Effectiveness of Timed and Targeted Counselling on Maternal, Newborn and Child Health and Nutrition (MNCH/N) Outcomes in Palestine: Assessment of Intervention

Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Background: In Palestine MNCH/N remains an urgent issue, various sources indicate widespread inappropriate traditional family practices with regards to care and nutrition during pregnancy, newborn/infant feeding and child care, which lead to increased risk of infections, malnutrition and death. Limited access to health services due to limited available health centres and movement restrictions due to the occupation are affecting families from receiving the proper services. The objective of this study was to evaluate the effectiveness of a community approach called Timed, Targeted Counselling (TTC) in improving mothers’ knowledge and practices in regards to (MNCH/N) in 37 different communities in Palestine.

Method: In September 2013 mothers (n=1556) were identified by community health workers (CHWs). The CHWs targeted the mothers with key timely messages and support for positive feeding and caring practices during organized home visits throughout 12 months. Baseline and post-intervention data were collected.

Results: Practices improved significantly among mothers: exclusive breastfeeding until six-months increased from 33% to 48.4%; proportion of mothers providing minimum meal diversity increased from 32.2% to72.2% , proportion of mothers providing appropriate meal frequency increased from 31.7%-59.1% , proportion of mothers providing appropriate feeding during illness increased from 30.2% to 51.6% , proportion of mothers providing correct diarrhoea management increased from 32.2% to 61.7%, proportion of mothers who report having 4 or more antenatal visits increased from 58.4% to 63.6%, proportion of mothers who received at least 2 post-natal visits increased from 26.8% to 52.4% and proportion of women practicing birth spacing increased from 64.4% to 74.1%.

Conclusion: This approach proved very effective it positively influenced different practices related to MNCH/N. Due to contextual similarities in most Palestinian localities, scale up for TTC integrated with early childhood stimulation component and maternal mental health is envisioned. Mobile technology to monitor the work will be applied soon.