A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol
Background Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life...
| Autores principales: | , , , , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Springer
2017
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/146172 |
| _version_ | 1855525444964581376 |
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| author | Billah, Masum Ferdous, Tarana E. Karim, Mohd Anisul Dibley, Michael J. Raihana, Shahreen Moinuddin, Md. Choudhury, Nuzhat Ahmed, Tahmeed Hoque, D. M. Emdadul Menon, Purnima El Arifeen, Shams |
| author_browse | Ahmed, Tahmeed Billah, Masum Choudhury, Nuzhat Dibley, Michael J. El Arifeen, Shams Ferdous, Tarana E. Hoque, D. M. Emdadul Karim, Mohd Anisul Menon, Purnima Moinuddin, Md. Raihana, Shahreen |
| author_facet | Billah, Masum Ferdous, Tarana E. Karim, Mohd Anisul Dibley, Michael J. Raihana, Shahreen Moinuddin, Md. Choudhury, Nuzhat Ahmed, Tahmeed Hoque, D. M. Emdadul Menon, Purnima El Arifeen, Shams |
| author_sort | Billah, Masum |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life from conception, on lives saved and costs incurred in countries with the highest burden of stunted children. However, primary research on the combined effects of these interventions is limited. Our study directly addresses this gap by examining the effect of combinations of 5 preventive interventions on length-for-age z-scores (LAZ) among 2-years old children. Methods This community-based cluster randomised trial (c-RCT) compares 4 intervention combinations against one comparison arm. Intervention combinations are: 1) Behaviour change communication (BCC) on maternal nutrition during pregnancy, exclusive breastfeeding, and complementary feeding, along with prenatal nutritional supplement (PNS) and complementary food supplement (CFS); 2) BCC with PNS; 3) BCC with CFS; and 4) BCC alone. The comparison arm receives only routine health and nutrition services. From a rural district, 125 clusters were selected and randomly assigned to any one of the five study arms by block randomisation. A bespoke automated tab-based system was developed linking data collection, intervention delivery and project supervision. Total sample size is 1500 pregnant women, with minimum 1050 resultant children expected to be retained, powered to detect a difference of at least 0.4 in the mean LAZ score of children at 24 months, the main outcome variable, between the comparison arm and each intervention arm. Length and other anthropometric measurements, nutritional intake and other relevant data on mother and children are being collected during enrolment, twice during pregnancy, postpartum monthly till 6 months, and every third month thereafter till 24 months. Discussion This c-RCT explores the effectiveness of bundles of preventive nutrition intervention approaches addressing the critical window of opportunity to mitigate childhood stunting. The results will provide robust evidence as to which bundle(s) can have significant effect on linear growth of children. Our study also will have policy-level implications for prioritising intervention(s) tackling stunting. |
| format | Journal Article |
| id | CGSpace146172 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Springer |
| publisherStr | Springer |
| record_format | dspace |
| spelling | CGSpace1461722025-12-08T10:29:22Z A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol Billah, Masum Ferdous, Tarana E. Karim, Mohd Anisul Dibley, Michael J. Raihana, Shahreen Moinuddin, Md. Choudhury, Nuzhat Ahmed, Tahmeed Hoque, D. M. Emdadul Menon, Purnima El Arifeen, Shams infants bundling stunting randomized controlled trial preschool children malnutrition nutrition children Background Prevalence of stunting among under-five children in Bangladesh is 36%, varying with geographic and socio-economic characteristics. Previously, research groups statistically modelled the effect of 10 individual nutrition-specific interventions targeting the critical first 1000 days of life from conception, on lives saved and costs incurred in countries with the highest burden of stunted children. However, primary research on the combined effects of these interventions is limited. Our study directly addresses this gap by examining the effect of combinations of 5 preventive interventions on length-for-age z-scores (LAZ) among 2-years old children. Methods This community-based cluster randomised trial (c-RCT) compares 4 intervention combinations against one comparison arm. Intervention combinations are: 1) Behaviour change communication (BCC) on maternal nutrition during pregnancy, exclusive breastfeeding, and complementary feeding, along with prenatal nutritional supplement (PNS) and complementary food supplement (CFS); 2) BCC with PNS; 3) BCC with CFS; and 4) BCC alone. The comparison arm receives only routine health and nutrition services. From a rural district, 125 clusters were selected and randomly assigned to any one of the five study arms by block randomisation. A bespoke automated tab-based system was developed linking data collection, intervention delivery and project supervision. Total sample size is 1500 pregnant women, with minimum 1050 resultant children expected to be retained, powered to detect a difference of at least 0.4 in the mean LAZ score of children at 24 months, the main outcome variable, between the comparison arm and each intervention arm. Length and other anthropometric measurements, nutritional intake and other relevant data on mother and children are being collected during enrolment, twice during pregnancy, postpartum monthly till 6 months, and every third month thereafter till 24 months. Discussion This c-RCT explores the effectiveness of bundles of preventive nutrition intervention approaches addressing the critical window of opportunity to mitigate childhood stunting. The results will provide robust evidence as to which bundle(s) can have significant effect on linear growth of children. Our study also will have policy-level implications for prioritising intervention(s) tackling stunting. 2017 2024-06-21T09:06:04Z 2024-06-21T09:06:04Z Journal Article https://hdl.handle.net/10568/146172 en Springer Billah, Masum; Ferdous, Tarana E.; Karim, Mohd Anisul; Dibley, Michael J.; Raihana, Shahreen; Moinuddin, Md; Choudhury, Nuzhat; Ahmed, Tahmeed; Hoque, D. M. Emdadul; Menon, Purnima; and El Arifeen, Shams. 2017. A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol. BMC Public Health 17: 375: https://doi.org/10.1186/s12889-017-4281-0 |
| spellingShingle | infants bundling stunting randomized controlled trial preschool children malnutrition nutrition children Billah, Masum Ferdous, Tarana E. Karim, Mohd Anisul Dibley, Michael J. Raihana, Shahreen Moinuddin, Md. Choudhury, Nuzhat Ahmed, Tahmeed Hoque, D. M. Emdadul Menon, Purnima El Arifeen, Shams A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title | A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title_full | A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title_fullStr | A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title_full_unstemmed | A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title_short | A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at 24 months of age in rural Bangladesh: study protocol |
| title_sort | community based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition specific interventions in improving mean length for age z score among children at 24 months of age in rural bangladesh study protocol |
| topic | infants bundling stunting randomized controlled trial preschool children malnutrition nutrition children |
| url | https://hdl.handle.net/10568/146172 |
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