Assessing Cost and Effectiveness of Training and Supervision of Front Line Workers on Early Breastfeeding Practices (iycfch)

Eminence

Status and phase: Completed; Phase 1

Conditions: Malnutrition

Treatments: Behavioral: Improve Early Breastfeeding

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT01407224

09-000076-AT10,EMI

Details and patient eligibility

About

The aim of this operational research is to compare the cost-effectiveness of two methods for capacity building of existing TBAs/CVs to improve rates of delayed cord clamping, early skin to skin contact and infant-led initiation of breastfeeding, to reduce prelacteal feeding and increase early exclusive breastfeeding in research areas of rural Bangladesh.

Full description

Suboptimal early infant feeding practices are the norm in Bangladesh, and contribute to its poor infant health and nutrition. However, the modern health services are unable to help because approximately 85% of births take place at home. The Government has begun the huge process of training the informal community traditional birth attendants (TBAs) who, along with community volunteers (CVs), deliver the majority of babies, especially in the rural areas. The proposed operations research will take place in one of the poorest rural districts. It will compare the cost effectiveness of practical training of these relatively uneducated community members, with or without supportive supervision in improving early infant feeding practices, using a cluster-randomized study design. The practices to be measured before and after on probability samples include: 1) delayed cord clamping, 2) early skin to skin contact and 3) newborn-led initiation of breastfeeding within one hour of birth, 4) avoidance of the traditional prelacteal feeds, and 5) exclusive breastfeeding, at least for the early months. Costs will be carefully monitored so as to compare the cost per behavior improved per infant.

Enrollment: 1,200 patients

Sex: All

Ages: 1 day to 5 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Lactating women of children ages 0 to 5 months and pregnant women with second and third trimester

Exclusion criteria

• First trimester women and lactating women of children ages 6 to 23 months.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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1,200 participants in 3 patient groups

Only training

Experimental group

Description:

Training on Early Breastfeeding Practices to front line health workers

Treatment:

Behavioral: Improve Early Breastfeeding

Training and supervision

Active Comparator group

Description:

Training as well as supervision by field supervisor for six months intervention

Treatment:

Behavioral: Improve Early Breastfeeding

Control

No Intervention group

Description:

No intervention such as training or supervision

Treatment:

Behavioral: Improve Early Breastfeeding