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Leveraging an Existing Large-scale Safe Water Program to Deliver Nutrition Messages at a Low Marginal Cost

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ClinicalTrials.gov Identifier: NCT02427945
Recruitment Status : Completed
First Posted : April 28, 2015
Last Update Posted : March 19, 2019
Sponsor:
Collaborators:
Evidence Action
MaiMwana
Information provided by (Responsible Party):
Marcos Vera Hernandez, Institute for Fiscal Studies

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.

Condition or disease Intervention/treatment Phase
Child Malnutrition Behavioral: Provision of information on safe water Behavioral: Provision of information on safe water and child nutrition Not Applicable

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.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1671 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Leveraging an Existing Large-scale Safe Water Program to Deliver Nutrition Messages at a Low Marginal Cost
Study Start Date : May 2015
Actual Primary Completion Date : June 2017
Actual Study Completion Date : June 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Control
Provision of information on safe water
Behavioral: Provision of information on safe water
A promoter from Evidence Action will visit the household and provide information on safe water.

Experimental: Treatment traditional
Provision of information on safe water and child nutrition. The information will be targeted to the mother of the child aged between 6 and 24 months old.
Behavioral: Provision of information on safe water and child nutrition
A promoter from Evidence Action will visit the household and provide information on safe water, as well as child nutrition (including hygiene on food preparation and storage). Households will be given a poster to hang in their dwellings with basic nutrition information. The poster might be smaller and in black and white, or larger and in color.

Experimental: Treatment couple
Provision of information on safe water and child nutrition. The information will be targeted to the mother of the child aged between 6 and 24 months old, and her husband.
Behavioral: Provision of information on safe water and child nutrition
A promoter from Evidence Action will visit the household and provide information on safe water, as well as child nutrition (including hygiene on food preparation and storage). Households will be given a poster to hang in their dwellings with basic nutrition information. The poster might be smaller and in black and white, or larger and in color.




Primary Outcome Measures :
  1. Height-for-age z-score [ Time Frame: Up to 18 months ]

Secondary Outcome Measures :
  1. Knowledge of child nutrition issues measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  2. Child nutritional intake measured using a 7 day Food Frequency Questionnaire [ Time Frame: Up to 18 months ]
    Measured using a 7 day Food Frequency Questionnaire

  3. Child's age when breastfeeding stops measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  4. 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) [ Time Frame: Up to 18 months ]
    The composite index will include child's weight for age z-score, child's mid-upper arm circumference, and child's head circumference.

  5. Probability that the child suffers from bipedal oedema [ Time Frame: Up to 18 months ]

Other Outcome Measures:
  1. Household food consumption measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  2. Household consumption measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  3. Total Chlorine Residual score [ Time Frame: Up to 18 months ]
  4. Labor supply measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  5. Time cooking on the day prior to the interview measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  6. Women's empowerment measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire

  7. Probability of having a chat with a friend or acquaintance about food or nutrition measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire. Having a chat in the last 3 days prior to the survey interview.

  8. Probability of child suffering from diarrhea measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire. Suffering from diarrhea in the last 7 days prior to the survey. Diarrhea is defined as having 3 loose stools in any one day and/or having blood in the stools at least once.

  9. Hygiene practices measured using a structured questionnaire [ Time Frame: Up to 18 months ]
    Measured using a structured questionnaire



Information from the National Library of Medicine

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Ages Eligible for Study:   up to 18 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02427945


Locations
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Kenya
Evidence Action
Busia, Busia County, Kenya
Sponsors and Collaborators
Marcos Vera Hernandez
Evidence Action
MaiMwana
Investigators
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Principal Investigator: Marcos Vera-Hernandez, PhD Research Fellow
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Responsible Party: Marcos Vera Hernandez, Research Fellow, Institute for Fiscal Studies
ClinicalTrials.gov Identifier: NCT02427945    
Other Study ID Numbers: 1827/006
First Posted: April 28, 2015    Key Record Dates
Last Update Posted: March 19, 2019
Last Verified: March 2019
Keywords provided by Marcos Vera Hernandez, Institute for Fiscal Studies:
Information provision
Additional relevant MeSH terms:
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Malnutrition
Child Nutrition Disorders
Nutrition Disorders