Enhancing Growth Monitoring Visits in Joshipur Rural Municipality, Kailai, Nepal

Enhancing Growth Monitoring Visits Through Health Workers Training on Growth Monitoring and Promotion, GMP Guideline a Community Health Volunteer Mobilization for Increasing Demand of GMP Through GMP Day in Joshipur Rural Municipality, Kailai, Nepal

The goal of this clinical trial is to learn if health workers training on growth promotion and monitoring guideline and Female Community Health Volunteers mobilization for increasing demand for growth monitoring and promotion, GMP through growth monitoring and promotion day, GMP day) can enhance the growth monitoring and promotion practices in mothers and caretaker having under two years children. The main questions it aims to answer are:

• Does health workers training on GMP guideline enhances the growth monitoring and promotion practices in mothers and caretakers having under two years children?
• Does FCHV mobilization enhances growth monitoring and promotion practices in mothers and caretakers having under two years children? Participants will
• Health workers of the Joshipur rural municipality will have to attend Training session on GMP guideline,
• Mothers and caretakers having under two years children will have to visit to the nearest health facility for GMP visits for their children

Study Overview

• Status: Not yet recruiting
• Conditions: Malnourished Children
• Intervention / Treatment: Other: Health workers training on GMP guideline; Other: Female community health volunteers' mobilization for inviting mothers and caretakers

Detailed Description

For addressing the problem of malnutrition in the municipality, determinants of the problem have been identified through CFIR framework. Based on the identified facilitator and barriers, two strategies have been developed for solving the problem of the municipality- (a) health workers training on latest GMP guideline to update the knowledge and skills of the service providers (b) For increasing demand generation, inviting mothers and caretakers having under two years children

1. Health workers Training on GMP guideline: Mr. Ashish Timalsina will be responsible for one day training on GMP guideline to the health workers of all six health facilities who are primarily engaged in nutrition in Joshipur rural municipality.
2. FCHV mobilization for increasing demand of growth monitoring and promotion through GMP day: Particular days of the month will be specified as GMP day in the municipality. Mothers and caretakers having under two years children. Health coordinator of the Joshipur rural municipality will be responsible for monitoring and supervision of this strategy.

Objectives General Objective

● To assess the implementation outcomes of Health workers Training on GMP guidelines and FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day.

Specific Objectives

• To assess acceptability, appropriateness, feasibility, fidelity of (a) Health workers Training on GMP guideline; and acceptability, appropriateness, feasibility of (b)FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day by using PROCTOR's framework.

• To assess the effectiveness of interventions- Health workers Training on GMP guideline and FCHV mobilization for increasing demand of Growth monitoring and Promotion through GMP day by average number of GMP visits.

  6. Methodology

Study site and its justification:

The study site will be Joshipur rural municipality, Kailali. There are seven wards in Joshipur Rural Municipality, in which a total of six health facilities are providing services in the Municipality. Average growth monitoring visit of the municipality was only 8 visits per child out of 24 visits per child (who have completed two years) in the fiscal year 2079/80 BS (2022 AD). The practice of growth monitoring was only 43% in the fiscal year 2079/80 BS (2022 AD). (HMIS)

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Amrita Ghimire, MPH; Phone Number: +977-9851188538; Email: ghimireamrita@gmail.com
• Study Contact Backup: Name: Asish Timalsina, MPH; Phone Number: +977-9843523211; Email: ashish.timalsina@gmail.com

Study Locations

• Nepal
  • Far western
    • Joshipur, Far western, Nepal, 10909
      • Joshipur rural Municipality
      • Contact: Nirpa R Dangaura, MPH; Phone Number: +977-9843282694; Email: nirpa.chy@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

For Health Workers:

1. Nutrition focal person of the health facility having primary engagement in growth monitoring and promotion.
2. Trained on growth monitoring and promotion guideline.

For Female Community Health Volunteers 1. Active for inviting mothers and caretakers of the municipality

For Mothers and caretakers having under two years children

1. Any mothers and caretakers having under two years children residing in Joshipur Rural Municipality during intervention.

Exclusion Criteria:

Who not available during the time of data collection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Health workers of Joshipur rural municipality and Female community health volunteers; Health workers will receive Training on GMP guideline, while FCHV will be mobilized for inviting mothers and caretakers having under two years children.

Other: Health workers training on GMP guideline; One day training will be conducted to health workers on updated GMP guideline for the health workers primarily engaged in Growth monitoring and promotion of the children.; Other: Female community health volunteers' mobilization for inviting mothers and caretakers; Female community health volunteers will be mobilized for inviting mothers and caretakers for two consecutive months for enhancing GMP practices in the municipality

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of Health Workers Training using key informant interview	Acceptability includes the attitude and perception of health workers regarding Health workers training and satisfaction level of health workers attending Health workers training on GMP guidelines. For which, a qualitative method (KII) with health workers using KII guideline will be employed for information collection among the health workers attending the health worker's Training	At three months
Appropriateness of Health workers Training using Key informant interview	Appropriateness is defined as Health workers training suitable for the cultural, social and economic context of Joshipur rural municipality and alignment of Health workers training to the needs and preferences of the health workers. For which, Key Informant Interview using KII guideline will be employed for information collection	At three months
Feasibility of Health workers Training	Feasibility includes practicality and ease of attending health workers training and availability of resources. For which information will be collected from health workers through Key Informant Interview using KII guideline.	At three months
Fidelity to GMP steps assed through observing HMIS register	Fidelity to GMP steps refers to evaluating the extent to which health workers adhere to the steps of GMP. It will be assessed by observing at the nutrition register by health workers as recoded of the steps conducted for growth monitoring and Promotion.	At three months
Acceptability of GMP day	Acceptability includes the attitude and perception of mothers and caretakers regarding Growth monitoring and Promotion Day . For which, qualitative method (Focus group discussion, FGD using FGD guideline, In-depth Interview, IDI using IDI guideline) will be employed for information collection.	At three months
Appropriateness of GMP day	Appropriateness includes the alignment of the Growth monitoring and Promotion Day with the needs and preferences of the target population. For which Qualitative method will be employed for information collection.	At three months
Feasibility of GMP day to health workers using key informant interview	Feasibility includes practicality and ease of implementing GMP day from health workers in the health facility which will be assessed using Key informant interview with health workers using KII guideline.	At three months

Collaborators and Investigators

• Sponsor: Kathmandu University School of Medical Sciences
• Investigators: Principal Investigator: Amrita Ghimire, MPH, Kathmandu University School of Medical Sciences

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2024
• Primary Completion (Estimated): August 1, 2025
• Study Completion (Estimated): August 1, 2025

Study Registration Dates

• First Submitted: December 10, 2024
• First Submitted That Met QC Criteria: December 16, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 16, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: Nepal; Malnutrition; Growth monitoring and Promotion
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition
• Other Study ID Numbers: GMP2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No