Peer-reviewed article
Impact of home-visit counselling on maternal and child health and nutrition by Barangay health workers: a quasi-experimental study from Eastern Visayas, Philippines.
Kang Y, Choi A, Kim H, Edward A, Ji H et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether home visits by community health workers using a structured counselling approach could improve maternal and child health during pregnancy and the child's first two years in the Philippines. Women in intervention areas received more frequent home visits and better recalled health messages compared to those receiving routine services. The intervention reduced maternal depression symptoms, but did not improve diet or child nutrition outcomes.
Key points
- Intervention areas received an average of 3.2 home visits during pregnancy versus 1.7 in comparison areas
- Women in intervention areas had significantly higher recall of prenatal, birth, and postpartum care messages
- Maternal depressive symptoms were reduced by 9.16 percentage points in the intervention group
- EPDS depression score decreased by 1.20 points in the intervention group
- No significant improvements were found in maternal dietary diversity or child diet and nutrition indicators
Limitations
The study could not determine whether improvements in diet and nutrition require additional complementary interventions beyond counselling, or whether the follow-up period was sufficient to detect changes. The quasi-experimental design without randomisation may be subject to selection bias.
Abstract
Background Maternal and child undernutrition and poor mental health remain public health concerns in the Philippines. We evaluated the impact of home visits with timed and targeted care for family (ttCF) strategies for maternal and child nutrition and mental health during the first 1000 days of life. Methods We designed a quasi-experimental study encompassing 12 municipalities (six intervention and six comparison) and enrolling 1518 pregnant women or mothers with children <12 months. Trained Barangay health workers (BHWs) conducted 12 scheduled home visits from pregnancy through child's second year in the intervention areas, while comparison areas received routine health services. We estimated the intervention's impact using multilevel mixed-effect models and generalised linear models, adjusting for socioeconomic covariates. The outcomes of interest included frequency of BHW's home visits, maternal message recall scores, possible depressive symptoms (Edinburgh Postnatal Depression Scale (EPDS) score >9), maternal and child diet, and child nutritional status. Results We assessed 1313 women and children (655 in comparison; 658 in intervention) at 12-month follow-up. Women in the intervention areas received higher home visits during pregnancy (mean (x̄) = 3.2, standard deviation (SD) = 2.7 vs. x̄ = 1.7, SD = 2.0; P < 0.001) and postpartum (x̄ = 2.6, SD = 2.1 vs. x̄ = 1.3, SD = 1.4; P < 0.001), and they had higher recall of health and nutrition messages across the intervention period: prenatal care (adjusted mean difference (AMD) = 2.25; 95% CI = 1.57, 2.94), birth (AMD = 1.83; 95% CI = 1.24, 2.41), and postpartum care (AMD = 2.20; 95% CI = 1.43, 2.96). The intervention reduced maternal potential depressive symptoms by 9.16 percentage points (95% CI = -15.7, -2.62) and a reduction of 1.20 points in EPDS score (95% CI = -1.88, -0.52). There were no significant differences between intervention and comparison groups for maternal dietary diversity or child diet and nutrition indicators. Conclusions The ttCF strategy improved the frequency and quality of BHW home visits and demonstrated promising impacts on maternal mental health. However, additional enabling interventions are needed to improve maternal and child diet and nutrition outcomes.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Timed and targeted care for family (ttCF) strategies delivered through 12 scheduled home visits by trained Barangay health workers from pregnancy through child's second year
- Population
- 1518 pregnant women or mothers with children under 12 months across 12 municipalities in Eastern Visayas, Philippines (658 in intervention, 655 in comparison at 12-month follow-up)
Key finding
Home visits during pregnancy significantly higher in intervention areas (mean 3.2 vs 1.7; P<0.001)