Accent modification as a raciolinguistic ideology: a commentary in response to Burda et al. (2022)

In this commentary, we collectively examine a recent article titled “Effectiveness of Intense Accent Modification Training with Refugees from Burma” by Burda et al. (2022). Whilst our response is aimed at revealing the theoretical and methodological shortcomings of Burda et al., it will also expose the raciolinguistic ideologies in accent modification and highlight the need for careful ethical considerations on vulnerable populations, such as refugees and asylum seekers

Impacts of a social and behavior change communication program implemented at scale on infant and young feeding practices in Nigeria: Results of a cluster-randomized evaluation

Background Infant and young child feeding (IYCF) practices are important for child survival and healthy growth, but IYCF practices remain suboptimal in Nigeria. The objective of this study was to measure the impact of Alive & Thrive’s IYCF social and behavior change communication intervention on early initiation of breastfeeding, exclusive breastfeeding, and minimum dietary diversity in Kaduna and Lagos States. Methods Local government areas were randomly allocated to intervention or comparison. Cross-sectional surveys of households with children aged 0–23 months were conducted [N = 6,266 baseline (2017), N = 7,320 endline (2020)]. Logistic regression was used to calculate difference-in-differences estimates (DDEs) of impact on IYCF practices and to assess within group changes from baseline to endline. Associations between intervention exposures and IYCF practices were tested in both study groups combined. Results In Kaduna, a positive differential effect of the intervention was found for exclusive breastfeeding (adjusted DDE 8.9 pp, PConclusions This evaluation found weak impacts of the Alive & Thrive intervention on IYCF practices in the difference-in-differences analysis because of suspected intervention spillover to the comparison group. Substantial within group increases in IYCF practices from baseline to endline are likely attributable to the intervention, which was the major IYCF promotion activity in both states. This is supported by the association between intervention exposures and IYCF practices. Trial registration The study was registered with clinicaltrials.gov (NCT02975063)

Impacts of a social and behavior change communication program implemented at scale on infant and young feeding practices in Nigeria: Results of a cluster-randomized evaluation.

BackgroundInfant and young child feeding (IYCF) practices are important for child survival and healthy growth, but IYCF practices remain suboptimal in Nigeria. The objective of this study was to measure the impact of Alive & Thrive's IYCF social and behavior change communication intervention on early initiation of breastfeeding, exclusive breastfeeding, and minimum dietary diversity in Kaduna and Lagos States.MethodsLocal government areas were randomly allocated to intervention or comparison. Cross-sectional surveys of households with children aged 0-23 months were conducted [N = 6,266 baseline (2017), N = 7,320 endline (2020)]. Logistic regression was used to calculate difference-in-differences estimates (DDEs) of impact on IYCF practices and to assess within group changes from baseline to endline. Associations between intervention exposures and IYCF practices were tested in both study groups combined.ResultsIn Kaduna, a positive differential effect of the intervention was found for exclusive breastfeeding (adjusted DDE 8.9 pp, PConclusionsThis evaluation found weak impacts of the Alive & Thrive intervention on IYCF practices in the difference-in-differences analysis because of suspected intervention spillover to the comparison group. Substantial within group increases in IYCF practices from baseline to endline are likely attributable to the intervention, which was the major IYCF promotion activity in both states. This is supported by the association between intervention exposures and IYCF practices.Trial registrationThe study was registered with clinicaltrials.gov (NCT02975063)

Gender norms and women’s empowerment as barriers to facility birth : A population-based cross-sectional study in 26 Nigerian states using the World Values Survey

Background Central and western Africa struggle with the world’s lowest regional proportion of facility birth at 57%. The aim of the current study was to compare beliefs related to maternal health care services, science/technology, gender norms, and empowerment in states with high vs. low proportions of facility birth in Nigeria. Methods Face-to-face interviews were performed as part of a nationally representative survey in Nigeria using a new module to measure values and beliefs related to gender and sexual and reproductive health and rights collected as part the 2018 World Values Survey. We compared beliefs related to maternal health care services, science/technology, gender norms, and empowerment between Nigerian states with facility birth proportions > 50% vs. < 25% as presented in the 2018 Nigerian Demographic Health Survey report. Pearson’s chi-squared test, the independent t-test, and univariable and multivariable logistic and linear regression were used for analyses. Results were also stratified by gender. Results Among the 1,273 participants interviewed, 653 resided in states with high and 360 resided in states with low proportions of facility birth. There were no significant differences between the groups in perceived safety of facility birth (96% vs. 94%) and confidence in antenatal care (91% vs 94%). However, in states with low proportions of facility birth, participants had higher confidence in traditional birth attendants (61% vs. 39%, adjusted odds ratio [aOR] 2.1, [1.5–2.8]), men were more often perceived as the ones deciding whether a woman should give birth at a clinic (56% vs. 29%, aOR 2.4 [1.8–3.3]), and participants experienced less freedom over their own lives (56% vs. 72%, aOR 0.56 [0.41–0.76]). Most differences in responses between men and women were not statistically significant. Conclusions In order to increase facility births in Nigeria and other similar contexts, transforming gender norms and increasing women’s empowerment is key

Impact of Alive & Thrive on mothers’ knowledge and awareness of key IYCF practices in Kaduna and Lagos States, Nigeria.

Impact of Alive & Thrive on mothers’ knowledge and awareness of key IYCF practices in Kaduna and Lagos States, Nigeria.</p

COVID endline sensitivity analysis for IYCF practices, by state.

COVID endline sensitivity analysis for IYCF practices, by state.</p

Impact of Alive & Thrive on IYCF practices in Kaduna and Lagos States, Nigeria.

Impact of Alive & Thrive on IYCF practices in Kaduna and Lagos States, Nigeria.</p

Consort diagram for the Alive & Thrive Nigeria impact evaluation.

Consort diagram for the Alive & Thrive Nigeria impact evaluation.</p

Alive & Thrive Nigeria impact evaluation survey sample sizes for baseline and endline.

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Alive & Thrive Nigeria impact evaluation initial study protocol.

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