Nutrition-sensitive Agricultural Interventions for Ethiopia
NCT ID: NCT03152227
Last Updated: 2018-08-23
Study Results
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Basic Information
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COMPLETED
NA
2117 participants
INTERVENTIONAL
2016-11-30
2018-05-08
Brief Summary
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Detailed Description
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ATONU will implement an additional nutrition-sensitive intervention among ACGG households that will use behavior change communication (BCC) to encourage consumption of chicken products (meat and eggs); good water, sanitation, and hygiene (WASH) practices in poultry production; use of income from sale of chicken products to improve nutrition; empowerment of women in decision-making around chicken production and sale; and home gardening of nutrient-dense vegetables to improve dietary quality within the household. Qualitative work is supporting development of this intervention.
ACGG's intervention to increase chicken production may improve the nutritional status of women and children through increasing access to chicken meat and eggs for household consumption and empowering women by giving them access to income, which could be used for purchase of other nutrient-dense foods. However, increasing production and income alone may not necessarily translate into improved diets or nutritional outcomes. ATONU's intervention will specifically encourage the use of chicken products and income to provide nutritious diets for women of reproductive age, emancipated minors and young children through extensive nutrition behavior change communication. Further, recognizing that lack of availability of nutrient-dense foods in local markets may be an important barrier to a diverse and nutritious diet, the home gardening component of ATONU's intervention seeks to increase the availability of nutrient-dense vegetables at household level.
The ACGG program is operating in diverse agroecologies in Ethiopia. Within its target areas, the program listed villages in which chicken production was an important activity and, from this list, randomly selected villages in which to implement its intervention. In a subset of these ACGG villages, ATONU will implement its intervention. As a result, there will be two groups of ACGG villages: those receiving only the poultry production intervention, and those receiving the poultry production intervention coupled with ATONU's nutrition-sensitive intervention. Allocation of ACGG villages to one of these two groups will be done randomly. Investigators will evaluate the nutritional impact of these two interventions among smallholder chicken-producing households in Ethiopia. Specifically, investigators will use the two groups of villages described above and a third group of ACGG-eligible villages that ACGG did not choose for intervention to conduct a cluster-randomized controlled trial with the goal of evaluating the effect of the ACGG and ATONU interventions on maternal and child diets, nutritional status, and health.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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ACGG & ATONU
ACGG high-producing chicks to households along with provision of technical input on production and ATONU Nutrition sensitive BCC on poultry-specific aspects of nutrition, WASH, women's empowerment, and use of income combined with home gardening.
ACGG
50 high-producing chicks to households along with provision of technical input on production
BCC
Nutrition sensitive BCC on poultry-specific aspects of nutrition, WASH, women's empowerment, and use of income combined with home gardening.
ACGG only
ACGG high-producing chicks to households along with provision of technical input on production
ACGG
50 high-producing chicks to households along with provision of technical input on production
Control
ACGG eligible households in non-ACGG villages receiving standard of care agricultural and health services as provided in Ethiopia
No interventions assigned to this group
Interventions
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ACGG
50 high-producing chicks to households along with provision of technical input on production
BCC
Nutrition sensitive BCC on poultry-specific aspects of nutrition, WASH, women's empowerment, and use of income combined with home gardening.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
1. Are participating in the ACGG program
2. Have at least one woman of reproductive age (18-49 years at enrollment) or emancipated minor (girl aged 15 to less than 18 years)
3. Plan to remain in the study area throughout the study duration
4. Provide informed consent.
Households in the control arm will be eligible for inclusion if they meet all of the following criteria:
1. Meet the criteria for participating in the ACGG program, namely, they have produced chickens for at least two years and are currently keeping no more than 50 chickens with interest to expand production in the future
2. Have at least one woman of reproductive age (18-49 years at enrollment) or emancipated minor (girl aged 15 to less than 18 years)
3. Plan to remain in the study area throughout the study duration
4. Provide informed consent.
Exclusion Criteria
15 Years
49 Years
FEMALE
No
Sponsors
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The International Livestock Research Institute (ILRI)
OTHER
Addis Continental Institute of Public Health
OTHER
Food, Agriculture and Natural Resources Policy Analysis Network
UNKNOWN
Harvard School of Public Health (HSPH)
OTHER
Responsible Party
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Wafaie Fawzi
Dr.
Principal Investigators
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Wafaie W Fawzi, DrPH,MBBS
Role: PRINCIPAL_INVESTIGATOR
Harvard School of Public Health (HSPH)
Yemane Berhane, PhD
Role: PRINCIPAL_INVESTIGATOR
Addis Continental Institute of Public Health
Locations
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Addis Continental Institute of Public Health (ACIPH)
Addis Ababa, , Ethiopia
Countries
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References
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Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet. 2011 Dec 17;378(9809):2123-35. doi: 10.1016/S0140-6736(10)62304-5. Epub 2011 Aug 1.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451. doi: 10.1016/S0140-6736(13)60937-X. Epub 2013 Jun 6.
Iannotti LL, Lutter CK, Bunn DA, Stewart CP. Eggs: the uncracked potential for improving maternal and young child nutrition among the world's poor. Nutr Rev. 2014 Jun;72(6):355-68. doi: 10.1111/nure.12107. Epub 2014 May 7.
Lee AC, Katz J, Blencowe H, Cousens S, Kozuki N, Vogel JP, Adair L, Baqui AH, Bhutta ZA, Caulfield LE, Christian P, Clarke SE, Ezzati M, Fawzi W, Gonzalez R, Huybregts L, Kariuki S, Kolsteren P, Lusingu J, Marchant T, Merialdi M, Mongkolchati A, Mullany LC, Ndirangu J, Newell ML, Nien JK, Osrin D, Roberfroid D, Rosen HE, Sania A, Silveira MF, Tielsch J, Vaidya A, Willey BA, Lawn JE, Black RE; CHERG SGA-Preterm Birth Working Group. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013 Jul;1(1):e26-36. doi: 10.1016/S2214-109X(13)70006-8. Epub 2013 Jun 25.
Leroy JL, Frongillo EA. Can interventions to promote animal production ameliorate undernutrition? J Nutr. 2007 Oct;137(10):2311-6. doi: 10.1093/jn/137.10.2311.
Marquis GS, Habicht JP, Lanata CF, Black RE, Rasmussen KM. Breast milk or animal-product foods improve linear growth of Peruvian toddlers consuming marginal diets. Am J Clin Nutr. 1997 Nov;66(5):1102-9. doi: 10.1093/ajcn/66.5.1102.
Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, Fawzi WW, Caulfield LE, Danaei G; Nutrition Impact Model Study (anthropometry cohort pooling). Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013 May 29;8(5):e64636. doi: 10.1371/journal.pone.0064636. Print 2013.
Ruel MT, Alderman H; Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013 Aug 10;382(9891):536-51. doi: 10.1016/S0140-6736(13)60843-0. Epub 2013 Jun 6.
Stevens GA, Finucane MM, Paciorek CJ, Flaxman SR, White RA, Donner AJ, Ezzati M; Nutrition Impact Model Study Group (Child Growth). Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: a systematic analysis of population representative data. Lancet. 2012 Sep 1;380(9844):824-34. doi: 10.1016/S0140-6736(12)60647-3. Epub 2012 Jul 5.
Sudfeld CR, McCoy DC, Danaei G, Fink G, Ezzati M, Andrews KG, Fawzi WW. Linear growth and child development in low- and middle-income countries: a meta-analysis. Pediatrics. 2015 May;135(5):e1266-75. doi: 10.1542/peds.2014-3111. Epub 2015 Apr 6.
Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008 Jan 26;371(9609):340-57. doi: 10.1016/S0140-6736(07)61692-4.
Passarelli S, Ambikapathi R, Gunaratna NS, Madzorera I, Canavan CR, Noor RA, Tewahido D, Berhane Y, Sibanda S, Sibanda LM, Madzivhandila T, Munthali BLM, McConnell M, Sudfeld C, Davison K, Fawzi W. The role of chicken management practices in children's exposure to environmental contamination: a mixed-methods analysis. BMC Public Health. 2021 Jun 8;21(1):1097. doi: 10.1186/s12889-021-11025-y.
Ambikapathi R, Passarelli S, Madzorera I, Canavan CR, Noor RA, Abdelmenan S, Tewahido D, Tadesse AW, Sibanda L, Sibanda S, Munthali B, Madzivhandila T, Berhane Y, Fawzi W, Gunaratna NS. Men's nutrition knowledge is important for women's and children's nutrition in Ethiopia. Matern Child Nutr. 2021 Jan;17(1):e13062. doi: 10.1111/mcn.13062. Epub 2020 Aug 4.
Passarelli S, Ambikapathi R, Gunaratna NS, Madzorera I, Canavan CR, Noor AR, Worku A, Berhane Y, Abdelmenan S, Sibanda S, Munthali B, Madzivhandila T, Sibanda LM, Geremew K, Dessie T, Abegaz S, Assefa G, Sudfeld C, McConnell M, Davison K, Fawzi W. A Chicken Production Intervention and Additional Nutrition Behavior Change Component Increased Child Growth in Ethiopia: A Cluster-Randomized Trial. J Nutr. 2020 Oct 12;150(10):2806-2817. doi: 10.1093/jn/nxaa181.
Other Identifiers
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HSPH-16-0912
Identifier Type: -
Identifier Source: org_study_id
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