Clinical trial NCT02427945: Leveraging an Existing Large-scale Safe Water Program to Deliver Nutrition Messages at a Low Marginal Cost
Official title: Leveraging an Existing Large-scale Safe Water Program to Deliver Nutrition Messages at a Low Marginal Cost
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Child Malnutrition
Keywords: Information provision
Lead sponsor: Institute for Fiscal Studies
Sponsor class: OTHER
Collaborators: name: Evidence Action
name: MaiMwana
First posted: 2015-04-28
Enrollment: 1671
Sex: ALL
Maximum age (years): 18
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The investigators are seeking to overcome the dual challenges of under-nutrition and diarrhea using an existing safe water supply platform to deliver nutrition information to targeted groups in Western Kenya. Using a randomized evaluation, investigators will determine the impact on nutrition status and practices of delivering nutrition information. The evaluation results will enable Evidence Action to make strategic decisions regarding the potential scale-up of the combined program across Kenya.

Detailed description: Evidence Action's Dispensers for Safe Water program currently provides access to safe water for two million people. The program would be able to leverage the existence of this service delivery platform to provide promoters with training on proper nutrition and methods for delivering these messages to target groups.

The intervention is a home visiting program that will provide nutrition advice on complementary feeding to households with children aged 6-24 months. Two types of home visits will be evaluated, a 'traditional visit mode' in which the child's mother receives the visit; and a 'couples visit mode' in which the promoter attempts to involve both the father and mother.

Households in the control group will also receive home visits by promoters but the content of the visit will be restricted to safe water. The same information on safe water will also be provided to households in the treatment group. Hence, the evaluation will measure the additional effect of providing nutrition information on top of information on safe water.

Promoters will provide advice on nutrition and food hygiene to target households, according to criteria established by Evidence Action. Following the Guiding Principles for Complementary Feeding of the Breastfed Child (PAHO/WHO 2003), the intervention will include information on the maintenance of breastfeeding, safe/hygienic preparation and storage of complementary foods, amount of complementary food needed, food consistency, meal frequency and energy density, nutrient content of complementary foods, and feeding after illness. The home visits will be modelled on the MaiMwana Infant Feeding intervention (http://www.maimwana.malawi.net/MaiMwana/Home.html) that has been taking place in Mchinji (Malawi) since 2005.

Households within the treatment group will be provided by a poster to hang in their dwellings with some basic information on nutrition. A random subset of households will be given a small poster in black and white, and the other subset of households will be give a larger color poster.

Eligibility criteria: Inclusion Criteria:

* Children will be included if they are between 0 and 18 months at baseline and live within the catchment area of a water point in which Evidence Action installs a chlorine dispenser

Exclusion Criteria:

* None

Primary outcomes:
measure: Height-for-age z-score
timeFrame: Up to 18 months
Secondary outcomes:
measure: Knowledge of child nutrition issues measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Child nutritional intake measured using a 7 day Food Frequency Questionnaire
timeFrame: Up to 18 months
measure: Child's age when breastfeeding stops measured using a structured questionnaire
timeFrame: Up to 18 months
measure: A composite index of other anthropometric indicators (includes child's weight for age z-score, child's mid-upper arm circumference, and child's head circumference)
timeFrame: Up to 18 months
measure: Probability that the child suffers from bipedal oedema
timeFrame: Up to 18 months
Other outcomes:
measure: Household food consumption measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Household consumption measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Total Chlorine Residual score
timeFrame: Up to 18 months
measure: Labor supply measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Time cooking on the day prior to the interview measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Women's empowerment measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Probability of having a chat with a friend or acquaintance about food or nutrition measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Probability of child suffering from diarrhea measured using a structured questionnaire
timeFrame: Up to 18 months
measure: Hygiene practices measured using a structured questionnaire
timeFrame: Up to 18 months
Locations:
city: Busia
country: Kenya
facility: Evidence Action
state: Busia County
Study officials:
affiliation: Research Fellow
name: Marcos Vera-Hernandez, PhD
role: PRINCIPAL_INVESTIGATOR
References: