title: The effect of participatory women's groups on infant feeding and child health knowledge, behaviour and outcomes in rural Bangladesh: a controlled before-and-after study.
abstract: BACKGROUND
  Despite efforts to reduce under-5 mortality rates worldwide, an estimated 6.6 million under-5 children die every year. Community mobilisation through participatory women's groups has been shown to improve maternal and newborn health in rural settings, but little is known about the potential of this approach to improve care and health in children after the newborn period.
  
  
  METHODS
  Following on from a cluster-randomised controlled trial to assess the effect of participatory women's groups on maternal and neonatal health outcomes in rural Bangladesh, 162 women's groups continued to meet between April 2010 and December 2011 to identify, prioritise and address issues that affect the health of children under 5 years. A controlled before-and-after study design and difference-in-difference analysis was used to assess morbidity outcomes and changes in knowledge and practices related to child feeding, hygiene and care-seeking behaviour.
  
  
  RESULTS
  Significant improvements were measured in mothers' knowledge of disease prevention and management, danger signs and hand washing at critical times. Significant increases were seen in exclusive breast feeding for at least 6 months (15.3% (4.2% to 26.5%)), and mean duration of breast feeding (37.9 days (17.4 to 58.3)). Maternal reports of under-5 morbidities fell in intervention compared with control areas, including reports of fever (-10.5% (-15.1% to -6.0%)) and acute respiratory infections (-12.2% (-15.6% to -8.8%)). No differences were observed in dietary diversity scores or immunisation uptake.
  
  
  CONCLUSIONS
  Community mobilisation through participatory women's groups can be successfully adapted to address health knowledge and practice in relation to child's health, leading to improvements in a number of child health indicators and behaviours.
authors.affiliation: UCL Institute for Global Health, University College London, London, UK.
authors.forename: Leila
authors.initials: L
authors.lastname: Younes
authors.affiliation: UCL Institute for Global Health, University College London, London, UK Department of Public Health, ErasmusMC University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Tanja A J
authors.initials: TA
authors.lastname: Houweling
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Kishwar
authors.initials: K
authors.lastname: Azad
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Abdul
authors.initials: A
authors.lastname: Kuddus
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Sanjit
authors.initials: S
authors.lastname: Shaha
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Bedowra
authors.initials: B
authors.lastname: Haq
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Tasmin
authors.initials: T
authors.lastname: Nahar
authors.affiliation: Perinatal Care Project (PCP), Diabetic Association of Bangladesh (BADAS), Dhaka, Bangladesh.
authors.forename: Munir
authors.initials: M
authors.lastname: Hossen
authors.affiliation: UCL Institute for Global Health, University College London, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Beard
authors.affiliation: Department of Infection and Population Health, University College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Copas
authors.affiliation: UCL Institute for Global Health, University College London, London, UK.
authors.forename: Audrey
authors.initials: A
authors.lastname: Prost
authors.affiliation: UCL Institute for Global Health, University College London, London, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Costello
authors.affiliation: UCL Institute for Global Health, University College London, London, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Fottrell
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D001942:Breast Feeding / Q000639:trends*; D000067576:Child Health; D053198:Child Nutrition Sciences / Q000193:education*; D002675:Child, Preschool; D003256:Community Participation; D065187:Controlled Before-After Studies / Q000379:methods / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D000068104:Infant Health; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000193:education*; D015397:Program Evaluation; D012044:Regression Analysis; D014930:Women / Q000193:education*; D055815:Young Adult
keywords: Bangladesh; Community Mobilisation; Participatory Women's Groups; Rural Areas