A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya

Sheillah Simiyu; Evalyne Aseyo; John Anderson; Oliver Cumming; Kelly K Baker; Robert Dreibelbis; Jane Awiti Odhiambo Mumma

doi:10.1007/s10995-022-03548-6

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A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya

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A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya

Sheillah Simiyu, Evalyne Aseyo, John Anderson, Oliver Cumming, Kelly K Baker, Robert Dreibelbis and Jane Awiti Odhiambo Mumma

Maternal and child health journal, Vol.27(5), pp.824-836

05/2023

DOI: 10.1007/s10995-022-03548-6

PMCID: PMC10115704

PMID: 36352283

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Abstract

OBJECTIVES Diarrhoea is a leading cause of infant mortality with the main transmission pathways being unsafe water and contaminated food, surfaces and hands. The 'Safe Start' trial evaluated a food hygiene intervention implemented in a peri-urban settlement of Kisumu, Kenya, with the aim of reducing diarrhoeagenic enteric infections among infants. Four food hygiene behaviours were targeted: handwashing with soap before preparation and feeding, boiling infant food before feeding, storing infant food in sealed containers, and exclusive use of designated utensils during feeding. METHODS A process evaluation of the intervention was guided by a theory of change describing the hypothesised implementation and receipt of the intervention, mechanisms of change, and the context. These were assessed by qualitative and quantitative data that included debriefing sessions with the delivery teams and Community Health Volunteers (CHVs), and structured observations during food preparation. RESULTS The intervention achieved high coverage and fidelity with over 90% of 814 eligible caregivers participating in the intervention. Caregivers in the intervention arm demonstrated an understanding of the intervention messages, and had 1.38 (95% CI: 1.02-1.87) times the odds of washing hands before food preparation and 3.5 (95% CI: 1.91-6.56) times the odds of using a feeding utensil compared to caregivers in the control group. Contextual factors, especially the movement of caregivers within and outside the study area and time constraints faced by caregivers influenced uptake of some intervention behaviours. CONCLUSION Future interventions should seek to explicitly target contextual factors such as secondary caregivers and promote food hygiene interventions as independent of each other.

Details

Title: Subtitle: A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya
Creators: Sheillah Simiyu - African Population and Health Research Center
Evalyne Aseyo - Great Lakes University of Kisumu
John Anderson - Independent Research Consultant, 78702, Austin, TX, USA.
Oliver Cumming - University of London
Kelly K Baker - University of Iowa
Robert Dreibelbis - University of London
Jane Awiti Odhiambo Mumma - Great Lakes University of Kisumu
Resource Type: Journal article
Publication Details: Maternal and child health journal, Vol.27(5), pp.824-836
DOI: 10.1007/s10995-022-03548-6
PMID: 36352283
PMCID: PMC10115704
NLM abbreviation: Matern Child Health J
ISSN: 1092-7875
eISSN: 1573-6628
Grant note: DOI: 10.13039/501100002992, name: Department for International Development, UK Government, award: PO 6981
Language: English
Electronic publication date: 11/09/2022
Date published: 05/2023
Academic Unit: Occupational and Environmental Health; Epidemiology
Record Identifier: 9984315588202771

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