Weight Gain Clinical Trial
Official title:
Effectiveness of Post Disaster Nutrition Intervention to Optimize Growth and Development of Under-two-year-old Children in Lombok, Indonesia
In 2018, multiple earthquake with magnitude range from 6 to 7 hit Lombok Island, West Nusa
Tenggara Province, Indonesia. Following the situational analysis and baseline study in
December 2018 (4 months after the first earthquake), it was found that the prevalence of
wasting and underweight of underfive children in the affected population is moderate (10.2%
and 28.8%) but the prevalence of stunting and anemia is considered of highly significant
public health problem (33.3% and 43.8%). Various organizations have provided support at the
emergency phase but there is no specific program for nutrition support at the rehabilitation
phase.
Draft of intervention model which utilize early child education (ECE) centers as center of
nutrition recovery in the community has been discussed with the local education and health
officers. Training will be delivered to ECE teachers and community health officers. ECE
teachers are expected to have regular parenting class for nutrition education and activities,
whilst the community health officers will monitor the activities and provide technical
guidance as needed. Mothers of the underfive children will be invited to attend weekly
parenting class at nearby ECE center in which they receive messages related to infant and
young child feeding (IYCF), including distribution of liver and fish floss as nutrient dense
food supplement to their children, and provision of appropriate psychosocial care.This
parenting class will be held for 6 months with regular monitoring from the researchers and
health personnel from public health center. Effectiveness of the intervention will be
assessed in improving IYCF practices and psychosocial care of mothers and nutrient intakes,
nutritional status and developmental outcomes of the underfives children.
This study aims to strengthen management of nutrition program during post-disaster recovery
for underfive children. In this study the following steps will be carried out.
Phase 1: Situation analysis is carried out with two approaches. The first approach is to
analyze secondary data in the form of data related to nutrition, health and description of
the affected population. The second approach is primary data collection by conducting a
qualitative study in the form of in-depth interviews and focus group discussion (FGD)
involving the local government and other parties related to the disaster management in East
Lombok. Then, interviews and FGDs will be conducted to chief of villages and staff, community
leaders and refugees, especially mothers with children under five children to complete data
on the status and IYCF practices. The results of this situation analysis will be reported to
the local government and also used as a basis for improving the implementation of the next
stage.
Phase 2: Preparation of technical guidelines for the nutrition recovery program for underfive
children by the research team based on situation analysis and literature review which has
been carried out previously.
Stage 3: Representatives from ECE teachers and health workers from Public Health Centers will
be trained on the implementation of parenting class and its monitoring. Then, together with
the researchers, ECE teachers and community health workers will carry out the weekly
parenting class, periodic monitoring and program evaluation.
Stage 4: At this stage there will be an intervention in the form of nutrient-dense food
supplementation and psychosocial care for mothers with the concept of "Community
Participation". Mothers and community members such as cadres will be involved in joint
activities to provide nutrient-dense food for underfives children.
Stage 5: At the end of the activity an evaluation and monitoring program will be conducted by
the research team in collaboration with the district health office.
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