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Fink G, Chembe M, Henderson S, Rockers PC, Parkerson D. Feasibility of caregiver-administered anthropometric measurements of children under age 5: evidence from Zambia. Popul Health Metr 2024; 22:2. [PMID: 38297266 PMCID: PMC10829329 DOI: 10.1186/s12963-024-00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Accurate measurement of children's anthropometry is of central importance for the assessment of nutritional status as well as for the evaluation of nutrition-specific interventions. Social distancing requirements during the recent Covid-19 pandemic made administration of standard assessor-led measurement protocols infeasible in many settings, creating demand for alternative assessment modalities. OBJECTIVE To assess the feasibility and reliability of caregiver-administered anthropometric assessments of children under age 5. DESIGN We compared standard and caregiver-administered assessments within an ongoing nutrition trial in Zambia (NCT05120427). We developed a "no-contact" protocol whereby trained staff verbally instruct caregivers from an appropriate distance to measure the height, weight and MUAC of their children. We captured measurements of height, weight and MUAC among a sample of caregivers and infants in Zambia using both the "no-contact" protocol and a standard assessor-led protocol. We analyzed each anthropometric variable, comparing means between protocol group, the proportions yielding standardized z-scores outside the plausible ± 6SD range and the proportions of children classified stunted, underweight and wasted. RESULTS Anthropometric measurements were captured for 76 children using both the no-contact protocol and the standard protocol. An additional 1430 children were assessed by the standard protocol only and an additional 748 children by the no-contact protocol only. For the 76 children measured by both methods, we find no differences in average height, weight and MUAC between caregivers and interviewer assessments. The estimated kappa for the binary stunting and underweight classifications were 0.84 and 0.93, respectively. In the larger samples measured only following one protocol, we find no differences in average outcomes after adjusting for child, caregiver and household characteristics. CONCLUSIONS Anthropometric measurement protocols administered by caregivers with verbal instruction from trained assessors are a promising alternative to standard protocols in situations where study staff are unable to come in close contact with study participants. Clinical trials registration This study was conducted within a larger trial registered at clinicaltrials.gov as trial NCT05120427. https://clinicaltrials.gov/ct2/show/NCT05120427 .
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Affiliation(s)
- Günther Fink
- Swiss Tropical and Public Health Institute and University of Basel, Kreuzstrasse 2, 4123, Allschwil, Basel, Switzerland.
| | - Mpela Chembe
- Innovations for Poverty Action Zambia, Lusaka, Zambia
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Falgas-Bague I, Melero-Dominguez M, de Vernisy-Romero D, Tembo T, Chembe M, Lubozha T, Paul R, Parkerson D, Rockers PC, Sikazwe D, Fink G. Testing the feasibility, acceptability, and exploring trends on efficacy of the problem management plus for moms: Protocol of a pilot randomized control trial. PLoS One 2024; 19:e0287269. [PMID: 38181004 PMCID: PMC10769019 DOI: 10.1371/journal.pone.0287269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/24/2023] [Indexed: 01/07/2024] Open
Abstract
Mental health disorders are one of the most common causes that limit the ability of mothers to care for themselves and for their children. Recent data suggest high rates of distress among women in charge of young children in Zambia. Nevertheless, Zambia's public healthcare offers very limited treatment for common mental health distress. To address this treatment gap, this study aims to test the feasibility, acceptability, and potential efficacy of a context-adapted psychosocial intervention. A total of 265 mothers with mental health needs (defined as SRQ-20 scores above 7) were randomly assigned with equal probability to the intervention or control group. The intervention group will receive a locally adapted version of the Problem-Management Plus and "Thinking Healthy" interventions developed by the World Health Organization (WHO), combined with specific parts of the Strong Minds-Strong Communities intervention. Trained and closely supervised wellbeing-community health workers will provide the psychosocial intervention. Mental health distress and attendance to the intervention will be assessed at enrollment and 6 months after the intervention. We will estimate the impact of the intervention on mental health distress using an intention-to-treat approach. We previously found that there is a large necessity for interventions that aim to address mother anxiety/depression problems. In this study, we tested the feasibility and efficacy of an innovative intervention, demonstrating that implementing these mental health treatments in low-income settings, such as Zambia, is viable with an adequate support system. If successful, larger studies will be needed to test the effectiveness of the intervention with increased precision. Trial registration: This study is registered at clinicaltrials.gov as NCT05627206.
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Affiliation(s)
- Irene Falgas-Bague
- Department of Epidemiology and Public Health. Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Economics, University of Basel, Basel, Switzerland
- Disparities Research Unit, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Medicine. Harvard Medical School, Boston, Massachusetts, United States of America
| | - Maria Melero-Dominguez
- Department of Epidemiology and Public Health. Swiss Tropical and Public Health Institute, Basel, Switzerland
- Disparities Research Unit, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Daniela de Vernisy-Romero
- Department of Epidemiology and Public Health. Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Global Health. Boston University School of Public Health, Boston, Massachusetts, United States of America
| | | | - Mpela Chembe
- Innovations for Poverty Action, New York, New York, New York, United States of America
| | - Theresa Lubozha
- Innovations for Poverty Action, New York, New York, New York, United States of America
| | - Ravi Paul
- Department of Psychiatry, University of Zambia, Lusaka, Zambia
| | - Doug Parkerson
- Innovations for Poverty Action, New York, New York, New York, United States of America
| | - Peter C. Rockers
- Department of Global Health. Boston University School of Public Health, Boston, Massachusetts, United States of America
| | | | - Günther Fink
- Department of Epidemiology and Public Health. Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Economics, University of Basel, Basel, Switzerland
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Egger D, Miguel E, Warren SS, Shenoy A, Collins E, Karlan D, Parkerson D, Mobarak AM, Fink G, Udry C, Walker M, Haushofer J, Larreboure M, Athey S, Lopez-Pena P, Benhachmi S, Humphreys M, Lowe L, Meriggi NF, Wabwire A, Davis CA, Pape UJ, Graff T, Voors M, Nekesa C, Vernot C. Falling living standards during the COVID-19 crisis: Quantitative evidence from nine developing countries. Sci Adv 2021; 7:7/6/eabe0997. [PMID: 33547077 PMCID: PMC7864564 DOI: 10.1126/sciadv.abe0997] [Citation(s) in RCA: 133] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/18/2020] [Indexed: 05/19/2023]
Abstract
Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.
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Affiliation(s)
- Dennis Egger
- University of California, Berkeley, Berkeley, CA, USA
- The World Bank, Washington, D.C., USA
| | - Edward Miguel
- University of California, Berkeley, Berkeley, CA, USA
| | | | | | | | - Dean Karlan
- Innovations for Poverty Action, Washington, D.C., USA
- Northwestern University, Evanston, IL, USA
| | | | - A Mushfiq Mobarak
- Yale University and Y-RISE, New Haven, CT, USA.
- Deakin University, Melbourne, Australia
| | | | | | | | - Johannes Haushofer
- Stockholm University, Department of Economics; Research Institute of Industrial Economics, Stockholm, Sweden
- Max Planck Institute for Collective Goods, Bonn, Germany
- Jain Family Institute, New York, USA
| | - Magdalena Larreboure
- Princeton University, Princeton, NJ, USA
- Busara Center for Behavioral Economics, Nairobi, Kenya
| | | | | | | | | | - Layna Lowe
- University of California, Berkeley, Berkeley, CA, USA
| | | | | | - C Austin Davis
- Yale University and Y-RISE, New Haven, CT, USA
- American University, Washington, D.C., USA
| | - Utz Johann Pape
- The World Bank, Washington, D.C., USA
- University of Goettingen, Göttingen, Germany
| | | | - Maarten Voors
- Wageningen University & Research, Wageningen, Netherlands
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