PDF(Pubmed)
Abstract：
OBJECTIVE: This study assesses change in caregiver practices after integrating responsive care and early learning (RCEL) in nutrition and health services and community platforms in northern Ghana.
METHODS: We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers\' RCEL practices before and after the intervention with a household questionnaire and caregiver-child observations.
METHODS: The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups.
METHODS: We enrolled 211 adult caregivers in the study sites who had children 0-23 months at baseline and were enrolled in a CWC or a VSLA.
RESULTS: We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress.
CONCLUSIONS: This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.
METHODS: We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers\' RCEL practices before and after the intervention with a household questionnaire and caregiver-child observations.
METHODS: The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups.
METHODS: We enrolled 211 adult caregivers in the study sites who had children 0-23 months at baseline and were enrolled in a CWC or a VSLA.
RESULTS: We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress.
CONCLUSIONS: This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.
摘要：
目的：本研究评估了加纳北部在营养和健康服务以及社区平台中整合响应式护理和早期学习（RCEL）后护理人员实践的变化。
方法：我们对医疗机构工作人员和社区卫生志愿者进行了培训，通过现有的医疗机构和社区团体为2岁以下儿童的照顾者提供RCEL咨询。我们通过家庭问卷和照顾者-儿童观察评估了干预前后照顾者RCEL实践的变化。
方法：这项研究在萨格纳里古进行，Gushegu,Wa东,以及2022年4月至2023年3月的Mamprugu-Moagduri地区。研究地点包括加纳卫生服务设施的79个儿童福利诊所（CWC）和80个村庄储蓄和贷款协会团体（VSLA）。
方法：我们在研究中心招募了211名在基线时有0-23个月儿童的成人照顾者，并加入了CWC或VSLA。
结果：我们观察到RCEL和婴幼儿喂养方法的改善，早期学习的机会(例如，在家庭环境中获取书籍和玩具)，减少父母的压力。
结论：本研究证明了将RCEL含量纳入现有营养和健康服务的有效性。这些发现可以用来发展，增强,并倡导将RCEL整合到加纳现有服务和平台的政策。未来的研究可能会探讨照顾者行为的积极变化与儿童发育结果的改善之间的关系，以及加强父亲参与护理实践的策略。改善儿童监督，并确保有利的环境。
方法：我们对医疗机构工作人员和社区卫生志愿者进行了培训，通过现有的医疗机构和社区团体为2岁以下儿童的照顾者提供RCEL咨询。我们通过家庭问卷和照顾者-儿童观察评估了干预前后照顾者RCEL实践的变化。
方法：这项研究在萨格纳里古进行，Gushegu,Wa东,以及2022年4月至2023年3月的Mamprugu-Moagduri地区。研究地点包括加纳卫生服务设施的79个儿童福利诊所（CWC）和80个村庄储蓄和贷款协会团体（VSLA）。
方法：我们在研究中心招募了211名在基线时有0-23个月儿童的成人照顾者，并加入了CWC或VSLA。
结果：我们观察到RCEL和婴幼儿喂养方法的改善，早期学习的机会(例如，在家庭环境中获取书籍和玩具)，减少父母的压力。
结论：本研究证明了将RCEL含量纳入现有营养和健康服务的有效性。这些发现可以用来发展，增强,并倡导将RCEL整合到加纳现有服务和平台的政策。未来的研究可能会探讨照顾者行为的积极变化与儿童发育结果的改善之间的关系，以及加强父亲参与护理实践的策略。改善儿童监督，并确保有利的环境。
