Scaling up Small-Scale Food Processing to Promote Food Security Among Women Farmers in Rural Vietnam

Study Overview
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Brief Summary
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This repeated measures, cluster randomized, cohort trial design was carried out in three provinces in the northern mountainous area of Vietnam. Communes here were randomly selected for community based interventions with local production complimentary foods and marketing and distribution of fortified complimentary foods.

Detailed Description
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In rural northern Vietnam, childhood stunting rates are high. In Lào Cai province, female subsistence farmers grow crops, but face barriers sending produce to markets. The present intervention purchases local crops from local women subsistence farmers which are processed in local small-scale food processing facilities to produce instant fortified complementary foods for weaning. Methods: A repeated measures survey was conducted from October to November 2016, with Caregiver-Child(<2y) pairs (n=800) in the provinces of Lai Chau, Lao Cai and Ha Giang. Anthropometric data of mother/child dyads was assessed and logistic regression analysis of stunted and underweight children explored associated factors. These included: core infant and young child feeding practices indicators, food insecurity, antenatal care check-ups, core water/sanitation, anemia and hygiene indicators. This project leveraged the experience of the National Institute of Nutrition of Vietnam to ensure HACCP standards during manufacture. Locally grown rice was combined with a Zn/Fe premix before extrusion and hammer-milling. Local vegetables such as: Sweet leaf (Sauropus androgynous), pumpkin, Shiitake mushrooms (Lentinula edodes) and carrots were made into complimentary foods and sold locally.

Official Title
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Scaling up Small-Scale Food Processing: A Strategy to Promote Food Security Among Women Subsistence Farmers in Rural Vietnam

Conditions
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Food Insecurity, Stunting, Wasting, Underweight, Anemia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child participants must be younger than 2y at baseline. Caregivers must volunteer and were required to give informed written consent Exclusion Criteria: Free from oedema Free from physical and mental disabilities Free from memory disorders and/or mental illness

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 2 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Community Based Production and Access of Complimentary Foods<br>Nine communes were randomly selected with the cluster inclusion criteria as having high levels of; agricultural production, childhood under-nutrition and food security. This was carried out in the three rural mountainous provinces of Lao Cai, Lai Chau, and Ha Giang. In each of these provinces, one district and three subsequent communes were selected, for a total of 9 communes. The districts of Bat Xat, Tam Duong, and Vi Xuyen were selected in Lao Cai, Lai Chau and Ha Giang province respectively. This second stage district sampling selected sites with similar characteristic of population density, area, number of women of reproductive age(15-35y), percentage of children(<2y), income primarily from agricultural production, poverty and climate data. Changes were observed on food security and nutritional status with exposure to community based self reported purchasing local agricultural products and access to locally produced fortified complimentary foods. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Household Food Insecurity Access Scale | Score from 1-27 indicating household food Insecurity. Where higher scores indicate greater food insecurity. This was taken at the beginning of intervention in Nov 2016 till completion in June 2018. | Nov 2016-June 2018 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight in kilograms | Stunting (Height-for-age Z score <-2SD), Underweight (Weight-for-age Z score<-2SD), Wasting (Weight-for-height Z score<-2SD) compared with World Health Organization's growth charts. | Nov 2016-June 2018 | 
| Height in Meters | Stunting (Height-for-age Z score <-2SD), Underweight (Weight-for-age Z score<-2SD), Wasting (Weight-for-height Z score<-2SD) compared with World Health Organization's growth charts. | Nov 2016-June 2018 | 
| Age in Months | Stunting (Height-for-age Z score <-2SD), Underweight (Weight-for-age Z score<-2SD), Wasting (Weight-for-height Z score<-2SD) compared with World Health Organization's growth charts. | Nov 2016-June 2018 | 
| Hemoglobin Levels of Children (<2y) | Hemoglobin levels among Children participants assessed by finger prick blood sampling. | Nov 2016-June 2018 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food Insecurity, Stunting, Wasting, Underweight, Anemia, Complimentary Foods, Food Fortification, Complimentary Feeding