Sydney School of Public Health, The University of Sydney, Sydney, Australia.
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
BMC Public Health. 2020 Nov 25;20(1):1776. doi: 10.1186/s12889-020-09780-5.
Undernutrition is strongly associated with poverty - levels of undernutrition are higher in poor countries than in better-off countries. Social protection especially cash transfer is increasingly recognized as an important strategy to accelerate progress in improving maternal and child nutrition. A critical method to improve nutrition knowledge and influence feeding practices is through behaviour change communication intervention. The Shonjibon Cash and Counselling study aims to assess the effectiveness of unconditional cash transfers combined with a mobile application on nutrition counselling and direct counselling through mobile phone in reducing the prevalence of stunting in children at 18 months.
The study is a longitudinal cluster randomised controlled trial, with two parallel groups, and cluster assignment by groups of villages. The cohort of mother-child dyads will be followed-up over the intervention period of approximately 24 months, starting from recruitment to 18 months of the child's age. The study will take place in north-central Bangladesh. The primary trial outcome will be the percentage of stunted children at 18 m as measured in follow up assessments starting from birth. The secondary trial outcomes will include differences between treatment arms in (1) Mean birthweight, percentage with low birthweight and small for gestational age (2) Mean child length-for age, weight for age and weight-for-length Z scores (3) Prevalence of child wasting (4) Percentage of women exclusively breastfeeding and mean duration of exclusive breastfeeding (5) Percentage of children consuming > 4 food groups (6) Mean child intake of energy, protein, carbohydrate, fat and micronutrients (7) Percentage of women at risk of inadequate nutrient intakes in all three trimesters (8) Maternal weight gain (9) Household food security (10) Number of events for child suffering from diarrhoea, acute respiratory illness and fever (11) Average costs of mobile phone BCC and cash transfer, and benefit-cost ratio for primary and secondary outcomes.
The proposed trial will provide high-level evidence of the efficacy and cost-effectiveness of mobile phone nutrition behavior change communication, combined with unconditional cash transfers in reducing child undernutrition in rural Bangladesh.
The study has been registered in the Australian New Zealand Clinical Trials Registry ( ACTRN12618001975280 ).
营养不良与贫困密切相关-在贫困国家，营养不良的水平高于富裕国家。社会保护，特别是现金转移，正日益被视为加速改善孕产妇和儿童营养的重要战略。提高营养知识和影响喂养习惯的关键方法是通过行为改变沟通干预。Shonjibon 现金和咨询研究旨在评估无条件现金转移与移动应用程序结合使用对营养咨询的有效性，并通过移动电话进行直接咨询，以降低 18 个月儿童发育迟缓的患病率。
该研究是一项纵向群组随机对照试验，有两个平行组，通过村庄群组进行分组分配。母婴对子组的队列将在大约 24 个月的干预期间进行随访，从招募开始到儿童 18 个月。该研究将在孟加拉国中北部进行。主要试验结果将是在出生后开始的随访评估中，18 个月时发育迟缓儿童的百分比。次要试验结果将包括治疗组之间的差异：(1)平均出生体重、低出生体重和小于胎龄儿的百分比；(2)平均儿童长度-年龄、体重-年龄和体重-长度 Z 分数；(3)儿童消瘦的患病率；(4)纯母乳喂养的妇女百分比和纯母乳喂养的平均持续时间；(5)儿童食用>4 种食物组的百分比；(6)儿童摄入的能量、蛋白质、碳水化合物、脂肪和微量营养素的平均量；(7)所有三个三个月中营养摄入不足风险的妇女百分比；(8)产妇体重增加；(9)家庭粮食安全；(10)儿童患腹泻、急性呼吸道疾病和发烧的事件数；(11)移动电话 BCC 和现金转移的平均成本，以及主要和次要结果的效益-成本比。
拟议的试验将提供高质量的证据，证明在孟加拉国农村地区，移动电话营养行为改变沟通与无条件现金转移相结合，可有效减少儿童营养不良。
该研究已在澳大利亚新西兰临床试验注册中心（ACTRN12618001975280）注册。
