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Completed

NCT Number: NCT02427945

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

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.

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Key information

Conditions

Child Malnutrition Child Nutrition Disorders Nutrition Disorders Nutritional and Metabolic Diseases

Age range

Up to 18 month

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Evidence Action

Busia, Busia County, Kenya

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Provision of information on safe water

Behavioral

A promoter from Evidence Action will visit the household and provide information on safe water.

Provision of information on safe water and child nutrition

Behavioral

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 outcomes

  1. Height-for-age z-score

    Time frame: Up to 18 months

Secondary outcomes

  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 outcomes

  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

Sponsors and collaborators

Lead sponsor

Marcos Vera Hernandez

Other

Collaborators

  • Evidence Action
  • MaiMwana

Registry information

Important dates

Study start
2015
Primary completion
2017
Study completion
2017
First posted
Apr 28, 2015
Registry last updated
Mar 19, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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