Abstract：
Suaahara, an at-scale multisectoral nutrition programme in Nepal, aimed to advance knowledge and skills of frontline health workers to improve the quality of nutrition and health services at health facility and community levels. This study assessed the impact of Suaahara interventions on knowledge and skills of health facility workers and Female Community Health Volunteers (FCHVs). The study used a quasi-experimental design in which four Suaahara intervention districts were compared with pair-matched comparison districts. One health facility worker and three FCHVs from each survey cluster were included. Baseline survey consisted of 93 health facility workers (2015) and 118 FCHVs (2012), and endline survey (2022) consisted of 40 health facility workers and 120 FCHVs. Difference-in-differences regression models employing intent-to-treat analysis, accounting for clustering at the district level, assessed the impact of intervention. The intervention, relative to comparison, had no effect on health facility workers\' knowledge. There was a positive effect, however, on FCHVs\' knowledge in intervention relative to comparison areas on exclusive breastfeeding, timing of introduction of complementary feeding, sick child feeding and growth monitoring and promotion (GMP) for children under 2 years. Health facility workers and FCHVs in intervention versus comparison districts had higher endline scores for skills related to measuring the weight of children and pregnant women, measuring the height/length of children, conducting GMP for children under 2 years and identifying malnourished children. Suaahara interventions improved the capacity of health workers, particularly nutrition-related knowledge among FCHVs and GMP-related skills of both health facility workers and FCHVs.
摘要：
Suaahara,尼泊尔的大规模多部门营养方案，旨在提高一线卫生工作者的知识和技能，以提高卫生机构和社区一级的营养和卫生服务质量。这项研究评估了Suaahara干预措施对医疗机构工作人员和女性社区卫生志愿者（FCHV）的知识和技能的影响。该研究使用了准实验设计，其中将四个Suaahara干预区与配对的比较区进行了比较。每个调查组包括一名医疗机构工作人员和三名FCHV。基线调查包括93名医疗机构工作人员(2015年)和118名FCHV(2012年)，终点线调查(2022年)包括40名医疗机构工作人员和120名FCHV。采用意向治疗分析的差异回归模型，考虑到地区一级的集群，评估干预的影响。干预,相对于比较，对医疗机构工作人员的知识没有影响。产生了积极的影响，然而,关于与纯母乳喂养比较领域相关的FCHV干预知识，引入补充喂养的时机，2岁以下儿童的患病儿童喂养和生长监测与促进（GMP）。与比较地区相比，干预地区的医疗机构工作人员和FCHV在与测量儿童和孕妇体重相关的技能方面具有更高的终点得分，测量儿童的身高/长度，对2岁以下儿童进行GMP，并识别营养不良儿童。Suaahara干预措施提高了卫生工作者的能力，特别是FCHV中的营养相关知识以及医疗机构工作人员和FCHV的GMP相关技能。
