Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA.
IFPRI, New Delhi, India.
J Nutr. 2023 Apr;153(4):1220-1230. doi: 10.1016/j.tjnut.2023.02.010. Epub 2023 Feb 14.
Counseling on infant and young child feeding (IYCF) to support optimal breastfeeding and complementary feeding practices is an essential intervention, and accurate coverage data is needed to identify gaps and monitor progress. However, coverage information captured during household surveys has not yet been validated.
We examined the validity of maternal reports of IYCF counseling received during community-based contacts and factors associated with reporting accuracy.
Direct observations of home visits conducted by community workers in 40 villages in Bihar, India served as the "gold standard" to maternal reports of IYCF counseling received during 2-wk follow-up surveys (n = 444 mothers with children less than 1 y of age, interviews matched to direct observations). Individual-level validity was assessed by calculating sensitivity, specificity, and AUC. Population-level bias was measured using the inflation factor (IF). Multivariable regression models were used to examine factors associated with response accuracy.
Prevalence of IYCF counseling during home visits was very high (90.1%). Maternal report of any IYCF counseling received in the past 2 wk was moderate (AUC: 0.60; 95% CI: 0.52, 0.67), and population bias was low (IF = 0.90). However, the recall of specific counseling messages varied. Maternal report of any breastfeeding, exclusive breastfeeding, and dietary diversity messages had moderate validity (AUC > 0.60), but other child feeding messages had low individual validity. Child age, maternal age, maternal education, mental stress, and social desirability were associated with reporting accuracy of multiple indicators.
Validity of IYCF counseling coverage was moderate for several key indicators. IYCF counseling is an information-based intervention that may be received from various sources, and it may be challenging to achieve higher reporting accuracy over a longer recall period. We consider the modest validity results as positive and suggest that these coverage indicators may be useful for measuring coverage and tracking progress over time.
对婴儿和幼儿喂养（IYCF）进行咨询以支持最佳母乳喂养和补充喂养实践是一项必要的干预措施，需要准确的覆盖数据来确定差距并监测进展。然而，家庭调查中收集的覆盖信息尚未得到验证。
我们检查了社区接触期间母亲报告的 IYCF 咨询的有效性，以及与报告准确性相关的因素。
直接观察印度比哈尔邦 40 个村庄的社区工作人员进行的家访，作为社区工作人员家访期间接受 IYCF 咨询的母亲报告（n = 444 名 1 岁以下儿童的母亲，访谈与直接观察相匹配）的“金标准”。通过计算灵敏度、特异性和 AUC 来评估个体水平的有效性。使用膨胀因子（IF）测量人群水平的偏差。使用多变量回归模型检查与响应准确性相关的因素。
家访期间 IYCF 咨询的流行率非常高（90.1%）。母亲报告在过去 2 周内接受过任何 IYCF 咨询的比例适中（AUC：0.60；95%CI：0.52，0.67），人群偏差较低（IF = 0.90）。然而，对特定咨询信息的回忆有所不同。母亲报告任何母乳喂养、纯母乳喂养和饮食多样性信息的有效性适中（AUC>0.60），但其他儿童喂养信息的个体有效性较低。儿童年龄、母亲年龄、母亲教育、精神压力和社会期望与多种指标的报告准确性相关。
几个关键指标的 IYCF 咨询覆盖范围的有效性适中。IYCF 咨询是一种基于信息的干预措施，可能来自各种来源，并且在较长的回忆期内实现更高的报告准确性可能具有挑战性。我们认为适度的有效性结果是积极的，并建议这些覆盖指标可能有助于衡量覆盖范围并随着时间的推移跟踪进展。
