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

Phase 1

Completed

• Conditions: Malnutrition
• Interventions: Behavioral: Improve Early Breastfeeding

• Registration Number: NCT01407224
• Lead Sponsor: Eminence

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2010-05
• Primary Completion: 2011-05
• Study Completion: 2011-06
• Study First Submitted: 2011-06-30
• Status Verified: 2011-07
• Study First Submitted QC: 2011-07-31
• Last Update Submitted: 2011-07-31
• Study First Posted: 2011-08-02
• Last Update Posted: 2011-08-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1200

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Only training	Improve Early Breastfeeding	Training on Early Breastfeeding Practices to front line health workers
Training and supervision	Improve Early Breastfeeding	Training as well as supervision by field supervisor for six months intervention
Control	Improve Early Breastfeeding	No intervention such as training or supervision

Primary Outcome Measures

Name	Time	Method
Increased proportions of mothers who follow the recommended infant feeding behaviors	six months intervention	Practice related to early breastfeeding and cord clumping

Secondary Outcome Measures

Name	Time	Method
Improve practice on breastfeeding, early initiation and cord clumping .	six months intervention	Evaluation studies are carried out before and after six months of intervention
Improved capacity of TBAs on breastfeeding counseling and knowledge.	Six months	Increase capacity of TBAs on breastfeeding counseling and knowledge.

Trial Locations

Locations (1)

Eminence; 🇧🇩 Dhaka, Bangladesh