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

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 Akter, Shoab Akm, Rezaul Hasan, Helen O. Pitchik, Fahmida Tofail, Lia C. H. Fernald, Stephen P. Luby and Mahbubur Rahman
Additional contact information
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
Shoab Akm: 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

IJERPH, 2021, vol. 18, issue 15, 1-15

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.

Keywords: community health workers; integrated intervention; group sessions; early child development; maternal mental health; prevention of lead exposure; Bangladesh (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/15/7891/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/15/7891/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:15:p:7891-:d:601437

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().