Participatory women's groups and counselling through home visits to improve child growth in rural eastern India: protocol for a cluster randomised controlled trial

被引：21

作者：

Nair, Nirmala ^{[1
]}

Tripathy, Prasanta ^{[1
]}

Sachdev, Harshpal S. ^{[2
]}

Bhattacharyya, Sanghita ^{[3
]}

Gope, Rajkumar ^{[1
]}

Gagrai, Sumitra ^{[1
]}

Rath, Shibanand ^{[1
]}

Rath, Suchitra ^{[1
]}

Sinha, Rajesh ^{[1
]}

Roy, Swati Sarbani ^{[1
]}

Shewale, Suhas ^{[1
]}

Singh, Vijay ^{[1
]}

Srivastava, Aradhana ^{[3
]}

Pradhan, Hemanta ^{[1
]}

Costello, Anthony ^{[4
]}

Copas, Andrew ^{[5
]}

Skordis-Worrall, Jolene ^{[4
]}

Haghparast-Bidgoli, Hassan ^{[4
]}

Saville, Naomi ^{[4
]}

Prost, Audrey ^{[4
]}

机构：

[1] Ekjut, Chakradharpur, Jharkhand, India

[2] Sitaram Bhartia Inst Sci & Res, New Delhi, India

[3] Publ Hlth Fdn India, New Delhi, India

[4] UCL, Inst Global Hlth, London WC1N 1EH, England

[5] UCL, MRC Clin Trials Unit, London, England

来源：

BMC PUBLIC HEALTH | 2015年 / 15卷

基金：

英国惠康基金; 英国医学研究理事会;

关键词：

Stunting; India; Child; Nutrition; Public health; INTERVENTIONS; HEALTH; UNDERNUTRITION; COMPLEMENTARY; MICRONUTRIENTS; MORBIDITY; NUTRITION; HEIGHT; ZINC;

D O I：

10.1186/s12889-015-1655-z

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Child stunting (low height-for-age) is a marker of chronic undernutrition and predicts children's subsequent physical and cognitive development. Around one third of the world's stunted children live in India. Our study aims to assess the impact, cost-effectiveness, and scalability of a community intervention with a government-proposed community-based worker to improve growth in children under two in rural India. Methods: The study is a cluster randomised controlled trial in two rural districts of Jharkhand and Odisha (eastern India). The intervention tested involves a community-based worker carrying out two activities: (a) one home visit to all pregnant women in the third trimester, followed by subsequent monthly home visits to all infants aged 0-24 months to support appropriate feeding, infection control, and care-giving; (b) a monthly women's group meeting using participatory learning and action to catalyse individual and community action for maternal and child health and nutrition. Both intervention and control clusters also receive an intervention to strengthen Village Health Sanitation and Nutrition Committees. The unit of randomisation is a purposively selected cluster of approximately 1000 population. A total of 120 geographical clusters covering an estimated population of 121,531 were randomised to two trial arms: 60 clusters in the intervention arm receive home visits, group meetings, and support to Village Health Sanitation and Nutrition Committees; 60 clusters in the control arm receive support to Committees only. The study participants are pregnant women identified in the third trimester of pregnancy and their children (n = 2520). Mothers and their children are followed up at seven time points: during pregnancy, within 72 hours of delivery, and at 3, 6, 9, 12 and 18 months after birth. The trial's primary outcome is children's mean length-for-age Z scores at 18 months. Secondary outcomes include wasting and underweight at all time points, birth weight, growth velocity, feeding, infection control, and care-giving practices. Additional qualitative and quantitative data are collected for process and economic evaluations. Discussion: This trial will contribute to evidence on effective strategies to improve children's growth in India.

引用

页数：12

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