Wednesday, September 11, 2013

Making movies and cuddling babies


Megan and Sydney here- the nutrition interns from UPEI.  We have recently returned from Kenya, and wanted to bring you up to date on some of the work we did in July and August (now that it is easier to upload blogs and pictures!).

Over the summer, we worked on three projects: 1) the assessment of food security and diet among women in the Muchui and Ruuju women’s self help-groups 2) using a ‘train the trainer’ model with women ‘champs’ to teach women and men in the broader community about nutrition and healthy family meals and 3) the development of an infant feeding resource to improve the nutritional quality of infant foods and to extend the period of exclusive breastfeeding. This blog is about the final one-where we developed a video which can be used by the local St. Theresa’s hospital to educate women from the community.  It is our first ever experience as directors and videographers!

 Before we developed a video, we had to decide what information was needed, and what approach to take. That took a fair bit of interviewing and research. Our professor Jennifer (Prof Jen) provided us with information and concerns identified from previous nutrition interns [Amy, Harrison (2011); Kaylynne and Christina (2010)]; we also had the guidelines for infant feeding from the World Health Organization which would form the basis for our recommendations. 

Our first step was to meet with women in their homes and in the hospitals to get an understanding of what their infant feeding practices were. We also met with healthcare professionals such as dietitians, HIV advisors and nurses to get an idea of what the teachings around infant feeding were. Most of the women understood that breastfeeding was good for their baby but were unsure of how long to breastfeed for; many women breastfed for only one month before giving their baby solid foods.
We spoke with one of the new mothers (she had a healthy baby boy on July 10th) who had not yet received any nutrition education from Caroline the dietitian (who was hired in 2012 after one of the UPEI nutrition students (Harrison) recommended they do so!). We were concerned about some of this mother's responses. She would be returning to work in three months and would no longer be able to breastfeed her child. She thought that because she was going back to work, there was no other alternative but to resort to a formula made with cow’s milk, bananas and Irish potatoes for her child.  She also told us that her mother said that the baby needed to be fed water immediately as well, or it would become dehydrated.  After interviewing the women and Caroline, we were reassured that one reason behind women weaning their infant too soon, or introducing less nutritious foods was a lack of knowledge and that our video could, in fact, help. We also believe that hiring a Dietitian was one of the best choices that St Theresa's Hospital could have made! Caroline is working with all the new mothers and educating them on the importance of exclusive breastfeeding, and complementary feeding once the child becomes six months old.  Our video can be one tool that she can use to help women from the surrounding community who come to the hospital.

 The information that we got from talking to the women and healthcare professionals helped us to decide what we needed  to include in the video. We developed an outline for the video and had it reviewed by Prof Jen.  After an introduction, we would cover benefits of breast feeding exclusively for 6 months, concerns and myths about breast feeding and infant feeding, and the how/when/what of introducing solid or complementary foods. We wanted to have the entire video in Kimeru with some English subtitles so that it would be understood by local pregnant women and new mothers, and the staff at the hospital.
Megan and a little baby girl

Now it was time for the fun stuff: we got out our high tech video gear (IPHONE) and went into women’s homes, the hospital and Machaka Children's home to get all this information on tape. At Machaka, Grace, the social worker, and Susan, a childcare provider, helped us out as we taped the babies being fed. They were all ready to begin when we arrived; the videotaping went very well and the women were excited to watch themselves on video.  They even called some of their coworkers to come watch it with us!   
Sydney and little Jonah at the children's home in Machaka

We interviewed several woman from the Kiirua area, some of whom were part of our home assessments in June of food security. One women, Harriet, is currently seven months pregnant with her first child. She is a working single mother and we were happy to hear that when she does have to go back to work, she will continue to breastfeed as her baby will be at work with her.  We videotaped her talking about two of the benefits of breastfeeding. Of course, she gave us a cup of Kenyan tea before we left!   

At the women's homes and at the hospital, we were a little rusty at first with the information having to first go through Rose (our translator) first and then one of the women to be videotaped. The women were happy to help and excited to be famous throughout Kiirua!   After two weeks of taping in the community, the hospital and Machaka children’s home, it was time to make our edits, add in English subtitles and get it flowing together nicely. We completed the video and went to the Muchui Business Centre to have the first showing of the video. We wanted to evaluate how effective the video was so we had the women do a short multiple choice quiz before the video and the same one after.  We were pleased that most women chose the correct answer after watching the video. 

Sydney(L) and Megan's (R) CME presentation
The last showing of the video was for the healthcare professionals at the hospital because this is where the video will be used the most.These CME, or continuing medical education, presentations are a bit nerve racking because they are around an hour and 15 minutes and the people that come are all health professionals…doctors, surgeons, nurses, clinical officers, etc. (We waited 45 minutes for people to show up...we are finally learning to live on Kenyan time!)  The presentation went fantastic which was great, because the Minister of Health happened to show up…. Talk about intimidating!! After the presentation, she said she loved the presentation and said it was one of the most creative things she’s seen. She asked for a copy to take back with her. How cool!   Caroline also asked for a copy of the video for herself and we hope that she will use it as a resource within the hospital and community.   By the way, a small TV and DVD player was bought with the money from last year's UPEI Students for Development fundraising dinner which will be used in the Maternity ward to show the video. 
Overall, the video recording went really well, considering it was both our first ever experience producing a movie.We showed it to Prof Jen a few days ago, and she was pretty pumped about it.  We had raised money for a small TV and DVD player in the hopes that the video will be shown at the MCH (Maternal & Child Health) clinic at the hospital, and will help educate pregnant women, new mothers and their families to give babies the best possible start in life.  We plan to have a screening of the video in the Department of Applied Human Sciences this fall- we will keep you posted on that!