Service recipient’s monitoring of the micronutrient powder (MNP)
consumption and perceived health status of young children in rural
Bangladesh
Abstract
Background: Monitoring of the health programs is a growing
challenge and plagued by lack of resources, personnel, especially in the
resources-poor settings. Client’s self-monitoring of the services
consumption is a new concept in program implementation needing validity.
Client’s self-perception of the health status of their children is a
potential idea which needs assessment of the validity. Methods:
A cross-sectional study was conducted in a rural district in Bangladesh.
Mothers monitored their children’s daily consumption of micronutrient
powder (MNP) by checking in a paper-form supplied to them. Project
personnel reported the consumption by enumerating the empty sachets of
MNPs. The project personnel asked mothers a simple question inquiring
about the health status of their children over the preceding one week.
Data was collected on actual sufferings of health issues and medical
treatment received. Validity of client’s monitoring of MNP consumption
was assessed by correlation, kappa estimates and the Bland-Altman plots.
Client’s health perception of their children was assessed for validity
by sensitivity, specificity, positive predictive value, and
correct-classification analyses. Results: Spearman rho
coefficient was 0.44 between the mother’s and project’s monitoring of
MNP consumption. Kappa statistics for agreement was 0.3. Bland-Altman
plots showed 4.2% of the observations falling outside of the limits of
agreement. Mother’s reporting of the children being “sick/unwell”
predicted the occurrence of any illnesses in the children with 98%
sensitivity and 86.9% specificity. Conclusion: Service
recipient’s monitoring of service consumption and their assessment of
the health well-being of their children by asking a simple question is
valid and potentially a cost-containing monitoring tool in resources
poor settings.