Clinical trial NCT05448287: Suaahara Impact Evaluation: End-line Survey
Official title: Suaahara Impact Evaluation: End-line Survey
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Nutritional Stunting
Feeding Behavior
Lead sponsor: University of South Carolina
Sponsor class: OTHER
Collaborators: name: Helen Keller International
First posted: 2022-07-07
Enrollment: 2480
Sex: ALL
Minimum age (years): 0
Maximum age (years): 60
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Two-arm quasi-experimental design with baseline and end-line. The baseline and end-line were collected on different households but in the same clusters.
Primary purpose: PREVENTION

Brief summary: Suaahara's primary aim is to reduce the prevalence of stunting, wasting, and underweight among children under 5 years of age and to reduce the prevalence of anemia among women of reproductive age and children 6-59 months of age. For this, the program uses a multi-sectoral approach to achieve four key intermediate results: 1) improved household nutrition, sanitation, and health behaviors; 2) increased use of quality nutrition and health services by women and children; 3) improved access to diverse and nutrient-rich foods by women and children; and 4) accelerated roll-out of the Multi-Sectoral Nutrition Plan (MSNP) through strengthened local governance

Detailed description: The Government of Nepal and development partners have prioritized multi-sectoral (integrated) nutrition as a key development agenda. The Suaahara program funded by the United States Agency for International Development is one of the programs that support the Government of Nepal's multi-sectoral nutrition plan. It aims to reduce maternal and child under-nutrition over a period of ten years, spanning two phases: Suaahara I (2011-2016) and Suaahara II (2016-2021). Initially launched in 20 of 75 districts, the program has scaled-up to 42 of 77 districts that span across Nepal's three agroecological zones of mountains, hills, and terai.

Suaahara I was led by Save the Children International in partnership with Helen Keller International, Johns Hopkins University Center for Communications Programs, Jhpiego, Nepal Water for Health (NEWAH), the National Promotion and Consultancy Service, and the Nepali Technical Assistance Group (NTAG). Suaahara II was led by Helen Keller International in partnership with Cooperative for Assistance and Relief Everywhere, Inc., Family Health International 360), he Nepali Technical Assistance Group, Digital Broadcast Initiative Equal Access, Environmental and Public Health Organization, and Vijaya Development Resource Center.

Suaahara's primary aim is to reduce the prevalence of stunting, wasting, and underweight among children under 5 years of age and to reduce the prevalence of anemia among women of reproductive age and children 6-59 months of age. For this, the program uses a multi-sectoral approach to achieve four key intermediate results (IRs): 1) improved household nutrition, sanitation, and health behaviors; 2) increased use of quality nutrition and health services by women and children; 3) improved access to diverse and nutrient-rich foods by women and children; and 4) accelerated roll-out of the MSNP through strengthened local governance. Suaahara interventions span health and family planning (FP), nutrition, agriculture/homestead food production (HFP), and water, sanitation and hygiene (WASH). Diverse social and behavior change communication interventions are used, primarily to generate demand for access to improved services and to motivate households to adopt optimal health, nutrition, and WASH practices. All Suaahara interventions are supported by a crosscutting theme of gender equality and social inclusion (GESI), in part by targeting women and disadvantaged groups and conducting activities that address GESI-related barriers to optimal health, nutrition, and WASH behaviors. Suaahara's conceptual framework illustrates the paths by which the program activities linked to desired outcomes achieve Suaahara II objectives.

Eligibility criteria: Inclusion Criteria:

* At the household level, the primary respondents are mothers of children under 5 years of age from the selected households.
* Other survey respondents include a primary male (or female, if male unavailable) household decision-maker, and a grandmother of children under 5 years of age residing in the household.
* The Female Community Health Volunteer and health workers are also Suaahara beneficiaries, as the program explicitly aims to improve their knowledge and skills.

Exclusion Criteria:

* None.

Primary outcomes:
measure: Child dietary diversity (Indicators for Assessing Infant and Young Child Feeding Practices)
timeFrame: Over the 24 hours of the day before data collection
measure: Maternal dietary diversity (Minimum Dietary Diversity for Women)
timeFrame: Over the 24 hours of the day before data collection
measure: Stunting
timeFrame: Over the 24 hours of the day of data collection
measure: Underweight prevalence
timeFrame: Over the 24 hours of the day of data collection
measure: Wasting
timeFrame: Over the 24 hours of the day of data collection
measure: Maternal underweight
timeFrame: Over the 24 hours of the day of data collection
measure: Maternal anemia
timeFrame: Over the 24 hours of the day of data collection
measure: Anemia among children aged 6-59 months
timeFrame: Over the 24 hours of the day of data collection
measure: Accurate health, nutrition, and water, sanitation, and hygiene knowledge and skills among Female Community Health Volunteers and health workers from 52 items
timeFrame: Over the 24 hours of the day of data collection
Secondary outcomes:
measure: Child minimum dietary diversity (Indicators for Assessing Infant and Young Child Feeding Practices)
timeFrame: Over the 24 hours of the day before data collection
measure: Maternal minimum dietary diversity (Minimum Dietary Diversity for Women)
timeFrame: Over the 24 hours of the day before data collection
measure: Height for age
timeFrame: Over the 24 hours of the day of data collection
measure: Weight for age
timeFrame: Over the 24 hours of the day of data collection
measure: Weight for height
timeFrame: Over the 24 hours of the day of data collection
measure: Maternal body mass index
timeFrame: Over the 24 hours of the day of data collection
measure: Maternal hemoglobin
timeFrame: Over the 24 hours of the day of data collection
measure: Child hemoglobin
timeFrame: Over the 24 hours of the day of data collection
measure: Knowledge score on core infant and young child feeding practices among mothers from 15 items
timeFrame: Over the 24 hours of the day of data collection
measure: Knowledge score on health and water, sanitation, and hygiene practices among mothers from 37 items
timeFrame: Over the 24 hours of the day of data collection
measure: Female Community Health Volunteers and health workers with ideal practices related to health, nutrition, and water, sanitation, and health from 52 items
timeFrame: Over the 24 hours of the day of data collection
Other outcomes:
Locations:
city: Kathmandu
country: Nepal
facility: Helen Keller International
Study officials:
affiliation: University of South Carolina
name: Edward A Frongillo, PhD
role: PRINCIPAL_INVESTIGATOR
References: