{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:13Z","timestamp":1753879213948,"version":"3.41.2"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Systematic crises may disrupt well\u2010designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive &amp; Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID\u201019 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics).<\/jats:p>","DOI":"10.1111\/mcn.13750","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T13:09:33Z","timestamp":1731330573000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9425-9586","authenticated-orcid":false,"given":"Jessica","family":"Escobar\u2010DeMarco","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Community Health University of North Carolina at Charlotte Charlotte North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3418-1674","authenticated-orcid":false,"given":"Phuong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI) Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gourob","family":"Kundu","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowshan","family":"Kabir","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohsin","family":"Ali","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santhia","family":"Ireen","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Ash","sequence":"additional","affiliation":[{"name":"FHI 360 Global Nutrition Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeba","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celeste","family":"Sununtnasuk","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI) Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purnima","family":"Menon","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI) Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8265-9815","authenticated-orcid":false,"given":"Edward A.","family":"Frongillo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior, Arnold School of Public Health University of South Carolina Columbia South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Alive & Thrive. 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