In our first published article, we asked Kenyan mothers and healthcare workers about child feeding practices in the research areas prior to the distribution of the GloCal videos.
We found that the mothers were quite knowledgeable when it came to breastfeeding but that there were serious gaps in their knowledge about complementary feeding. Also some the health care workers were less confident in their knowledge about complementary feeding.
We concluded that:
- the mothers should be supported in their own decision making and given the tools to be able to make good decisions about child feeding
- the mothers would need more support in general
- the mothers should be encouraged to turn to the health centers rather than the internet or commercials for correct information about child feeding
- the healthcare workers should be further educated in the area of complementary feeding to be able to convincingly advice the mothers.
Is competence enough to enable Kenyan mothers to make good infant and young child feeding decisions?
Schneider L, Ollila S, Kimiywe J, Lubeka C, Mutanen M. Matern Child Nutr. 2017 Oct;13(4). doi: 10.1111/mcn.12422. Epub 2017 Feb 10.
The aim of this study was to explore factors associated with maternal infant and young child feeding motivation in urban and rural Kenya. We conducted 18 focus group discussions with mothers of children 0 to 23 months of age and healthcare workers. The data were transcribed, translated, and explored following the principles of content analysis. We first explored and coded the data inductively and categorized it according to emerging themes representing the most relevant topics for young child feeding. After this, these themes were theorized into an explanatory framework. Finally, the results yielded seven themes integrated into self‐determination theory’s three basic motivation‐building pillars: autonomy, competence, and relatedness. We found that maternal intrahousehold autonomy on child feeding was substantial. However, this autonomy was lost for a period of time while in close contact with the healthcare staff. The authority of the healthcare workers was at its peak when the child was born and faded gradually as the child grew. Building maternal competence is important for child‐feeding outcomes, but our data showed that the health education methods used by the healthcare workers were inadequate to improve maternal motivation. The competence of Kenyan healthcare workers should be improved in the area of complementary feeding counseling, and they should be trained to provide practical and emotional support as a way of increasing maternal motivation on infant and child feeding.
In our second published article, we evaluated the effectiveness of the videos when these were shown in the waiting rooms of Mother and Child Health Centers in Kenya.
We did this through two different approaches: a questionnaire and group discussions with mothers.
We found that:
- the videos were an accepted form of education and the mothers found them beneficial
- the videos enhanced mothers’ learning and empowered them to support others in learning
- outcomes were better among mothers who had seen videos often.
Mothers’ perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach
Schneider L, Kosola M, Uusimäki K, Ollila S, Lubeka C, Kimiywe J, Mutanen M. Mothers’ perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach. Public Health Nutr. 2021 May 26:1-14. doi: 10.1017/S1368980021002342.
The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0.06), complementary feeding knowledge (P = 0.01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0.003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.
In our third article, we asked community health workers (CHWs) and mothers in rural Uganda to tell us about their experience of the videos after these had been used as a teaching tool by the CHWs who visited families in the area.
We discovered that:
- Mobile phones with the GloCal videos can improve CHW motivation in rural Uganda as these videos enhanced impact, meaningfulness, competence and choices of perceived CHW work.
- CHWs and families felt that learning from videos was easier compared with traditional education methods, primarily as it was easier to see the message in addition to hearing it.
- Mothers reported improvements in child feeding and hygiene practices during the intervention and the same was echoed by the CHWs.
- Educational videos are a promising method to improve child feeding and hygiene in Uganda.
The usefulness of nutrition and health videos displayed on mobile phones in rural Uganda: Experiences of community health workers and mothers
Schneider L, Ollila S, Mutanen M. Matern Child Nutr. 2022 Jan 24;e13322. doi: 10.1111/mcn.13322. Online ahead of print.
Improvements in community health workers’ (CHWs) knowledge and practices in low‐income countries increasingly involve mobile phones and videos. However, little data exists on CHWs’ and mothers’ experiences of using such phones and videos. In this study, educational videos on nutrition, health and hygiene were downloaded onto mobile phones, which were given to 12 CHWs in rural Uganda. In 2018, these CHWs used the videos for a period of 3 months to support their work during their visits with families. We subsequently conducted individual interviews with eight CHWs and held four focus group discussions with 16 mothers. From the inductively analysed data, we identified four key themes: impact, competence, meaningfulness and choice, which are also dimensions of the Intrinsic Task Motivation Model. The model describes the motivation of workers and has previously been used in connection with CHWs. In our study, CHWs and mothers considered that the videos had more strongly impacted their learning than traditional teaching methods, and they felt the videos improved the child feeding and caring competence of both CHWs and mothers. Furthermore, the CHWs found that the videos enhanced the meaningfulness of their work, as they felt more greatly appreciated and necessary. In addition, they experienced more freedom of choice in their ability to influence their working routines. This study shows that educational videos are well received among CHWs and mo- thers. Educational videos are a promising method to maintain and improve the motivation of voluntary CHWs and influence correct child feeding and hygiene practices in Uganda.