期刊
BMJ OPEN
卷 12, 期 4, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-047741
关键词
public health; community child health; nutrition & dietetics; international health services
资金
- MRC Global Challenges Research Fund [MR/P024114/1]
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust
- NIHR Biomedical Research Centre based at UCL Great Ormond Street Institute of Child Health/Great Ormond Street Hospital NHS Foundation Trust
- BBOXX/Royal Academy of Engineering Senior Research Fellowship
- MRC [MR/P024114/1] Funding Source: UKRI
India has been struggling with infant malnutrition for a long time. This study explores the potential of schools as sites for community engagement and positive change in rural India. Schools are considered important community resources, but there are challenges such as low parental participation and student absenteeism. However, schools have the potential to be intervention delivery sites and mobilize the community. This research suggests that schools, with teachers and children as change agents, could be suitable settings for future intervention studies.
Objective India has been struggling with infant malnutrition for decades. There is a need to identify suitable platforms for community engagement to promote locally feasible, resource efficient Infant and Young Child Feeding (IYCF) interventions. This study aims to explore if and how schools could represent a site for community engagement in rural India, acting as innovation hubs to foster positive change in partnership with the Angawadi centres. Design Five-phase formative study; A parallel mixed methods approach structured by a socioecological framework was used for data collection at individual, household and community levels. This paper focuses on the qualitative findings. Setting This study was undertaken in nine villages within two blocks, 'Ghatol' and 'Kushalgarh', in the Banswara district of Rajasthan, India. Participants 17 schools were identified. Interviews were conducted with local opinion leaders and representatives in the education sector, including principals, schoolteachers, block and district education officers. Across the nine study villages, information was gathered from 67 mothers, 58 paternal grandmothers using Focus Discussion Groups (FDGs) and 49 key respondents in Key Informant Interviews. Results Schools were considered an important community resource. Challenges included limited parental participation and student absenteeism; however, several drivers and opportunities were identified, which may render schools a suitable intervention delivery site. Enrolment rates were high, with schools and associated staff encouraging parental involvement and student attendance. Existing initiatives, including the mid-day meal, play opportunities and education on health and hygiene, further highlight the potential reliability of schools as a platform for community mobilisation. Conclusions Schools have been shown to be functional platforms frequently visited and trusted by community members. With teachers and children as change agents, schools could represent a suitable setting for community mobilisation in future wider scale intervention studies. Expanding the supportive environment around schools will be essential to reinforce healthy IYCF practices in the long term.
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