Clinical trial NCT04081441: Impacts of Clean Cookstoves and Empowerment Training on Women's Health in Refugee Settings
Official title: Impacts of Clean Cookstoves/Efficient Fuels Uptake and Empowerment Trainings on Women's Health and Well Being in Humanitarian Settings in Rwanda
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Gender-based Violence
Adherence
Mental Health Wellness 1
Empowerment
Food Insecurity
Relationship, Family
Keywords: gender-based violence
intimate-partner violence
empowerment
food insecurity
humanitarian settings
depression
fuel use
clean cookstoves
Lead sponsor: Johns Hopkins Bloomberg School of Public Health
Sponsor class: OTHER
Collaborators: name: Fundacion Plan International Espana
name: Global Alliance for Clean Cookstoves
name: World Bank
First posted: 2019-09-09
Enrollment: 1555
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Intervention model description: In this natural experiment, we have two connected randomized intervention deployments. The cookstove/fuel program was randomly rolled out to 750 households in Kigeme camp over a 6-month period (September 2018-March 2019) by Inyenyeri (a Rwandan social business). A second intervention (I-ACT empowerment training) was rolled out by Plan, International (December 2018-March 2019). I-ACT was deployed to women and their male partners (if applicable and available). After March 2019, the cookstove/pellet program was available to the whole camp. Assessments of impacts are done at 6 months after deployment of the interventions. Due to the staggering of the intervention roll-outs, the midline follow-up includes a six-month follow-up of the cookstove deployment and approximately 2-3 months of the I-ACT intervention and includes both partnered and non-partnered women. The 12-month assessment includes a 6-month follow up of the I-ACT empowerment intervention for partnered women only.
Primary purpose: PREVENTION

Brief summary: The main objective of this study is to understand the links and outcomes of adoption of a cleaner cookstove/fuel and exposure to a personal empowerment training on women's health outcomes in a Congolese refugee camp in Rwanda, with a focus on gender-based violence (GBV).

Detailed description: This randomized controlled trial examines the impacts of a phased-in integrated technology -behavior change intervention on women's health with a focus on gender-based violence. In a population of approximately 1500 Congolese households in Kigeme refugee camp in Rwanda, two interventions are randomly deployed in the camp. The first intervention is the Inyenyeri cookstove/pellet fuel system, a Tier 4 clean cookstove system; the second intervention is a behavior change intervention (referred to as I-ACT, Individual-Agency-Centered Training) designed to foster personal agency and empowerment, given to women and, if applicable, their male partner. Analyses will be done with interviews on 1500 women (ages 18-45) from these households that may have received one, both or none of the interventions, either as the full sample or the sub-sample of partnered-only women.

Eligibility criteria: Inclusion Criteria:

* Study participants are between the ages of 18 years - 45 years of age
* Reported as currently living in a refugee camp with no intention to relocate
* Has lived in any refugee camp for at least 1 year and can be interviewed in private
* Has the ability to give informed consent

Exclusion Criteria:

* Inability to provide informed consent
* Individuals having evidence of significant illness and/or are not able to engage fully in the surveys
* Women younger than 18 or over 45 years of age
* Those who have not lived continuously in a refugee camp setting for the past 12 months
* If two or more women live in a household, only one of these will be included in the study. The one responsible for fuel purchase/collection will be selected. If more than one woman is responsible for fuel collection, we will randomly choose one woman to participate in the study.

Primary outcomes:
measure: Rates of gender-based violence
timeFrame: 6 months
measure: Number of households reporting uptake and consistent use of clean cooking system and fuel
timeFrame: 6 months
measure: Number of participants reporting minor psychiatric disorders
timeFrame: 6 months
measure: Number of participants reporting anxiety and depression
timeFrame: 6 months
measure: Number of participants reporting emotional symptoms of trauma
timeFrame: 6 months
measure: Number of participants reporting increased economic and social empowerment
timeFrame: 6 months
measure: Number of participants reporting reduced food insecurity
timeFrame: 6 months
measure: Number of participants reporting increased self-efficacy
timeFrame: 6 months
measure: Number of participants reporting increased grit
timeFrame: 6 months
measure: Number of participants reporting increased social agency
timeFrame: 6 months
Secondary outcomes:
measure: Number of participants reporting increased quality and quantity of social networks
timeFrame: 6 months
Other outcomes:
Locations:
city: Kacyiru
country: Rwanda
facility: Plan International, Rwanda
state: Kigali
Study officials:
affiliation: Johns Hopkins Bloomberg School of Public Health
name: Anita V Shankar, Ph.D.
role: PRINCIPAL_INVESTIGATOR
affiliation: Johns Hopkins Bloomberg School of Public Health
name: Naira Kalra, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: