The Long-term Impact of Community Mobilization through Women’s Groups on Child Growth in Rural Bangladesh

Session: Women’s Groups Working Together to Save Newborn Lives and Improve Maternal and Child Health and Nutrition

Presenter: Naveed Ahmed, Diabetic Association of Bangladesh Perinatal Care Project
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Background: A women’s group community mobilization intervention in rural areas of Bangladesh in 2009-2011 reduced neonatal mortality by 38% and improved hygienic delivery and essential newborn care practices. We followed-up all children conceived and delivered to women directly exposed to the women’s group intervention and a random sample of control children conceived at the same time to explore differences in anthropometric outcomes at ages 2 to 4 years.

Methodology: A cross-sectional survey of 1261 mother-child intervention pairs and 1311 control area pairs by trained fieldworkers at the child’s home collected child’s weight, height, abdominal, head, chest and mid-upper arm circumferences, triceps measurements and sub-scapular skinfold thickness. Maternal weight, height and BMI were also measured. Analysis used z-scores from WHO child growth standards. Results were stratified by maternal BMI, using BMI classification for Asian populations (<18.5 Underweight; 18.5-22.9 Normal range; >23 Overweight), and adjusted for maternal age, education and household asset ownership.

Results: Among children whose mothers were underweight at the time of the survey, those whose mothers were exposed to the women’s group intervention at the time of conception (n=391) had significantly (p<0.05) higher BMI, weight-for-length, head circumference, abdominal circumference and mid upper arm circumference z-scores than children whose mothers were not exposed to the intervention (n=352). No effect was seen in children whose mothers had BMI in the normal category (n=606 control; n=605 intervention), although MUAC increased in children of intervention mothers. Among overweight mothers, intervention children (n=265) had significantly lower weight-for-age and weight for length z-scores compared with controls (n=353).

Conclusion: Participatory women’s group intervention may have a positive impact on anthropometric outcomes for children born to underweight mothers. Differences could be of nutritional and metabolic significance in child development.