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Success Factors for Community Health Workers in Implementing an Integrated Group-Based Child Development Intervention

Tania Jahir1, Peter J Winch2, Elli Leontsini2

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Summary

Community Health Workers (CHWs) successfully delivered integrated maternal and child health interventions in Bangladesh. Training and technology aided CHWs, but complexity and distractions posed challenges for scaling up child stimulation programs.

Keywords:
Bangladeshcommunity health workersearly child developmentgroup sessionsintegrated interventionmaternal mental healthprevention of lead exposure

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Area of Science:

  • Global Health
  • Public Health Interventions
  • Child Development

Background:

  • Community Health Workers (CHWs) are vital for maternal and child health (MCH) but integrating child stimulation at scale remains under-researched.
  • Evidence is limited on how to effectively incorporate child development interventions into existing CHW programs.

Purpose of the Study:

  • To evaluate the implementation of an integrated MCH intervention including child stimulation, delivered by CHWs in rural Bangladesh.
  • To identify success factors and challenges for delivering integrated interventions at scale.

Main Methods:

  • A mixed-methods approach was used, involving qualitative data collection through focus groups and interviews with CHWs and supervisors.
  • The intervention was delivered by CHWs in 16 villages, reaching 20 households each, through bi-weekly group meetings and home visits.
  • CHWs utilized tablet computers as job aids for delivering behavioral recommendations.

Main Results:

  • CHW training, supervision, community introduction, and tablet use facilitated effective delivery of behavioral recommendations.
  • CHWs faced challenges with complex recommendations, age-specific materials, and distractions from young children attending group sessions.
  • Qualitative findings highlighted areas for improvement to strengthen intervention delivery and facilitate scale-up.

Conclusions:

  • Integrated MCH interventions, including child stimulation, can be feasibly delivered by CHWs.
  • Iterative revisions based on implementation findings are crucial for successful scale-up of CHW-delivered programs.
  • Addressing complexity, material specificity, and session dynamics can enhance intervention effectiveness.