Developing Two-Generation Approaches in Communities: Final Report from Family-Centered Community Change

The Annie E. Casey Foundation launched its Family-Centered Community Change (FCCC) initiative with a goal of integrating two-generation strategies into existing place-based community initiatives. The innovative effort, which ran from 2012 to 2019, focused on supporting local partners in three neighborhoods with low economic resources: Buffalo, New York; Columbus, Ohio; and San Antonio, Texas.Over the course of the initiative, the sites worked to promote the healthy development and academic success of children while simultaneously delivering adult services focused on parenting and financial stability. In year three, the community partners also received training and technical assistance — provided by the Casey Foundation — aimed at enhancing racial and ethnic equity and inclusion.The Urban Institute conducted a formative evaluation of this effort, which included: 1) qualitative data collection from interviews and focus groups with partner staff and participants; 2) descriptive analysis of program data; and 3) a cost study

Acceptability and user experiences of a patient-held smart card for antenatal services in Nigeria: a qualitative study

BACKGROUND: Poor maternal, newborn and child health outcomes remain a major public health challenge in Nigeria. Mobile health (mHealth) interventions such as patient-held smart cards have been proposed as effective solutions to improve maternal health outcomes. Our objectives were to assess the acceptability and experiences of pregnant women with the use of a patient-held smartcard for antenatal services in Nigeria. METHODS: Using focus group discussions, qualitative data were obtained from 35 pregnant women attending antenatal services in four Local Government Areas (LGAs) in Benue State, Nigeria. The audio-recorded data were transcribed and analyzed using framework analysis techniques such as the PEN-3 cultural model as a guide. RESULTS: The participants were 18-44 years of age (median age: 24 years), all were married and the majority were farmers. Most of the participants had accepted and used the smartcards for antenatal services. The most common positive perceptions about the smartcards were their ability to be used across multiple health facilities, the preference for storage of the women\u27s medical information on the smartcards compared to the usual paper-based system, and shorter waiting times at the clinics. Notable facilitators to using the smartcards were its provision at the Baby showers which were already acceptable to the women, access to free medical screenings, and ease of storage and retrieval of health records from the cards. Costs associated with health services was reported as a major barrier to using the smartcards. Support from health workers, program staff and family members, particularly spouses, encouraged the participants to use the smartcards. CONCLUSION: These findings revealed that patient-held smart card for maternal health care services is acceptable by women utilizing antenatal services in Nigeria. Understanding perceptions, barriers, facilitators, and supportive systems that enhance the use of these smart cards may facilitate the development of lifesaving mobile health platforms that have the potential to achieve antenatal, delivery, and postnatal targets in a resource-limited setting

Male Partner Involvement on Initiation and Sustainment of Exclusive Breastfeeding Among HIV-infected Post-partum Women: Study Protocol for a Randomized Controlled Trial

Exclusive Breastfeeding (EBF) among human immunodeficiency virus (HIV)-infected mothers is known to be associated with a sustained and significant reduction in HIV transmission and has the potential to reduce infant and under-five mortality. Research shows that EBF is not common in many HIV-endemic, resource-limited settings despite recommendations by the World Health Organization. Although evidence abounds that male partner involvement increases HIV testing and uptake and retention of prevention of mother-to-child transmission interventions, few studies have evaluated the impact of male partners\u27 involvement and decision-making on initiation, maintenance, and sustainment of EBF. We propose a comparative effectiveness trial of Men\u27s Club as intervention group compared to the control group on initiation and sustainment of EBF. Men\u27s Club will provide male partners of HIV-infected pregnant women one 5-hr interactive educational intervention to increase knowledge on EBF and explore barriers and facilitators of EBF and support. Additionally, participating male partners in the Men\u27s Club as intervention group will receive weekly text message reminders during the first 6-week post-natal period to improve initiation and sustainment of EBF. Participants in the Men\u27s Club as control group will receive only educational pamphlets. Primary outcomes are the differences in the rates of initiation and sustainment of EBF at 6 months between the two groups. Secondary outcomes are differences in male partner knowledge of infant feeding options and the intent to support EBF in the two groups. Understanding the role and impact of male partners on the EBF decision-making process will inform the development of effective and sustainable evidence-based interventions to support the initiation and sustainment of EBF