WP4 leader: Caroline Fall
The Perinatal Care Project (PCP) survey represents a part of WP-4 (childhood outcomes) of the GIFTS programme. A participatory women’s groups (PWG) community mobilization intervention, conducted by PCP in 18 rural unions in 3 districts of Bangladesh (Faridpur, Bogra and Moulavibazar) in 2009-2011, reduced neonatal mortality by 38% and improved hygienic delivery and essential newborn care practices. The intervention was based on a participatory learning and action (PLA) cycle of monthly meetings facilitated by lay, locally recruited women. In the PLA cycle, women themselves identified and prioritized local health challenges and then designed, implemented and evaluated their own solutions to these challenges. Subsequent to the intervention and evaluation focused on neonatal mortality, facilitated PWGs continued to meet, focusing on child (under-fives) health and women’s and reproductive health, with encouraging results in relation to breastfeeding practices and knowledge and awareness of hygienic and nutritional practices.
We followed-up all children (aged 24-48 months at time of survey) born to women who were exposed to the PWG intervention during their pregnancy and a random sample of contemporary mothers and their children (control) in the same age group to assess the impact of the intervention on child growth and body fat.
Survey and anthropometric data were obtained from 2587 children: 1264 children and their mothers in intervention clusters and 1323 children and their mothers in control areas, representing response rates of 94% and 89% respectively. Interactions between child anthropometric outcomes and maternal BMI were explored and a clear differential effect of the intervention depending on maternal BMI was recorded. These results will be presented in a publication that is currently under submission.
There is an equal weight of evidence to link both under-nutrition (overall diet and specific nutritional deficiencies) and over-nutrition (obesity and hyperglycaemia) with the future development of obesity, diabetes and cardio-metabolic disease. It is therefore, of great interest that the PWGs had a differential effect on child outcomes dependant of the BMI category of the mother.