Browsing by Author "Huda, Tarique Md. Nurul"

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A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh
(BMJ Journals, 3/16/2021) Pitchik, Helen O; Tofail, Fahmida; Rahman, Mahbubur; Akter, Fahmida; Sultana, Jesmin; Shoab, Abul Kasham; Huda, Tarique Md. Nurul; Jahir, Tania; Amin, Md Ruhul; Hossain, Md Khobair; Das, Jyoti Bhushan; Chung, Esther O; Byrd, Kendra A; Yeasmin, Farzana; Kwong, Laura H; Forsyth, Jenna E; Mridha, Malay K; Winch, Peter J; Luby, Stephen P; Fernald, Lia CH
Introduction In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention. Methods We conducted a 9-month, parallel, multiarm, clusterrandomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers. Results In July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (ageadjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54). Conclusion Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale.
Exploration of attendance, active Participation, and behavior change in a group-based responsive stimulation, maternal and child health, and nutrition intervention
(ASTMH, 1/18/2021) Yeasmin, Farzana; Winch, Peter J.; Hwang, Sharon T.; Leontsini, Elli; Jahir, Tania; Das, Jyoti B.; Amin, Mohammad R.; Hossain, Md K.; Huda, Tarique Md. Nurul; Akter, Fahmida; Shoab, Abul Kashem; Tofail, Fahmida; Mridha, Malay K.; Sultana, Jesmin; Pitchik, Helen; Fernald, Lia C. H.; Luby, Stephen P.; Rahman, Mahbubur
Delivery of interventions through group sessions allows for in-depth discussions and creates opportunities for group members to work together to identify and solve common problems. However, low attendance may limit impact. We explored factors affecting attendance, active participation, and behavior change in an integrated group-based child development and maternal and child health intervention in Bangladesh. Community health workers (CHWs) facilitated two sessions a month including material on child stimulation; water, sanitation, and hygiene; nutrition, maternal depression, and lead exposure prevention. Sessions were conducted with 320 pregnant women and mothers with children younger than 24 months, in 16 villages in Kishoreganj district. After 4 and 9 months of intervention, we conducted focus group discussions and in-depth interviews with mothers (n = 55 and n = 48) to identify determinants of attendance and behavior change, and to examine potential for intervention scale-up. Recruiting family members to assist with childcare resulted in improved attention during sessions. Adopting a storytelling format for presentation of session materials resulted in more engaged participation during courtyard sessions. Session attendance and behavior change, especially purchasing decisions, were difficult for participants without the support of male heads of the household. Selecting a rotating leader from among the group members to remind group members to attend sessions and support CHWs in organizing the sessions was not successful. Facilitating self-appraisals and planning for water and sanitation allowed participants to identify areas for improvement and track their progress. Key determinants of a participant’s attendance were identified, and the resulting intervention shows promise for future implementation at scale.