(P30-024-24) Design and Evaluation of a Timed and Targeted Counseling Program in Eastern and Western Samar, Philippines: Protocol for a Quasi-experimental Study

Objectives: Maternal mortality rate in the Philippines is still high. Timed and Targeted Care for Family (ttCf), a family-inclusive and gender-transformative behavioral communication, has been implemented in East Visayas by World Vision (2023-2027). The proposed study will evaluate the impact and process of the program to improve maternal and child health and nutrition outcomes focusing on the first 1000 days.

Methods: A quasi-experimental design was applied to evaluate the impact of the ttCf with 12 municipalities (6 intervention areas and 6 comparison areas) in East and West Samar. 12 household visits by community health workers from pregnancy to 2 years of child age in intervention areas, and the government routine health services will be available in the comparison areas. The sample size was calculated from an 8% difference between two areas in child’s minimum dietary diversity after 1 year of follow-up. In September 2023, a total of 1520 women aged 15-49 who were pregnant or mothers with children under 11.9 months, were enrolled in prospective cohort study. The process evaluation was designed using the five components of RE-AIM framework – reach, impact/outcomes, adoption, implementation and sustainability. Primary outcomes include infant and young child feeding and prevalence of child stunting (LAZ< -2). The secondary outcomes are the utilization of antenatal and postnatal health services and maternal nutritional status. Using Chi-square test and student t-test, the comparability of the two groups was checked for demographic and socio-economic characteristics.

Results: Out of 1520 mothers, the intervention group (n=757) had 532 mothers with children under 11.9 months and 228 pregnant women, while 518 mothers and 245 pregnant women for the comparison (n=763), respectively. The mean age (±SD) of the mothers and children were 27.8 years (±6.7) and 5.9 months (±3.6) for the intervention group and 28.1 years (±6.3) and 5.9 months (±3.4) for the comparison group. Socio-demographic, economic, and household food insecurity factors did not vary significantly across the two groups (p > 0.05).

Conclusions: The evaluation evidence of ttCf program will strengthen the community health system and improve maternal and health outcomes in the Philippines.

Funding Sources: World Vision Korea & Korea International Cooperation Agency