Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh
This article was published in the Maternal & Child Nutrition [© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd. ] and the definite version is available at : https://doi.org/10.1111/mcn.12613 The Journal's website is at: https://onlinelibrary.wiley.com...
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10361-163922022-03-22T04:21:15Z Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh Nguyen, Phuong Hong Frongillo, Edward A. Sanghvi, Tina Kim, Sunny S. Alayon, Silvia Tran, Lan Mai Mahmud, Zeba Aktar, Bachera Menon, Purnima Brac James P. Grant School of Public Health Bangladesh Implementation Maternal nutrition Service delivery This article was published in the Maternal & Child Nutrition [© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd. ] and the definite version is available at : https://doi.org/10.1111/mcn.12613 The Journal's website is at: https://onlinelibrary.wiley.com/doi/10.1111/mcn.12613 Understanding implementation of interventions is critical to illuminate if, how, and why the interventions achieve impact. Alive & Thrive integrated a nutrition intervention into an existing maternal, neonatal, and child health (MNCH) programme in Bangladesh, documenting improvements in women's micronutrient supplement intake and dietary diversity. Here, we examined how well the nutrition intervention was implemented and which elements of implementation explained intervention impact. Survey data were collected in 2015 and 2016 from frontline health workers (FLW) and households in areas randomized to nutrition‐focused MNCH (intensified interpersonal counselling, community mobilization, distribution of free micronutrient supplements, and weight‐gain monitoring) or standard MNCH (antenatal care with standard nutrition counselling). Seven intervention elements were measured: time commitment, training quality, knowledge, coverage, counselling quality, supervision, and incentives. Multiple regression was used to derive difference‐in‐differences (DID) estimates. Using village‐level endline data, path analysis was used to determine which elements most explained intervention impacts. FLWs in both areas were highly committed and well supervised. Coverage was high (>90%) for counselling, supplement provision, and weight‐gain monitoring. Improvements were significantly greater for nutrition‐focused MNCH, versus standard MNCH, for training quality (DID: 2.42 points of 10), knowledge (DID: 1.20 points), delivery coverage (DID: 4.16 points), and counselling quality (DID: 1.60 points). Impact was substantially explained by coverage and delivery quality. In conclusion, integration nutrition intervention into the MNCH programme was feasible and well‐implemented. Although differences in coverage and counselling quality most explained impacts, all intervention elements—particularly FLW training and performance—were likely important to achieving impact. Published 2022-03-06T04:36:40Z 2022-03-06T04:36:40Z 2018 2018-10 Journal Article Nguyen, P. H., Frongillo, E. A., Sanghvi, T., Kim, S. S., Alayon, S., Tran, L. M., Mahmud, Z., Aktar, B., & Menon, P. (2018). Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh. Maternal & child nutrition, 14(4), e12613. https://doi.org/10.1111/mcn.12613 http://hdl.handle.net/10361/16392 https://doi.org/10.1111/mcn.12613 en_US https://onlinelibrary.wiley.com/doi/10.1111/mcn.12613 Maternal & Child Nutrition Journal application/pdf Wiley Online Library |
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Brac University |
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Institutional Repository |
| language |
en_US |
| topic |
Bangladesh Implementation Maternal nutrition Service delivery |
| spellingShingle |
Bangladesh Implementation Maternal nutrition Service delivery Nguyen, Phuong Hong Frongillo, Edward A. Sanghvi, Tina Kim, Sunny S. Alayon, Silvia Tran, Lan Mai Mahmud, Zeba Aktar, Bachera Menon, Purnima Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| description |
This article was published in the Maternal & Child Nutrition [© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd. ] and the definite version is available at : https://doi.org/10.1111/mcn.12613 The Journal's website is at: https://onlinelibrary.wiley.com/doi/10.1111/mcn.12613 |
| author2 |
Brac James P. Grant School of Public Health |
| author_facet |
Brac James P. Grant School of Public Health Nguyen, Phuong Hong Frongillo, Edward A. Sanghvi, Tina Kim, Sunny S. Alayon, Silvia Tran, Lan Mai Mahmud, Zeba Aktar, Bachera Menon, Purnima |
| format |
Journal Article |
| author |
Nguyen, Phuong Hong Frongillo, Edward A. Sanghvi, Tina Kim, Sunny S. Alayon, Silvia Tran, Lan Mai Mahmud, Zeba Aktar, Bachera Menon, Purnima |
| author_sort |
Nguyen, Phuong Hong |
| title |
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| title_short |
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| title_full |
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| title_fullStr |
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| title_full_unstemmed |
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh |
| title_sort |
importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in bangladesh |
| publisher |
Wiley Online Library |
| publishDate |
2022 |
| url |
http://hdl.handle.net/10361/16392 https://doi.org/10.1111/mcn.12613 |
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