Supporting Optimal Infant, Young Child and Maternal Nutrition and Health in Jordan: An Evaluation of the CHN Program
- Conditions
- Evaluations
- Interventions
- Behavioral: Community Health and Nutrition Program
- Registration Number
- NCT05365698
- Lead Sponsor
- Tufts University
- Brief Summary
The purpose of the comprehensive evaluation is to assess USAID supported Community Health and Nutrition (CHN) program's ability to effect change, the comprehensive evaluation will assess the effectiveness of CHN in influencing the knowledge, attitudes, practices, motivation, and support of health care providers, as well as the behavior change in pregnant and lactating women of reproductive age and their infants/young children thus supporting optimal maternal, infant and young child nutrition and health.
- Detailed Description
Breastfeeding (BF) plays an important foundation for a healthy and well-developed child, and complementary feeding (CF) builds upon this foundation. Appropriate timing and introduction of high-quality complementary foods are key to sound infant, young child feeding (IYCF) practices. There is compelling evidence that BF and CF are crucial for the growth and development of a child, and in preventing malnutrition. Given this context, the USAID-supported "Community Health and Nutrition" (CHN) is being implemented in three governorates (Amman, Karak, Zarqa) of Jordan to improve the nutritional status of pregnant and lactating women (PLW) and children under the age of two years. The program will fulfill this goal by implementing activities to support improvement in IYCF practices, increase adoption of optimal family planning practices and maternal, infant, and young child nutrition (MIYCN) practices, and by improving health care provider support for proper IYCF practices and use of modern contraceptives methods (MCMs).
The purpose of the comprehensive evaluation is to assess USAID supported Community Health and Nutrition (CHN) program's ability to effect change. The evaluation will assess the effectiveness of CHN in influencing the knowledge, attitudes, practices, motivation, and support of health care providers, as well as the behavior change in pregnant and lactating women of reproductive age and their infants/young children thus supporting optimal maternal, infant and young child nutrition and health.
The study will utilize a cluster-randomized stratified stepped wedge design with two steps and two strata (cohort I and cohort 2). The stepped wedge study design is a staggered rollout design in which treatments are introduced to clusters at different time points. This design is particularly well suited for evaluating large-scale programs, like CHN, that roll out the intervention across clusters in phases. The use of strata (stratification) ensures representation of both regional and facility-level differences across the two cohorts.
The investigators will conduct 4 repeat annual cross-sectional surveys on women of reproductive age who are pregnant or are lactating and have a child under 2 years of age. Women will be recruited in the facilities and data will be collected at 12-month intervals. They will also conduct 3 repeat annual cross-sectional surveys on service providers (health care providers and community health agents) who work at these health facilities and within districts that are targets of the CHN program.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- Female
- Target Recruitment
- 1145
- Pregnant and Lactating women with child under 2 years:
Currently a beneficiary of CHN (except at baseline, prior to CHN implementation) Pregnant or lactating women (18-49 years) with children under the age of two years Willing to participate in the study and able to provide informed consent Currently lives within the study area
- Service providers:
Currently working in a CHN accredited social franchise facility Currently working in a maternal and child health department and actively providing services to PLWs Willing to participate in the study Received training from CHN on integrated maternal and child nutrition and healthcare services
- Pregnant and Lactating Women with child under 2 years Not willing to participate or provide informed consent Not living in the study area
- Service providers No specific exclusion criteria
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Cohort II Community Health and Nutrition Program randomly assigned 12 health facilities that will serve as a control for the first year of the program implementation and then transition into the intervention/treatment group Cohort I Community Health and Nutrition Program randomly assigned 12 health facilities (treatment/intervention group) that will have access to CHN program components
- Primary Outcome Measures
Name Time Method Exclusive breastfeeding 2024 Percentage of women who exclusively breastfeed their infants from birth to 6 months of age
Diet Diversity in Pregnant and Lactating women 2024 Percentage of pregnant and lactating women meeting the minimum dietary diversity for women metric (MDDW)
Early initiation of breastfeeding 2024 Percentage of women who initiate breastfeeding within the first hour of birth
Median duration of exclusive breastfeeding 2024 Increased median duration of exclusive breastfeeding (months) in infants aged 0-6 months
Improved nutritionally adequate diet and safe complementary feeding in infants and young children 6-23 months 2021 Percentage of children aged 6-23 months achieving a minimum acceptable diet (MAD)
Improved post party family planning 2024 Percentage of women using modern contraceptive improved postpartum practice on the use of modern contraceptive methods
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Mindset
🇯🇴Amman, Jordan