A qualitative assessment of routine Vitamin A supplementation integrated with complementary feeding and family planning counselling within a six-monthly contact point program
Bibliographic record
Abstract
Abstract ObjectivesTo assess the relevance, effectiveness, efficiency, impact, sustainability, learning and replicability of the transition from mass vitamin A supplementation to a routine six monthly contact point, integrated with complementary feeding and family planning counselling.Study designProgram performance was assessed taking into consideration the knowledge, attitudes and practices of both healthcare providers and caregivers to understand barriers and enablers to service uptake. A cross sectional qualitative survey with 63 key informant interviews with stakeholders and implementation staff and focus group discussions with 60 caregivers. Data was transcribed then coded through a framework analysis (developing themes from specific objectives) and thematic analysis (developing emerging themes not identified by the objectives). MethodsThe ‘routine six-monthly contact point’ included vitamin A, Albendazole, growth monitoring plus the promotion of optimal infant and young child feeding practices with complementary feeding demonstrations, the promotion of personal and food hygiene, access to confidential, family planning counselling and the provision of modern contraceptives for caregivers including hormonal implants. ResultsThe six-monthly contact point was found to be highly relevant, effective, efficient, with a positive impact on maternal and child health and sustainable. Lessons for replicability focus mainly on the extensive need for sensitisation of men/husbands and religious leaders regarding family planning. The challenges that prevent health seeking behaviour included distance to the facilities, poor roads, difficulty/cost of transportation and workload. The participatory complementary feeding demonstrations and community health workers encouraged attendance and appear to have contributed to the reduction of malnutrition but stockouts of essential commodities remain discouraging. ConclusionsThe program has been fully adopted by all levels of the health sector. The integration of family planning and its acceptance by caregivers is commendable and there has been an increase in the uptake of modern especially hormonal implants. This integrated approach was thought to have contributed to the reduction of childhood malnutrition. Recommendations include increasing awareness of affordable, accessible local foods for complementary feeding, more training for health workers on reporting and family planning counselling for the provision of long-term reversible contraceptives and further sensitisation of men and religious leaders on the importance of child spacing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".