A&T Bangladesh Urban Maternal Nutrition Endline Survey 2022: Antenatal Care Case Observation

This dataset is the result of the Case Observation survey that was conducted to gather data for the endline part of the impact evaluation study of the Alive & Thrive (A&T) interventions delivered through the Urban Maternal, Neonatal and Child Health (MNCH) Services in Bangladesh. These include building capacity for health providers and nutritional counselors in urban health clinics, creating friendly environment for maternal infant, and young child nutrition (MIYCN) counseling in clinic settings, community mobilization for demand creation of MIYCN services, interpersonal counseling on diet during pregnancy and consumption of iron-folic acid (IFA) and calcium, promotion of adequate weight-gain monitoring during pregnancy, and counseling on breastfeeding and complementary feeding practices. A&T is a global initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding, and complementary feeding practices. Using a quasi-experimental design, the primary objectives of the A&T evaluation study in Bangladesh are to answer the following questions: What are the impacts of standardized and upgraded MIYCN counselling services on behaviors of clients including: Pregnant women: 1) consumption of diversified foods; 2) intake of IFA and calcium supplements during pregnancy Mothers of children <12 months: age-appropriate infant feeding Is it feasible to standardize the delivery of MIYCN counselling services in existing urban health facilities? Can the quality of MIYCN counselling services be improved by upgrading and standardizing existing MIYCN counselling services in urban health facilities? What are the impacts of standardized and upgraded MIYCN counselling service on the utilization of MIYCN services? The endline survey used 16 facilities in Dhaka, Bangladesh, with a non-random assignment of facilities to the intervention and control groups. Eight facilities from two NGOs of Radda and Marie Stopes received the intervention, while eight facilities operated by Nari Maitree and Shimantik served as the comparison group. The survey took place in May-July 2022 by the team from International Food Policy Research Institute (IFPRI), in collaboration with the survey firm, DATA (Data Analysis and Technical Assistance). The endline survey comprised four questionnaires: 1) health facility assessment; 2) healthcare provider survey; 3) case observations and 4) client interviews. The Antenatal Care Case Observations were conducted using an observation checklist to observe the service content, providers’ skills, counselling processes, and interactions between the client and provider. At the end of the observation, brief exit interviews were used to assess clients’ satisfaction with the services received.本数据集为孟加拉国城市孕产妇、新生儿及儿童卫生（Urban Maternal, Neonatal and Child Health, MNCH）服务体系下，“生机与成长（Alive & Thrive, A&T）”干预措施影响评估研究终期数据采集所依托的案例观察调查成果。该干预措施具体包括：为城市卫生诊所的医疗服务提供者与营养咨询师开展能力建设；在诊所场景中搭建利于孕产妇、婴幼儿营养（Maternal, Infant and Young Child Nutrition, MIYCN）咨询的友好环境；开展社区动员以激发MIYCN服务的市场需求；针对孕期饮食、叶酸铁（iron-folic acid, IFA）与钙剂摄入提供人际咨询服务；推广孕期体重增长监测工作；以及提供母乳喂养与辅食喂养实践指导。 “生机与成长”是一项全球性倡议，旨在通过优化孕产妇营养、母乳喂养与辅食喂养实践，推广营养干预措施，以挽救生命、预防疾病并助力个体健康成长与发展。 本次孟加拉国A&T评估研究采用准实验设计，核心研究目标为解答以下四类问题： 1. 标准化与升级后的MIYCN咨询服务对服务对象行为的影响如何？具体涵盖： - 孕妇群体：①多样化食物摄入情况；②孕期叶酸铁与钙剂摄入情况 - 12月龄以下儿童母亲：符合年龄适配标准的婴幼儿喂养行为 2. 能否在现有城市卫生机构中标准化开展MIYCN咨询服务？ 3. 能否通过升级并标准化现有城市卫生机构中的MIYCN咨询服务，提升其服务质量？ 4. 标准化与升级后的MIYCN咨询服务对MIYCN服务利用率的影响如何？ 本次终期调查覆盖孟加拉国达卡市的16家卫生机构，采用非随机分组方式将机构划分为干预组与对照组。其中，来自Radda与玛丽·斯托普斯（Marie Stopes）两家非政府组织的8家机构纳入干预组，由Nari Maitree与Shimantik运营的8家机构作为对照组。 本次调查于2022年5月至7月开展，由国际粮食政策研究所（International Food Policy Research Institute, IFPRI）团队与调查机构DATA（数据分析与技术援助，Data Analysis and Technical Assistance）合作执行。 本次终期调查包含四类调研工具：1）卫生机构评估问卷；2）医疗服务提供者调查问卷；3）案例观察问卷；4）服务对象访谈问卷。 产前保健案例观察环节采用标准化观察清单开展，用于记录服务内容、服务提供者的专业技能、咨询流程以及服务对象与提供者之间的互动情况。观察环节结束后，通过简短的访后访谈评估服务对象对所接受服务的满意度。