Agnès B Guyon

JSI Research & Training Institute, Inc., Boston, Massachusetts, United States

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Publications (5)5.85 Total impact

  • Agnes B. Guyon, Kou Baawo
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    ABSTRACT: Having babies too soon, too closed, and practicing sub-optimal breastfeeding are known to have negative impacts on the health and nutrition of women and young children is reported in Liberia as in many African countries. According to the Liberian DHS 2007, nearly half of the women have their first pregnancy before 20 years of age, and 20% of them are identified with under nutrition. About 60% of women have another child within 36 months, only 29% are practicing exclusive breastfeeding until the baby is 6 months old, and 47% are still breastfeeding when the child reaches 24 months. Over 26% of children 0-23 months are stunted. The Ministry of Health and Social Welfare focuses its strategy on a minimum package of interventions that includes family planning and the essential nutrition actions. Implementing the Essential Nutrition Actions (ENA) framework is recognized in the National Nutrition Policy as a mean to expand the coverage of seven affordable and proven nutrition interventions at multiple contact points and through communications channels with an emphasis on prevention. Recognizing the critical links between family planning and nutrition, the MOHSW has introduced messages and counseling into the Essential Nutrition Actions training to enhance selected family planning practices, namely to delay the first pregnant to allow the full development of the girls before being pregnant, the spacing of pregnancies to allow continuation of breastfeeding to 24 months, and the promotion and support of exclusive breastfeeding with LAM until the infant is 6 months old. By integrating family planning and nutrition messages, synergy has been created in term of reaching more women and children, particularly young women (before being pregnant) and children 0-23 months and their mothers. Outcomes are expected in term of better lessening young women under nutrition, low birth weight, and stunted for young children.
    13th World Congress on Public Health World Health Organization; 04/2012
  • Agnes B. Guyon, Abdulsalam Jirga
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    ABSTRACT: Ethiopia has some of the highest rates of child stunting, maternal malnutrition, and infant mortality in sub-Saharan Africa. The ENA framework was applied to provide improved nutrition support through advocacy, capacity building, interpersonal communication, and community mobilization. Emphasis is given to the programmatic integration of these nutrition actions so that they do not operate in isolation from one another and from other child survival programs. Changes in practices were assessed through a comparison from representative cross-sectional household surveys for children <2 years collected at baseline in 2003 (1789) and at end of program implementation in 2006 (1200). The surveys were conducted in one region in southerner Ethiopia (population 15 million). Iron folic acid supplementation during pregnancy increased from 28% to 39%, initiation of breastfeeding within 1 hour of birth increased from 64% to 72%, exclusive breastfeeding of infants <6 months from 54% to 66%, , and postpartum vitamin A supplementation from 5% to 19%, Vitamin A for children 6-23 months from 24% to 61%, , all with significant p values. Improvement was also achieved in women dietary practices from 8% to 50% during pregnancy and breastfeeding during illness from 6% to 47%. No improvements were reported in increasing food intake during pregnancy. The ENA framework promotes key nutrition actions to be taken at key contact points in the life cycle. Maximizing contacts through multiple program opportunities within existing health systems, the health extension programs and existing community structures can achieve large-scale coverage of nutrition actions known to have a public health impact in reducing under-five mortality and morbidity.
    13th World Congress on Public Health World Health Organization; 04/2012
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    Naoko Horii, Agnès B Guyon, Victoria J Quinn
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    ABSTRACT: A number of studies have examined the possible adverse impact of services offered by health workers and community members on postpartum infant feeding practices. The present analysis utilized extant data collected previously through the baseline surveys of two related child health and nutrition projects implemented in rural Ethiopia and explored key risk factors associated with delayed initiation of breastfeeding for more than 1 hour after birth. To investigate the most important determinants of delayed initiation of breastfeeding. Multivariate logistic regression was performed to analyze data from baseline cross-sectional surveys carried out in 2003 and 2004 in selected districts across three regions in Ethiopia. Attendance at delivery by a health worker was found to be an important risk factor for the delayed initiation of breastfeeding, whereas attendance by traditional birth attendants or family and/or friends represented a protective factor for early initiation of breastfeeding. Additional analysis suggests that targeting of behavior change interventions on optimal infant feeding to these health workers could reverse the risk relationship and lead to improvements in the rate of early initiation of breastfeeding. Provision of inadequate breastfeeding information in the health system and attendance at delivery by health workers are associated with a delay in the initiation of breastfeeding. Births attended by trained traditional birth attendants and family members are associated with better practices. Targeting health workers, community members, families, and women to promote optimal infant feeding practices is likely to hold much potential to increase the adoption of early initiation of breastfeeding.
    Food and nutrition bulletin 06/2011; 32(2):94-102. · 2.11 Impact Factor
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    ABSTRACT: Madagascar has some of the highest rates of child stunting, maternal malnutrition, and infant mortality in sub-Saharan Africa. To improve infant and young child feeding practices, increase uptake of micronutrient supplements, and improve women's dietary practices through implementation of a nutrition project based on the Essential Nutrition Actions (ENA) framework. Interventions included training, interpersonal communication, community mobilization, and mass media. Changes in practices were assessed through a comparison of data for children under 2 years of age from representative cross-sectional household surveys collected at baseline in 2000 (n = 1,200) and at the end of program implementation in 2005 (n = 1,760). The surveys were conducted in six districts with a population of 1.4 million. The rate of initiation of breastfeeding within 1 hour of birth increased from 32% to 68%, the rate of exclusive breastfeeding of infants under 6 months of age increased from 42% to 70%, the rate of continuation of breastfeeding at 20 to 23 months increased from 43% to 73%, the rate of feeding children the minimum recommended number of meals per day at 6 to 23 months increased from 87% to 93%, the rate of iron-folic acid supplementation during pregnancy increased from 32% to 76%, and the rate of postpartum vitamin A supplementation increased from 17% to 54% (p < .001 for all changes). Modest improvement was achieved in maternal dietary practices during lactation and feeding of the sick child after illness. The results were inconclusive regarding food diversity for complementary feeding. No improvements were reported in increasing food intake during child illness or pregnancy. The ENA framework allows broad-scale improvement of nutritional practices to be achieved through the maximization of contacts using multiple program opportunities within existing health systems and community structures and through mass media.
    Food and nutrition bulletin 09/2009; 30(3):233-44. · 2.11 Impact Factor
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    ABSTRACT: Large-scale community-level behavior change programs designed to improve breastfeeding practices were implemented in Bolivia, Ghana, and Madagascar. These programs reached sizable populations: Bolivia, 1 million; Ghana, 3.5 million; and Madagascar, 6 million. Over 3 to 4 years, timely initiation of breastfeeding (within 1 hour of birth) increased from 56% to 74% (P < .001) in Bolivia, 32% to 40% (P < .05) in Ghana, and 34% to 78% (P < .001) in Madagascar. Marked increases in exclusive breastfeeding of infants 0 to 6 months of age were also documented: from 54% to 65% (P < .001) in Bolivia, 68% to 79% (P < .001) in Ghana, and 46% to 68% (P < .001) in Madagascar. In Ghana and Madagascar, significant results were seen within 1 year of community interventions. The authors conclude that large-scale programs designed to improve breastfeeding practices are feasible and should be a central component of any child survival strategy.
    Journal of Human Lactation 08/2005; 21(3):345-54. · 1.64 Impact Factor