Locally-led, integrated programmes can notably improve health, well-being

Locally-led and integrated nutrition and hygiene programmes can significantly improve the health and well-being of pregnant women, adolescent girls and young children living in the country's slums, found a new study.

As part of its AdSEARCH dissemination series, icddr,b held a scientific seminar at the Sasakawa Auditorium in the capital's Mohakhali area on Monday, where it shared results of the Nutri-CAP study.

With 62 million people now living in urban areas, and projections indicating this number could double by 2035, pressure is mounting on already strained urban health systems.

Bauniabadh reflects many of the challenges faced by Bangladesh's urban poor. Among more than 15,000 married women living in the area, 721 were pregnant during the study period.

Alongside them, the programme engaged over 4,200 adolescent girls and nearly 2,500 children under the age of two. The study reached 16,532 households in total, with a focused analysis conducted on 2,826 households between November 2021 and February 2022.

The median household income was Tk 21,000, but nearly one in four families reported distress financing for food, and among food-insecure households, over 91 per cent had taken loans.

While 47 per cent of the households were categorised as upper-income within the slum context, 13.5 per cent belonged to the lower-income group.

Overcrowding was common, with 39 per cent of households having more than three people per sleeping room. Women contributed to household incomes in 42 per cent of the families, and just over a third of household heads had completed primary education.

Women in the intervention group gained an average of 8.9 kg during pregnancy, compared to 7.5 in the comparison group, and were significantly more likely to reach optimal weight gain.

Adolescent girls in the intervention group saw a substantial increase in haemoglobin levels, rising from 12.0 to 12.8 g/dL, compared to a smaller gain in the comparison group.

For young children, the study recorded significant improvements in growth.

The programme also brought economic benefits. Out-of-pocket health expenditure was consistently lower among intervention households, especially for pregnant women and children.

Speaking at the seminar, Dr Mustafa Mahfuz, principal investigator of the study, explained that the programme's success stemmed from its locally-rooted approach.

Dr Tahmeed Ahmed, Executive Director at icddr,b, said, "With its adaptable and locally-driven design, the Nutri-CAP model is not only effective but ready to scale in other informal settlements in Bangladesh and similar settings elsewhere."

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