METHODOLOGYThis chapter givedetails of themethodology used for the study. The present study was design with the broad aim of to engage communityand grassroot level functionaries to deliver key nutrition and dietaryinterventions to improve knowledge, practices for optimizing weight throughimproved home diet, iron rich foods, and improve utilisation of availablepublic health services unmarried adolescent girls aged (15-19 years). SPECIFICOBJECTIVES To assess the nutritionalstatus of the target population by anthropometric measurements to identifymalnutrition (BMI <18.5kg/m2)& MUAC (<21.1cm) overweight(>23kg/m2)and obesity ( > 30kg/m2), and waistcircumference(>80cm) To assess theregularity of supply and utilization of commodities and fortified wheat flour (ifavailable) under PDS system by the target population To assess the dietarypractices to compute consumption of food groups/CU/day and food frequency ofiron rich foods of the target population Profile of ASHAs andrepresentative members of MAS in selected zone and areas To identify the trainingneeds of ASHAs and representative members of MAS using knowledge and practiceassessment tool to optimize weightand to improve iron deficiency anemia in the target population and developing amonitoring and counselling module To build the capacity ofASHAs and selected MAS representatives to optimizeweight and to improve iron deficiency anemia of target population usingtraining module and study the impact of training by comparing the data onknowledge, practice and delivery of services to the target population. To facilitate and supportMAS representatives to build capacities of MAS members to optimize weight,improve iron deficiency anemia and to improve utilization of relevant servicesby using training module as a counselling tool and develop action plan forreaching the target population. To conduct random checkson the delivery of nutritional health interventions by the trained MAS membersand to review the monthly meetings organised by the ASHA & MASrepresentatives.
To evaluate the communityengagement strategy by documenting the participation of MAS members indelivering the key interventions to the community. To evaluate the impact ofcommunity engagement strategy on knowledge, dietary practices and utilizationof available health services practices of target population. The study wasapproved under the Department Of Medical Ethics Committee (No.
IECHR/2017/18).The Maharaja Sayaji Rao University of Baroda, Vadodara. Writtenconsent of all the subjects were taken in order to enrol them for the researchstudy.Under Vadodara Mahanagar Seva Sadan (VMSS)there are 4 zones i.e. east, west, north, south.
From that 1 zone will bePurposively selected that will be east Zone, under that 1 UHC Sawad waspurposively selected STUDYSITE STUDYDESIGNThestudy was divided into 3 phases. Detailsof experimental design for the research is presented inPhase- I Situational analysis UHC profile (n=1) Anganwadi profile (n=7) Public distributionsystem (n=6) Background information(n= 250) Weight, Height, MUAC, andWC (n=250) Haemoglobin estimation(n=250) Knowledge and practices(n=250) 24 hr dietary recall (perCU/day) (n=250) Semi- quantitative foodfrequency (n=250)Phase- II Identificationof the training needs of ASHAs and selected members of MAS and development oftraining module Profile of ASHA (n=6) Profile of MASrepresentatives (n=18) Knowledge and practice ofASHA (n=6) Knowledge and practice ofMAS representatives (n=18) Development of thetraining cum monitoring module for ASHAs and MAS representatives (n=24) Training cum counsellingmodule for ASHA and MAS (n=55)Phase-IIISupportive Supervision Research student willmonitor ASHA (n=2) ASHA in turn will monitorthe MAS representatives (n=18) MAS representatives willfurther monitor the MAS members (n=) Number of MAS activelyengaged in delivering key dietary and health intervention of the targetpopulation (n=) To evaluate the impact ofcommunity engagement strategy on knowledge, dietary and utilization of healthservices practices of target population (n=250) 1 UHC will be purposively selected 10-12 AWCs from that 7 AWCs would be randomly selected to get a sample of 250 unmarried adolescent girls PHASE-II(A) Identification of The Training Needs PHASE-II (B) ToBuild the Capacities of ASHAs and Selected Members of MAS East zone Total 7AWC = 6 ASHAs Master trainers =24 (7 ASHA and 18 MAS representatives) 7ASHAs = 18 MAS representatives 10 MAS committee = 100 MAS members (10×10) 100 MAS members