Enhancing Milk Consumption for Improved Nutrition in Rwanda
Condition: Inadequate Child Growth
Study type: Interventional

Summary: 
      This study is a mixed-methods cluster-randomized controlled trial in Rwanda designed to
      measure the impact of a dairy asset transfer program with or without nutrition education
      promoting the home consumption of dairy milk and other animal source foods.
    

Detailed description: 
      The purpose of this research is to contribute to efforts for improving the consumption of
      milk in Rwanda. It will do so by generating and communicating evidence on the nutritional
      benefits of including animal source food (ASF) in diets of young children and pregnant and
      lactating women through nutrition education. The proposed project draws upon the work of a
      Government of Rwanda program - the One Cow per Poor Family (Girinka) program. The Girinka
      program (2006 - present) is a country-wide program whose goal is to increase household income
      and reduce child malnutrition among poor households through livestock asset transfer. The
      study has two main objectives. First, researchers will measure the impact of a nutrition
      education/ASF promotion intervention on child and maternal nutritional status in households
      that have received a cow through the Girinka program. Second, researchers will compare
      nutrition outcomes in the Girinka + nutrition education and Girinka only groups to
      individuals in households that are eligible for Girinka, but have not yet received a cow. The
      nutrition education/ASF promotion intervention will be designed and overseen by a local
      organization and implemented through Government of Rwanda community health workers. The main
      study outcomes are child height-for-age z-score, child milk consumption, and child dietary
      diversity. The secondary outcomes are child weight-for-age z-score, child weight-for-height
      z-score, and maternal body-mass index. The researchers plan to randomly assign all cells in
      two districts to receive the nutrition education intervention or no intervention. The study
      will enroll a cohort of 687 mother-child pairs (229 per study arm). The aim is to enroll
      children 12-17 months of age at baseline; however, if there are not adequate numbers of
      households that meet all other eligibility criteria, then the child age range will be
      expanded to 12-29 months of age at baseline. The research team will conduct baseline and
      endline surveys to measure differences between the groups. At endline, researchers will
      collect qualitative data from participants and community health workers in the intervention
      arm to triangulate with the survey findings.
    

Intervention name(s): ASF promotion plus Girinka
Intervention type(s): Behavioral
Intervention description(s): Behavior change communication promoting the consumption of milk produced in the household and other optimal maternal and child nutrition practices. The intervention will be implemented by government of Rwanda Community Health Workers.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: stunting; underweight; wasting