Project Lead(s): Gulshan Ara
Issue
In developing countries, an estimated 219 million children below five years of age do not reach their full developmental potential. In Bangladesh, at least 60% of children below five years of age are at risk for poor development, due to poverty, malnutrition and unstimulating home environments.
The optimum development and growth of young children requires affection and responsiveness from the mother/caregiver, cognitive stimulation, good nutrition and infection control.
Solution
The aim of the project was to determine if combining peer counselling about infant feeding with a psychosocial stimulation program (promoting mothers positive parenting) starting in the third trimester of pregnancy would improve children’s cognitive, motor and language development and mothers’ breastfeeding practices.
The team conducted a randomized controlled trial (RCT) to examine the impact of a peer counselling infant feeding education program with psychosocial stimulation, compared to a control group receiving the usual health messages.
Outcome
Preliminary analysis of study results showed that 90% of mothers in the study group reported breastfeeding within one hour of birth (compared to 78% in the study group). A more significant achievement was the improvement of the exclusive breastfeeding rate among the mothers who received peer counselling. At three months, 81% in the intervention group (versus 49% in the control group) reported breastfeeding exclusively during the previous 24 hours. Similarly, the rate of exclusive breastfeeding at the fifth month was significantly higher in the intervention group than control group (74% versus 28%).
Analysis showed that the mothers in the control group were 7.3 times more likely not to practice exclusive breastfeeding compared to the mothers in the intervention arm. Subjectively, mothers in the intervention arm reported appreciation for the hands-on training and counselling from the peer counsellor. Mean cognitive score, language expressive communication and motor score were all higher in the intervention group compared to the control group.
In general, the interventions used (homemade toys, feeding bowl, hand washing agent) were well accepted by mothers in the study group.
The team plans to disseminate the results with donors and other key stakeholders. They also intend to apply for Transition To Scale (TTS) funding and are looking to identify potential partners to scale up the proposed project. They believe the Government of Bangladesh would be a good partner to scale the project, as the intervention can be integrated into existing nutrition counselling programs within community clinics.