Original Research

Effect of personalized home-based support for pregnant women on pregnancy outcomes: a cluster randomized trial

Bernard Ilboudo, Léon G.B. Savadogo, Isidore Traoré, Clément Z. Meda, Hien Hervé, Maurice Kinda, Michèle Dramaix-Wilmet, Philippe Donnen
Journal of Public Health in Africa | Vol 13, No 3 | a458 | DOI: https://doi.org/10.4081/jphia.2022.1939 | © 2024 Bernard Ilboudo, Léon G.B. Savadogo, Isidore Traoré, Clément Z. Meda, Hien Hervé, Maurice Kinda, Michèle Dramaix-Wilmet, Philippe Donnen | This work is licensed under CC Attribution 4.0
Submitted: 11 April 2024 | Published: 07 September 2022

About the author(s)

Bernard Ilboudo, Superior Institute of Health Sciences, Nazi Boni University, Burkina Faso; Institut National de Santé Publique, Burkina Faso; School of Public Health, Université libre de Bruxelle, Belgium
Léon G.B. Savadogo, Superior Institute of Health Sciences, Nazi Boni University, Burkina Faso; School of Public Health, Université libre de Bruxelles, Belgium
Isidore Traoré, Superior Institute of Health Sciences, Nazi Boni University, Burkina Faso; Institut National de Santé Publique, Burkina Faso
Clément Z. Meda, Superior Institute of Health Sciences, Nazi Boni University, Burkina Faso
Hien Hervé, Institut National de Santé Publique, Burkina Faso
Maurice Kinda, Superior Institute of Health Sciences, Nazi Boni University, Burkina Faso
Michèle Dramaix-Wilmet, School of Public Health, Université libre de Bruxelles, Belgium
Philippe Donnen, School of Public Health, Université libre de Bruxelles, Belgium

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Abstract

Background. Anemia during pregnancy has been linked to higher maternal and perinatal morbidity and mortality. The purpose of this study is to examine the impact of individualized home-based care for pregnant women on pregnancy outcomes.

Methods: This was a cluster-randomized experiment done in Burkina Faso’s Sindou health area between 2015 and 2016. The intervention included a monthly home-based visit focused on nutritional counseling and pregnancy monitoring for pregnant women, and a training on nutrition for pregnant women, prevention of anemia in pregnancy, and management of anemia in pregnancy for health facility teams. In the control group, prenatal care was administered in accordance with national program guidelines. The primary outcome was the reported prevalence of anemia in pregnancy. The secondary outcomes of stillbirth, preterm birth, low birth weight, and abortion were evaluated using a difference in differences analysis and mixed models across the two groups. The sample consisted of 617 pregnant women, with 440 women assigned to the intervention group and 177 assigned to the control group. No maternal fatalities occurred in either group. The intervention decreased stillbirths by -1.6% (95% confidence interval: -3.1% to - 0.1%). It had no impact on the rates of low birth weight, premature birth, and abortion.

Conclusion: In rural Burkina Faso, personalized support of pregnant women at home, in conjunction with appropriate prenatal care, reduced stillbirths, but not the rates of low birth weight, preterm birth, or abortion.


Keywords

anemia; pegnancy outcome

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