Barriers and facilitators to participation in mother-to-mother support groups (MtMSGs) in northern Sierra Leone Pubblico

Abstract

ABSTRACT

Background:
Sierra Leone has one of the highest child mortality ratios in the world. Over half of these
deaths are due to undernutrition. Mother-to-mother support groups (MtMSG) have been
identified as a strategy to increase optimal infant and young child feeding (IYCF) practices
to combat the high rates of undernutrition. Previous research on MtMSGs focuses primarily
on the effectiveness of MtMSGs on IYCF indicators, and fails to explore the barriers and
facilitators to participation. Research on the barriers and facilitators to participation is the
first of its kind in northern Sierra Leone and will equip implementing NGOs with invaluable
information to achieve maximum participation in MtMSGs.

Methods:
Qualitative methods were used to explore the barriers and facilitators to participation in
MtMSGs in two districts in northern Sierra Leone. The research took place in three stages:
(1) doer/non-doer surveys were conducted to explore the differences between the MtMSG
members and non-participant mothers; (2) decision trees, social mapping, and ten seed
analyses were used to explore the barriers to participation, influential parties, and alternative
sources of IYCF information and; (3) focus group discussions and key informant interviews
further explored the barriers and facilitators arising from stages one and two.

Results:
Barriers and facilitators to participation that impacted the women's desire to attend MtMSGs
were dependent upon (1) whether MtMSG members were mobilized to the households after
meetings to share the information gained; (2) whether mothers perceived the benefits of
attending to include gender empowerment and self efficacy, increased social capital, and
having a safe place to discuss issues about their husbands and; (3) whether women valued
these benefits of attending MtMSGs greater than alternative activities. The women's ability
to attend MtMSGs is contingent upon (1) whether the husband needs to grant permission
which is based upon if the activity requires capital and; (2) whether the MtMSG is currently
at capacity.

Conclusion:
Programmatic recommendations to overcome the identified barriers include mobilizing
MtMSGs members, sensitizing mothers about the additional benefits of MtMSGs,
sensitizing husbands, increasing the number of MtMSGs in communities and combining
village savings and loans (VS&L) with MtMSGs to maximize participation.

Table of Contents

TABLE OF CONTENTS


Acknowledgments...vi

List of Tables and Figures...vii

List of Acronyms...viii

INTRODUCTION...1

LITERATURE REVIEW...4

METHODS...31

RESULTS...45

DISCUSSION AND RECCOMMENDATIONS...70

REFERENCES...85

APPENDIX A: Doer/ Non-Doer Survey Guide...90

APPENDIX B: Focus Group Discussion Guide...92

APPENDIX C: Key Informant Interview Guide...94

APPENDIX D: IRB Clearance...96

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Sierra Leone Breastfeeding Mother-to-Mother Support Groups IYCF
Committee Chair / Thesis Advisor	Golding, Lenette C., Emory University
Committee Members	Girard, Amy Webb, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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