Peer-reviewed article
Impact of facility based versus home based growth monitoring and promotion programs on child nutritional status in rural Bangladesh.
Muttaquina Hossain, Md Ahshanul Haque, A S G Faruque, Md M Islam Bulbul, Tahmeed Ahmed et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared two approaches to growth monitoring and promotion programs for children in rural Bangladesh: facility-based services alone versus facility-based services combined with NGO-supported home visits. Over 12 months, both programs showed similar poor outcomes, with child growth faltering and malnutrition rates increasing in both groups. The facility-based program alone showed slightly better results for meal frequency, but neither approach significantly improved child nutritional status. The findings suggest that existing growth monitoring programs need strengthening through better engagement with caregivers and community networks.
Key points
- Linear growth declined similarly in both groups (no significant difference between facility-based alone versus facility-based plus home-based programs)
- Stunting and wasting prevalence increased equally in both programs during the 12-month period
- Underweight prevalence increased more in the combined facility-based plus NGO home-based program (4.7% increase)
- Facility-based program alone showed significantly better improvement in meal frequency than the combined approach
- Neither program achieved significant improvements in minimum dietary diversity or acceptable diet
Limitations
The study does not explain why both programs failed to improve nutritional outcomes, nor does it provide details on the quality or intensity of implementation. The reasons for deteriorating nutrition across both groups in rural Bangladesh are not explored.
Abstract
The delivery platform for growth monitoring and promotion (GMP) programs to improve child nutrition remains debated. This study compared the impact of facility-based plus non-governmental organization supported home-based GMP (FGMP + NGO-supported HGMP) versus facility-based GMP (FGMP) on child nutritional status in rural Bangladesh. Using a quasi-experimental design, 1,519 children aged 6-12 months were enrolled in each program and assessed at baseline and after 12 months. The primary outcome was linear growth (length-for-age Z-scores, LAZ), while secondary outcomes included weight-for-age (WAZ), weight-for-height (WHZ), stunting, wasting, and underweight prevalence, minimum dietary diversity, minimum meal frequency, and caregivers' complementary feeding practices. Child linear growth (Difference-in-difference, D-I-D: -4.5; 95% CI: -15.2, 6.1) and weight (D-I-D: -3.5; 95% CI: -11.7, 4.6) faltered in both groups, with no significant differences between the programs. Stunting (D-I-D: 2.8%; 95% CI: -1.3, 7.1) and wasting (D-I-D: 0.43%; 95% CI: -3.2, 4.1) prevalence increased equally across programs. Underweight prevalence rose more in FGMP + NGO-supported HGMP (D-I-D: 4.7%; 95% CI: 1.7,7.8) than in FGMP programs. Caregivers in FGMP areas showed slight improvements in complementary feeding practices (D-I-D: -1.4%; 95% CI:-6.5, 3.7) and significantly improved meal frequency (D-I-D: -4.7%; 95% CI: -9.1,-0.3). No significant differences were observed in minimum dietary diversity (D-I-D: -1.5%; 95% CI: -6.1, 3.1) or acceptable diet (D-I-D: -2.0%; 95% CI: -6.6, 2.6) between the programs. Findings highlight the need to strengthen both FGMP and FGMP + NGO-supported HGMP programs by actively engaging caregivers and incorporating the influential role of family members and local social networks, which appeared to have a stronger impact on child feeding practices than GMP providers.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Facility-based plus NGO-supported home-based growth monitoring and promotion programs compared to facility-based growth monitoring and promotion alone
- Population
- 1,519 children aged 6-12 months in each program arm in rural Bangladesh
Key finding
Linear growth (LAZ) declined in both groups with no significant difference between programs (D-I-D: -4.5; 95% CI: -15.2, 6.1)