Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation
Background Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, commun...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | Inglés |
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American Society for Nutrition
2017
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| Subjects: | |
| Online Access: | https://hdl.handle.net/10568/147898 |
| _version_ | 1855523894603022336 |
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| author | Nguyen, Phuong Hong Kim, Sunny S. Sanghvi, Tina Mahmud, Zeba Tran, Lan Mai Shabnam, Sadia Aktar, Bachera Haque, Raisul Afsana, Kaosar Frongillo, Edward A. Ruel, Marie T. Menon, Purnima |
| author_browse | Afsana, Kaosar Aktar, Bachera Frongillo, Edward A. Haque, Raisul Kim, Sunny S. Mahmud, Zeba Menon, Purnima Nguyen, Phuong Hong Ruel, Marie T. Sanghvi, Tina Shabnam, Sadia Tran, Lan Mai |
| author_facet | Nguyen, Phuong Hong Kim, Sunny S. Sanghvi, Tina Mahmud, Zeba Tran, Lan Mai Shabnam, Sadia Aktar, Bachera Haque, Raisul Afsana, Kaosar Frongillo, Edward A. Ruel, Marie T. Menon, Purnima |
| author_sort | Nguyen, Phuong Hong |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. Objective We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. Methods We used a cluster-randomized design with cross-sectional surveys at baseline (2015) and endline (2016) (n ∼ 300 and 1000 pregnant or recently delivered women, respectively, per survey round). We derived difference-in-difference effect estimates, adjusted for geographic clustering and infant age and sex. Results Coverage of interpersonal counseling was high; >90% of women in the nutrition-focused MNCH group were visited at home by health workers for maternal nutrition and breastfeeding counseling. The coverage of community mobilization activities was ∼50%. Improvements were significantly greater in the nutrition-focused MNCH group than in the standard MNCH group for consumption of iron and folic acid [effect: 9.8 percentage points (pp); 46 tablets] and calcium supplements (effect: 12.8 pp; 50 tablets). Significant impacts were observed for the number of food groups consumed (effect: 1.6 food groups), percentage of women who consumed ≥5 food groups/d (effect: 30.0 pp), and daily intakes of several micronutrients. A significant impact was also observed for exclusive breastfeeding (EBF; effect: 31 pp) but not for early initiation of breastfeeding. Conclusions Addressing nutrition during pregnancy by delivering interpersonal counseling and community mobilization, providing free supplements, and ensuring weight-gain monitoring through an existing MNCH program improved maternal dietary diversity, micronutrient supplement consumption, and EBF practices. |
| format | Journal Article |
| id | CGSpace147898 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | American Society for Nutrition |
| publisherStr | American Society for Nutrition |
| record_format | dspace |
| spelling | CGSpace1478982025-04-03T21:29:28Z Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation Nguyen, Phuong Hong Kim, Sunny S. Sanghvi, Tina Mahmud, Zeba Tran, Lan Mai Shabnam, Sadia Aktar, Bachera Haque, Raisul Afsana, Kaosar Frongillo, Edward A. Ruel, Marie T. Menon, Purnima therapy nutrient intake randomized controlled trial community involvement malnutrition trace elements breastfeeding maternal nutrition dietary diversity Background Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. Objective We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. Methods We used a cluster-randomized design with cross-sectional surveys at baseline (2015) and endline (2016) (n ∼ 300 and 1000 pregnant or recently delivered women, respectively, per survey round). We derived difference-in-difference effect estimates, adjusted for geographic clustering and infant age and sex. Results Coverage of interpersonal counseling was high; >90% of women in the nutrition-focused MNCH group were visited at home by health workers for maternal nutrition and breastfeeding counseling. The coverage of community mobilization activities was ∼50%. Improvements were significantly greater in the nutrition-focused MNCH group than in the standard MNCH group for consumption of iron and folic acid [effect: 9.8 percentage points (pp); 46 tablets] and calcium supplements (effect: 12.8 pp; 50 tablets). Significant impacts were observed for the number of food groups consumed (effect: 1.6 food groups), percentage of women who consumed ≥5 food groups/d (effect: 30.0 pp), and daily intakes of several micronutrients. A significant impact was also observed for exclusive breastfeeding (EBF; effect: 31 pp) but not for early initiation of breastfeeding. Conclusions Addressing nutrition during pregnancy by delivering interpersonal counseling and community mobilization, providing free supplements, and ensuring weight-gain monitoring through an existing MNCH program improved maternal dietary diversity, micronutrient supplement consumption, and EBF practices. 2017 2024-06-21T09:23:28Z 2024-06-21T09:23:28Z Journal Article https://hdl.handle.net/10568/147898 en Open Access American Society for Nutrition Nguyen, Phuong Hong; Kim, Sunny S.; Sanghvi, Tina; Mahmud, Zeba; Tran, Lan Mai; Shabnam, Sadia; Aktar, Bachera; Haque, Raisul; Afsana, Kaosar; Frongillo, Edward A.; Ruel, Marie T.; and Menon, Purnima. 2017. Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation. Journal of Nutrition 147(12): 2326-2337. https://doi.org/10.3945/jn.117.257303 |
| spellingShingle | therapy nutrient intake randomized controlled trial community involvement malnutrition trace elements breastfeeding maternal nutrition dietary diversity Nguyen, Phuong Hong Kim, Sunny S. Sanghvi, Tina Mahmud, Zeba Tran, Lan Mai Shabnam, Sadia Aktar, Bachera Haque, Raisul Afsana, Kaosar Frongillo, Edward A. Ruel, Marie T. Menon, Purnima Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title | Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title_full | Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title_fullStr | Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title_full_unstemmed | Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title_short | Integrating nutrition interventions into an existing maternal, neonatal, and child health program increased maternal dietary diversity, micronutrient intake, and exclusive breastfeeding practices in Bangladesh: results of a cluster-randomized program evaluation |
| title_sort | integrating nutrition interventions into an existing maternal neonatal and child health program increased maternal dietary diversity micronutrient intake and exclusive breastfeeding practices in bangladesh results of a cluster randomized program evaluation |
| topic | therapy nutrient intake randomized controlled trial community involvement malnutrition trace elements breastfeeding maternal nutrition dietary diversity |
| url | https://hdl.handle.net/10568/147898 |
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