Hossain Muttaquina, Ferdous Tarana-E-, Islam Ziaul, Billah Sk Masum, Bulbul Md M Islam, Rahman Md Mezanur, Ahmed Tahmeed
Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh.
BMJ Open. 2019 Oct 10;9(10):e032458. doi: 10.1136/bmjopen-2019-032458.
The Government of Bangladesh is implementing growth monitoring and promotion (GMP) through community clinics (CC) to improve the nutritional status of children. However, little primary evidence is available on the effectiveness of GMP when delivered through CCs. We aim to examine the effectiveness of GMP activities strengthened in CCs to improve the nutritional status of children under 2 years of age.
This is a quasiexperimental, two-arm, mixed methods study. In the intervention arm, a non-governmental organisation is providing support to strengthen GMP implementation in the 30 CCs. The comparison arm has no intervention to strengthen GMP implementation in the 30 CCs. Study participants will be under-two children and their caregivers, and CC service providers (community healthcare provider, CHCP). We will collect quantitative information on children and mothers' anthropometry, sociodemographic condition, food security, children's feeding practices, morbidity and vaccination history at baseline, and follow them up every third month thereafter for 12 months. We will collect qualitative information on (1) knowledge, skill and practice of CHCPs to implement GMP; (2) mothers/caregivers' perception, knowledge and experience of GMP from CCs; (3) experience and suggestions of programme managers about operational challenges and for improving quality of GMP service delivery; and (4) views of the concerned policy planners to strengthen GMP at the CC level. Qualitative information will be collected through key informant and in-depth interviews at baseline and endline. The primary outcome will be the change observed in length-for-age Z-score of children. A difference-in-difference and linear mixed effects analysis of quantitative data will be done. Thematic analysis will be conducted for qualitative information. Triangulation of data derived from different methods will be carried out.
This study received ethical approval from the Institutional Review Board of International Centre for Diarrhoeal Disease Research, Bangladesh, and results will be disseminated via peer-reviewed publications and conference presentations.
NCT03824756.
孟加拉国政府正在通过社区诊所实施生长监测与促进项目（GMP），以改善儿童的营养状况。然而，关于通过社区诊所开展生长监测与促进项目的有效性，几乎没有第一手证据。我们旨在研究在社区诊所加强生长监测与促进活动对改善2岁以下儿童营养状况的有效性。
这是一项准实验性、双臂、混合方法研究。在干预组，一个非政府组织正在为加强30家社区诊所的生长监测与促进项目实施提供支持。对照组则不对30家社区诊所的生长监测与促进项目实施进行干预。研究参与者将是2岁以下儿童及其照料者，以及社区诊所服务提供者（社区医疗服务提供者，CHCP）。我们将在基线时收集有关儿童和母亲的人体测量学、社会人口状况、食品安全、儿童喂养习惯、发病率和疫苗接种史的定量信息，并在之后的12个月里每三个月对他们进行一次随访。我们将收集以下定性信息：（1）社区医疗服务提供者实施生长监测与促进项目的知识、技能和实践；（2）母亲/照料者对社区诊所生长监测与促进项目的认知、知识和经验；（3）项目经理关于运营挑战以及改善生长监测与促进服务质量的经验和建议；（4）相关政策规划者对在社区诊所层面加强生长监测与促进项目的看法。定性信息将在基线和终线时通过关键信息提供者访谈和深入访谈收集。主要结果将是观察到的儿童年龄别身长Z评分的变化。将对定量数据进行差分和线性混合效应分析。将对定性信息进行主题分析。将对不同方法得出的数据进行三角验证。
本研究获得了孟加拉国腹泻病研究国际中心机构审查委员会的伦理批准，研究结果将通过同行评审出版物和会议报告进行传播。
NCT03824756。
