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  • 1
    Online Resource
    Online Resource
    Factors associated with home visits by volunteer community health workers to implement a home-fortification intervention in Bangladesh: a multilevel analysis
    Cambridge University Press (CUP) ; 2021
    In:  Public Health Nutrition Vol. 24, No. S1 ( 2021-04), p. s23-s36
    Details
    In: Public Health Nutrition, Cambridge University Press (CUP), Vol. 24, No. S1 ( 2021-04), p. s23-s36
    Abstract: BRAC, an international development organization based in Bangladesh, engages community health workers called Shasthya Shebikas (SS) to implement home fortification of foods with micronutrient powders (MNP). We identified factors associated with home visits by SS, at different levels of the BRAC programme-delivery hierarchy, to implement home-fortification interventions. Design: We conducted a cross-sectional survey, semi-structured interviews, and collected programme-related data from sub-districts included in the caregiver survey of BRAC’s home-fortification programme and performed multilevel logistic regression modelling to investigate factors associated with home visits by SS. Settings: Sixty-eight sub-districts in Bangladesh. Participants: Caregivers of children aged 6–59 months ( n 1408) and BRAC’s SS ( n 201). Results: Households with older children (0·55; 0·42, 0·72; P 〈 0·001) and located 〉 300 m from the SS’s house (0·67; 0·50, 0·89; P = 0·006) were less likely to have been visited by the SS, whereas those with caregivers who had ≥5 years of schooling (1·53; 1·10, 2·12; P = 0·011) were more likely to have been visited by the SS (adjusted OR; 95 % CI). Households in the catchment area of older SS aged 〉 50 years (0·44; 0·21, 0·90; P = 0·025) were less likely to have been visited by the SS, whereas those with SS who received incentives of 〉 800 BDT (3·00; 1·58, 5·58; P = 0·001) were more likely to have been visited by the SS (adjusted OR; 95 % CI). Conclusions: The number of home visits is a function of the characteristics of SS, factors that characterize the households they serve and characteristics of their organizational context, particularly to implement home fortification of foods with MNP.
    Type of Medium: Online Resource
    ISSN: 1368-9800 , 1475-2727
    URL: Article
    DOI: 10.1017/S1368980019003768
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2016337-X
    SSG: 21
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  • 2
    Online Resource
    Online Resource
    Study protocol to assess the impact of an integrated nutrition intervention on the growth and development of children under two in rural Bangladesh
    Springer Science and Business Media LLC ; 2019
    In:  BMC Public Health Vol. 19, No. 1 ( 2019-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Abstract: The period from birth to two years is the “critical window” for achieving optimal growth and development. An inadequate quality and quantities of complementary foods, poor child-feeding practices and infection negatively impact the growth of under-twos. Approximately one-third of under-fives in developing countries are stunted; many are also micronutrient deficient. An estimated 6% of mortalities among under-fives can be prevented by ensuring optimal complementary feeding. The objective of the study was to assess the ability of a 12-month integrated nutrition intervention to improve the nutritional status (length-for-age Z -score) of 6 to 12-month-old children in rural Bangladesh. Methods In this community-based randomized controlled trial, the intervention group received a package of interventions that includes, food vouchers; to prepare egg-based nutritious snacks ( suji firni for 〈  1-year-olds, suji halwa for 〉  1-year-olds), micronutrient powder to fortify children’s food at home, child feeding counselling and water, sanitation and hygiene (WASH), behaviour change communication. The control group received routine health messages provided by the government. Baseline and endline surveys were conducted; Data collection was performed monthly on children’s growth, food voucher utilization, child feeding and morbidity. In addition, we assessed the cognitive development of the children after 12 months of intervention. Conclusion This trial aims to explore whether an integrated nutrition intervention can mitigate childhood stunting during the critical window of opportunity in rural Bangladesh. The results may provide robust evidence to improve the linear growth of children in developing countries. Trial registration The study was retrospectively registered on August 17, 2018 and is available online at ClinicalTrials.gov (ID: NCT02768181).
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-019-7777-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2041338-5
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  • 3
    Online Resource
    Online Resource
    An Intervention Package Including Egg and Milk-Based Snack Improved Growth and Development of U-2 Children in Bangladesh: A Community-Based Randomized Controlled Trial
    Elsevier BV ; 2021
    In:  Current Developments in Nutrition Vol. 5 ( 2021-06), p. 99-
    Details
    In: Current Developments in Nutrition, Elsevier BV, Vol. 5 ( 2021-06), p. 99-
    Type of Medium: Online Resource
    ISSN: 2475-2991
    URL: Article
    DOI: 10.1093/cdn/nzab035_007
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2908329-1
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  • 4
    Online Resource
    Online Resource
    Table_2.DOCX
    Frontiers Media SA ; 2024
    In:  Frontiers in Nutrition Vol. 10 ( 2024-1-5)
    Details
    In: Frontiers in Nutrition, Frontiers Media SA, Vol. 10 ( 2024-1-5)
    Abstract: Anemia poses a significant public health problem, affecting 1.6 billion people and contributing to the loss of 68.4 million disability-adjusted life years. We assessed the impact of a market-based home fortification program with micronutrient powder (MNP) called Pushtikona-5 implemented by Bangladesh Rural Advancement Committee (BRAC) on the prevalence of anemia among children aged 6–59 months in Bangladesh. Methods We used a modified stepped wedged design and conducted three baseline, two midline, and three endline surveys to evaluate the Pushtikona-5 program implemented through three BRAC program platforms. We interviewed children’s caregivers, and collected finger-prick blood samples from children to measure hemoglobin concentration. We also collected data on coverage of Pushtikona-5 and infant and young child feeding (IYCF) practices. We performed bivariate and multivariable analysis and calculated adjusted risk ratios (ARRs) to assess the effect of program outcomes. Results A total of 16,936 households were surveyed. The prevalence of anemia was 46.6% at baseline, dropping to 32.1% at midline and 31.2% at endline. These represented adjusted relative reductions of 34% at midline (RR 0.66, 95%CI 0.62 to 0.71, value of p & lt;0.001) and 32% at endline (RR 0.68, 95%CI 0.64 to 0.71, value of p & lt;0.001) relative to baseline. Regarding MNP coverage, at baseline, 43.5% of caregivers surveyed had heard about MNP; 24.3% of children had ever consumed food with MNP, and only 1.8% had consumed three or more sachets in the 7 days preceding the survey. These increased to 63.0, 36.9, and 4.6%, respectively, at midline and 90.6, 68.9, and 11.5%, respectively, at endline. Conclusion These results show evidence of a reduction in the prevalence of anemia and an improvement in coverage. This study provides important evidence of the feasibility and potential for impact of linking market-based MNP distribution with IYCF promotion through community level health workers.
    Type of Medium: Online Resource
    ISSN: 2296-861X
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.3389/fnut.2023.1271931
    DOI: 10.3389/fnut.2023.1271931.s001
    DOI: 10.3389/fnut.2023.1271931.s002
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2024
    detail.hit.zdb_id: 2776676-7
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  • 5
    Online Resource
    Online Resource
    A comprehensive intervention package improves the linear growth of children under 2-years-old in rural Bangladesh: a community-based cluster randomized controlled trial
    Springer Science and Business Media LLC ; 2022
    In:  Scientific Reports Vol. 12, No. 1 ( 2022-12-19)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-12-19)
    Abstract: Approximately one-third of children under the age of five are stunted in developing countries and many of them are micronutrient-deficient. We designed a comprehensive intervention package including egg/milk-based snacks to improve linear growth and dietary diversity among 6 to 12-month-old children in rural Bangladesh. In this 1-year community-based cluster randomized controlled longitudinal experiment, 412 mother–infant pairs were randomly assigned to receive either monthly food vouchers (for eggs, milk, semolina, sugar, and oil) to prepare egg and milk-based snacks for their children, along with multiple micronutrient powder (MNP), counseling on child feeding and handwashing, or regular government health communication alone (control; n = 206, treatment; n = 206). The trial was conducted in 12 clusters (small administrative units of sub-district). The primary inclusion criteria were ultra-poor households with limited resources and having children under 2-years-old. The primary and secondary outcomes were differences in children's length gain and dietary diversity. The effect of intervention on child growth was examined using a mixed effect linear regression model. Mean weight and length of the children did not significantly differ between groups at baseline. Around 90% of the children in both groups were breastfed. After receiving intervention for 12 months, LAZ score increased by 0.37 (CI 0.24, 0.51, p   〈  0.001) and risk of stunting reduced by 73% (OR: 0.27, CI 0.13, 0.58, p  = 0.001). This comprehensive intervention package improved the growth and dietary diversity of children in extremely poor Bangladeshi households. A scaling-up of this intervention in contexts with limited resources should be taken into consideration. Trial registration: This trial registered retrospectively at ClinicalTrials.gov as NCT03641001, 21/8/2018.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-022-26269-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 6
    Online Resource
    Online Resource
    Role of home visits by volunteer community health workers: to improve the coverage of micronutrient powders in rural Bangladesh
    Cambridge University Press (CUP) ; 2021
    In:  Public Health Nutrition Vol. 24, No. S1 ( 2021-04), p. s48-s58
    Details
    In: Public Health Nutrition, Cambridge University Press (CUP), Vol. 24, No. S1 ( 2021-04), p. s48-s58
    Abstract: We assessed the role of home visits by Shasthya Shebika (SS) – female volunteer community health workers (CHWs) – in improving the distribution of micronutrient powder (MNP), and explored the independent effects of caregiver–provider interaction on coverage variables. Design: We used data from three cross-sectional surveys undertaken at baseline ( n 1927), midline ( n 1924) and endline ( n 1540) as part of an evaluation of a home fortification programme. We defined an exposure group as one that had at least one SS visit to the caregiver’s household in the 12 months preceding the survey considering three outcome variables – message (ever heard), contact (ever used) and effective coverage (regular used) of MNP. We performed multiple logistic regressions to explore the determinants of coverage, employed an ‘interaction term’ and calculated an odds ratio (OR) to assess the modifying effect of SS’s home visits on coverage. Settings: Sixty-eight sub-districts from ten districts of Bangladesh. Participants: Children aged 6–59 months and their caregivers. Results: A home visit from an SS positively impacts message coverage at both midline (ratio of OR 1·70; 95 % CI 1·25, 2·32; P 〈 0·01) and endline (ratio of OR 3·58; 95 % CI 2·22, 5·78; P 〈 0·001), and contact coverage both at midline (ratio of OR 1·48; 95 % CI 1·06, 2·07; P = 0·021) and endline (ratio of OR 1·74; 95 % CI 1·23, 2·47; P = 0·002). There was no significant effect of a SS’s home visit on effective coverage. Conclusions: The households visited by BRAC’s volunteer CHWs have better message and contact coverage among the children aged 6–59 months.
    Type of Medium: Online Resource
    ISSN: 1368-9800 , 1475-2727
    URL: Article
    DOI: 10.1017/S1368980020000038
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2016337-X
    SSG: 21
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    Online Resource
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