This study is a mixed-methods cluster-randomized controlled trial in Rwanda designed to measure the impact of a dairy asset transfer program with or without nutrition education promoting the home consumption of dairy milk and other animal source foods.
The purpose of this research is to contribute to efforts for improving the consumption of milk in Rwanda. It will do so by generating and communicating evidence on the nutritional benefits of including animal source food (ASF) in diets of young children and pregnant and lactating women through nutrition education. The proposed project draws upon the work of a Government of Rwanda program - the One Cow per Poor Family (Girinka) program. The Girinka program (2006 - present) is a country-wide program whose goal is to increase household income and reduce child malnutrition among poor households through livestock asset transfer. The study has two main objectives. First, researchers will measure the impact of a nutrition education/ASF promotion intervention on child and maternal nutritional status in households that have received a cow through the Girinka program. Second, researchers will compare nutrition outcomes in the Girinka + nutrition education and Girinka only groups to individuals in households that are eligible for Girinka, but have not yet received a cow. The nutrition education/ASF promotion intervention will be designed and overseen by a local organization and implemented through Government of Rwanda community health workers. The main study outcomes are child height-for-age z-score, child milk consumption, and child dietary diversity. The secondary outcomes are child weight-for-age z-score, child weight-for-height z-score, and maternal body-mass index. The researchers plan to randomly assign all cells in two districts to receive the nutrition education intervention or no intervention. The study will enroll a cohort of 687 mother-child pairs (229 per study arm). The aim is to enroll children 12-17 months of age at baseline; however, if there are not adequate numbers of households that meet all other eligibility criteria, then the child age range will be expanded to 12-29 months of age at baseline. The research team will conduct baseline and endline surveys to measure differences between the groups. At endline, researchers will collect qualitative data from participants and community health workers in the intervention arm to triangulate with the survey findings.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
746
Behavior change communication promoting the consumption of milk produced in the household and other optimal maternal and child nutrition practices. The intervention will be implemented by government of Rwanda Community Health Workers.
Ruhango District
Ruhango, Southern Province, Rwanda
Nyabihu District
Nyabihu, Western Province, Rwanda
Child height-for-age z-score (HAZ)
Measure child recumbent length in triplicate and age reported by mother. HAZ will be calculated using the World Health Organization standard.
Time frame: Baseline at study initiation
Child height-for-age z-score (HAZ)
Measure child recumbent length in triplicate and age reported by mother. HAZ will be calculated using the World Health Organization standard.
Time frame: Endline (approximately one year)
Child dairy milk consumption
Measurement based on 24 hour recall of consumption amount
Time frame: Baseline at study initiation
Child milk consumption
Measurement based on 24 hour recall of consumption amount
Time frame: Endline (approximately one year)
Child dietary diversity
Measurement based on 24 hour recall of consumption and calculated using the World Health Organization child dietary diversity indicator
Time frame: Baseline at study initiation
Child dietary diversity
Measurement based on 24 hour recall of consumption and calculated using the World Health Organization child dietary diversity indicator
Time frame: Endline (approximately one year)
Child weight-for-height z-score (WHZ)
Measurement based on recumbent length and body weight measured in triplicate. WHZ will be calculated using the World Health Organization standard.
Time frame: Baseline at study initiation
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Child weight-for-height z-score (WHZ)
Measurement based on recumbent length and body weight measured in triplicate. WHZ will be calculated using the World Health Organization standard.
Time frame: Endline (approximately one year)
Child weight for age z-score (WAZ)
Measurement based on weight measured in triplicate and age reported by mother. WAZ will be calculated based on the World Health Organization standard.
Time frame: Baseline at study initiation
Child weight for age z-score (WAZ)
Measurement based on weight measured in triplicate and age reported by mother. WAZ will be calculated based on the World Health Organization standard.
Time frame: Endline (approximately one year)
Maternal body-mass index
Measurement based on weight and standing height.
Time frame: Baseline at study initiation
Maternal body-mass index
Measurement based on weight and standing height.
Time frame: Endline (approximately one year)