Integrating Nutrition Into Health Systems at Community Level: Impact Evaluation of the Community-based Maternal and Neonatal Health and Nutrition Projects in Ethiopia, Kenya, and Senegal

Background: Maternal undernutrition and mortality are high across many countries in Africa. There is lack of evidence on how to strengthen health systems to ensure that women and newborns can utilize health interventions.

Methods: Three quasi-experimental nonrandomized community-based projects on maternal and neonatal health and nutrition were conducted in Ethiopia, Senegal, and Kenya. The aim was to evaluate the impact on knowledge and practices as they relate to maternal and neonatal care. Logistic regression and repeated-measures models were used.

Results: Combined country analyses showed significant positive effects of the intervention on women receiving first ANC visit, consumption of iron and folic acid, exclusive breastfeeding infants, facility-based deliveries, and facility-based postnatal care. No significant differences were found between the intervention and control groups regarding one or more and four or more ANC visits, early initiation of breastfeeding, and women consuming iron and folic acid for more than 90 days.

Conclusions: Integrating proven nutrition interventions into community-level health programs improved access to and use of ANC, delivery services, and postnatal care by women.