TABLE 2.
Descriptions of interventions to engage fathers, grandmothers and other family members †
| Author, country | Study design | Participants (n) | Intervention components | Theory | Formative research | Main topics |
|---|---|---|---|---|---|---|
| Maternal nutrition interventions | ||||||
| (A. Alam, Chowdhury, et al., 2020; Chowdhury et al., 2017) Bangladesh | Qualitative: IDI, FGD, KII, observations |
M: 16 IDI; 4 FGDs F: 1 FGD Gm: 1 FGD |
Home visits during pregnancy, husbands, mothers, mothers‐in‐law were invited. Families were reached together | Yes | Maternal nutrition (balanced plate) | |
| (M. Alam, Banwell, & Lokuge, 2020) Bangladesh | Cross‐sectional survey | M: 459 | mHealth text messages to pregnant women and new mothers and their families. Families reached separately and together. | Yes (Rajan et al., 2013) | Safe pregnancy, planning for delivery, maternal nutrition, WASH | |
| (Doyle et al., 2014; Doyle et al., 2018) Rwanda | RCT qualitative: FGDs |
F: 1195 n/a |
Community groups for fathers; mothers invited to some. Fathers reached separately and as a couple. | Yes | Gender norms, couple communication, decision making, maternal and child health, childcare, parenting, violence | |
| (Martin et al., 2018; Martin, Omotayo, Pelto, et al., 2017) Kenya |
Secondary analysis C‐RCT Qualitative: IDI |
M: 1036 M: 32 F: 13 Gm: 7 |
Facility‐based individual counselling during antenatal care. Family members reached through women. |
Social support theoretical constructs | Yes (Martin, Omotayo, Chapleau, et al., 2017) | Calcium and iron‐folic acid supplementation, adherence, social support |
| (Nguyen et al., 2018) Bangladesh | Secondary & path analysis of C‐RCT; cross‐sectional |
M: 2000 F: 1307 |
Home visits, community groups (fathers forums), community mobilization. Couples reached together (counselling and community events) and separately (husband forum). | Theory of reasoned action | Yes | Diet quality and quantity, IFA and calcium supplements, optimal weight‐gain, rest, father and family member support for maternal nutrition |
| (Surtimanah et al., 2019) Indonesia | Quasi‐experimental | M: 60 | Facility‐based group sessions for pregnant women and husbands or other family member. Families reached together. | Iron supplementation during pregnancy | ||
| Breastfeeding interventions | ||||||
| Fathers | ||||||
| (Ajike et al., 2020) Nigeria | Quasi‐experimental | F:50 | Community group for expectant fathers. Fathers reached separately. | Theory of planned behaviour | EBF, EBF support skills, connections to holy writings | |
| (Bich et al., 2014; Bich et al., 2016; Bich & Nguyen Manh, 2017) Viet Nam | Quasi‐experimental |
M: 469 F: 239 |
Home visits, community groups for fathers, mass media (radio). Fathers reached separately. | BF initiation, EBF, maternal nutrition, father support | ||
| (Bich et al., 2019; Rempel et al., 2020) Viet Nam | Quasi‐experimental |
M: 761 F: 396 |
Home visits, community groups for fathers, community mobilization. Couples participated for 1y. Fathers reached separately. | Theory of planned behaviour | BF initiation, EBF, maternal nutrition, father support, | |
| (Daniele et al., 2018) Burkina Faso | RCT | M: 1101 | Facility‐based individual and group counselling for couples during antenatal and postnatal care. Couples reached together. | EBF, family planning | ||
| (Dehcheshmeh et al., 2014) Iran | RCT | M: 58 | Facility‐based group educational sessions. Couples reached together. | Health during pregnancy, maternal diet, BF initiation | ||
| (Haider & Thorley, 2019) Bangladesh | Longitudinal prospective study with interviews |
M: 304 M: 48 |
Home visits by peer counsellors; and community group meetings with husbands, teachers, community leaders. Fathers reached separately. | Early initiation EBF, BF techniques, maternity care, IFA supplementation | ||
| (Jones et al., 2018) South Africa | 2‐phase RCT | M: 836 | Facility‐based individual counselling. Couples reached either together or separately. | PMTCT, stigma, disclosure; partner communication; violence; family planning; EBF, CF | ||
| (Krakowiak et al., 2016) Kenya | RCT: 2 arms |
M: 502 F: 487 |
Home visits couples counselling during pregnancy and postpartum. Couples reached together. | HIV testing; EBF; family planning | ||
| (Özlüses & Çelebioglu, 2014) Turkey | Quasi‐experimental | M: 117 | Facility‐based individual counselling couples reached separately. | BF | ||
| (Rabiepoor et al., 2019) Iran | RCT |
M: 33 F: 33 |
Facility‐based group training sessions; educational materials, telephone counselling service. Couples reached together. | Social cognitive theory | BF benefits, techniques, and continuation | |
| (Raeisi et al., 2014) Iran | RCT |
M: 100 F: 100 |
Facility‐based group training sessions for fathers during pregnancy. Couples reached separately. | Father support, BF | ||
| (Sahip & Turan, 2007) Turkey |
Quasi‐experimental Qualitative: FGD |
F: 160 M: 19 |
Worksite sessions for expectant fathers. Fathers reached separately. | Maternal nutrition, infant feeding, EBF, health seeking, fatherhood, communication | ||
| (Su & Ouyang, 2016) China | Quasi‐experimental | M: 72 | Facility‐based group sessions for couples during pregnancy and 6 m postpartum. Couples reached together. | BF; father involvement in decision‐making, BF support | ||
| (Susin et al., 1999; Susin & Giugliani, 2008) Brazil | Quasi‐experimental |
M: 547 F: 547 |
Facility‐based group postnatal counselling with video, pamphlets, and discussion. Couples reached together. | EBF, management of common BF problems, father support | ||
| (Turan et al., 2001) Turkey | RCT |
M: 279 F: 253 |
Facility‐based group couple education sessions, print material, and telephone counselling service during pregnancy and postpartum. Couples reached together. | Yes | Healthy pregnancy, safe birth, infant care and feeding, women's health | |
| (Turan et al., 2001) Turkey | Community‐based effectiveness trial |
M: 142 F: 43 |
Community‐based group educational programme for pregnant mothers with separate group educational programme for fathers. Fathers reached separately. | Yes | Healthy pregnancy, safe birth, infant care and feeding, women's health, support, communication | |
| Grandmothers | ||||||
| (Bang et al., 2005) India | Quasi‐experimental | M: 913 | Home visits by CHWs and community group meetings for pregnant women and grandmothers. Families reached together. | Yes | Nutrition during pregnancy, delivery, BF, neonatal care | |
| (Bica & Giugliani, 2014; DeOliveira et al., 2012; DeOliveira et al., 2014; Nunes et al., 2011) Brazil | RCT |
M: 323 Gm: 169 |
Facility‐based individual counselling for adolescent mothers and grandmothers (separately); home visits counselling together; information booklet. Mothers and grandmothers reached separately and together. | EBF/BF importance, duration, and technique; avoidance of early introduction of food and liquids | ||
| (Bootsri & Taneepanichskul, 2017) Thailand | Quasi‐experimental |
M: 84 Gm: 84 |
Facility‐based group training for mothers of pregnant adolescents (grandmothers) during pregnancy and postpartum. Grandmothers reached separately. | Experiential learning, empowerment, social support | Benefits breastfeeding, positioning and attachment, grandmothers' role | |
| (Gharaei et al., 2020) Iran | Quasi‐experimental | M: 64 |
Facility‐based group education sessions for mothers and grandmothers during pregnancy and before discharge. Mothers and grandmothers reached together |
EBF, support for breastfeeding mother | ||
| Fathers and/or grandmothers or other family members | ||||||
| (Akbarzadeh et al., 2015) Iran | Quasi‐experimental |
M: 100 F: 19 Gm: 35 |
Facility‐based group educational sessions with print materials and videos. Family members reached separately. | Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF) model. | BF benefits for children and mothers, milk sufficiency, pumping, infant growth and development | |
| (Andreson et al., 2013; Reimers et al., 2018) South Africa |
Qualitative pilot study Cluster‐RCT |
M: 12 F: 3 Gm: 2 O: 9 M: 550 Buddies: 273 |
Facility‐based individual counselling for women and ‘infant feeding buddy’ during antenatal and postnatal visits. Mothers and buddies reached together. Facility‐based individual counselling for women and ‘infant feeding buddy’ during antenatal and postnatal visits. Mothers and buddies reached together. |
Informed by pilot |
PMTCT, EBF, formula feeding PMTCT, pregnancy, safe motherhood, EBF, CF, disclosure, adherence |
|
| (Gu et al., 2016) China | RCT | M: 285 | Facility‐based individual and facility‐based group counselling sessions for women with husband or grandmother, with postnatal telephone counselling. Families reached together. | Theory of planned behaviour | EBF benefits, EBF techniques/problems | |
| (Heidari et al., 2016; Kohan et al., 2019) Iran | RCT | M: 70 | Facility‐based group education sessions with mothers and fathers/key family members during pregnancy and postpartum. Postpartum telephone counselling. Families reached together. | Yes | Benefits BF, BF techniques, BF problems treatment; expressing milk, nutrition during BF, family support | |
| (Ke et al., 2018) China | Quasi‐experimental | M: 59 | Home visits when father or grandmother present, telephone calls or text messages during pregnancy and postpartum. Families reached together. | Detailed BF messages and support at key time points | ||
| (Namale‐Matovu et al., 2018) Uganda | RCT | M: 218 | Facility‐based group sessions during pregnancy and postpartum. Families reached together. | EBF, BF, maternal nutrition, complementary feeding, food safety | ||
| (Smittenaar et al., 2020) India |
M: 5,469 F: 3,064 G: 3,626 |
Home visits conducted by ASHAs (CHWs), community mobilization through village health and nutrition events. Families reached together. | Maternal and newborn health, early initiation, EBF | |||
| Whole community | ||||||
| (Cresswell et al., 2019) Burkina Faso | Repeated cross‐sectional C‐RCT | M: 2253 | Community mobilization included community events and facilitated group discussions for fathers and family members in public places (Alive & Thrive). Families reached together. | Early initiation, colostrum, avoiding water other liquids, EBF | ||
| (Harding et al., 2020) Ghana | Cross‐sectional |
Female: 280 Male: 171 |
mHealth Breastfeed4Ghana was a social media (Facebook and twitter) campaign with videos and a website. Family members reached individually or together. | Socioecological model | Message and material pretesting | EBF |
| (Horii et al., 2016) Niger | Cross‐sectional survey | M: 2091 | Facility‐based individual counselling, home visits, mass media. Families reached together (mass media) and separately (counselling and peer education). | EBF, complementary feeding | ||
| (Jenkins et al., 2012) Zimbabwe | Cross‐sectional survey |
M: 234 F: 228 |
Community mobilization social marketing activities included road shows with music, drama, dancing, and mass media materials. Reached whole community. | Yes | EBF, expressing and heat treating breast milk | |
| (Susiloretni et al., 2013; Susiloretni et al., 2015) Indonesia | Quasi‐experimental |
M: 163 F: 163 Gm: 163 O: 110 |
Community group trainings for families (mothers, fathers, grandmothers); mass media posters, banners, brochures. Families reached together. | Socioecological orientation | EBF | |
| Complementary feeding interventions | ||||||
| (Abiyu & Belachew, 2020a, 2020b) Ethiopia | C‐RCT | M: 612 | Home visits from women development Army volunteers with mothers, fathers, and grandmothers. Families reached together | Complementary feeding; support to mothers | ||
| (Betancourt et al., 2020) Rwanda | Quasi‐experimental pilot |
M: 19 F: 10 Gm: 2 |
Home visits conducted by ‘coaches’ (university graduate students). Families reached together. | Child development, nutrition, hygiene, responsive parenting | ||
| (Dinga et al., 2018) Kenya |
RCT FGD |
M: 290 F: 290 n/a |
Facility‐based individual sessions for fathers and mothers. Provided pamphlet summarizing key messages. Couples reached together. | BF benefits; diet diversity; food prep; responsive feeding; father participation | ||
| (Martin et al., 2015; Mukuria et al., 2016; Thuita et al., under review) Kenya |
Quasi‐experimental Qualitative: IDI;FGD |
M: 217 F: 138 Gm: 154 F:7; 8 Gm: 10; 10 |
Community‐based group peer education sessions for father groups and grandmother groups; community mobilization (family bazaars; fathers days at clinics). Family members reached separately and together. | Socioecological model | Yes (Thuita et al., 2015) | Maternal nutrition and rest, EBF, CF, child health, HIV and IYCF, gender roles, family communication |
| (Roy et al., 2007) Bangladesh |
C‐RCT Qualitative: FGD |
M: 576 | Community mobilization activities for fathers, grandmothers, and other family members. Family members reached separately. | Yes | CF, child health, child interaction | |
| (Singla et al., 2015) Uganda | C‐RCT | M: 319 | Home visits to mothers and fathers. Mothers and fathers reached together and separately. | Social cognitive theory | Yes | Diet diversity, child care and diet, maternal wellbeing, father involvement |
| Interventions for multiple nutrition behaviours | ||||||
| (Afsana et al., 2014) Bangladesh | Implement‐ation research | n/a | Community mobilization activities to promote micronutrient powders and infant feeding among family members and others. Families reached together. | Micronutrient supplementation, EBF, CF | ||
| (Aidam et al., 2020) Sierra Leone | Quasi‐experimental |
M: 392 G: 219 |
Community‐based group dialogue sessions with grandmothers and intergenerational dialogue forums; community mobilization days of praise for grandmothers. Family members reached together and separately. | Family systems theory, community empowerment | Yes (MacDonald et al., 2020) | Grandmothers' roles, maternal nutrition, EBF, CF |
| (Aubel et al., 2004) Senegal |
Quasi‐ experimental Qualitative: FGDs |
WRA: 200 Gm: 150 |
Community‐based group participatory nutrition education sessions for grandmothers mothers and grandmothers reached separately. | Transcultural approach to nutrition education; empowerment education, social network, self‐efficacy | Yes | Maternal nutrition, EBF, CF |
| (Bezner Kerr et al., 2019) Malawi | Pre‐post longitudinal study; qualitative |
M: 352 IDI: 90 FGD: 29 |
Community‐based group education meetings on agriculture and nutrition included discussions and community‐based dialogue. Families reached together. | Farming practices, food security and dietary diversity, gender | ||
| (Bezner Kerr et al., 2011; Satzinger et al., 2009) Malawi |
Quasi‐ experimental Qualitative: IDI |
Families: 160 M: 18 F: 17 |
Community‐based groups discussed agriculture and nutrition with mothers, fathers, grandmothers, and other family members. Families reached both together and separately. | Yes | IYCF, sharing household resources, gender norms | |
| (Brasington et al., 2016) Egypt | Quasi‐experimental | M: 3445 | Community‐based group counselling by CHWs for pregnant women, grandmothers, and fathers. Family members reached separately. | Similar to a socioecological framework | Birth preparedness, BF, food selection, and growth monitoring | |
| (Downs et al., 2019) Senegal |
Pre/post Qualitative: FGDs |
M: 47 F: 47 M: 24 F: 2 |
mHealth voice messaging intervention sent to mothers and fathers of children 6–23 m. mothers and fathers reached separately. | Theory of planned behaviour | Yes | Continued BF, diet diversity, consistency of porridge, handwashing |
| (DeLorme et al., 2018; Fiorella et al., 2019) Kenya | Quasi‐experimental FGD |
Community members: 192 CHWs: 86 M: 28 F: 7 |
Community‐based group facilitated by CHWs to engage social support networks, including fathers, grandparents, and other community members. Families reached together. | Constructs related to social networks/social support | IYCF, social support, family planning, safe pregnancy, food security | |
| (Flax et al., 2019) Malawi |
Qualitative: IDI Process data |
M:18 F: 7 |
Community‐based group intervention for HIV positive women incorporated into village savings and loans association meetings; fathers invited to some sessions. Mothers and fathers reached together. | Yes | Early initiation of BF, EBF, breastfeeding on demand, continued BF, CF, food hygiene, and feeding during illness | |
| (Hoddinott et al., 2018) Bangladesh | C‐RCT | M: 2,341 | Community‐based group nutrition behaviour change sessions led by CHWs, husbands and mothers‐in‐law invited to certain sessions. Included monthly cash transfer and/or food rations made to mothers. Families reached together. | Theory of reasoned action; socio‐ecological model | Yes | BF; CF; diet diversity; micronutrients; WASH, diarrhoea; maternal nutrition; homestead food production; women's status, family relationships |
| (Knight et al., 1990) Jamaica | Quasi‐experimental |
M: 126 C: 622 |
Child‐to‐child programme delivered by teachers to schoolchildren who were encouraged to share with their parents. Children reached separately. | IYCF, WASH, early child development, child growth | ||
| (Kumar et al., 2015; Kumar et al., 2018; Rosenberg et al., 2018) Zambia | Pre/post repeated cross‐sectional | M: 6580 | Community‐based groups led by female smallholder model farmers fathers invited to attend; community mobilization (drama), mass media (print, radio). Fathers and mothers reached together. | Similar to a socioecological framework | IYCF, WASH, crop diversity, gender equity, women's empowerment | |
| (S. S. Kim, Nguyen, et al., 2018; S. S. Kim, Roopnaraine, et al., 2018; Menon et al., 2016; Nguyen et al., 2019; Sanghvi et al., 2013) Bangladesh | Cluster randomized, impact evaluation design |
M: 4200 (endline) M: 2400 (2 y follow up) |
Home visits from nutrition focused front line health workers and volunteers, community mobilization (theatre), and mass media (television) to engage other family members. Families reached together. | Stages of change, diffusion of innovations, and elements of theory of planned behaviour and social cognitive theory | Yes | EBF, CF |
| (Matare et al., 2019; Martin et al., 2021) Tanzania | Qualitative: Interviews and FGDs |
EBF/CF M: 36/50 F: 30/40 |
Home visits (during household trials) with counselling for mothers and fathers. Couples reached separately. | EBF, CF, dietary diversity | ||
| (Salasibew et al., 2019) Ethiopia | Qualitative: FGDs and observations |
M: 54 F: 54 |
Home visits by health and agriculture extension workers and community‐based group meetings with programme households. Implemented for 3y. Mothers and fathers reached together. | Trans‐theoretical model (stages of change) | EBF, CF, dietary diversity | |
| (Selassie & Fantahun, 2011) Ethiopia | Cross‐sectional survey | M/CG: 800 | Home visits by CHWs trained on integrated Management of Neonatal and Childhood Illness. Families reached together. | BF initiation, prelacteal feeding, CF, vitamin A supplementation | ||
| (Sloand et al., 2010) Haiti | Quasi‐experimental | C = 559 | Community‐based group fathers' clubs held health education sessions (e.g. discussions, songs, skits). Fathers reached separately. | EBF, child nutrition, immunization, feeding during illness, supporting wives | ||
| (Tall et al., 2018) Senegal | Qualitative: FGDs, IDI | 10 FGDs | Community‐based groups included grandmother groups, pregnant Women's solidarity circles, future father groups. Family members reached separately. | Maternal and neonatal health, IFA supplementation, breastfeeding | ||
| (Cunningham et al., 2021) Nepal | Cross‐sectional monitoring data |
2017/2019 M:1850/1827 F:938/942 |
Home visits by frontline workers to all family members; community mobilization (food and handwashing demonstrations); mass media edutainment radio programme. Families reached together. | Yes | Maternal, newborn, and child nutrition | |
†
A sub‐sample of these interventions have also been presented in a mixed methods systematic review (Martin et al., 2020). Abbreviations: ANC, Antenatal care; BF, Breastfeeding; BRAC, an international development organization based in Bangladesh; EBF, Exclusive breastfeeding; C, children; CF, complementary feeding; CG, caregiver; CHW, community health workers and is used to denote village health worker, community resource person, community health volunteer; C‐RCT, cluster randomized control trial; F, Fathers; FGD, focus group discussion; Gm, Grandmothers; IDI, In‐depth Interview; IFA, Iron Folic Acid supplements; IYCF, infant and young child feeding; M, mothers; O, others; PMTCT, prevention of mother‐to‐child transmission; RCT, randomized control trial; WASH, water, sanitation, and hygiene; WRA, women of reproductive age.