Khan Nazib Uz Zaman, Rasheed Sabrina, Sharmin Tamanna, Siddique A K, Dibley Micheal, Alam Ashraful
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
International Public Health, Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
BMC Health Serv Res. 2018 Jul 9;18(1):530. doi: 10.1186/s12913-018-3351-z.
Nutrition has been integrated within the health services in Bangladesh as it is an important issue for health and development. High penetration of mobile phones in the community and favourable policy and political commitment of the Government of Bangladesh has created possibilities of using Information Communication Technology such as mobile phones for nutrition programs. In this paper the implementation of nutrition services with a specific focus on infant and young child feeding was explored and the potential for using mobile phones to improve the quality and coverage of nutrition services was assessed.
A qualitative study was conducted in Mirzapur and Chakaria sub-districts, Bangladesh from February-April 2014. We conducted 24 in-depth interviews (mothers of young children), 8 focus group discussions (fathers and grandmothers); and 13 key informant interviews (community health workers or CHWs). We also observed 4 facilities and followed 2 CHWs during their work day. The data was analyzed manually using pre-existing themes.
In this community, mothers demonstrated gaps in knowledge about IYCF. They depended on their social network and media for IYCF information. Although CHWs were trusted in the community, mothers and their family members did not consider them a good source of nutrition information as they did not talk about nutrition. In terms of ICTs, mobile phones were the most available and used by both CHWs and mothers. CHWs showed willingness to incorporate nutrition counselling through mobile phone as this can enhance their productivity, reduce travel time and improve service quality. Mothers were willing to receive voice calls from CHWs as long as the decision makers in the households were informed.
Our study indicated that there are gaps in IYCF related service delivery and there is a potential for using mobile phones to both strengthen the quality of service delivery as well as reaching out to the mothers in the community. It is important however, to consider the community readiness to accept the technology during the design and delivery of the intervention.
营养问题对健康与发展至关重要，已被纳入孟加拉国的卫生服务体系。社区中手机的高普及率以及孟加拉国政府有利的政策和政治承诺，为利用手机等信息通信技术开展营养项目创造了可能性。本文探讨了以婴幼儿喂养为重点的营养服务实施情况，并评估了利用手机改善营养服务质量和覆盖范围的潜力。
2014年2月至4月在孟加拉国米尔扎布尔和查卡里亚分区进行了一项定性研究。我们进行了24次深入访谈（幼儿母亲）、8次焦点小组讨论（父亲和祖母）以及13次关键 informant 访谈（社区卫生工作者或CHW）。我们还观察了4个机构，并跟踪了2名CHW的工作日工作情况。数据使用预先设定的主题进行人工分析。
在这个社区，母亲们在婴幼儿喂养知识方面存在差距。她们依靠社交网络和媒体获取婴幼儿喂养信息。尽管CHW在社区中受到信任，但母亲及其家庭成员并不认为他们是良好的营养信息来源，因为他们不谈论营养问题。在信息通信技术方面，手机是CHW和母亲们最常用的工具。CHW表示愿意通过手机提供营养咨询，因为这可以提高他们的工作效率、减少出行时间并改善服务质量。只要告知家庭中的决策者，母亲们愿意接听CHW的语音电话。
我们的研究表明，在婴幼儿喂养相关服务提供方面存在差距，利用手机既可以提高服务质量，也可以覆盖社区中的母亲们。然而，在设计和实施干预措施时，考虑社区对接受该技术的准备情况非常重要。
