Community Development and Nutrition Education in Banke District, Nepal: Effect on Child Health and Growth
Condition: Malnutrition
MeSH terms: Malnutrition
Study type: Interventional

Summary: 
      Heifer Project International is a globally active NGO with more than 400 projects in over 30
      countries. The organization uses the introduction of livestock and related training in the
      development of social capital as tools for poverty alleviation, citizen empowerment, and
      community development. In a pilot project conducted in 2009-2012, these activities were found
      to promote some improvement in child health and nutritional status. However, robust
      enhancement of these important indicators was not observed. Heifer now intends to investigate
      the efficacy of a nutrition and child health education program in amplifying these effects.
    

Detailed description: 
      Child health and survival remain significant challenges in Nepal. Nepal is ranks 63rd highest
      in the world for "under 5 mortality" rate, with 54/1000 children dying before their 5th
      birthdays and 46/1000 infants dying before their first birthdays. Annually, more than 47,000
      children die before reaching age 5 years. At these mortality levels, one in every 22 Nepalese
      children dies before reaching age 1, and one in every 19 does not survive to his or her fifth
      birthday. Nutritional status of children is extremely poor, with ~29% of children underweight
      and 41% stunted (respectively, weight and height <-2 SD from median) (UNICEF, 2011) (Ministry
      of Health and Population et al., 2012).

      Heifer Project International is a globally active NGO with more than 400 projects in over 30
      countries. The organization uses the introduction of livestock and related training in the
      development of social capital as tools for poverty alleviation, citizen empowerment, and
      community development. Heifer International recognizes the links between poverty, child
      malnutrition, and disease. However, improving economic indicators is not always sufficient to
      improve child outcomes. Thus, the organization now wishes to conduct a systematic assessment
      to evaluate the effects of introducing a child health and nutrition component into their
      work, and to clarify the links (if any) between social capital training and child growth and
      health. In doing so, Heifer International expects to develop a model which could be adapted
      for use in other regions of the world. The interaction of Heifer community development
      activities, specific child and family characteristics, and child health and nutritional
      status will also be explored.
    

Intervention name(s): Training Plus; Training Only; No Inputs then Community development and training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Training plus enhanced community development activities; Training Only (livestock management and child nutrition) for 24 months then add community development inputs; No inputs for 24 months then add community development and training
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: Randomized cluster design of households in rural Nepal. Groups will be randomized to receive either: (a) Training Only (livestock management and child nutrition), (b) Training plus enhanced community development activities, or (c) no inputs (Control). After 24 months, groups A and C will receive community development inputs
Masking: None (Open Label)
Primary purpose: Other
Keywords: Nepal; child growth; nutrition education; community development