Bangladesh-Australia child health project: a child-to-child and child-to-parent approach for nutrition and health education

Abstract

Objective: Evaluate the Child-to-Child and Child-to-Parent approach for message communication. This approach was used by the Bangladesh-Australia Child Health (BACH) Project to disseminate health and nutrition education, with special emphasis on growth monitoring, personal hygiene, oral rehydration therapy, and immunization through scouts and guides. Methodology: The approach was implemented in 25 Bangladeshi villages over a 6-year period (1986-1992). Two hundred and thirty-nine Australian Rovers and Rangers (Scouts and Guides aged 16-26 years) worked in 16 batches with 787 Bangladeshi counterparts. A joint evaluation team, comprising the Bangladeshi and Australian members, visited each BACH village in March-April 1994. The team also included one scientist from ICDDR.B. The team visited every household of the project area to assess the nutrition and health status of children and the impact of the project activities. The parents were interviewed, and each child aged less than five years was measured and weighed. Results': The growth of children as measured by height and weight showed that the vast majority of the values fell within the 2 SD (standard deviation) of the msan. In respect of measuring the nutritional status by mid-upper arm cicumference (MUAC), 8% of the male children and 13% of the female children were found to be malnourished. The infant mortality rate was found below 30/thousand livebirths. The result also showed a significant coverage in immunization (95%), the use of sanitary latrines, and other aspects of sanitation. Low-cost measures were taken for the implementation of the programme. The Australian rovers and rangers came on their own expenses. On an average, US$ 3.000 were spent for an average of 400 families in each village. The immediate cost appeared one dollar per person. Conclusion: The Child-to-Child and Child-to-Parem approach tor health and nutrition education was found to be attractive :nd effective. The progftjmme was found to be sustainable, cost-effective, and replicable without using any extra manpower. Behavioural changes in respect of nutrition and health are possible through scouts and guides.