Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India

Abstract Background India suffers from a double burden of malnutrition and anaemia. The Karnataka anaemia project indicated that a counselling intervention delivered by community health workers improved anaemia cure rates. Objective To evaluate the effect of maternal counselling on nutritional aspec...

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Autores principales:	Israa Alzain Ali, Arun Shet, Maya Mascarenhas, Maria Rosaria Galanti
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Counselling Child nutrition Dietary intake Maternal knowledge Cluster RCT Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/2ea4aeac0849460e8b842e87d12b2114
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spelling	oai:doaj.org-article:2ea4aeac0849460e8b842e87d12b21142021-11-08T10:43:35ZEffect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India10.1186/s12889-021-11998-w1471-2458https://doaj.org/article/2ea4aeac0849460e8b842e87d12b21142021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-11998-whttps://doaj.org/toc/1471-2458Abstract Background India suffers from a double burden of malnutrition and anaemia. The Karnataka anaemia project indicated that a counselling intervention delivered by community health workers improved anaemia cure rates. Objective To evaluate the effect of maternal counselling on nutritional aspects of anaemia prevention. Methods Secondary analysis of a cluster randomised controlled trial (55 simultaneously randomised villages using random number generator in Chamrajnagar district, Northern India). In the intervention group mothers of anaemic children received five monthly counselling sessions plus usual care (iron and folic acid supplements), while mothers of anaemic children in the control group received usual care alone. Daily intake of nutrients related to anaemia prevention, i.e. iron (mg) and vitamin C (mg), was estimated using the 24-h dietary recall method at baseline and 6 months follow-up. Linear and logistic mixed regression models were used to assess between-groups difference in changes in nutrients intake from baseline to end of follow-up. Data collectors and analysts were blinded to the group assignment. Results Participants were 534 (intervention n = 303; usual treatment n = 231) anaemic children, aged 1 to 5 years and their caregivers, of whom 521(intervention n = 299 from 28 villages; usual treatment n = 222 from 27 villages) were retained at 6 months follow-up and included in the analysis. This study provides inconclusive evidence of improvement in the intake of nutrients that prevent anaemia from baseline to follow-up among the intervention compared to the control group; increase in iron intake was 0.24 mg/day (95% CI -0.67; 1.15) and increase in vitamin C intake was 4.61 mg/day (95% CI -0.69, 9.91). Although encouraging, it is notable that the overall intake of nutrients that prevent anaemia remained well below the national recommended daily allowance. Conclusion This study provides inconclusive evidence of the effect of parental counselling on nutritional aspects of anaemia prevention. The results highlight the need to devise multi-component anaemia-prevention interventions that include facilitators of the availability of nutritious food and should be evaluated in studies that are adequately powered to detect nutritional changes. Trial registration International Standard Randomized Controlled Trial Number ISRCTN68413407 , prospectively registered on 17/12/2013.Israa Alzain AliArun ShetMaya MascarenhasMaria Rosaria GalantiBMCarticleCounsellingChild nutritionDietary intakeMaternal knowledgeCluster RCTPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Counselling Child nutrition Dietary intake Maternal knowledge Cluster RCT Public aspects of medicine RA1-1270
spellingShingle	Counselling Child nutrition Dietary intake Maternal knowledge Cluster RCT Public aspects of medicine RA1-1270 Israa Alzain Ali Arun Shet Maya Mascarenhas Maria Rosaria Galanti Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
description	Abstract Background India suffers from a double burden of malnutrition and anaemia. The Karnataka anaemia project indicated that a counselling intervention delivered by community health workers improved anaemia cure rates. Objective To evaluate the effect of maternal counselling on nutritional aspects of anaemia prevention. Methods Secondary analysis of a cluster randomised controlled trial (55 simultaneously randomised villages using random number generator in Chamrajnagar district, Northern India). In the intervention group mothers of anaemic children received five monthly counselling sessions plus usual care (iron and folic acid supplements), while mothers of anaemic children in the control group received usual care alone. Daily intake of nutrients related to anaemia prevention, i.e. iron (mg) and vitamin C (mg), was estimated using the 24-h dietary recall method at baseline and 6 months follow-up. Linear and logistic mixed regression models were used to assess between-groups difference in changes in nutrients intake from baseline to end of follow-up. Data collectors and analysts were blinded to the group assignment. Results Participants were 534 (intervention n = 303; usual treatment n = 231) anaemic children, aged 1 to 5 years and their caregivers, of whom 521(intervention n = 299 from 28 villages; usual treatment n = 222 from 27 villages) were retained at 6 months follow-up and included in the analysis. This study provides inconclusive evidence of improvement in the intake of nutrients that prevent anaemia from baseline to follow-up among the intervention compared to the control group; increase in iron intake was 0.24 mg/day (95% CI -0.67; 1.15) and increase in vitamin C intake was 4.61 mg/day (95% CI -0.69, 9.91). Although encouraging, it is notable that the overall intake of nutrients that prevent anaemia remained well below the national recommended daily allowance. Conclusion This study provides inconclusive evidence of the effect of parental counselling on nutritional aspects of anaemia prevention. The results highlight the need to devise multi-component anaemia-prevention interventions that include facilitators of the availability of nutritious food and should be evaluated in studies that are adequately powered to detect nutritional changes. Trial registration International Standard Randomized Controlled Trial Number ISRCTN68413407 , prospectively registered on 17/12/2013.
format	article
author	Israa Alzain Ali Arun Shet Maya Mascarenhas Maria Rosaria Galanti
author_facet	Israa Alzain Ali Arun Shet Maya Mascarenhas Maria Rosaria Galanti
author_sort	Israa Alzain Ali
title	Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
title_short	Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
title_full	Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
title_fullStr	Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
title_full_unstemmed	Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India
title_sort	effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in india
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2ea4aeac0849460e8b842e87d12b2114
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Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India

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