Alive & Thrive Nigeria Impact Evaluation

Study Overview
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Brief Summary
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Investigators will use a cluster-randomized design to evaluate the overall impact of the Alive & Thrive infant and young child feeding communication strategies in Lagos and Kaduna States, Nigeria. The impact in each state and in a subset of urban local government areas (LGAs) will also be tested.This is a mixed methods evaluation; the quantitative data will be complemented by qualitative data obtained from different groups targeted by or involved in the program.

Detailed Description
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Adequate nutrition during the first 1,000 days is necessary for children to grow and develop to their full potential. Alive & Thrive (A&T) contributes to better nutrition during the first 1,000 days by promoting improved infant and young child feeding (IYCF) practices. A&T is expanding its efforts to Nigeria and will target Lagos and Kaduna States. In Nigeria, 33% of infants are breastfed within 1 hour of delivery, 60% are given other fluids in the first 3 days of life, and only 17% of children 0-5.9 months are exclusively breastfed. Approximately 60% of children 6 to 23 months achieve the minimum meal frequency for their age and 19% are fed four or more food groups per day. To address these gaps in optimal IYCF practices, A&T will use an implementation framework for IYCF impact at scale that includes advocacy, interpersonal communication and community mobilization, mass communication, and strategic use of data. The A&T intervention will be compared to mass media communication on IYCF, which will be provided throughout the two states. LGAs in Lagos and Kaduna will be randomly allocated such that two-thirds receive the A&T intervention and one-third are assigned to the comparison group. The primary objectives of the evaluation are to measure the impact of the A&T intervention on IYCF practices among mothers with children 0-23 months of age overall, in each state, and in a subset of urban LGAs. Secondary evaluation objectives are to document: the type, quantity, and timing of the implementation of A&T program activities; coverage levels A&T achieves with different program activities; extent to which A&T increases knowledge and awareness of optimal IYCF practices among women with children 0 to 23 months and health providers; extent to which A&T improves the capacity of health providers to counsel mothers on IYCF; and extent to which A&T improves the capacity of stakeholders to implement community-based activities that support optimal IYCF practices.

Official Title
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Alive & Thrive Nigeria Impact Evaluation

Conditions
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Complementary Feeding

Intervention / Treatment
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* Behavioral: A&T IYCF intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For mother's survey: Women of reproductive age (15-49 years), Must be married if 15-17 years, Has a child 0-23 months For provider's survey: Male or female, 18 years or older Works in a government or private health facility or works as a community pharmacist, private patent medicine vendor, or traditional birth attendant Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 49 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A&T IYCF intervention<br>A&T IYCF intervention is includes comprehensive IYCF counseling which includes intensive activity that aims to deliver one-on-one counseling at home or in a health facility. | Behavioral: A&T IYCF intervention<br>* (1) Interpersonal communication through frontline workers/volunteers to increase mothers' knowledge and practice of optimal infant and young child feeding (IYCF) behaviors. Interpersonal communication will involve multiple contacts with mothers and an array of IYCF messages; (2) Community mobilization activities to raise awareness of the benefits of optimal IYCF practices among opinion leaders and family members, and increase their support to mother for IYCF; (3) Training of facility and community-based health workers on IYCF to improve their ability to support mothers and provide timely information on IYCF; and (4) Mass media communication on IYCF.<br>|
| No Intervention: Control<br>No intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exclusive breastfeeding on the day preceding the interview. | The proportion of infants 0-5 months who were exclusively breastfed on the previous day. | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Exclusive breastfeeding from 0-5 months. | The proportion of children who were exclusively breastfed from 0-5 months. | 2 years | 
| Breastfeeding within 1 hour of birth. | The proportion of children 0-23 months who were breastfed within 1 hour of birth. | 2 years | 
| Minimum dietary diversity. | The proportion of children 6-23 months who were fed the minimum number of food groups on the previous day based on the WHO infant and young child feeding guidelines. | 2 years | 
| Minimum meal frequency. | Description: The proportion of children 6-23 months who were fed the minimum number of meals on the previous day based on the World Health Organization infant and young child feeding guidelines. | 2 years | 
| Mothers' accurate knowledge of optimal infant and young child feeding practices. | Mothers' accurate knowledge of: Optimal timing of breastfeeding initiation Optimal duration of exclusive breastfeeding Solution to common breastfeeding problems Optimal timing to introduce complementary foods Optimal dietary diversity and frequency of complementary feeding from 6-23 months | 2 years | 
| Health providers' knowledge of optimal infant and young child feeding practices. | Providers' accurate knowledge of: Optimal timing of breastfeeding initiation Optimal duration of exclusive breastfeeding Solution to common breastfeeding problems Optimal timing to introduce complementary foods Optimal dietary diversity and frequency of complementary feeding from 6-23 months | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exclusive breastfeeding