Singida Nutrition and Agroecology Project

Study Overview
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Brief Summary
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The purpose of this study is to test if a participatory, agroecological peer farmer-led education intervention can be effective at improving legume production, food security, and infant and young child feeding practices in Singida District, Tanzania.

Detailed Description
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Approximately 40% of under five children in Tanzania are stunted, with higher levels in rural areas. Our inception research in Singida identified five pressing issues faced by smallholder farmers that may contribute to this high rate of stunting. They are (A) hierarchical, or top down farmer education, (B) low soil fertility and little knowledge of agroecological solutions, (C) high levels of gender inequality and high workloads for women, (D) food insecurity and low dietary diversity, and (E) sub-optimal infant and young child feeding. Singida Nutrition and Agroecology Project (SNAP) is a randomized effectiveness trial of a participatory, agroecological peer farmer education intervention. Each intervention village will choose 2 mentor farmers, 1 man and 1 woman, who will participate in a field visit to and training by existing mentor farmers in Malawi and a two week long follow-up and refresher trainings in Tanzania integrating agroecology, climate change, nutrition, and gender equality. Mentor farmers will then conduct monthly visits to participating households and support the households in conducting experimentation with agroecological practices and/or new behaviors regarding nutrition and gender equality. Quarterly meetings among mentor farmers and biannual meeting of participating farmers within each village will be held to discuss progress and challenges of peer education and household experimentations.

Official Title
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Singida Nutrition and Agroecology Project

Conditions
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Malnutrition

Intervention / Treatment
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* Behavioral: Mentor farmer training (Malawi)
* Behavioral: Mentor farmer training (Singida, Tanzania)
* Behavioral: Mentor farmer visits and facilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Are among the most vulnerable, as indicated by food insecurity Have a child who will be <= 1 year old in February 2016 Are farmers who have regular access to the same farms/plots (but they do not need to own the land per se) Female headed households are acceptable, so long as not more than half the selected households in the village are female headed (to be able to detect change in gender equity) Willing to stay in study for 3 years, i.e. do not plan to move Interested in experimenting with new farming techniques Exclusion Criteria: Refuses to take part

Ages Eligible for Study
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Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention (Participatory education)<br>Participatory education | Behavioral: Mentor farmer training (Malawi)<br>* Mentor farmers, 1 man, 1 woman, from each village will participate in a field visit to and training by existing mentor farmers in Malawi. Only the intervention arm of this study will receive mentor farmer training in Malawi, delayed intervention arm will receive mentor farmer training from farmers participating in the initial intervention in Tanzania.<br>Behavioral: Mentor farmer training (Singida, Tanzania)<br>* Mentor farmers will receive training in Singida, Tanzania on agroecology practices, climate change, nutrition, and gender equality. Intervention villages will receive training in 2016. Delayed intervention villages will receive training in 2019.<br>Behavioral: Mentor farmer visits and facilitation<br>* Mentor farmers will conduct monthly visits to participating households and support the households in conducting experimentation with agroecological practices and/or new behavior regarding nutrition and gender equality. Quarterly meetings among farmers within each village will be held to discuss progress and challenges of household experimentations. Intervention households will receive support and facilitation for approximately 2 years. Delayed intervention households will receive support and facilitation for approximately 6 months after end line survey.<br>|
| No Intervention: Control<br>Delayed participatory education | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in dietary diversity score (mean and proportion of score >4) | As defined by World Health Organization (see Citations), this refers to the number of food groups (out of 7) consumed by children the previous day . | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in mean child's height-for-age z-score | According to World Health Organization growth chart | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 
| Change in proportion of children who are stunted (HAZ<-2) | According to World Health Organization growth chart | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 
| Change in mean child's weight-for-height z-score | According to World Health Organization growth chart | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 
| Change in proportion of children who are wasted (WHZ<-2) | According to World Health Organization growth chart | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 
| Change in mean Food Insecurity Score | Household Food Insecurity Access Scale (HFIAS) | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) | 
| Change in proportion of households with severe or moderate food insecurity | Household Food Insecurity Access Scale (HFIAS) | Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) |