Wright Jemma L, Achieng Florence, Tindi Linda, Patil Manasi, Boga Mwanamvua, Kimani Mary, Barsosio Hellen C, Juma Dan, Kiige Laura, Manu Alexander, Kariuki Simon, Mathai Matthews, Nabwera Helen M
Department of Community Paediatrics, Countess of Chester Hospital, Chester, United Kingdom.
KEMRI-Center for Global Health Research, Kisumu, Kenya.
Front Pediatr. 2023 Jul 3;11:1173238. doi: 10.3389/fped.2023.1173238. eCollection 2023.
Globally, low birthweight (LBW) infants (<2,500 g) have the highest risk of mortality during the first year of life. Those who survive often have adverse health outcomes. Post-discharge outcomes of LBW infants in impoverished communities in Africa are largely unknown. This paper describes the design and implementation of a mother-to-mother peer training and mentoring programme for the follow-up of LBW infants in rural Kenya.
Key informant interviews were conducted with 10 mothers of neonates (infants <28 days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen completing all the visits over a 6-month period. A mixed methods approach was used to evaluate the implementation of the programme. Quantitative data of peer mother socio-demographic characteristics, recruitment, and retention was collected. Two post-training focus group discussions were conducted with the peer mothers to explore their experiences of the programme. Descriptive statistics were generated from the quantitative data and the qualitative data was analysed using a thematic framework.
The median age of the peer mothers was 26 years (range 21-43). From March-August 2019, each peer mother conducted a median of 28 visits (range 7-77) with fourteen (88%) completing all their assigned follow-up visits. Post training, our interviews suggest that peer mothers felt empowered to promote appropriate infant feeding practices. They gave multiple examples of improved health seeking behaviours as a result of the peer mother training programme.
Our peer mother training programme equipped peer mothers with the knowledge and skills for the post-discharge follow-up of LBW infants in this rural community in Kenya. Community-based interventions for LBW infants, delivered by appropriately trained peer mothers, have the potential to address the current gaps in post-discharge care for these infants.
在全球范围内，低出生体重（LBW）婴儿（<2500克）在出生后第一年的死亡风险最高。那些存活下来的婴儿往往有不良的健康后果。非洲贫困社区中低出生体重婴儿出院后的情况在很大程度上尚不清楚。本文描述了一项在肯尼亚农村地区为低出生体重婴儿随访开展的母婴同伴培训和指导计划的设计与实施。
对来自肯尼亚西部两个农村社区的10名新生儿（<28天的婴儿）母亲进行了关键信息访谈。这些数据为确定在低出生体重婴儿出院后进行母婴同伴支持（同伴母亲）所需的关键特征提供了依据。40名潜在的同伴母亲被邀请参加一个为期5天的培训计划，该计划聚焦于三个主要主题：使用适当沟通方式的支持性护理、识别严重疾病以及针对低出生体重婴儿的推荐护理策略。16名同伴母亲接受指导，对每对母婴进行7次社区随访，其中15名在6个月内完成了所有随访。采用混合方法评估该计划的实施情况。收集了同伴母亲社会人口学特征、招募和留存情况的定量数据。与同伴母亲进行了两次培训后焦点小组讨论，以探讨她们对该计划的体验。从定量数据中生成描述性统计数据，并使用主题框架对定性数据进行分析。
同伴母亲的年龄中位数为26岁（范围21 - 43岁）。2019年3月至8月，每位同伴母亲进行的随访次数中位数为28次（范围7 - 77次），其中14名（88%）完成了所有分配的随访。培训后，我们的访谈表明同伴母亲感到有能力促进适当的婴儿喂养做法。她们给出了多个因同伴母亲培训计划而改善就医行为的例子。
我们的同伴母亲培训计划使同伴母亲具备了在肯尼亚这个农村社区对低出生体重婴儿出院后进行随访的知识和技能。由经过适当培训的同伴母亲提供的针对低出生体重婴儿的社区干预措施，有可能弥补这些婴儿目前在出院后护理方面的差距。
