Academic Journal

Is integrated private-clinic based early child development care effective? A clustered randomised trial in Pakistan

التفاصيل البيبلوغرافية
العنوان: Is integrated private-clinic based early child development care effective? A clustered randomised trial in Pakistan
المؤلفون: Muhammad Amir Khan, Syeda Somyyah Owais, Shazia Maqbool, Sehrish Ishaq, Haroon Jehangir Khan, Fareed A Minhas, Joseph Hicks, Muhammad Ahmar Khan, John D Walley
المصدر: BJGP Open, Vol 2, Iss 2 (2018)
بيانات النشر: Royal College of General Practitioners, 2018.
سنة النشر: 2018
المجموعة: LCC:Medicine (General)
مصطلحات موضوعية: primary care, primary health care, general practice, Pakistan, child development, nutrition, depression, Medicine (General), R5-920
الوصف: Background: In Pakistan, high prevalence of delays in early child development (ECD) is associated with poverty and lack of mothers’ caregiving skills. GP clinics, the main sources of care in poor urban localities, lack quality ECD care delivery. A contextualised intervention was developed and tested to enable GPs to deliver clinic-based, tool-assisted ECD counselling of mothers on a quarterly basis. Aim: To assess the effectiveness of delivering a contextualised ECD mother-counselling intervention. Design & setting: Clustered randomised controlled trial, in poor urban localities of Pakistan. Locality clusters were allocated to intervention and control arm using simple randomisation. Method: A total of 2327 mother–child pairs were recruited at 32 GP clinics, one from each cluster-locality; 16 GP clinics per arm. The clinic-based counselling intervention covering child stimulation, nutrition, and maternal mental health was delivered mainly by clinic assistants to mothers at ≤6 weeks, and 3, 6, and 9 months of child age. At 12 months of child age, each mother–child pair was assessed for the primary outcome, that is, delays in the five development domains (determined by Ages and Stages Questionnaire-3 [ASQ-3] score); and secondary outcomes, namely the prevalence of stunting and maternal depression (determined by Patient Health Questionnaire-9 [PHQ-9] score). The outcome assessors were blinded to the cluster–arm allocation. Outcome analyses were calculated on cluster-level. Results: At 12 months, the number of children with delay in two or more development domains was significantly lower in the intervention arm (-0.17 [95% confidence interval {CI} = -0.26 to -0.09]; P
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2398-3795
Relation: https://bjgpopen.org/content/2/2/bjgpopen18X101593; https://doaj.org/toc/2398-3795
DOI: 10.3399/bjgpopen18X101593
URL الوصول: https://doaj.org/article/0f57c99250584a35ae251425a1006fe8
رقم الانضمام: edsdoj.0f57c99250584a35ae251425a1006fe8
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:23983795
DOI:10.3399/bjgpopen18X101593