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<p>The delivery platform for growth monitoring and promotion (GMP) programs to improve child nutrition remains debated. This study compared the impact of facility-based plus non-governmental organization supported home-based GMP (FGMP + NGO-supported HGMP) versus facility-based GMP (FGMP) on child nutritional status in rural Bangladesh. Using a quasi-experimental design, 1,519 children aged 6–12 months were enrolled in each program and assessed at baseline and after 12 months. The primary outcome was linear growth (length-for-age Z-scores, LAZ), while secondary outcomes included weight-for-age (WAZ), weight-for-height (WHZ), stunting, wasting, and underweight prevalence, minimum dietary diversity, minimum meal frequency, and caregivers’ complementary feeding practices. Child linear growth (Difference-in-difference, D-I-D: -4.5; 95% CI: -15.2, 6.1) and weight (D-I-D: -3.5; 95% CI: -11.7, 4.6) faltered in both groups, with no significant differences between the programs. Stunting (D-I-D: 2.8%; 95% CI: -1.3, 7.1) and wasting (D-I-D: 0.43%; 95% CI: -3.2, 4.1) prevalence increased equally across programs. Underweight prevalence rose more in FGMP + NGO-supported HGMP (D-I-D: 4.7%; 95% CI: 1.7,7.8) than in FGMP programs. Caregivers in FGMP areas showed slight improvements in complementary feeding practices (D-I-D: -1.4%; 95% CI:-6.5, 3.7) and significantly improved meal frequency (D-I-D: -4.7%; 95% CI: -9.1,-0.3). No significant differences were observed in minimum dietary diversity (D-I-D: -1.5%; 95% CI: -6.1, 3.1) or acceptable diet (D-I-D: -2.0%; 95% CI: -6.6, 2.6) between the programs. Findings highlight the need to strengthen both FGMP and FGMP + NGO-supported HGMP programs by actively engaging caregivers and incorporating the influential role of family members and local social networks, which appeared to have a stronger impact on child feeding practices than GMP providers.</p>

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Impact of facility based versus home based growth monitoring and promotion programs on child nutritional status in rural Bangladesh

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月30日

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  • Muttaquina Hossain,
  • Md Ahshanul Haque,
  • A. S. G. Faruque,
  • Md M. Islam Bulbul,
  • Tahmeed Ahmed,
  • Ulla Ashorn,
  • Per Ashorn

摘要

The delivery platform for growth monitoring and promotion (GMP) programs to improve child nutrition remains debated. This study compared the impact of facility-based plus non-governmental organization supported home-based GMP (FGMP + NGO-supported HGMP) versus facility-based GMP (FGMP) on child nutritional status in rural Bangladesh. Using a quasi-experimental design, 1,519 children aged 6–12 months were enrolled in each program and assessed at baseline and after 12 months. The primary outcome was linear growth (length-for-age Z-scores, LAZ), while secondary outcomes included weight-for-age (WAZ), weight-for-height (WHZ), stunting, wasting, and underweight prevalence, minimum dietary diversity, minimum meal frequency, and caregivers’ complementary feeding practices. Child linear growth (Difference-in-difference, D-I-D: -4.5; 95% CI: -15.2, 6.1) and weight (D-I-D: -3.5; 95% CI: -11.7, 4.6) faltered in both groups, with no significant differences between the programs. Stunting (D-I-D: 2.8%; 95% CI: -1.3, 7.1) and wasting (D-I-D: 0.43%; 95% CI: -3.2, 4.1) prevalence increased equally across programs. Underweight prevalence rose more in FGMP + NGO-supported HGMP (D-I-D: 4.7%; 95% CI: 1.7,7.8) than in FGMP programs. Caregivers in FGMP areas showed slight improvements in complementary feeding practices (D-I-D: -1.4%; 95% CI:-6.5, 3.7) and significantly improved meal frequency (D-I-D: -4.7%; 95% CI: -9.1,-0.3). No significant differences were observed in minimum dietary diversity (D-I-D: -1.5%; 95% CI: -6.1, 3.1) or acceptable diet (D-I-D: -2.0%; 95% CI: -6.6, 2.6) between the programs. Findings highlight the need to strengthen both FGMP and FGMP + NGO-supported HGMP programs by actively engaging caregivers and incorporating the influential role of family members and local social networks, which appeared to have a stronger impact on child feeding practices than GMP providers.