Mother–child care
| Usual care |
Standard counselling session on childhood nutrition, development, and maternal mental health, using pictorial flipbook. Monitoring and screening of child growth and maternal mental health. Assessment and treatment (including referral to specialist) of childhood nutrition, development, or maternal depression. Follow-up of mother–child pairs in clinic at 3, 6 and 9 months (including SMS or telephone reminder, if required)
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Low dose vitamin A
| Yes | Yes |
Community advocates
| Yes | Yes |
Branding of clinic by Directorate General Health Services
| Yes | Yes |
Training of private doctors (GPs) and clinic assistants
| Control clinic staff will receive basic training only, focused on the correct use of study recording forms, with a general overview of the importance of childhood development and maternal health; that is, they will not receive any specific training on intervention activities. |
Clinic assistants will be trained by project field coordinator (under supervision of project manager and specialist doctor) using the study clinical assistant training protocol (CATP), which includes: how to conduct a standardised counselling session using the flipbook; how to administer the PHQ-2; and how to measure and record child length and weight.
Private GPs will be trained by an experienced specialist according to the study private doctor training protocol (PDTP), which includes: clinical management of children with malnutrition and developmental delay in the private clinic setting; how to use PHQ-9 for the diagnosis of maternal depression; and how to assess the mother–child pair for a specialist referral, when required, to the appropriate public tertiary care facility.
The training protocols, both CATP and PDTP, are developed by a group of local experts and specialists, adapted from international best-practice guidelines and standards.16,17
Training will last approximately 2 hours, and will include a mixture of explanation by the project field coordinator, and role-play exercises by participants.
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