Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh

Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services i...

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Autores principales: Escobar-DeMarco, Jessica, Nguyen, Phuong Hong, Kundu, Gourob, Kabir, Rowshan, Ali, Mohsin, Ireen, Santhia, Ash, Deborah, Mahmud, Zeba, Sununtnasuk, Celeste, Menon, Purnima, Frongillo, Edward A.
Formato: Journal Article
Lenguaje:Inglés
Publicado: Wiley 2025
Materias:
Acceso en línea:https://hdl.handle.net/10568/160011
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author Escobar-DeMarco, Jessica
Nguyen, Phuong Hong
Kundu, Gourob
Kabir, Rowshan
Ali, Mohsin
Ireen, Santhia
Ash, Deborah
Mahmud, Zeba
Sununtnasuk, Celeste
Menon, Purnima
Frongillo, Edward A.
author_browse Ali, Mohsin
Ash, Deborah
Escobar-DeMarco, Jessica
Frongillo, Edward A.
Ireen, Santhia
Kabir, Rowshan
Kundu, Gourob
Mahmud, Zeba
Menon, Purnima
Nguyen, Phuong Hong
Sununtnasuk, Celeste
author_facet Escobar-DeMarco, Jessica
Nguyen, Phuong Hong
Kundu, Gourob
Kabir, Rowshan
Ali, Mohsin
Ireen, Santhia
Ash, Deborah
Mahmud, Zeba
Sununtnasuk, Celeste
Menon, Purnima
Frongillo, Edward A.
author_sort Escobar-DeMarco, Jessica
collection Repository of Agricultural Research Outputs (CGSpace)
description Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID-19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics).
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spelling CGSpace1600112025-12-08T09:54:28Z Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh Escobar-DeMarco, Jessica Nguyen, Phuong Hong Kundu, Gourob Kabir, Rowshan Ali, Mohsin Ireen, Santhia Ash, Deborah Mahmud, Zeba Sununtnasuk, Celeste Menon, Purnima Frongillo, Edward A. children nutrition pregnancy women Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID-19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics). 2025-01 2024-11-20T19:32:29Z 2024-11-20T19:32:29Z Journal Article https://hdl.handle.net/10568/160011 en Open Access Wiley Escobar-DeMarco, Jessica; Nguyen, Phuong; Kundu, Gourob; Kabir, Rowshan; Ali, Mohsin; Ireen, Santhia; et al. 2025. Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh. Maternal and Child Nutrition 21(1): e13750. https://doi.org/10.1111/mcn.13750
spellingShingle children
nutrition
pregnancy
women
Escobar-DeMarco, Jessica
Nguyen, Phuong Hong
Kundu, Gourob
Kabir, Rowshan
Ali, Mohsin
Ireen, Santhia
Ash, Deborah
Mahmud, Zeba
Sununtnasuk, Celeste
Menon, Purnima
Frongillo, Edward A.
Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title_full Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title_fullStr Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title_full_unstemmed Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title_short Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
title_sort disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in dhaka bangladesh
topic children
nutrition
pregnancy
women
url https://hdl.handle.net/10568/160011
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