From didactic to personalized health and nutrition counselling: A mixed‐methods review of the GALIDRAA approach in Nepal

Cunningham, Kenda; Suresh, Shalini; Kjeldsberg, Cecilie; Sapkota, Femila; Shakya, Nabin Bhakta; Manandhar, Shraddha

doi:10.1111/mcn.12681

Cited by 12 publications

(14 citation statements)

References 15 publications

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“…This training and evaluation contributes towards the translation of evidence-based behavior change science into health care practices [28] and will help to inform future delivery of communication and behavior change training in Ethiopia and in similar contexts. In contrast to similar projects elsewhere [29,30], this project was able to demonstrate HEWs' effective use of behavior change techniques in a challenging context. It is important for this type of training which involves new concepts and skills, to be ongoing and sustainable, to allow HEWs to develop confidence, have the opportunity to practice, and normalize new behaviors.…”

Section: Discussionmentioning

confidence: 80%

Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

et al. 2021

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Maternal and infant nutrition are problematic in areas of Ethiopia. Health extension workers (HEWs) work in Ethiopia’s primary health care system, increasing potential health service coverage, particularly for women and children, providing an opportunity for health improvement. Their roles include improving maternal and infant nutrition, disease prevention, and health education. Supporting HEWs’ practice with ‘non-clinical’ skills in behavior change and health communication can improve effectiveness. This intervention study adapted and delivered a UK-developed training intervention for Health Extension Workers (HEWs) working with the United Nations World Food Programme in Ethiopia. The intervention included communication and behavioral training adapted with local contextual information. Mixed methods evaluation focused on participants’ reaction to training, knowledge, behavior change, and skills use. Overall, 98 HEWs were trained. The intervention was positively received by HEWs. Pre-post evaluations of communication and behavior change skills found a positive impact on HEW skills, knowledge, and motivation to use skills (all p < 0.001) to change women’s nutritional behavior, also demonstrated in role-play scenarios. The study offered substantial learning about intervention delivery. Appropriate cultural adaptation and careful consideration of assessment of psychological constructs are crucial for future delivery.

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Section: Discussionmentioning

confidence: 80%

Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

et al. 2021

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“…In addition, in some countries and settings community health workers are overstretched and lack the skills, training and support needed to deliver behaviour change programmes effectively. [54][55][56] Following norms in resource requirement estimation, 12 we estimate the cost of reaching all target households. Therefore, uptake and adherence are not accounted for, as would be necessary in a cost-benefit or costeffectiveness analysis.…”

Section: Discussionmentioning

confidence: 99%

Costs of hand hygiene for all in household settings: estimating the price tag for the 46 least developed countries

et al. 2021

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IntroductionDomestic hand hygiene could prevent over 500 000 attributable deaths per year, but 6 in 10 people in least developed countries (LDCs) do not have a handwashing facility (HWF) with soap and water available at home. We estimated the economic costs of universal access to basic hand hygiene services in household settings in 46 LDCs.MethodsOur model combines quantities of households with no HWF and prices of promotion campaigns, HWFs, soap and water. For quantities, we used estimates from the WHO/UNICEF Joint Monitoring Programme. For prices, we collated data from recent impact evaluations and electronic searches. Accounting for inflation and purchasing power, we calculated costs over 2021–2030, and estimated total cost probabilistically using Monte Carlo simulation.ResultsAn estimated US$12.2–US$15.3 billion over 10 years is needed for universal hand hygiene in household settings in 46 LDCs. The average annual cost of hand hygiene promotion is US$334 million (24% of annual total), with a further US$233 million for ‘top-up’ promotion (17%). Together, these promotion costs represent US$0.47 annually per head of LDC population. The annual cost of HWFs, a purpose-built drum with tap and stand, is US$174 million (13%). The annual cost of soap is US$497 million (36%) and water US$127 million (9%).ConclusionThe annual cost of behavioural change promotion to those with no HWF represents 4.7% of median government health expenditure in LDCs, and 1% of their annual aid receipts. These costs could be covered by mobilising resources from across government and partners, and could be reduced by harnessing economies of scale and integrating hand hygiene with other behavioural change campaigns where appropriate. Innovation is required to make soap more affordable and available for the poorest households.

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Section: Discussionmentioning

confidence: 99%

Costs of hand hygiene for all in household settings - estimating the price tag for the 46 least developed countries

Ross

Mills²,

Slaymaker

et al. 2021

Preprint

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Introduction: Domestic hand hygiene could prevent over 500,000 attributable deaths per year, but 6 in 10 people in least developed countries (LDCs) do not have a handwashing facility with soap and water available at home. We estimated the economic costs of universal access to basic hand hygiene services in household settings in 46 LDCs. Methods: Our model combines quantities of households with no handwashing facility (HWF) and prices of promotion campaigns, HWFs, soap, and water. For quantities, we used estimates from the WHO/UNICEF Joint Monitoring Programme. For prices, we collated data from recent impact evaluations and electronic searches. Accounting for inflation and purchasing power, we calculated costs over 2021-2030, and estimated total cost probabilistically using Monte Carlo simulation. Results: An estimated US$ 12.2 - 15.3 billion over 10 years is needed for universal hand hygiene in household settings in 46 LDCs. The average annual cost of hand hygiene promotion is $334 million (24% of annual total), with a further $233 million for "top-up" promotion (17%). Together, these promotion costs represent $0.47 annually per head of LDC population. The annual cost of HWFs, a purpose-built drum with tap and stand, is $174 million (13%). The annual cost of soap is $497 million (36%), and water $127 million (9%). Conclusion: The annual cost of behaviour change promotion to those with no handwashing facility represents 4.7% of median government health expenditure in LDCs, and 1% of their annual aid receipts. These costs could be covered by mobilising resources from across government and partners, and could be reduced by harnessing economies of scale and integrating hand hygiene with other behaviour change campaigns where appropriate. Innovation is required to make soap more affordable and available for the poorest households.

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From didactic to personalized health and nutrition counselling: A mixed‐methods review of the GALIDRAA approach in Nepal

Cited by 12 publications

References 15 publications

Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

Costs of hand hygiene for all in household settings: estimating the price tag for the 46 least developed countries

Costs of hand hygiene for all in household settings - estimating the price tag for the 46 least developed countries

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