGPr), 13.5% (p<0.05). Intention to breastfeed up to 24 months increased from 1.9% to 2.2% (p>0.05) in control group at post-intervention (CGPo) and from 3.1% to 8.8% (p<0.05) in experimental group at post-intervention (EGPo). Use of 3 to 4 food groups for CF increased from 32.1% to 32.7% in CGPo (p>0.05), and 26.9% to 28.0% in EGPo (p<0.05). Intention to practice MI decreased from 62.9% in CGPr to 24.4% in CGPo and increased from 15.4% in EGPr to 63.4% in EGPo. Scores on knowledge domains increased (p<0.05) in EGPo compared to EGPr as follows: micronutrient intake (MI) (4.37±0.71 vs. 3.95±0.7), ExBF (3.95±0.23 vs. 3.47±1.11), CF (2.71±0.7 vs. 2.34±0.81), and GMP (2.39±0.9 vs. 1.77±0.83). Intention to practice recommended behaviours improved significantly (p<0.05) in the four domains, EBF (2.57±0.63 vs. 2.88±0.44), CF (2.12±0.71 vs. 2.59±0.64), GMP (2.42±0.59 vs. 2.57±0.59) and MI (1.55±0.76 vs. 2.72±0.72). Utilisation by GMP services increased from 0.2% in EGPr to 6.2% in EGPo (p<0.05). The faith-based approach was effective to promote knowledge, caregivers’ behavioural change and increase in utilisation of nutritional services in Akwa Ibom state. Faith-based communication approach should be adopted to complement other health intervention approaches in Nigeria.