Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study
Objectives In the context of persistent child malnutrition in the Philippines, the objective of this study was to examine how different dimensions of trust affected programme retention and physiological outcomes when a faith-based organisation (FBO) addressed moderate and severe acute malnutrition a...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e036091.full |
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| author | Lincoln Leehang Lau Warren Dodd Han Lily Qu Donald C Cole |
| author_facet | Lincoln Leehang Lau Warren Dodd Han Lily Qu Donald C Cole |
| author_sort | Lincoln Leehang Lau |
| collection | DOAJ |
| description | Objectives In the context of persistent child malnutrition in the Philippines, the objective of this study was to examine how different dimensions of trust affected programme retention and physiological outcomes when a faith-based organisation (FBO) addressed moderate and severe acute malnutrition among children from households experiencing extreme poverty.Setting We retrospectively analysed survey data collected by International Care Ministries (ICM) in 2012–2013 across 150 communities in eight provinces (Negros Oriental, Negros Occidental, Bohol, Palawan, Sarangani, South Cotabato, Sultan Kudarat and Zamboanga del Norte) of the Philippines.Study participants Caregivers of 1192 children experiencing moderate acute malnutrition and severe acute malnutrition between the ages of 6 and 60 months.Intervention A 16-week child malnutrition treatment programme called Malnourished Child Outreach offered by ICM in partnership with local religious leaders and institutions.Primary and secondary outcome measures Programme dropout and weight-for-height z-score (WHZ) at the end of the programme for enrolled children were the two outcomes of interest. A logistic mixed-effects model was built to assess factors associated with programme dropout and a linear mixed-effects model for factors associated with WHZ at the end of the programme.Results Trust in religious leaders or institutions (−0.87 (95% CI: −1.43,–0.26)) was negatively associated with programme dropout, suggesting that with increasing levels of trust, decreasing proportions of children dropped out of treatment. Retention in the programme led to improved WHZ among participating children (−0.38 (95% CI: −1.43, 0.26)). Various measures of social capital, including trust in religious and public institutions, were not associated with WHZ at the end of the programme.Conclusions Leveraging pre-existing trust in religious leaders and institutions among households experiencing extreme poverty is one way that ICM, and potentially other FBOs, can promote retention in child nutrition interventions among vulnerable populations. |
| format | Article |
| id | doaj-art-4969b3d0f9634ef2b5486b21885761c6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-4969b3d0f9634ef2b5486b21885761c62025-01-08T23:15:13ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-036091Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort studyLincoln Leehang Lau0Warren Dodd1Han Lily Qu2Donald C Cole3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada3 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, CanadaInternational Care Ministries, Manila, NCR, Philippines5 Dalla Lana School of Public Health, University of Toronto, Toronto, CanadaObjectives In the context of persistent child malnutrition in the Philippines, the objective of this study was to examine how different dimensions of trust affected programme retention and physiological outcomes when a faith-based organisation (FBO) addressed moderate and severe acute malnutrition among children from households experiencing extreme poverty.Setting We retrospectively analysed survey data collected by International Care Ministries (ICM) in 2012–2013 across 150 communities in eight provinces (Negros Oriental, Negros Occidental, Bohol, Palawan, Sarangani, South Cotabato, Sultan Kudarat and Zamboanga del Norte) of the Philippines.Study participants Caregivers of 1192 children experiencing moderate acute malnutrition and severe acute malnutrition between the ages of 6 and 60 months.Intervention A 16-week child malnutrition treatment programme called Malnourished Child Outreach offered by ICM in partnership with local religious leaders and institutions.Primary and secondary outcome measures Programme dropout and weight-for-height z-score (WHZ) at the end of the programme for enrolled children were the two outcomes of interest. A logistic mixed-effects model was built to assess factors associated with programme dropout and a linear mixed-effects model for factors associated with WHZ at the end of the programme.Results Trust in religious leaders or institutions (−0.87 (95% CI: −1.43,–0.26)) was negatively associated with programme dropout, suggesting that with increasing levels of trust, decreasing proportions of children dropped out of treatment. Retention in the programme led to improved WHZ among participating children (−0.38 (95% CI: −1.43, 0.26)). Various measures of social capital, including trust in religious and public institutions, were not associated with WHZ at the end of the programme.Conclusions Leveraging pre-existing trust in religious leaders and institutions among households experiencing extreme poverty is one way that ICM, and potentially other FBOs, can promote retention in child nutrition interventions among vulnerable populations.https://bmjopen.bmj.com/content/10/9/e036091.full |
| spellingShingle | Lincoln Leehang Lau Warren Dodd Han Lily Qu Donald C Cole Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study BMJ Open |
| title | Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study |
| title_full | Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study |
| title_fullStr | Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study |
| title_full_unstemmed | Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study |
| title_short | Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study |
| title_sort | exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the philippines a retrospective cohort study |
| url | https://bmjopen.bmj.com/content/10/9/e036091.full |
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