Clinical trial NCT02761876: Singida Nutrition and Agroecology Project
Official title: Singida Nutrition and Agroecology Project
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Malnutrition
Lead sponsor: Cornell University
Sponsor class: OTHER
Collaborators: name: Nelson Mandela African Institute of Science and Technology
name: Action Aid Tanzania
name: Ilonga Agricultural Research Institute
First posted: 2016-05-04
Enrollment: 700
Sex: ALL
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Change in dietary diversity score (mean and proportion of score >4)
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
Secondary outcomes:
measure: Change in mean child's height-for-age z-score
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
measure: Change in proportion of children who are stunted (HAZ<-2)
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
measure: Change in mean child's weight-for-height z-score
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
measure: Change in proportion of children who are wasted (WHZ<-2)
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
measure: Change in mean Food Insecurity Score
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
measure: Change in proportion of households with severe or moderate food insecurity
timeFrame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
Other outcomes:
Locations:
Study officials:
affiliation: Cornell University
name: Rachel N Bezner Kerr, MS PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Cornell University
name: Sera L Young, MA PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Action Aid Tanzania
name: Elias Mtinda
role: PRINCIPAL_INVESTIGATOR
References:
citation: Santoso MV, Bezner Kerr RN, Kassim N, Martin H, Mtinda E, Njau P, Mtei K, Hoddinott J, Young SL. A Nutrition-Sensitive Agroecology Intervention in Rural Tanzania Increases Children's Dietary Diversity and Household Food Security But Does Not Change Child Anthropometry: Results from a Cluster-Randomized Trial. J Nutr. 2021 Jul 1;151(7):2010-2021. doi: 10.1093/jn/nxab052.