Khan Nuruzzaman, Imam Mahmudul Hassan Al, Jahan Israt, Muhit Mohammad, Badawi Nadia, Khandaker Gulam
Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia.
Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.
Food Nutr Bull. 2025 Jun;46(2-3):70-77. doi: 10.1177/03795721251348338. Epub 2025 Jun 19.
BackgroundHousehold food insecurity is a critical concern for ultra-poor families in low- and middle-income countries like Bangladesh, particularly those with members who have disabilities. The COVID-19 pandemic has worsened this situation.ObjectiveThis study aimed to assess the impact of microfinance-based livelihood programs on food insecurity in ultra-poor families with members affected by cerebral palsy in Bangladesh.MethodsData were extracted from the SUPPORT CP trial for 251 children with cerebral palsy. The Household Food Insecurity Access Scale score was the outcome variable. The explanatory variable was the intervention type, dividing the sample into 3 arms: Arm C (care as usual), Arm B (Community-Based Rehabilitation [CBR]), and Arm A (CBR with the integrated microfinance-based livelihood program [IMCBR]). Both linear regression and the Generalized Estimating Equations model were used to determine the association of outcome variable with explanatory variables adjusting for covariates.ResultsWe found a consistent level of household food insecurity across each time point, with a significant increase in the midline during the peak of COVID-19 pandemic in 2020. However, following the end of the COVID-19 pandemic, both Arms A and B, where interventions were provided, reported a significant decline in food insecurity. Notably, Arm A, where IMCBR was provided, exhibited the fastest decrease in food insecurity followed by Arm B, where only CBR was provided, compared to Arm C.ConclusionMicrofinance programs can reduce food insecurity among families of children with cerebral palsy in Bangladesh, especially during crises like COVID-19, underscoring the need to integrate them with tailored disability rehabilitation services.
背景
家庭粮食不安全是孟加拉国等低收入和中等收入国家极端贫困家庭面临的一个关键问题，尤其是那些有残疾成员的家庭。2019冠状病毒病疫情使这一情况更加恶化。
目的
本研究旨在评估基于小额信贷的生计项目对孟加拉国患有脑瘫的极端贫困家庭粮食不安全状况的影响。
方法
数据取自SUPPORT CP试验中251名脑瘫儿童的资料。家庭粮食不安全获取量表得分是结果变量。解释变量是干预类型，将样本分为三组：C组（常规护理）、B组（社区康复[CBR]）和A组（结合基于小额信贷的生计项目的社区康复[IMCBR]）。线性回归和广义估计方程模型均用于确定结果变量与经协变量调整后的解释变量之间的关联。
结果
我们发现每个时间点的家庭粮食不安全水平一致，在2020年新冠疫情高峰期，中间阶段显著增加。然而，在新冠疫情结束后，接受干预的A组和B组报告粮食不安全状况显著下降。值得注意的是，与C组相比，提供IMCBR的A组粮食不安全状况下降最快，其次是仅提供CBR的B组。
结论
小额信贷项目可以减少孟加拉国脑瘫儿童家庭的粮食不安全状况，尤其是在新冠疫情等危机期间，这突出了将其与量身定制的残疾康复服务相结合的必要性。
