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

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.

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

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.

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

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.

scholarly journals 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)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ashraful Alam ◽  
Morseda Chowdhury ◽  
Camille Raynes-Greenow ◽  
Michael Dibley
Keyword(s):  
Community Health ◽  
Nutrition Education ◽  
Community Health Workers ◽  
Dietary Habits ◽  
Health Workers ◽  
Education Intervention ◽  
Community Based ◽  
Rural Bangladesh ◽  
Portion Sizes ◽  
Practical Demonstration

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.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

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 ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Rural Bangladesh ◽  
Home Based

scholarly journals Connecting communities to primary care: a qualitative study on the roles, motivations and lived experiences of community health workers in the Philippines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eunice Mallari ◽  
Gideon Lasco ◽  
Don Jervis Sayman ◽  
Arianna Maever L. Amit ◽  
Dina Balabanova ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Community Health ◽  
Community Health Workers ◽  
Financial Incentives ◽  
Lived Experiences ◽  
Health Workers ◽  
The Philippines ◽  
Community Members ◽  
Cross Sectional ◽  
The Impact

Abstract Background Community health workers (CHWs) are an important cadre of the primary health care (PHC) workforce in many low- and middle-income countries (LMICs). The Philippines was an early adopter of the CHW model for the delivery of PHC, launching the Barangay (village) Health Worker (BHW) programme in the early 1980s, yet little is known about the factors that motivate and sustain BHWs’ largely voluntary involvement. This study aims to address this gap by examining the lived experiences and roles of BHWs in urban and rural sites in the Philippines. Methods This cross-sectional qualitative study draws on 23 semi-structured interviews held with BHWs from barangays in Valenzuela City (urban) and Quezon province (rural). A mixed inductive/ deductive approach was taken to generate themes, which were interpreted according to a theoretical framework of community mobilisation to understand how characteristics of the social context in which the BHW programme operates act as facilitators or barriers for community members to volunteer as BHWs. Results Interviewees identified a range of motivating factors to seek and sustain their BHW roles, including a variety of financial and non-financial incentives, gaining technical knowledge and skill, improving the health and wellbeing of community members, and increasing one’s social position. Furthermore, ensuring BHWs have adequate support and resources (e.g. allowances, medicine stocks) to execute their duties, and can contribute to decisions on their role in delivering community health services could increase both community participation and the overall impact of the BHW programme. Conclusions These findings underscore the importance of the symbolic, material and relational factors that influence community members to participate in CHW programmes. The lessons drawn could help to improve the impact and sustainability of similar programmes in other parts of the Philippines and that are currently being developed or strengthened in other LMICs.

Sign in / Sign up

Export Citation Format

Share Document