EFFECTS OF BEHAVIOURALCHANGE COMMUNICATION ON CHILD SURVIVAL PRACTICES AMONGMOTHERS OF UNDER-FIVE CHILDREN INSELECTEDSOUTHWESTERN STATES, NIGERIA

Abstract

ABSTRACT Child Survival (CS) is an essential component of public health concerned with reducing child morbidity and mortality. Despite the availability of knowledge and technology for life-saving interventions, Nigeria ranks seventh highest in Under-5 Mortality Rate (U5MR) globally. Behavioural Change Communication (BCC) is useful in promoting positive health outcome through several models. However,its potential in promoting CS practices remains understudied. The study was conducted to evaluate the effects of BCC on CS practices among mothers of under-five children in selected Southwestern states, Nigeria. Cluster randomized designinvolving a four-stage sampling technique was adopted. In Oyo, Ogun, and EkitiStates, two Local Government Areas (LGAs) per state and three communities per LGA were selected using simple random sampling technique. Households and mother-child pair were selected using a systematic sampling technique. A total of 1308 (Oyo-438, Ogun-444,and Ekiti-426) mother-child pairs were selected at baseline, from which 654 (218 per state) were randomly assigned to Experimental Group (EG) (327) and Control Group (CG) (327). Experimental group was exposed to six sessions of BCC and followed-up using interpersonal communication approach for six months. Pre-tested, interviewer-administered, semi-structured questionnaire containing 12-point knowledge and 13-point practice scales were used to assess mothers’ knowledge and practices of CS. The CS components measured were newborn care, breastfeeding,and complementary feeding, micronutrient supplementation, immunisation, management of sick children and use of mosquito net. Dietary intake (24-hour recall) and Anthropometric parameters of children were analysed using total dietary assessment and WHO Anthro. Data were analysed using descriptive statistics, paired students’t-test and multiple regression models at α0.05.

Ages of mothers and children were 30.7±6.1 years and 28.8±14.8 months respectively. Majority of the mothers were Yoruba (89.8%), married (94.9%) and had secondary education (51.7%). The majority (69.1%) and 59.1% had no access to an improved toilet facility and refuse disposal methods, respectively. Overall, U5MR was 52 per 1,000 live births. Wasting, underweight, stunting, overweight and obesity were: 4.8%, 8.4%, 18.3%, 12.3% and 13.5%, respectively. Mothers’ knowledge of CS components significantly increased from 4.5±3.0 at baseline to 10.2±1.8for EG and increased from 4.9±2.1 to 5.3±2.1 for CG. Mothers’ practice of CS increased from 3.96±2.13 at baseline to 12.9±2.4 for EG and from 3.8±2.1 to 3.9±2.1 for CG. Adequate intake of energy, protein, carbohydrate, vitamin A, iron and calcium among children increased from 24.6%, 25.4%, 33.3%, 5.6%, 35.7% and 6.3% at baseline to 41.6%, 32.9%, 36.6%, 6.2%, 37.9% and 6.9% post-intervention, respectively. Wasting, underweight and stunting decreased in EG from 7.3%, 9.3% and 20.6% at baseline to 2.7%, 3.0% and 16.3% at post-intervention, respectively. The odds of CS is twice higher in literate than non-literate mothers (OR: 1.9; CI: 1.2-2.8), urban than rural dwellers (OR: 2.2; CI: 1.1-4.8).

Behavioural change communication improved mothers’ child survival knowledge and practices and reduced child’s under-nutrition. Its use is recommended for promoting child survival practices among mothers of under-five children.