Effect of Behavior Change Communication on the Incidence of Pneumonia in Under Five Children: A Cluster Randomized Controlled Trial

2021 ◽  
Vol 58 (11) ◽  
pp. 1046-1051
Author(s):  
Jayashree Gothankar ◽  
Prasad Pore ◽  
Girish Dhumale ◽  
Prakash Doke ◽  
Sanjay Lalwani ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Behavior Change Communication ◽  
Under Five ◽  
Under Five Children ◽  
Randomized Controlled ◽  
Change Communication ◽  
Cluster Randomized

scholarly journals Effectiveness of unconditional cash transfers combined with lipid-based nutrient supplement and/or behavior change communication to prevent stunting among children in Pakistan: a cluster randomized controlled trial

2021 ◽  
Author(s):  
Sajid Bashir Soofi ◽  
Shabina Ariff ◽  
Gul Nawaz Khan ◽  
Atif Habib ◽  
Sumra Kureishy ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Behavior Change Communication ◽  
Randomized Controlled ◽  
Change Communication ◽  
Nutrient Supplement ◽  
Significant Difference ◽  
Cluster Randomized

Abstract Background In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades. Objective We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age. Design This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 months of age and measured monthly for 18 months until the age of 24 months. Results At 24 months of age, children who received UCT+LNS (rate ratio [RR], 0.85 [95% CI 0.74, 0.97]; P = 0.015); and UCT+LNS+SBCC (RR, 0.86 [95% CI 0.77, 0.96]; P = 0.007) had significantly lower risk of being stunted as compared to the UCT arm. No significant difference was noted among children who received UCT+SBCC (RR, 1.03 [95% CI 0.91, 1.16]; P = 0.675) in the risk of being stunted as compared to the UCT arm. The pooled prevalence of stunting among children 6-23 months was 41.7%, 44.8%, 38.5% and 39.3% in UCT, UCT+SBCC, UCT+LNS and UCT+LNS+SBCC, respectively. In pairwise comparisons, a significant impact on stunting among children in UCT+LNS (P = 0.029) and UCT+LNS+SBCC (P = <0.001) was noted as compared to UCT arm. Conclusions UCT combined with LNS and UCT+LNS+SBCC were effective in reducing the prevalence of stunting among children aged 6-23 months in marginalized populations. UCT+SBCC was not effective in reducing the child stunting prevalence. Clinical trial registration number: ClinicalTrials.gov NCT03299218

scholarly journals Community Case Management of Fever Due to Malaria and Pneumonia in Children Under Five in Zambia: A Cluster Randomized Controlled Trial

PLoS Medicine ◽  
2010 ◽  
Vol 7 (9) ◽  
pp. e1000340 ◽  
Author(s):  
Kojo Yeboah-Antwi ◽  
Portipher Pilingana ◽  
William B. Macleod ◽  
Katherine Semrau ◽  
Kazungu Siazeele ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Case Management ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Community Case Management ◽  
Children Under Five ◽  
Under Five ◽  
Randomized Controlled ◽  
Cluster Randomized

scholarly journals Specialized Nutritious Food Combined With Cash Transfers and Social and Behavior Change Communication to Prevent Stunting Among Children Aged 6 to 23 Months in Pakistan: Protocol for a Cluster Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Gul Nawaz Khan ◽  
Sumra Kureishy ◽  
Shabina Ariff ◽  
Muhammad Atif Habib ◽  
Asra Abeer Usmani ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Rural Areas ◽  
Controlled Trial ◽  
Cash Transfers ◽  
Monthly Basis ◽  
Randomized Controlled ◽  
Change Communication ◽  
Cluster Randomized ◽  
And Behavior

BACKGROUND In Pakistan, the prevalence of stunting in children younger than 5 years has remained above global critical levels over the past two decades, with the stunting rate being 40.2% in 2018. Children living in rural areas and in the poorest households suffer the most from stunting across the country—43.2% in rural areas and 51.4% in the lowest wealth quintile. As a continuing public health concern, it is essential that stunting prevention is a national priority in order to ensure human capital development, especially among the poorest households. OBJECTIVE The primary objective of this study is to determine the effect of a medium quantity of a lipid-based nutrient supplement (LNS) combined with unconditional cash transfers and social and behavior change communication (SBCC) on reduction of stunting in children aged 6 to 23 months. METHODS A 5-arm cluster randomized controlled trial will be conducted in the district of Rahim Yar Khan in Punjab, Pakistan. The intervention packages will be (1) cash only, (2) cash with LNS, (3) cash with SBCC, and (4) cash with SBCC and LNS. The control arm will receive routine standard of care. We will enroll children at 6 months of age and follow up on a monthly basis up to 24 months of age. A total of 2000 children, 400 in each arm, will be enrolled to detect a 20% reduction in the prevalence of stunting among children aged 24 months. Length, weight, food intake, compliance to interventions, morbidities, and other relevant data will be collected at enrollment and on a monthly basis over the period of 18 months. The process evaluation will assess acceptability of the interventions and potential barriers to implementation through focus group discussions and in-depth interviews with the target population and relevant stakeholders. Furthermore, a cost analysis will be conducted to assess the cost-effectiveness of each intervention package. RESULTS The study protocol was approved by the Ethics Review Committee of Aga Khan University in Pakistan on January 4, 2017. Data collection began in May 2017 and was completed in July 2019. Data analyses are yet to be completed. This study will explore the effectiveness of intervention packages comprised of cash transfers from Benazir Income Support Programme with or without additional LNS and SBCC in preventing childhood stunting. We expect the results to be published in peer-reviewed journals by autumn of 2020. CONCLUSIONS The findings of this trial will provide robust evidence as to which intervention packages can have significant effects on linear growth of children and design effective intervention packages to prevent stunting in children aged 6 to 23 months. CLINICALTRIAL ClinicalTrials.gov NCT03299218; https://clinicaltrials.gov/ct2/show/NCT03299218 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19001

scholarly journals Behavior Change, Egg Consumption, and Child Nutrition: A Cluster Randomized Controlled Trial

PEDIATRICS ◽  
2020 ◽  
Vol 146 (6) ◽  
pp. e2020007930
Author(s):  
Sarah L. McKune ◽  
Heather Stark ◽  
Amanda C. Sapp ◽  
Yang Yang ◽  
Crystal M. Slanzi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Child Nutrition ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Egg Consumption ◽  
Randomized Controlled ◽  
Cluster Randomized

scholarly journals Effectiveness of Social Protection Program to Prevent Stunting Among Children 6–24 Months in Rural Pakistan; A Cluster Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 284-284
Author(s):  
Sajid Soofi ◽  
Gul Nawaz
Keyword(s):  
Randomized Controlled Trial ◽  
Social Protection ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Cash Transfer ◽  
Control Group ◽  
Monthly Basis ◽  
Randomized Controlled ◽  
Change Communication ◽  
Cluster Randomized

Abstract Objectives A 5-arm cluster randomized controlled trial to examine the effectiveness of specialized nutritious foods (SNF), unconditional cash transfers (UCTs) delivered to the regular BISP beneficiaries and social and behavioral change communication (SBCC) to prevent stunting among children 6–23 months. Methods The 5 study arms were (1) control group, which received routine government health services; (2) Unconditioned Cash Transfer (UCTs); (3) UCTs and Specialized Behaviour Change Communication (SBCC); (4) UCTs and SNF; and (5) UCTs, SNF and SBCC. BISP beneficiary households with children 6–23 months were eligible to participate in the study. Children at 6 months of age were enrolled and followed on a monthly basis up to 24 months of age. A total of 2179 children were randomized into the 4 interventions and control arms to detect a 20% reduction in the prevalence of stunting at 24 months of age. Results At 24 months of age, children who received UCTs with SNF (stunting RR = 0.80, 95% CI: 0.67–0.94, P = 0.007) and UCTs with SBCC and SNF (stunting RR = 0.77, 95% CI: 0.66–0.90, P = 0.001) had a significant reduction in the risk of being stunted as compared to the control arm. Furthermore, when compared with the control arm at 24 months of age (49.3%, 95% CI: 44.77–54.28), a 15% reduction in the prevalence of stunting was found in both the UCTs with SNF arm (41.73%, 95% CI: 37.22–46.74, P = 0.007) and the UCTs with SBCC and SNF arm (41.83%, 95% CI: 37.21–46.93, P = 0.001). Conclusions The study found a significant reduction in the prevalence of stunting, wasting, and underweight in children who received UCTs, SBCC and SNF between 6–23 months of age. Funding Sources World Food Programme and the German Government's Economic Cooperation and Development Section.

scholarly journals Specialized Nutritious Food Combined With Cash Transfers and Social and Behavior Change Communication to Prevent Stunting Among Children Aged 6 to 23 Months in Pakistan: Protocol for a Cluster Randomized Controlled Trial

10.2196/19001 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e19001
Author(s):  
Gul Nawaz Khan ◽  
Sumra Kureishy ◽  
Shabina Ariff ◽  
Muhammad Atif Habib ◽  
Asra Abeer Usmani ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Rural Areas ◽  
Controlled Trial ◽  
Cash Transfers ◽  
Monthly Basis ◽  
Randomized Controlled ◽  
Change Communication ◽  
Cluster Randomized ◽  
And Behavior

Background In Pakistan, the prevalence of stunting in children younger than 5 years has remained above global critical levels over the past two decades, with the stunting rate being 40.2% in 2018. Children living in rural areas and in the poorest households suffer the most from stunting across the country—43.2% in rural areas and 51.4% in the lowest wealth quintile. As a continuing public health concern, it is essential that stunting prevention is a national priority in order to ensure human capital development, especially among the poorest households. Objective The primary objective of this study is to determine the effect of a medium quantity of a lipid-based nutrient supplement (LNS) combined with unconditional cash transfers and social and behavior change communication (SBCC) on reduction of stunting in children aged 6 to 23 months. Methods A 5-arm cluster randomized controlled trial will be conducted in the district of Rahim Yar Khan in Punjab, Pakistan. The intervention packages will be (1) cash only, (2) cash with LNS, (3) cash with SBCC, and (4) cash with SBCC and LNS. The control arm will receive routine standard of care. We will enroll children at 6 months of age and follow up on a monthly basis up to 24 months of age. A total of 2000 children, 400 in each arm, will be enrolled to detect a 20% reduction in the prevalence of stunting among children aged 24 months. Length, weight, food intake, compliance to interventions, morbidities, and other relevant data will be collected at enrollment and on a monthly basis over the period of 18 months. The process evaluation will assess acceptability of the interventions and potential barriers to implementation through focus group discussions and in-depth interviews with the target population and relevant stakeholders. Furthermore, a cost analysis will be conducted to assess the cost-effectiveness of each intervention package. Results The study protocol was approved by the Ethics Review Committee of Aga Khan University in Pakistan on January 4, 2017. Data collection began in May 2017 and was completed in July 2019. Data analyses are yet to be completed. This study will explore the effectiveness of intervention packages comprised of cash transfers from Benazir Income Support Programme with or without additional LNS and SBCC in preventing childhood stunting. We expect the results to be published in peer-reviewed journals by autumn of 2020. Conclusions The findings of this trial will provide robust evidence as to which intervention packages can have significant effects on linear growth of children and design effective intervention packages to prevent stunting in children aged 6 to 23 months. Trial Registration ClinicalTrials.gov NCT03299218; https://clinicaltrials.gov/ct2/show/NCT03299218 International Registered Report Identifier (IRRID) DERR1-10.2196/19001

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