How the Women and the Community Responded to an Antenatal Balanced Plate Nutrition Education Intervention? A Qualitative Process Assessment in Rural Bangladesh (P04-002-19)

Abstract Objectives Acceptability to the beneficiaries is crucial for effectiveness of a community-based nutrition intervention. We conducted a process evaluation to explore the response of the women and the community to an antenatal balanced plate nutrition education intervention in rural Bangladesh. Methods We conducted in-depth interviews (IDI) to collect data from recently delivered women, their husbands, and older women ((mothers and mothers-in-law of the women) who received the intervention. Key informant interviews (KII) were conducted with BRAC Shasthya Kormis (community health workers) who provided balanced plate demonstration. Results We found that the balanced plate nutrition education helped women through practical demonstration to learn about a balanced meal considering appropriate portion sizes and diversity of foods. The family decision makers, such as husbands and mothers-in-law, considered adopting a healthier diet as a tactic to protect the newborn and the mother from health complications that might safeguard a healthier baby. We also found that rural Bangladeshi pregnant women needed the active involvement of CHWs in mobilizing social support to create an enabling environment essential to bring change in dietary habits with self-motivation. Conclusions A community-based balanced plate nutrition education aiming to increase birth weight was widely accepted by the beneficiaries. Practical demonstration of balanced plate with appropriate portion sizes involving the community health workers and family members enhanced the acceptance. Funding Sources Faculty of Medicine and Health, University of Sydney, Australia.

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What Worked for Improving Balanced Maternal Dietary Intake in Rural Bangladesh? Implications for New Programs

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_004 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 153-153

Author(s):

Ashraful Alam ◽

Morseda Chowdhury ◽

Michael Dibley ◽

Camille Raynes-Greenow

Keyword(s):

Pregnant Women ◽

Community Health ◽

Nutrition Education ◽

Community Health Workers ◽

Health Workers ◽

Controlled Trial ◽

Intervention Strategy ◽

Rural Bangladesh ◽

Portion Sizes ◽

Practical Demonstration

Abstract Objectives To assess the strategies that worked to motivate the women and families to adhere to a nutrition behavior change intervention trial that aimed to promote balanced diet in pregnancy in rural Bangladesh. Methods We designed this process evaluation as part of a cluster randomized controlled trial. We conducted in-depth interviews with pregnant women, recently-delivered women, and husbands; focus groups with mothers and mothers-in-law; and key-informant interviews with Shasthya Kormis (community health workers) who provided the balanced plate nutrition intervention. Results The novel finding in the study was that the balanced plate nutrition education helped women through practical demonstration to learn about a balanced meal considering appropriate portion sizes and diversity of foods. We also found that pregnant women needed active involvement of community health workers in mobilizing social support to create an enabling environment essential to bring changes in dietary behavior with self-motivation. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in own or neighbors’ kitchen were the most commonly mentioned reasons of acceptance of the intervention to the women and families. We identified six key areas within the intervention strategy that played crucial role in achieving desired adherence. These include: practical demonstration of portion sizes engaging the end-users; addressing local food perceptions; demystifying animal-source foods; engaging husbands and mothers-in-law; leveraging women's social networks; and harnessing community health workers’ social role. Conclusions Programs to improve maternal nutritious food consumption should focus on promoting diet through practical demonstration of portion sizes through active engagement of the women and family instead of replicating the conventional information-based counseling. Funding Sources The University of Sydney Faculty of Medicine and Health.

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How Can We Improve the Consumption of a Nutritionally-Balanced Maternal Diet in Rural Bangladesh? The Key Elements of the ‘Balanced Plate’ Intervention

10.20944/preprints202007.0197.v1 ◽

2020 ◽

Author(s):

Ashraful Alam ◽

Morseda Chowdhury ◽

Michael John Dibley ◽

Camille Raynes-Greenow

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Controlled Trial ◽

Maternal Diet ◽

Intervention Strategy ◽

Rural Bangladesh ◽

Portion Sizes ◽

The Impact ◽

Practical Demonstration

Social, cultural, environmental and economic factors closely regulate the selection, allocation and consumption of maternal diets. We developed a nutrition behaviour change intervention to promote a balanced diet in pregnancy through practical demonstration in rural Bangladesh and tested the impact with a cluster randomised controlled trial. This paper presents the findings of the process evaluation and describes the strategies that worked for intervention compliance. We conducted in-depth interviews with pregnant women, women who birthed recently, and their husbands; focus groups with mothers and mothers-in-law; key-informant interviews with community health workers, and observation of home visits. We identified six key areas within the intervention strategy that played a crucial role in achieving the desired adherence. These included practical demonstration of portion sizes; addressing local food perceptions; demystifying animal-source foods; engaging husbands and mothers-in-law; leveraging women’s social networks; and harnessing community health workers’ social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours’ kitchen were the most commonly mentioned reasons for acceptance of the intervention by the women and their families. The balanced plate intervention helped women through practical demonstration to learn about a balanced meal by highlighting appropriate portion sizes and food diversity. The women needed active involvement of community health workers in mobilising social support to create an enabling environment essential to bring changes in dietary behaviours. Programs to promote a nutritious maternal diet should focus on encouraging the use of healthy foods through practical demonstration of portion sizes and engagement of the women and family instead of replicating the traditional information-based counselling.

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How Can We Improve the Consumption of a Nutritionally Balanced Maternal Diet in Rural Bangladesh? The Key Elements of the “Balanced Plate” Intervention

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176289 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6289

Author(s):

Ashraful Alam ◽

Morseda Chowdhury ◽

Michael J. Dibley ◽

Camille Raynes-Greenow

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Controlled Trial ◽

Intervention Strategy ◽

Local Context ◽

Rural Bangladesh ◽

Portion Sizes ◽

The Impact ◽

Practical Demonstration

Social, cultural, environmental and economic factors closely regulate the selection, allocation and consumption of maternal diets. We developed a nutrition behaviour change intervention to promote a balanced diet in pregnancy through practical demonstration in rural Bangladesh and tested the impact with a cluster randomised controlled trial. This paper presents the findings of the process evaluation and describes the strategies that worked for intervention compliance. We conducted in-depth interviews with pregnant women, women who birthed recently, and their husbands; focus groups with mothers and mothers-in-law; key-informant interviews with community health workers, and observations of home visits. We identified six key areas within the intervention strategy that played a crucial role in achieving the desired adherence. These included practical demonstration of portion sizes; addressing local food perceptions; demystifying animal-source foods; engaging husbands and mothers-in-law; leveraging women’s social networks; and harnessing community health workers’ social role. Practical demonstration, opportunity to participate and convenience of making of the plate with the food available in their kitchen or neighbours’ kitchen were the most commonly mentioned reasons for acceptance of the intervention by the women and their families. The balanced plate intervention helped women through practical demonstration to learn about a balanced meal by highlighting appropriate portion sizes and food diversity. The women needed active involvement of community health workers in mobilising social support to create an enabling environment essential to bring changes in dietary behaviours. Future implementation of the intervention should tailor the strategies to the local context to ensure optimal adherence to the intervention.

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A Community-Based Participatory Diabetes Prevention and Management Intervention in Rural India Using Community Health Workers

The Diabetes Educator ◽

10.1177/0145721712459890 ◽

2012 ◽

Vol 38 (6) ◽

pp. 822-834 ◽

Cited By ~ 45

Author(s):

Padmini Balagopal ◽

N. Kamalamma ◽

Thakor G. Patel ◽

Ranjita Misra ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Diabetes Prevention ◽

Health Workers ◽

Rural India ◽

Community Based ◽

Management Intervention

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Effectiveness of Home-Based Management of Newborn Infections by Community Health Workers in Rural Bangladesh

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e31819069e8 ◽

2009 ◽

Vol 28 (4) ◽

pp. 304-310 ◽

Cited By ~ 76

Author(s):

Abdullah H. Baqui ◽

Shams E. Arifeen ◽

Emma K. Williams ◽

Saifuddin Ahmed ◽

Ishtiaq Mannan ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Rural Bangladesh ◽

Home Based

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Community-Based Interventions for Stroke Provided by Nurses and Community Health Workers: A Review of the Literature

Journal of Neuroscience Nursing ◽

10.1097/jnn.0000000000000512 ◽

2020 ◽

Vol 52 (4) ◽

pp. 152-159 ◽

Cited By ~ 1

Author(s):

Gayenell S. Magwood ◽

Michelle Nichols ◽

Carolyn Jenkins ◽

Ayaba Logan ◽

Suparna Qanungo ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Review Of The Literature ◽

Community Based Interventions ◽

Community Based

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Supervising Community Health Workers in Community-Based Delivery of Primary Health/Family Planning Services: Experiences in Mexico, 1977–1982

International Quarterly of Community Health Education ◽

10.2190/f094-ef1f-vd76-hmjw ◽

1986 ◽

Vol 6 (4) ◽

pp. 309-322 ◽

Cited By ~ 1

Author(s):

Michele G. Shedlin ◽

Joe D. Wray ◽

Sergio Correu

Keyword(s):

Community Health ◽

Community Health Workers ◽

Health Program ◽

Health Workers ◽

Community Based ◽

Family Planning Services ◽

Roles And Responsibilities ◽

Primary Health ◽

Wide Range

The supervision of CHWs in the Mexican Rural Health Program (1977–82) illustrates a wide range of problems and strengths because it was developed within a program based on a strong political mandate to deliver services to an extremely large, as well as culturally and geographically diverse population. This article presents an in-depth perspective on the issues involved in the supervision of community health workers with a focus on the myriad roles and responsibilities which are expected from supervisory personnel. The information and observations which are offered come from program evaluation materials as well as the long-term, first hand experience of the authors with the program discussed.

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Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh

Health Policy and Planning ◽

10.1093/heapol/czs070 ◽

2012 ◽

Vol 28 (4) ◽

pp. 386-399 ◽

Cited By ~ 54

Author(s):

Chloe Puett ◽

Kate Sadler ◽

Harold Alderman ◽

Jennifer Coates ◽

John L. Fiedler ◽

...

Keyword(s):

Cost Effectiveness ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Community Based

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“I was not Invited to be a [CHW] … I asked to be one”: Motives for Community Mobilization among Women Community Health Workers in Mexico

Health Education & Behavior ◽

10.1177/109019810102800203 ◽

2001 ◽

Vol 28 (2) ◽

pp. 150-165 ◽

Cited By ~ 13

Author(s):

Jesus Ramirez-Valles

Keyword(s):

Public Goods ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Community Mobilization ◽

Social Constructivist ◽

Personal Satisfaction ◽

Health Educators ◽

Community Based ◽

Community Based Organization

Despite health educators’ revitalized interest in community mobilization for health, little attention has been given to participants’ motives for mobilizing. The purpose of this article is to contribute to the understanding of community mobilizing by analyzing the motives for mobilization among a group of women community health workers (CHWs), members of a community-based organization in Mexico. The study is guided by critical feminist and social constructivist theories. It aims at identifying the categories of motives used by women CHWs and exploring how these motives are created while presenting women’s own voices. Women’s motives fall into four categories: getting out, serving, learning, and women’s betterment. These motives blend personal and public motives. The analysis suggests that mobilization for health may be enhanced by addressing both the personal satisfaction of individuals and the accomplishment of public goods. The study of motives may be useful for the recruitment and retention of participants in community mobilization efforts.

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