Tools to Improve Parental Recognition of Developmental Deficits in Children
Condition: Malnutrition; Child Development
MeSH terms: Malnutrition
Study type: Interventional

Summary: 
      In this study, we aim to improve child nutrition by increasing parents' awareness of their
      children's physical growth. We use a cluster-randomized trial design to evaluate two
      interventions that provide parents with regular information on their children's physical
      development and growth: 1) distribution of full-sized growth charts for measurement of child
      height within households; and 2) organization of community-based meetings, during which
      children's height and weight are measured by trained project staff.
    

Detailed description: 
      The target population for the study will be children between the ages of 6 and 18 months at
      baseline living in small-scale farming households in Chipata District, Zambia. As part of a
      cluster-randomized trial titled "Food Constraints, Yield Uncertainty and 'Ganyu' Labor"
      funded by IZA-DFID (PI: G Fink), 3,100 farming households in approximately 180 rural villages
      in Eastern Province are currently enrolled in a two-year study, which aims at assessing the
      effect of food loan programs on agricultural productivity. The study described here uses the
      "Food Constraints" population as a sampling frame; all households enrolled in the "Food
      Constraints" program that have a child between 6 and 18 months are invited to participate in
      this add-on trial. We anticipate that there will be around 600 eligible households recruited
      for this study. Study duration is about 18 months. Selected households will be visited for
      study enrollment and a short baseline assessment in September 2014, at which time the two
      interventions will also be rolled out. Final impact of the interventions will be assessed one
      year later, in September 2015.
    

Intervention name(s): Height measurement poster; Community-based monitoring
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Each household is provided with a poster which study personnel help to hang on the wall. The poster clearly indicates height-for-age benchmarks and stunting cut-offs for study-age children. Parents are provided training on how to measure their children at regular intervals, and interpret height readings to determine whether their child is developing normally or is stunted.; Once every three months, villages are visited by study staff who measure children's heights and weights, and parents are informed if their children are below the reference measures established by the World Health Organization. If a child's weight is such that the child is classified as severely malnourished, the child is referred to the nearest health center for treatment. If the child is stunted (height-for-age z-score more than 2 standard deviations below the reference median), we provide parents with a supply of "Yummy Soy" powder, a fortified soy and maize mix popular among parents and widely available in local super markets. Parents are instructed to give one or two tea spoons of the mix to the child each day.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention