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

Marcos Vera Hernandez

Status: Completed

Conditions: Child Malnutrition

Treatments: Behavioral: Provision of information on safe water and child nutrition; Behavioral: Provision of information on safe water

Study type: Interventional

Funder types: Other

Identifiers

NCT02427945

1827/006

Details and patient eligibility

About

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.

Full 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.

Enrollment: 1,671 patients

Sex: All

Ages: Under 18 months old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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1,671 participants in 3 patient groups

Control

Experimental group

Description:

Provision of information on safe water

Treatment:

Behavioral: Provision of information on safe water

Treatment traditional

Experimental group

Description:

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.

Treatment:

Behavioral: Provision of information on safe water and child nutrition

Treatment couple

Experimental group

Description:

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.

Treatment:

Behavioral: Provision of information on safe water and child nutrition