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      Eficácia de intervenções educativas realizadas por telefone para promoção do aleitamento materno: revisão sistemática da literatura Translated title: Efectividad de las intervenciones educativas por teléfono para la promoción de la lactancia: revisión sistemática de la literatura Translated title: Effectiveness of educational interventions conducted by telephone to promote breastfeeding: a systematic review of the literature

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          Abstract

          RESUMO Objetivo Avaliar a eficácia das intervenções educativas por telefone na duração e exclusividade do aleitamento materno. Método Revisão sistemática da literatura, incluindo somente Ensaios Clínicos Randomizados. O fator de exposição foi uma intervenção educativa por telefone, e os desfechos foram a duração e a exclusividade da amamentação. Literatura em português, inglês e espanhol publicadas entre 2010 e 2016 foram procuradas na Cochrane, Lilacs, Medline e Scopus. Os artigos foram analisados mediante a síntese dos resultados. Resultados Foram identificados 241 artigos, dos quais 231 não atenderam aos critérios de inclusão, de modo que apenas 10 artigos foram revisados. Quatro estudos não apresentaram eficácia relacionada à amamentação. Como características comuns, estes estudos foram realizados em períodos curtos e por pares. Os demais revelaram eficácia sobre a duração e/ou exclusividade da amamentação. Estes últimos eram majoritariamente estudos com intervenção de longa duração e realizados por enfermeiros consultores em lactação. Conclusão As evidências demonstram que o telefone é uma tecnologia viável para a promoção do aleitamento materno, concedendo às unidades e aos profissionais de saúde uma alternativa que pode contribuir para o cuidado mãe-bebê.

          Translated abstract

          RESUMEN Objetivo Evaluar la efectividad de las intervenciones educativas por teléfono en la duración y exclusividad de la lactancia Método Revisión sistemática de la literatura, incluyendo solo Ensayos Clínicos Randomizados. El factor de exposición fue una intervención educativa por teléfono, y los resultados fueron la duración y la exclusividad de la lactancia. Se buscaron literaturas en portugués, inglés y español publicadas entre 2010 y 2016 en Cochrane, Lilacs, Medline y Scopus. Los artículos fueron analizados mediante la síntesis de los resultados. Resultados Fueron identificados 241 artículos, de los que 231 no atendieron a los criterios de inclusión, de modo a que se revisaron solo 10 artículos. Cuatro estudios no presentaron efectividad relacionada con la lactancia. Como características comunes, esos estudios se llevaron a cabo en períodos cortos y por pares. Los demás revelaron efectividad acerca de la duración y/o exclusividad de la lactancia. Estos últimos eran en su mayoría estudios con intervención de largo plazo y realizados por enfermeros consultores en lactancia. Conclusión Las evidencias demuestran que el teléfono es una tecnología viable para la promoción de la lactancia, brindando a las unidades y los profesionales sanitarios una alternativa que puede contribuir al cuidado madre-bebé.

          Translated abstract

          ABSTRACT Objective To assess the effectiveness of telephone educational interventions on the duration and exclusiveness of breastfeeding. Method A systematic review of the literature was conducted including only Randomized Clinical Trials. The exposure factor was an educational intervention via telephone, and the outcomes were duration and exclusiveness of breastfeeding. Literature in Portuguese, English and Spanish published between 2010 and 2016 were searched for in the Cochrane, Lilacs, Medline and Scopus databases. The articles were analyzed through a results synthesis. Results 241 articles were identified, of which 231 did not meet the inclusion criteria. Therefore, only 10 articles were reviewed. Four studies showed no efficacy related to breastfeeding. Regarding common characteristics, these studies were performed in short periods and in pairs. The others revealed efficacy regarding duration and/or exclusiveness of breastfeeding. The latter were mostly studies with long-term interventions and carried out by nurse lactation consultants. Conclusion The evidence demonstrates that the telephone is a viable technology for promoting breastfeeding, representing an alternative for the health units and health professionals that can contribute to mother-baby care.

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          Integrating group counseling, cell phone messaging, and participant-generated songs and dramas into a microcredit program increases Nigerian women's adherence to international breastfeeding recommendations.

          In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5-7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely given that >150 million women, many of childbearing age, are involved in microfinance globally.
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            Antenatal breastfeeding education for increasing breastfeeding duration.

            Breast milk is well recognised as the best food source for infants. The impact of antenatal breastfeeding (BF) education on the duration of BF has not been evaluated.
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              Integrating microfinance and health strategies: examining the evidence to inform policy and practice.

              Single solutions continue to be inadequate in confronting the prevalent problems of poverty, ill health and insufficient health system capacity worldwide. The poor need access to an integrated set of financial and health services to have income security and better health. Over 3500 microfinance institutions (MFIs) provide microcredit and financial services to more than 155 million households worldwide. Conservative estimates indicate that at least 34 million of these households are very poor by the definition in the Millennium Development Goals, representing around 170 million people, many in remote areas beyond the reach of health agencies, both private and governmental. A small but increasing number of MFIs offer health-related services, such as education, clinical care, community health workers, health-financing and linkages to public and private health providers. Multiple studies indicate the effectiveness of microfinance and its impact on poverty. A small but growing number of studies also attempt to show that MFIs are capable of contributing to health improvement by increasing knowledge that leads to behavioural changes, and by enhancing access to health services through addressing financial, geographic and other barriers. While these studies are of uneven quality, they indicate positive health benefits in diverse areas such as maternal and child health, malaria and other infectious disease, and domestic violence. While more rigorous research is needed to inform policy and guide programme implementation to integrate microfinance and health interventions that can reliably enhance the well-being of the poor, there is useful evidence to support the design and delivery of integrated programmes now. Worldwide, current public health programmes and health systems are proving to be inadequate to meet population needs. The microfinance sector offers an underutilized opportunity for delivery of health-related services to many hard-to-reach populations.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                reeusp
                Revista da Escola de Enfermagem da USP
                Rev. esc. enferm. USP
                Universidade de São Paulo, Escola de Enfermagem (, SP, Brazil )
                0080-6234
                1980-220X
                July 2018
                : 52
                : 0
                : e03333
                Affiliations
                [2] Fortaleza Ceará orgnameUniversidade Estadual do Ceará Brazil
                [1] Fortaleza Ceará orgnameUniversidade Federal do Ceará Brazil
                Article
                S0080-62342018000100804
                10.1590/s1980-220x2017024303333
                30043928
                b2c58654-47d4-4021-aad6-c2370affdb55

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 31 December 2017
                : 08 June 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 43, Pages: 0
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                SciELO Brazil


                Educação em Saúde,Review,Maternal-Child Nursing,Telephone,Health Education,Breast Feeding,Revisión,Enfermería Maternoinfantil,Teléfono,Educación en Salud,Lactancia Materna,Revisão,Enfermagem Materno-Infantil,Telefone,Aleitamento Materno

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