目的:比较居住在正在实施包容性早期儿童发展(IECD)项目的地区的儿童的成长和发育状况之间的差异,以及通过训练有素的Anganwadi接受干预的儿童综合儿童发展服务(ICDS)计划下的前线工人(Frontlineworkers)与未接受包容性ECD项目干预的儿童。
方法:这是一项混合方法队列研究,嵌套在医学院的一个正在进行的项目中,通过国际儿童发展监测指南(GMCD)将包容性ECD用作干预措施,该指南是在现有政府机构和人员(例如Anganwadi工人)的帮助下进行监测和评估的工具,Anganwadi主管及其与社区的联络点。选择200名儿童的样本;干预组(IECD队列)和对照组(常规护理队列)各100名,并随访至儿童2岁。
结果:IECD干预对IECD队列的体重(p=0.04)和身高(p=0.03)具有统计学意义。总体发展评估显示,与常规护理队列(17.20%11.82%=29.02%)相比,IECD队列(9.67%5.37%=15.04%)中已确定的发展问题(关注延迟)约为一半。对发育结果进行二项逻辑回归的结果具有统计学意义(p=0.04),表明IECD干预的儿童发生发育问题的几率较低。
结论:研究表明,通过一线工人实施IECD干预措施是可能的,显着改善儿童的成长和发展。
OBJECTIVE: To compare the difference between the growth and developmental status of the children who were residing in the area where Inclusive Early Childhood Development (IECD) project was being implemented and who had received interventions through trained Anganwadi workers (Frontline workers) under Integrated Child Development Services (ICDS) scheme with the children who had not received the Inclusive ECD project interventions.
METHODS: It was a mixed method cohort study, nested in an ongoing project in a medical college in which Inclusive ECD was used as an intervention through International Guide for Monitoring Child Development (GMCD) which is a tool for both monitoring and assessment with the help of existing government structures and personnel such as Anganwadi workers, Anganwadi supervisors and their contact points with communities. A sample of 200 children was selected; 100 each from intervention group (IECD cohort) and comparison group (Usual care cohort) and were followed till the child became 2 y of age.
RESULTS: IECD intervention showed statistically significant effect on weight (p = 0.04) and height (p = 0.03) of the IECD cohort. Overall developmental assessment showed that the identified developmental issues (Concerns + Delays) were approximately half in IECD cohort (9.67% + 5.37% = 15.04%) as compared to usual care cohort (17.20% + 11.82% = 29.02%). The results from binomial logistic regression performed for developmental outcomes were statistically significant (p = 0.04) suggesting that children with IECD intervention have lower odds of developing developmental issues.
CONCLUSIONS: The study indicates that it is possible to implement IECD interventions through frontline workers, which significantly improves the growth and development of the children.