146 lines
4.6 KiB
YAML
146 lines
4.6 KiB
YAML
abstract: 'Background To address gaps in coverage and quality of nutrition
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services, Alive \& Thrive (A\&T) strengthened the delivery of maternal
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nutrition interventions through government antenatal care (ANC) services
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in Uttar Pradesh, India. The impact evaluation of the A\&T interventions
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compared intensive ANC (I-ANC) with standard ANC (S-ANC) areas and found
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modest impacts on micronutrient supplementation, dietary diversity, and
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weight-gain monitoring. Objectives This study examined
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intervention-specific program impact pathways (PIPs) and identified
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reasons for limited impacts of the A\&T maternal nutrition intervention
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package. Methods We used mixed methods: frontline worker (FLW) surveys
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(n = similar to 500), counseling observations (n = 407), and qualitative
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in-depth interviews with FLWs, supervisors, and block-level staff (n =
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59). We assessed 7 PIP domains: training and materials, knowledge,
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supportive supervision, supply chains, data use, service delivery, and
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counseling. Results Exposure to training improved in both I-ANC and
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S-ANC areas with more job aids used in I-ANC compared with S-ANC (90\%
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compared with 70\%), but gaps remained for training content and
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refresher trainings. FLWs'' knowledge improvement was higher in I-ANC
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than S-ANC (22-36 percentage points), but knowledge of micronutrient
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supplement benefits and recommended foods was insufficient (<50\%). Most
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FLWs received supervision (>90\%), but supportive supervision was
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limited by staff vacancies and competing work priorities. Supplies of
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iron-folic acid and calcium supplements were low in both areas (30-50\%
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stock-outs). Use of monitoring data during review meetings was higher in
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I-ANC than S-ANC (52\% compared with 36\%) but was constrained by time,
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understanding, and data quality. Service provision improved in both
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I-ANC and S-ANC areas, but counseling on supplement benefits and
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weight-gain monitoring was low (30-40\%). Conclusions
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Systems-strengthening efforts improved maternal nutrition interventions
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in ANC, but gaps remained. Taking an intervention-specific perspective
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to the PIP analysis in this package of services was critical to
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understand how common and specific barriers influenced overall program
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impact.'
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affiliation: 'Nguyen, PH (Corresponding Author), Int Food Policy Res Inst IFPRI, Washington,
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DC 20005 USA.
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Kachwaha, Shivani; Phuong H Nguyen; Avula, Rasmi; Menon, Purnima, Int Food Policy
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Res Inst IFPRI, Washington, DC 20005 USA.
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Lan Mai Tran; Young, Melissa F., Emory Univ, Atlanta, GA 30322 USA.
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Ghosh, Sebanti; Forissier, Thomas; Escobar-Alegria, Jessica; Sharma, Praveen Kumar,
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FHI Solut, Washington, DC USA.
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Frongillo, Edward A., Univ South Carolina, Columbia, SC 29208 USA.'
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author: Kachwaha, Shivani and Nguyen, Phuong H and Tran, Lan Mai and Avula, Rasmi
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and Young, Melissa F. and Ghosh, Sebanti and Forissier, Thomas and Escobar-Alegria,
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Jessica and Sharma, Praveen Kumar and Frongillo, Edward A. and Menon, Purnima
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author-email: p.h.nguyen@cgiar.org
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author_list:
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- family: Kachwaha
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given: Shivani
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- family: Nguyen
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given: Phuong H
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- family: Tran
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given: Lan Mai
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- family: Avula
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given: Rasmi
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- family: Young
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given: Melissa F.
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- family: Ghosh
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given: Sebanti
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- family: Forissier
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given: Thomas
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- family: Escobar-Alegria
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given: Jessica
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- family: Sharma
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given: Praveen Kumar
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- family: Frongillo
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given: Edward A.
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- family: Menon
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given: Purnima
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da: '2023-09-28'
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doi: 10.1093/jn/nxab390
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earlyaccessdate: JAN 2022
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eissn: 1541-6100
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files: []
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issn: 0022-3166
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journal: JOURNAL OF NUTRITION
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keywords: 'maternal nutrition; micronutrient supplementation; diet diversity;
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weight-gain monitoring; systems strengthening; service delivery;
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counseling; India'
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keywords-plus: 'MIDDLE-INCOME COUNTRIES; CHILD FEEDING PRACTICES; MIXED-METHODS
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RESEARCH; UNDERNUTRITION; HEALTH; IMPLEMENTATION; PROGRAMS; ACHIEVE;
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INFANT'
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language: English
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month: FEB 8
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number: '2'
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number-of-cited-references: '35'
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orcid-numbers: 'Young, Melissa Fox/0000-0002-2768-1673
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Nguyen, Phuong H/0000-0003-3418-1674'
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pages: 612-629
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papis_id: cfc13ccb5a6f1ed019d28520f596e0f7
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ref: Kachwaha2022specificitymatters
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researcherid-numbers: 'Young, Melissa Fox/AAW-2016-2021
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'
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times-cited: '4'
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title: 'Specificity Matters: Unpacking Impact Pathways of Individual Interventions
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within Bundled Packages Helps Interpret the Limited Impacts of a Maternal Nutrition
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Intervention in India'
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type: Article
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unique-id: WOS:000766302000027
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '152'
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web-of-science-categories: Nutrition \& Dietetics
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year: '2022'
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