What are the barriers to attendance to the MNCHW and how can these be reduced?

Maternal Newborn and Child Health Week (MNCHW) was launched in Nigeria in 2009 as a bi-annual campaign-style programme designed to deliver key child and maternal health interventions and to revitalise health care systems. Support to strengthen this programme, in the five northern Nigerian States of Katsina, Jigawa, Kebbi, Zamfara and Yobe, is being provided by the UK Department for International Development (DFID) through its 6-year programme - Working for Improving Nutrition in Northern Nigeria (WINNN). This programme is being implemented by Save the Children International (SCI) and Action Against Hunger (Action Contre la Faim, ACF) in partnership with the five state governments. WINNN focuses on strengthening three key interventions within MNCHW, which are supplementation of Vitamin A and deworming (Albendazole), for children 6-59 months of ages, and supplementation of iron-folate for pregnant women. However, a key challenge, identified by WINNN for MNCHW programme success, has been low rates of MNCHW attendance. This document reports on the operations research undertaken to understand the barriers to MNCHW attendance and how to strengthen social mobilisation to improve it.UKAi

How to Strengthen the CMAM programme in Northern Nigeria and reduce rates of programme defaulting

This report presents findings from the operations research (OR) study which was conducted to identify barriers to attendance of the Maternal Neonatal and Child Health Weeks programme (MNCHW), in two states of northern Nigeria – Jigawa and Zamfara States. The work was a collaborative project between the London School of Hygiene & Tropical Medicine, Food Basket Foundation International and Oxford Policy Management. The treatment and prevention of severe acute malnutrition via the Community Management of Acute Malnutrition programme (CMAM) is one of four outputs of the DFID-funded development project “Working to Improve Nutrition in Northern Nigeria” (WINNN). This output aims to deliver, in the five WINNN supported northern states, effective treatment for severe acute malnutrition through local health systems. WINNN is implemented by UNICEF, Action Against Hunger (ACF) and Save the Children International (SCI), in partnership with the five state governments. SCI is responsible for its implementation in Zamfara, Kebbi and Katsina states, and ACF is responsible for its implementation in Jigawa and Yobe states. The CMAM services include: (1) Community outreach, for the early identification and referral of severe acute malnutrition (SAM) and later follow-up; (2) Outpatient care for children with SAM without medical complications at health facilities and at home (Outpatient Therapeutic Programme, OTP); (3) Inpatient care for children with SAM, and medical complications or no appetite (Inpatient Therapeutic Programme, ITP)

How to strengthen an Infant and Young Child Feeding programme in Northern Nigeria

This four-page research summary brief highlights findings and recommendations from operations research into how to strengthen the implementation of an Infant and Young Child Feeding (IYCF) programme and to motivate behaviour change to improve IYCF practices in northern Nigeria. The research found that the IYCF programme was viewed positively by a range of beneficiaries and stakeholders, including family members, traditional birth attendants, IYCF programme community volunteers, health workers and state government officials, because of the perceived visibility of the health benefits, including less episodes of diarrhoea, and consequent savings on health care. Recommendations for the IYCF programme include review strategies for CV training and strengthen supportive supervision, especially in relation to counselling techniques and facilitation of support groups; reinforce and strengthen the use of examples of real healthy children who have been exclusively breastfed to enhance the acceptability of the messages and adoption of the behaviour change; and adopt multiple behaviour change techniques, including food demonstrations and professionally developed mass media

How to strengthen the Infant and Young Child Feeding (IYCF) programme in Northern Nigeria

This report presents findings from the operations research (OR) study which was conducted to strengthen the Infant and Young Child Feeding (ITCF) programme, in northern Nigeria .The work was a collaborative project between the London School of Hygiene & Tropical Medicine, Food Basket Foundation International and Oxford Policy Management. The prevention of under-nutrition via the IYCF programme is one of four outputs of the DFID-funded programme “Working to Improve Nutrition in Northern Nigeria” (WINNN). This output aims to prevent under-nutrition by promoting evidence-based IYCF feeding recommendations, including exclusive breastfeeding until an infant is 6 months of age, feeding a diverse diet of nutritious foods and breastmilk from 6-23 months of age, feeding a sick child and good hand-washing practices. WINNN is implemented by UNICEF, Action Against Hunger (ACF) and Save the Children International (SCI), in partnership with five state governments. SCI is responsible for its implementation in Zamfara, Kebbi and Katsina states, and ACF is responsible for its implementation in Jigawa and Yobe states. Each of the five WINNN states implements the IYCF programme in three Local Government Areas (LGAs). The IYCF programme includes: (1) Facility-based IYCF counselling for pregnant women and mothers with an infant less than 2 years of age, facilitated by health workers (HWs); (2) Community-based IYCF counselling for pregnant women and mothers with an infant less than 2 years of age, facilitated by community volunteers (CVs); (3) Community-based meetings with fathers of infants less than 2 years of age and grandmothers, facilitated by CVs

How to strengthen a Community-Based Management of Acute Malnutrition programme in northern Nigeria

This summary highlights findings and recommendations from operation research on a Community-Based Management of Acute Malnutrition (CMAM) programme in northern Nigeria. The study analysed the perceived benefits of CMAM; reasons for beneficiaries not defaulting from the programme; challenges of accessing CMAM services; the workloads and motivation of health workers and community volunteers; and what is required to integrate CMAM into the primary health system.UK Ai

Temporal proteomic profiling of postnatal human cortical development.

Healthy cortical development depends on precise regulation of transcription and translation. However, the dynamics of how proteins are expressed, function and interact across postnatal human cortical development remain poorly understood. We surveyed the proteomic landscape of 69 dorsolateral prefrontal cortex samples across seven stages of postnatal life and integrated these data with paired transcriptome data. We detected 911 proteins by liquid chromatography-mass spectrometry, and 83 were significantly associated with postnatal age (FDR < 5%). Network analysis identified three modules of co-regulated proteins correlated with age, including two modules with increasing expression involved in gliogenesis and NADH metabolism and one neurogenesis-related module with decreasing expression throughout development. Integration with paired transcriptome data revealed that these age-related protein modules overlapped with RNA modules and displayed collinear developmental trajectories. Importantly, RNA expression profiles that are dynamically regulated throughout cortical development display tighter correlations with their respective translated protein expression compared to those RNA profiles that are not. Moreover, the correspondence between RNA and protein expression significantly decreases as a function of cortical aging, especially for genes involved in myelination and cytoskeleton organization. Finally, we used this data resource to elucidate the functional impact of genetic risk loci for intellectual disability, converging on gliogenesis, myelination and ATP-metabolism modules in the proteome and transcriptome. We share all data in an interactive, searchable companion website. Collectively, our findings reveal dynamic aspects of protein regulation and provide new insights into brain development, maturation, and disease

Curricular Factors that Unintentionally Affect Learning in a Community-Based Interprofessional Education Program: The Student Perspective

Background: The Dalhousie Health Mentors Program (DHMP) is a community-based, pre-licensure interprofessional education initiative that aims to prepare health professional students for collaborative practice in the care of patients with chronic conditions. This program evaluation explores the students’ 1) learning and plans to incorporate skills into future practice; 2) ratings of program content, delivery, and assignments; 3) perspectives of curricular factors that inadvertently acted as barriers to learning; and 4) program improvement suggestions.Methods: All students (N = 745) from the 16 participating health programs were invited to complete an online mixed methods program evaluation survey at the conclusion of the 2012–2013 DHMP. A total of 295 students (40% response rate) responded to the Likert-type questions analyzed using descriptive and non-parametric statistics. Of these students, 204 (69%) provided responses to 10 open-ended questions, which were analyzed thematically.Findings: While the majority of respondents agreed that they achieved the DHMP learning objectives, the mixed-methods approach identified curriculum integration, team composition, and effectiveness of learning assignments as factors that unintentionally acted as barriers to learning, with three key student recommendations for program improvement.Conclusions: Educators and program planners need to be aware that even well-intended learning activities may result in unintended experiences that hamper interprofessional learning

A scoping review of medical education research in family medicine

Background: Little is known about the state of education research within family medicine. As family medicine education models develop, it is important to develop an understanding of the current state of this research and develop ways to advance the field. Methods: We conducted a scoping review of family medicine education research to describe 1) research topic areas and 2) the methodologies and methods used to study these topics. MEDLINE, Social Sciences Abstracts and ERIC electronic databases were searched. 817 full text articles from 2002 to 2012 were screened; 624 articles were included in the review. Results: The following research topic areas were identified: continuing education, curriculum development, undergraduate education, teaching methods, assessment techniques, selection of entrants, non-clinical skills, professional and faculty development, clinical decision-making and resident well-being. Quantitative studies comprised the large majority of research approaches; overall minimal methodological details were provided. Conclusions: Our review highlights an overall need for increased sophisticated in methodological approaches to education research in family medicine, a problem that could be ameliorated by multiple strategies including better engagement of methodologists throughout the research process. The results provide guidance for future family medicine education research programs