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Success Factors for Community Health Workers in Implementing an Integrated Group-Based Child Development Intervention in Rural Bangladesh

Author

Listed:
  • Tania Jahir

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Peter J. Winch

    (Department of International Health, John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Elli Leontsini

    (Department of International Health, John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Sharon T. Hwang

    (Department of International Health, John Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Farzana Yeasmin

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Khobair Hossain

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Jyoti Bhushan Das

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Ruhul Amin

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Tarique Md. Nurul Huda

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Jesmin Sultana

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Rizwana Khan

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Fahmida Akter

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • AKM Shoab

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Rezaul Hasan

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

  • Helen O. Pitchik

    (Division of Epidemiology, School of Public Health, University of California, Berkeley, CA 94720, USA)

  • Fahmida Tofail

    (Nutrition and Clinical Services Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh)

  • Lia C. H. Fernald

    (Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA)

  • Stephen P. Luby

    (Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA 94305, USA)

  • Mahbubur Rahman

    (Environmental Interventions Unit, Infectious Diseases Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh)

Abstract

Community Health Workers (CHWs) can effectively implement maternal and child health interventions, but there is paucity of evidence on how to integrate child stimulation into these interventions, and their delivery at scale. In rural Bangladesh, CHWs implemented an intervention integrating psychosocial stimulation, nutrition, maternal mental health, water, sanitation, hygiene (WASH) and lead exposure prevention. In each of 16 intervention villages, one CHW worked with 20 households. CHWs bi-weekly held group meetings or alternated group meetings and home visits with pregnant women and lactating mothers. We assessed the intervention through five focus groups, four interviews and one group discussion with CHWs and their supervisors to explore success factors of implementation. CHWs’ training, one-on-one supervision and introduction by staff to their own community, and adoption of tablet computers as job aids, enabled successful session delivery to convey behavioral recommendations. CHWs reported difficulties delivering session due to the complexity of behavioral recommendations and struggled with age-specific intervention material. Young children’s attendance in group sessions generated distractions that undermined content delivery. We identified ways to minimize the difficulties to strengthen intervention-delivery during implementation, and scale-up. Iterative revisions of similarly integrated interventions based on qualitative evaluation findings could be delivered feasibly by CHWs and allow for implementation at scale.

Suggested Citation

  • Tania Jahir & Peter J. Winch & Elli Leontsini & Sharon T. Hwang & Farzana Yeasmin & Khobair Hossain & Jyoti Bhushan Das & Ruhul Amin & Tarique Md. Nurul Huda & Jesmin Sultana & Rizwana Khan & Fahmida , 2021. "Success Factors for Community Health Workers in Implementing an Integrated Group-Based Child Development Intervention in Rural Bangladesh," IJERPH, MDPI, vol. 18(15), pages 1-15, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:15:p:7891-:d:601437
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    References listed on IDEAS

    as
    1. Schoepf, Brooke Grundfest, 1993. "AIDS action-research with women in Kinshasa, Zaire," Social Science & Medicine, Elsevier, vol. 37(11), pages 1401-1413, December.
    2. Fahmida Akter & Mahbubur Rahman & Helen O. Pitchik & Peter J. Winch & Lia C. H. Fernald & Tarique Mohammad Nurul Huda & Tania Jahir & Ruhul Amin & Jyoti Bhushan Das & Khobair Hossain & Abul Kashem Sho, 2020. "Adaptation and Integration of Psychosocial Stimulation, Maternal Mental Health and Nutritional Interventions for Pregnant and Lactating Women in Rural Bangladesh," IJERPH, MDPI, vol. 17(17), pages 1-16, August.
    3. Mats Målqvist & Beibei Yuan & Nadja Trygg & Katarina Selling & Sarah Thomsen, 2013. "Targeted Interventions for Improved Equity in Maternal and Child Health in Low- and Middle-Income Settings: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-10, June.
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