A clustered randomized control trial to assess feasibility, acceptability, and impact of implementing the birth companion intervention package in Ethiopia, Kenya, and Nigeria: study protocol.

BACKGROUND: A birth companion is a simple and low-cost intervention that can improve both maternal and newborn health outcomes. The evidence that birth companionship improves labor outcomes and experiences of care has been available for many years. Global and national policies exist in support of birth companions. Many countries including Ethiopia, Kenya, and Nigeria have not yet incorporated birth companions into routine practice in health facilities. This paper presents the protocol for a trial that aims to assess if a package of interventions that addresses known barriers can increase the coverage of birth companions. METHODS: This two parallel arm cluster randomized controlled trial will evaluate the impact of a targeted intervention package on scale-up of birth companionship at public sector health facilities in Ethiopia (five study sites encompassing 12 facilities), Kenya (two sites encompassing 12 facilities in Murang'a and 12 facilities in Machakos counties), and Nigeria (two sites encompassing 12 facilities in Kano and 12 facilities in Nasarawa states). Baseline and endline assessments at each site will include 744 women who have recently given birth in the quantitative component. We will interview a maximum of 16 birth companions, 48 health care providers, and eight unit managers quarterly for the qualitative component in each country. DISCUSSION: Ample evidence supports the contribution of birth companions to positive health outcomes for mothers and newborns. However, limited data are available on effective strategies to improve birth companion coverage and inform scale-up efforts. This trial tests a birth companion intervention package in diverse clinical settings and cultures to identify possible barriers and considerations to increasing uptake of birth companions. Findings from this study may provide valuable evidence for scaling up birth companionship in similar settings. TRIAL REGISTRATION: Trial is registered with ClinicalTrials.gov with identifier: NCT05565196, first posted 04/10/ 2022.

Glycemic Index and Load of Selected Ethiopian Foods: An Experimental Study.

BACKGROUND: Determining the glycemic index and load of foods has significant impact on meal planning for diabetes. However, there is no data on the glycemic index (GI) and glycemic load (GL) of Ethiopian foods. Therefore, the aim of this study was to analyze the glycemic index and glycemic load of Teff Injera, Corn Injera, and White Wheat Bread. METHODS: Experimental study design was conducted among selected healthy adults. Teff Injera, Corn Injera, and White Wheat Bread were selected as test foods for the study, and glucose was used as the reference food. The postprandial glucose concentrations in the blood were recorded at 0, 15, 30, 45, 90, and 120 minutes. The relative glycemic index of each food was calculated, and the presence of statistical difference in glycemic index among the three foods was analyzed. RESULTS: The mean age of the participants was 23 years (±1.6 years). The glycemic indexes of Teff Injera, White Wheat Bread, and Corn Injera were 36 (low), 46 (low), and 97 (high), respectively, and the glycemic loads were 7 (low), 14 (moderate), and 22 (high), respectively. There was a significant difference in glycemic index and load among the three food items (p < 0.001). Teff Injera had a much lower glycemic index and load compared with Corn Injera (p < 0.001) and White Wheat Bread (p = 0.03). CONCLUSIONS: Teff Injera and White Wheat Bread have low glycemic index and are recommended to be consumed by diabetic patients, whereas Corn Injera has high glycemic index and is not recommended for diabetic patients. Therefore, Teff Injera should be considered globally in the dietary modification programs for diabetes.