Long-term impact of Maternal and Child Health handbook in rural Bangladesh: A post-trial follow-up study.

BACKGROUND

This was a five-year follow-up study of a cluster randomized controlled trial (RCT) that evaluated the effectiveness of the Maternal and Child Health (MCH) handbook in rural Bangladesh, with a specific focus on maternal parental stress and children's anthropometric measurements.

METHODS

We conducted a follow-up survey from September to November 2023 on the mother-child dyads who participated in the cluster RCT during 2017-2018 in Lohagora Upazila, Narail District, located in the southwestern region of Bangladesh. Of the 620 mother-child dyads recruited, 617 dyads from nine unions were analyzed in this study using structured questionnaires. We used the Parental Stress Scale (PSS) to measure the mothers' parental stress. The mothers' health-seeking behaviors and children's anthropometric measurements were also examined. Multiple regression analysis was performed to examine the effectiveness of the MCH handbook.

RESULTS

Based on the PSS, stress levels among the mothers in the MCH handbook intervention group were lower in the univariate (p = 0.053) and multiple linear regression analysis, after adjusting for confounding variables (p = 0.057). However, there were no significant differences between the groups in both primary outcome (PSS) and secondary outcomes (growth monitoring experience, number of sources of parenting information used by the mothers, and children's growth status).

CONCLUSION

Although this study showed that the distribution of the MCH handbook generally reduced maternal parental stress, there were no significant differences between the groups. Further research is necessary to evaluate the effectiveness of the MCH handbook on parental stress as a distal outcome.