A&T India Maternal Nutrition Endline Survey 2019: Auxiliary Nurse Midwife

This dataset is the result of the frontline health workers/ auxiliary nurse midwife (ANM) 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 Reproductive, Maternal, Newborn, Child Health (RMNCH) services in India. These include the provision of iron and folic acid (IFA) and calcium supplements, interpersonal counseling on diet during pregnancy and consumption of IFA and calcium, community mobilization, and adequate weight-gain monitoring during pregnancy. 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 cluster-randomized evaluation design, the primary objectives of the A&T evaluation study in India are to answer the following questions: 1) Can the coverage and utilization of key maternal nutrition interventions be improved by integrating nutrition-focused social behavior change (SBC) communication and systems strengthening approaches into antenatal care (ANC) services under the RMNCH program? 2) What factors affect the effective integration of maternal nutrition interventions into a well-established government ANC service delivery platform under the RMNCH program? 3) What are the impacts of the program on i) consumption of diversified foods and adequate intake of micronutrient, protein, and energy compared to recommended intake; ii) intake of IFA and calcium supplements during pregnancy; iii) weight gain monitoring; and iv) early initiation of breastfeeding. As with the baseline, the endline survey used the same 26 blocks in Uttar Pradesh. Thirteen blocks from two districts (Kanpur Dehat and Unnao) were randomly allocated to receive intensified maternal nutrition interventions. Another 13 blocks from the same two districts were randomly allocated to the comparison groups. The survey took place between November and December 2019 by the team from International Food Policy Research Institute (IFPRI), in collaboration with the survey firm, NEERMAN (Network for Engineering and Economics Research and Management). The endline survey comprised 11 questionnaires: 1) Household questionnaire for recently delivered women (RDW) with children <6 months of age, 2) Household questionnaire for pregnant women (PW) of the second and third trimester of pregnancy (with detailed dietary recall), 3) Household questionnaire for husbands of PWs and husbands of RDWs, 4) Household questionnaire for mothers/mothers-in-law of PWs and mothers/mothers-in-law of RDWs, 5) Frontline health workers: Anganwadi workers (AWW), 6) Frontline health workers: Accredited Social Health Activist (ASHA), 7) Frontline health workers: Auxiliary Nurse Midwife (ANM), 8) Frontline health workers: Supervisor (SUP), 9) Observation: AWW, 10) Observation: ASHA, and 11) Observation: ANM. The auxiliary nurse midwife (ANM) survey (along with the other 3 FLW’s surveys: AWW, ASHA, and Supervisor) gathered data on service provision by government FLWs and other health care providers. Data were also gathered on FLWs’ time commitment, knowledge, and training related to maternal nutrition, and their job motivation, and supervision.本数据集源自一线卫生工作者/辅助助产士（Auxiliary Nurse Midwife, ANM）的调研成果，该调研旨在为"生机与成长"（Alive & Thrive, A&T）干预项目影响评估研究的终线数据收集环节提供支撑——该项目依托印度生殖、孕产妇、新生儿与儿童健康（Reproductive, Maternal, Newborn, Child Health, RMNCH）服务体系开展。其干预措施涵盖铁叶酸（Iron and Folic Acid, IFA）与钙剂的发放、孕期饮食及铁叶酸、钙剂服用的人际咨询、社区动员，以及孕期体重增长的规范监测。"生机与成长"是一项全球倡议，旨在通过优化孕产妇营养、母乳喂养及辅食喂养实践，推广营养干预措施，以实现挽救生命、预防疾病、促进健康成长与发育的目标。本研究采用整群随机评估设计，印度境内的A&T评估研究核心目标为解答以下三项问题：1）将聚焦营养的社会行为改变（Social Behavior Change, SBC）传播与系统强化方法融入生殖、孕产妇、新生儿与儿童健康项目框架下的产前保健（Antenatal Care, ANC）服务中，能否提升关键孕产妇营养干预措施的覆盖范围与使用率？2）哪些因素会影响将孕产妇营养干预措施有效融入生殖、孕产妇、新生儿与儿童健康项目下成熟的政府产前保健服务交付平台？3）该项目对以下维度产生了何种影响：i）多样化食物摄入及微量营养素、蛋白质、能量的摄入是否符合推荐标准；ii）孕期铁叶酸与钙剂的服用情况；iii）孕期体重增长监测情况；iv）母乳喂养的早期启动时机。与基线调研一致，本次终线调研选取北方邦的26个区块作为研究区域。其中来自坎普尔德哈特（Kanpur Dehat）与乌纳奥（Unnao）两个地区的13个区块被随机分配至强化孕产妇营养干预组，同属该两地区的另外13个区块则被随机分配至对照组。本次调研由国际粮食政策研究所（International Food Policy Research Institute, IFPRI）团队联合调研机构NEERMAN（工程与经济研究与管理网络，Network for Engineering and Economics Research and Management）于2019年11月至12月间完成。本次终线调研共包含11份问卷：1）针对育有6月龄以下子女的近期分娩妇女（Recent Delivered Women, RDW）的家庭问卷；2）针对孕中晚期孕妇（Pregnant Women, PW）的家庭问卷（含详细膳食回顾内容）；3）针对孕妇及近期分娩妇女丈夫的家庭问卷；4）针对孕妇及近期分娩妇女的母亲/婆婆的家庭问卷；5）一线卫生工作者问卷：安格瓦迪工作人员（Anganwadi Workers, AWW）；6）一线卫生工作者问卷：认证社会卫生活动家（Accredited Social Health Activist, ASHA）；7）一线卫生工作者问卷：辅助助产士（ANM）；8）一线卫生工作者问卷：督导员（Supervisor, SUP）；9）观察类问卷：安格瓦迪工作人员；10）观察类问卷：认证社会卫生活动家；11）观察类问卷：辅助助产士。辅助助产士调研（与其余3份一线卫生工作者问卷——安格瓦迪工作人员、认证社会卫生活动家及督导员问卷协同开展）收集了政府一线卫生工作者及其他医疗服务提供者的服务提供相关数据。此外，调研还覆盖了一线卫生工作者的时间投入、孕产妇营养相关知识与培训情况、职业动机及督导情况等维度的数据采集。