Promoting family integrated early child development (during first 1000 days) in urban slums of India (fine child 3‐3‐1000): Study protocol

• Published in: Journal of advanced nursing Vol. 76; no. 7; pp. 1823 - 1830
• Main Authors: Das, Manoja K., Seth, Suresh, Mundeja, Nutan, Singh, Arun K., Mukherjee, Sharmila B., Juneja, Monica, Khuda, Priyanka, Fatima, Rifat, Bhatnagar, Ayushi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-07-2020
• Subjects: Behavior change; Brain; Child development; Children & youth; Coaching; Cognitive development; Cognitive functioning; Cohort analysis; Community health workers; Developing countries; Domiciliary visits; Feasibility; Ghettos; Infants; Integrated care; Intervention; LDCs; Mothers; Nurses; Nutrition; Pregnancy; Slums; Social development; Stimulation; Stimulus; the first 1,000 days; India; child development; slums; the first 1,000 days; nurses; community health workers
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14384

Aims
This project tests a novel, targeted home visitation programme for child development targeted behaviour change during the first 1,000 days for families in Delhi urban slums.
Background
The first 1,000 days have highest brain development potential and is dependent on the available nutrition, health, social and cognitive stimulus. Over 1.3 million children are born annually in the slums of India and are at risk of limited development potential. The children in urban slums at multiplicity of adversities at family, society and environmental levels. No tools are available for the community health functionaries to support the families to promote child development.
Design
This cohort study targets provision of behaviour change interventions targeted at three groups (pregnant women, infants and children in year 2) to document the impact on child development.
Methods
This implementation project delivers nutrition, health and child stimulation integrated services for the families through existing government community health workers and nurses. These workers shall train the families using audio‐visual messages in tablets and demonstration kits for practice through quarterly home visits. Data on health, nutrition and child development shall be collected at baseline, midterm and after one year. The data from these participants shall be compared with data from recently delivered women, children aged 13 months and 25 months without intervention to document the impact.
Discussion
The successful implementation of the project has potential for future integration of the child development components into the existing programme at scale. The learning from this project shall be useful for India and other developing countries.
Impact
The first 1,000 days are critical period in human brain development and cognitive function acquisition potential, which is dependent on the available nutrition, health, social and cognitive stimulus. The development potential in children born and living in the slums, who are exposed to various adversities, can be mitigated through appropriate family‐level practices with support from the community health workers and Nurses. This study is documenting the feasibility and impact of home visit linked coaching of families for improving child development status during the first 1,000 days in three sums of Delhi, India.
目标
该项目针对德里城市贫民窟家庭头1000天儿童发育的行为变化开展一个新颖的、有针对性的家庭探访计划。
背景信息
头1000天的大脑发育潜力最大,其依赖于可获得的营养、健康、社会和认知激发。印度贫民窟出生的儿童每年有130多万,但发育的潜力有限。城市贫民窟儿童在家庭、社会和环境层面均面临多重的困境。社区卫生工作人员没有工具支持家庭促进儿童的发育。
设计
这项队列研究的目标是提供针对三组(孕妇、婴儿和2岁以下儿童)的行为改变介入治疗,以记录对儿童发育的影响。
方法
通过现有的政府社区卫生工作者和护士,为家庭提供营养、保健和儿童激发的综合服务。这些工作人员应通过季度家访,对使用平板电脑和演示工具包中的视听信息的家庭进行培训。应在基线、中期和一年后收集健康、营养和儿童发育数据。这些受访者的数据应与最近分娩的妇女、13个月和25个月大的儿童的数据进行比较,以记录其影响。
讨论
该项目的成功实施有可能使儿童的发育工作在未来按比例纳入现有方案。从这个项目中吸取的经验教训将对印度和其他发展中国家有益。
影响
头1000天是人类大脑发育和获得认知功能潜能的关键时期,这取决于可获得的营养、健康、社会和认知激发。在社区卫生工作者和护士的支持下,通过家庭层面采取的适当做法,可以推动在贫民窟出生和生活的儿童面临各种逆境的发育潜力。这项研究记录了家访相关的家庭辅导对于改善印度德里三个城市贫民窟的孩子前1000天发育状况的可行性和影响。