Caregiving and Intervention Uptake, an Exploration of Women's Experiences with Nutrition- specific and Nutrition- sensitive Interventions in Rural Zimbabwe (P10-132-19)

To explore women's caregiving experiences, and identify motivators and barriers to the uptake, of interventions aimed at improving health and nutrition behaviors. 40 in-depth interviews were conducted with a purposely selected sample of caregivers of infants (age 12 months to 18 months) using a semi structured interview guide. All participants in the interviews had received one or more interventions in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial, which included nutrition specific and nutrition sensitive messages delivered one on one by Village Health workers (VHWs) in the participant's household. All interviews were audio recorded, transcribed and translated, and then analyzed for themes and sub-themes, using standard text analysis coding procedures. Based on mothers’ narratives in response to broad, open-ended questions, the barriers and facilitators of reported appropriate child care practices and intervention uptake can be classified under four major themes: (1) caregiving environment (including sub themes around perceived child health and well-being, family involvement, social support, cultural/social norms, resources and husband involvement), (2) maternal capabilities (with sub themes around caregiver knowledge, self-efficacy and time, (3) intervention messages (with sub themes around perceived ease/complexity of intervention, mode of delivery and duration of intervention lessons), and (4) intervention delivery agent (with sub themes around perceived VHW knowledge, communication skills and reliability). Our results show that in rural Zimbabwe caregiving decisions and hence intervention uptake is influenced by multiple factors, but the underlying dynamic can be characterized in terms of the interaction between caregiver actions and child feedback. Supported by the Bill & Melinda Gates Foundation, the UK Department for International Development and Borlaug LEAP.