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

2009 ◽  
Vol 28 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Abdullah H. Baqui ◽  
Shams E. Arifeen ◽  
Emma K. Williams ◽  
Saifuddin Ahmed ◽  
Ishtiaq Mannan ◽  
...  
2018 ◽  
Vol 111 (12) ◽  
pp. 453-461 ◽  
Author(s):  
Benedict Hayhoe ◽  
Thomas E Cowling ◽  
Virimchi Pillutla ◽  
Priya Garg ◽  
Azeem Majeed ◽  
...  

Objective To model cost and benefit of a national community health worker workforce. Design Modelling exercise based on all general practices in England. Setting United Kingdom National Health Service Primary Care. Participants Not applicable. Data sources Publicly available data on general practice demographics, population density, household size, salary scales and screening and immunisation uptake. Main outcome measures We estimated numbers of community health workers needed, anticipated workload and likely benefits to patients. Results Conservative modelling suggests that 110,585 community health workers would be needed to cover the general practice registered population in England, costing £2.22bn annually. Assuming community health workerss could engage with and successfully refer 20% of eligible unscreened or unimmunised individuals, an additional 753,592 cervical cancer screenings, 365,166 breast cancer screenings and 482,924 bowel cancer screenings could be expected within respective review periods. A total of 16,398 additional children annually could receive their MMR1 at 12 months and 24,716 their MMR2 at five years of age. Community health workerss would also provide home-based health promotion and lifestyle support to patients with chronic disease. Conclusion A scaled community health worker workforce integrated into primary care may be a valuable policy alternative. Pilot studies are required to establish feasibility and impact in NHS primary care.


Author(s):  
Ashraful Alam ◽  
Morseda Chowdhury ◽  
Michael John Dibley ◽  
Camille Raynes-Greenow

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.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 153-153
Author(s):  
Ashraful Alam ◽  
Morseda Chowdhury ◽  
Michael Dibley ◽  
Camille Raynes-Greenow

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.


2015 ◽  
Vol 16 (17) ◽  
pp. 7853-7857 ◽  
Author(s):  
Touhidul Imran Chowdhury ◽  
Richard Reed Love ◽  
Mohammad Touhidul Imran Chowdhury ◽  
Abu Saeem Artif ◽  
Hasib Ahsan ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ashraful Alam ◽  
Morseda Chowdhury ◽  
Camille Raynes-Greenow ◽  
Michael Dibley

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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