Table 3.
Child development, maternal mental health, nutrition, water, sanitation and hygiene and lead outcomes at endline
| Indicators | Unadjusted mean±SD or N (%) by arm | Adjusted mean difference or risk difference versus control arm (95% CI) | |||
| Control | Group | Combined | Group | Combined | |
| FCI | |||||
| Activities | 3.2±1.5 | 4.2±1.5 | 4.8±1.3 | 1.05 (0.72 to 1.34) | 1.56 (1.33 to 1.78) |
| Materials | 2.5±1.4 | 3.64±1.7 | 3.9±1.6 | 1.18 (0.88 to 1.51) | 1.36 (1.18 to 1.51) |
| Observation | 8.3±1.5 | 8.8±1.2 | 8.9±1.5 | 0.56 (0.26 to 0.89) | 0.67 (0.35 to 0.99) |
| ASQi | |||||
| Communication | 56.0±16.4 | 58.4±15.3 | 58.6±16.3 | 0.32 (0.10 to 0.57) | 0.21 (−0.04 to 0.49) |
| Fine motor | 50.2±11.3 | 51.8±10.1 | 51.6±11.6 | 0.36 (0.11 to 0.63) | 0.23 (−0.04 to 0.49) |
| Gross motor | 58.6±15.1 | 60.8±14.1 | 59.3±16.1 | 0.27 (0.13 to 0.44) | 0.04 (−0.18 to 0.22) |
| Problem-solving | 55.6±15.8 | 56.9±14.6 | 58.2±15.6 | 0.18 (−0.04 to 0.43) | 0.19 (−0.14 to 0.49) |
| Personal social | 55.3±16.3 | 57.7±15.5 | 58.0±16.4 | 0.34 (0.10 to 0.63) | 0.30 (−0.04 to 0.64) |
| Total | 275.7±71.2 | 284.6±65.2 | 285.0±72.6 | 0.39 (0.16 to 0.64) | 0.25 (−0.07 to 0.54) |
| CDI | |||||
| Receptive | 44.8±23.7 | 49.0±22.4 | 49.0±23.3 | 0.25 (−0.04 to 0.55) | 0.19 (−0.15 to 0.52) |
| Expressive | 16.8±17.2 | 18.9±17.9 | 19.2±18.3 | 0.29 (0.06 to 0.50) | 0.17 (−0.17 to 0.53) |
| Depressive symptoms | |||||
| CES-D score | 15.0±9.0 | 13.2±7.0 | 14.1±9.1 | −2.06 (−3.23 to −0.66) | −1.34 (−3.12 to 0.41) |
| Minimum dietary diversity | |||||
| Child* | 146 (54%) | 85 (61%) | 98 (68%) | 0.07 (−0.03 to 0.17) | 0.14 (0.04 to 0.22) |
| Maternal† | 177 (63%) | 89 (63%) | 113 (76%) | 0.03 (−0.07 to 0.12) | 0.14 (0.05 to 0.19) |
| WASH | |||||
| Hygienic latrine‡ | 96 (34%) | 49 (35%) | 51 (35%) | −0.03 (−0.19 to 0.11) | 0.02 (−0.12 to 0.15) |
| Handwashing station with soap and water | 59 (21%) | 44 (31%) | 36 (24%) | 0.12 (0.01 to 0.24) | 0.04 (−0.08 to 0.19) |
| Use of potty§ | 55 (20%) | 42 (30%) | 44 (30%) | 0.13 (−0.02 to 0.28) | 0.10 (0.00 to 0.21) |
| Lead | |||||
| Knowledge of lead | 68 (24%) | 103 (73%) | 110 (74%) | 0.51 (0.40 to 0.60) | 0.52 (0.39 to 0.63) |
Activities: number of play activities that the mother participated in with the child in the last three days (out of six). Materials: number of varieties of play materials observed available in the home (out of six). Observation: 11 observation items about caregiver-child interactions during the interview, and observations of the home environment (S5 for details)
For ASQi and CDI results: unadjusted mean values are raw values before standardisation, all adjusted mean differences use scores which are internally age-standardised to the control arm, and point estimates represent SDs from the control arm mean.
Adjusted analyses include the following potential covariates: interviewer (for FCI, ASQi and CDI outcomes), maternal and paternal education, child age, child sex, household income above the median, household wall material, presence of electricity in the home, the presence of household assets (wardrobe, table, chair, watch/clock, television, bicycle, sewing machine) and the measure assessed at baseline (if assessed in the whole population). Covariates with p<0.20 from a likelihood ratio test for each outcome are included in adjusted analyses.
n for ASQi and CDI outcomes (excluding outliers ± 4 SD from the control arm mean): communication n=566; fine motor n=559, gross motor n=563; problem-solving n=563; personal social n=550; total n=532; receptive n=573; expressive n=498 (only children over 9 months of age included).
*Children>6 months (n=555) reported eating 5 or more food groups in the last 24 hours, out of the following groups: breast milk, grains, legumes, dairy products, flesh foods, eggs, vitamin A rich fruits and vegetables, other fruits and vegetables (n=553).
†Mother reported eating 5 or more food groups in the last 24 hours, out of the following 10 groups: grains, legumes, nuts and seeds, dairy products, flesh foods, eggs, vitamin A rich fruits and vegetables, other vitamin A rich fruits and vegetables, other vegetables, other fruits.
‡Hygienic latrine (according to Government of Bangladesh National Sanitation Strategy 2005): Flush or pour-flush toilet/latrine to (1) piped sewer system, (2) septic tank; pit latrine with slab and water seal; pit latrine with slab and lid, no water seal; pit latrine with slab and flap, no water seal; ventilated improved pit latrine; composting latrine.
§Use of potty for >50% of defecation events for the index child in the last 7 days.
ASQi, Ages and Stages Questionnaire Inventory; CDI, Communicative Development Inventories; CES-D, Center for Epidemiologic Studies 20 question Depression scale; WASH, Water, Sanitation and Hygiene.