Assessing the Effectiveness of Strengthening the Growth Monitoring and Promotional Activities in Rural Bangladesh
GMP
1 other identifier
interventional
2,000
0 countries
N/A
Brief Summary
Background: To tackle the high burden of undernutrition, the government of Bangladesh has identified growth monitoring and promotion (GMP) as a priority activity in the National Nutrition Services operational plan. Till date, no evidence are available from Bangladeshi studies to identify the effectiveness of GMP in improving the nutritional status of Bangladeshi children under 2 years of age. During 2013-14, two Bangladeshi studies looking at implementation issues of GMP at Community Clinic level and assessing the quality of nutrition services at primary health care facilities. The studies identified that lack of coordination, inadequate training, supervision, and logistic supplies as challenges to GMP implementation. Currently, GMP, (primarily sick child GMP) is being implemented through community clinics, supported by non-governmental organizations (NGOs) or other programs funded by donors. Besides, GMP is also taking place in areas where there are no NGO or donor support activities. However, the quality of nutrition data related to GMP is believed to be unsatisfactory. Hence, it is important to assess the effectiveness of GMP on the growth of under 2-year-old children. Hypothesis: GMP services could improve the growth of children under 2 years of age by 20 percent in the intervention group compared to the control group Objectives:To examine the effectiveness of GMP in improving nutritional status of children under 2 years of age Methods: Study design: Quasi-experimental study using mixed methods Study duration: 24 months Study setting: The study will be conducted in six sub-districts of rural Bangladesh where GMP is operational at the community clinic level. However, those areas will be excluded if there is any ongoing community or household level intervention on nutrition counseling being implemented by an NGO. For smooth implementation of GMP, refresher training on nutrition to health service providers will be provided by the study team. Study participants: children under 2 years of age, mother's/caregiver's of children \<2 and service providers. Intervention group: children under 2 years of age who are exposed to GMP services at community clinics where an NGO funded program is supporting GMP implementation Control group: children under 2 years of age, at community clinics where GMP is not operational
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jul 2022
Shorter than P25 for not_applicable
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
January 17, 2019
CompletedFirst Posted
Study publicly available on registry
January 31, 2019
CompletedStudy Start
First participant enrolled
July 1, 2022
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 30, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
December 30, 2022
CompletedMarch 31, 2022
February 1, 2022
6 months
January 17, 2019
March 30, 2022
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Change in length of the children under 2 years of age
Children who are aged between 6-12 months, their length in centimeter will be measured at baseline and then 3 monthly till end-line using a standard length board. The length for age z-score will be calculated by using a software developed by World Health Organization. The changes in length for age z-score will be detected through comparing the measurements over time by using difference-in-difference method.
12 months
Change in weight of the children under 2 years of age
Children who are aged between 6-12 months, their weight in kilograms will be measured at baseline and then 3 monthly till end-line using a standard weighing scale. The weight for age z-score will be calculated by using a software developed by World Health Organization. The changes in weight for age z-score will be detected through comparing the measurements over time by using difference-in-difference method.
12 months
Secondary Outcomes (2)
Change in mother's knowledge and attitude on infant and young child feeding (IYCF) practices measured by a standard semi-structured questionnaire
12 months
Changes in service provider's skill and perception on GMP
12 months
Study Arms (2)
NGO supported GMP program
EXPERIMENTALIntervention: NGO supported GMP program Site: Community clinic Duration: 12 months Study participants: 6-12 months aged children living within community clinic catchment area
Non-supported GMP program
ACTIVE COMPARATORComparison: Non-supported GMP program Site: Community clinic Duration: 12 months Study participants: 6-12 months aged children living within community clinic catchment area
Interventions
An International NGO has signed a contract with Government to support in implementing the growth Monitoring and Promotion (GMP) program. This program will be implemented at Community clinics. It will ensure the sustainability of community clinics in the selected areas through capacity building and follow up with community groups, community support groups, and Government Health and Family Planning service providers.
This is control arm of the study. In this arm, there will be Government's usual GMP program implemented at community clinics without any NGO support.
Eligibility Criteria
You may qualify if:
- Children aged between 6-12 months living in community clinic catchment area
- Free from any acute or chronic illness(es)
- Not a known case of a congenital anomaly or chromosomal abnormality
- Not severely stunted (length-for-age Z score, LAZ \<-3) or wasted (weight-for-length Z score, WLZ \<-3) or underweight (weight-for-age Z score, WAZ \<-3)
- Not enrolled in any other intervention program
- Caregiver report to have no plans to move out of the catchment area for at least 6 months following enrolment in the study
You may not qualify if:
- Children's parents who will decline consent will not be enrolled in the study
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Related Publications (1)
Hossain M, Ferdous TE, Islam Z, Billah SM, Bulbul MMI, Rahman MM, Ahmed T. Protocol for a quasiexperimental study testing the effectiveness of strengthening growth monitoring and promotion in community clinics for improving the nutritional status of under-two children in rural Bangladesh. BMJ Open. 2019 Oct 10;9(10):e032458. doi: 10.1136/bmjopen-2019-032458.
PMID: 31601604DERIVED
Study Officials
- PRINCIPAL INVESTIGATOR
Muttaquina Hossain, MPH
Assistant Scientist
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NON RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
January 17, 2019
First Posted
January 31, 2019
Study Start
July 1, 2022
Primary Completion
December 30, 2022
Study Completion
December 30, 2022
Last Updated
March 31, 2022
Record last verified: 2022-02
Data Sharing
- IPD Sharing
- Will not share
The privacy, anonymity, and confidentiality of data/information identifying the study participants will be strictly maintained. Personal identifications taken during the survey will be kept under lock and key. None other than the study personnel will have access to information on personal identification and other sensitive information.