Assessing implementation outcomes for launching balanced energy protein supplementation: A formative study in rural Bangladesh.
Balanced energy protein (BEP) supplementation is an efficacious intervention in pregnancy for improving birthweight and is recommended by World Health Organization (WHO) in countries with high maternal undernutrition. Few countries have implemented BEP programmes due in part to high cost, lack of da...
| Publicado en: | Maternal & Child Nutrition Vol. 20; pp. 1 - 16 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2024 Supplement 1
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180043187&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180043187 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17408695 0LU jtl: Maternal & Child Nutrition issn: 17408695 maglogo: Y pubinfo: dt: Oct2024 Supplement 1 vid: 20 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 180043187 174177304 180043187 180043187 10.1111/mcn.13606 180043187 ppf: 1 ppct: 15 formats: tig: atl: Assessing implementation outcomes for launching balanced energy protein supplementation: A formative study in rural Bangladesh. aug: au: Kalbarczyk, Anna de Boer, Mary Khaled, Nazrana Chakraborty, Barnali Rahman, Atiya Zavala, Eleonor Rahman, Hafizur Ali, Hasmot Haque, Rezwanul Ayesha, Kaniz Siddiqua, Towfida J. Afsana, Kaosar Christian, Parul Thorne‐Lyman, Andrew affil: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore Maryland,, USA sug: subj: Undernutrition Prevention and Control Dietary Proteins Supply and Distribution Dietary Supplementation Rural Population Psychosocial Factors Program Implementation Economics Family Attitudes Evaluation Patient Attitudes Evaluation Attitude of Health Personnel Evaluation Prenatal Care Human Bangladesh Funding Source Female Semi-Structured Interview Focus Groups Married Women Extended Family Health Personnel Pharmacists Implementation Science Qualitative Studies Descriptive Statistics Data Analysis Software Thematic Analysis Adolescence Adult Middle Age Pregnancy Food Security Expectant Mothers Formative Evaluation Research Interview Guides Community Support Male Pharmacy, Retail Spouses Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Balanced energy protein (BEP) supplementation is an efficacious intervention in pregnancy for improving birthweight and is recommended by World Health Organization (WHO) in countries with high maternal undernutrition. Few countries have implemented BEP programmes due in part to high cost, lack of data on acceptability and feasibility, and complexity of delivery. We sought to address implementation gaps in BEP interventions through a formative study designed to understand implementation outcomes. We conducted 52 in‐depth interviews and 8 focus‐group discussions with married women of reproductive age, family members, health care providers and pharmacists in three unions of the Gaibandha district in rural Bangladesh. Interviews were translated and transcribed in English and analysed using an analytic framework for implementation science in nutrition. BEP was viewed as an acceptable and appropriate intervention to combat undernutrition in this setting. There was a lack of clarity on who should or could be responsible for providing/distributing BEP in a way convenient to mothers. Many participants preferred door‐to‐door delivery and thought this approach could address social and gender inequities, but providers mentioned already being overworked and worried about adding new tasks. Participants were concerned about the affordability of BEP and opportunity costs associated with travel to proposed distribution sites such as ANC or pharmacies. Women in these communities do not always have the agency to travel without supervision or make purchasing decisions. BEP supplementation is a complex intervention; future trials seek to assess ways to overcome these implementation challenges and inform a long‐term systems‐owned BEP intervention. Key messages: Balanced energy protein (BEP) supplementation is an efficacious intervention in pregnancy for improving birthweight but its implementation through ANC, as recommended by WHO, is complex.Decisions about who bears the cost of the product should consider the feasibility of scaling solutions to different groups. Targeting the most in need and with government supported programmes should be considered.Door‐to‐door distribution emerged as the preferred delivery modality, though the feasibility of this mechanism at scale is a concern, particularly given the documented lack of human resources in health.Given the positive community perceptions around BEP supplements, delivery through ANC could increase ANC participation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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