Health Promotion Intervention to Reduce Child Morbidity
Condition: Diarrhea; Nutritional
MeSH terms: Diarrhea
Study type: Interventional

Summary: 
      While household-level water, sanitation and hygiene has been investigated extensively, this
      is the first comprehensive study to investigate the impact of improved water, sanitation and
      hygiene and nutrition at household on child health in Yemen.
    

Detailed description: 
      This study was conducted in Hufash district, Al-Mahweet Province, which is located on the
      southwest of the capital Sana'a, and takes about (113)kilometers from it. The study aimed to
      highlight the key role of the community based interventions in reducing child morbidity and
      mortality in rural Yemen.A community - randomized controlled field trail was implemented to
      evaluate the role of public health promotion on reducing child diarrhea, acute respiratory
      infection, nutrition, immunization in children under age of five at enrollment over a six
      month of study period. Due to the nature of the study, blinding is not possible so some
      measures would be done to reduce the non-blinding bias like, to keep the study staff blinded
      as much as possible, the observers and survey staff were not informed about the study design.
      The sample size required to measure the primary and secondary outcomes before and after the
      intervention in both groups was estimated using STATA 14.0.Based on data of a previous meta
      analysis, estimates of required sample size assumed a 20% reduction in the proportion of
      diarrhea. Intra-cluster correlation coefficient (ICC) was set low at 0.04 and the cluster
      sizes (number of subjects in a cluster, m) were expected to be 18. The sample size was
      multiplied by a design effect of 1.68, calculated using DE=1+ICC (m-1), to accommodate the
      clustering effect. The sample was further adjusted for a potential 20% loss to follow-up over
      one year, thus requiring a sample of 180 per group. Therefore, the present study estimated
      that a total of 20 clusters inhabited by 358 households with child aged 6 to 59 months would
      have 80% power to detect the 20% reduction in the proportion in diarrhea at 5% level of
      significance.
    

Intervention name(s): health promotion
Intervention type(s): Behavioral
Intervention description(s): health promotion on water, sanitation and hygiene and child feeding along with hygiene kits were delivered to the mothers in the intervention arm
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The frame work used in this study depends on the Evo-Eco theory of behavior change.This approach consists of five steps; assess, build, create, develop and evaluate (A, B, C, D and E). In the assessment steps, the researcher made a review about the role of water, hygiene and infant feeding promotion in reducing child morbidity and changing mothers' behavior. Based on this review and experience, the researcher developed a baseline questionnaire that was used two months ago before starting the intervention. Based on the results of baseline survey and literature, the researcher with expert team developed the health promotion messages. After developing the messages, interventions took six months. Furthermore, the implementation of the health promotion intervention was at household and community level. Two months later of performing the intervention, the post intervention survey was carried out to measure the primary and secondary outcome of the interventions.
Masking: Single (Participant)
Primary purpose: Prevention