This study will focus on a new community health worker (CHW) program called 'Flourish', which is implemented by Philippine non-governmental organization (NGO) International Care Ministries (ICM). ICM's core program is 'Transform', which is a poverty alleviation program that focuses on households living in ultra-poverty (less than 0.50 United States dollars (USD) per person per day). Transform leverages local community networks to identify 30 participants from the most marginalized households in the community. ICM then provides these participants with 15 weeks of health and livelihood education, as well as with health interventions, including childhood malnutrition treatment.
In ICM's Flourish program, one of the 30 participants in each Transform program is nominated by their peers to become an ICM-supported CHW. The CHWs will not only provide health services after the conclusion of the Transform program for their fellow Transform participants' households, but they will also serve an additional 50+ households in their communities. These additional 'non-Transform' households will be identified by asking the Transform participants to nominate peers in their social networks that share similar socioeconomic backgrounds and whose households are perceived to also benefit from CHW services.
The primary aim of this research is to assess the impact of CHWs on the prevalence of acute childhood malnutrition in hard-to-reach households within low-income communities.
The investigators hypothesize that this study will show that CHWs are able to reduce the prevalence of acute childhood malnutrition in hard-to-reach households within low-income communities.
Transform program participant and member of the savings group formed at the end of Transform
Nominated by a savings group member to participate in the study
Nominated by the local public health unit (based on confirmed malnutrition status) to participate in the study
Except for members of the savings group, households cannot participate in the study if they have previously received ICM programs.
Parallel
Community Health Worker Intervention
BehavioralCommunities that are randomized into the Treatment arm will receive the Flourish program. Communities with a Flourish program will select and train a Community Health Worker from the Transform program participants. At the end of the Transform program, a Savings Group will be formed from the Transform program participants. The Savings Group will nominate households to participate in the Flourish program and research study. The Community Health Worker will approach the nominees and attempt to enroll them into the Flourish program and research study. If the nominees agree to be enrolled in the Flourish program, the Community Health worker will provide screening, referral, counseling, and treatment services to the household for the duration of the study.
Child Malnutrition
For children under 5 years old, child malnutrition is defined as weight-for-height Z-score less than -2 without edema. For children over 5 years old, child malnutrition is defined as BMI-for-age Z-score less than -2 without edema.
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International Care Ministries, Philippines
Lead sponsor
University of Toronto
Collaborator
University of Waterloo
Collaborator
