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Assessing the Effect of Sustainable Small-scale Egg Production on Maternal and Child Nutrition in Rural Zambia

Primary Purpose

Malnutrition, Child, Malnutrition, Infant

Status
Completed
Phase
Not Applicable
Locations
Zambia
Study Type
Interventional
Intervention
Egg production
Sponsored by
Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malnutrition, Child focused on measuring community development; poultry; animal-source food; stunting

Eligibility Criteria

6 Months - 36 Months (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. the HH dwelling is ≤1.5 km from the egg production facility or central control point;
  2. there is a child 6-36 months of age in the HH; and,

Additionally, all HHs that include a member of the egg production group will be enrolled in the study, regardless of whether or not they meet the above inclusion criteria.

Exclusion Criteria:

  1. the mother/primary caretaker or head of HH cannot converse with the field staff because of language;
  2. the mother/primary caretaker or head of HH is unable to give informed consent or complete an interview without assistance; or,
  3. the child is deformed, disabled, severely ill, or unable to cooperate for anthropometric measures.

Sites / Locations

  • COMACO

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Intervention

Control

Arm Description

Outcomes

Primary Outcome Measures

Change in child height-for-age Z-score
Recumbent length for children < 24 months and standing height for those 24-36 months, with WHO Child Growth Standards as the reference population.

Secondary Outcome Measures

Change in household egg consumption
7 day recall on total number of chicken or other eggs consumed in the household
Change in maternal egg consumption
Change in child egg consumption
Change in maternal dietary diversity
Measured by Women's Dietary Diversity Score, a 24 hour recall of all foods consumed, organized into 9 food groups
Change in child dietary diversity
Change in child stunting
Defined as having a height-for-age z-score < -2.0, with WHO Growth Standards as the reference population.

Full Information

First Posted
August 3, 2015
Last Updated
February 2, 2018
Sponsor
Cornell University
Collaborators
Community Markets for Conservation (COMACO)
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1. Study Identification

Unique Protocol Identification Number
NCT02516852
Brief Title
Assessing the Effect of Sustainable Small-scale Egg Production on Maternal and Child Nutrition in Rural Zambia
Official Title
Assessing the Effect of Sustainable Small-scale Egg Production on Maternal and Child Nutrition in Rural Zambia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
June 2014 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
May 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cornell University
Collaborators
Community Markets for Conservation (COMACO)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Animal source foods (ASF), such as meat and eggs, are rich in nutrients critical for growth and development. Yet, for poor children in developing countries, ASF consumption is limited by cost, inadequate caregiver knowledge, and lack of local production and physical availability. The impact of HH- and village-level livestock interventions on household dietary diversity and nutritional status in resource-poor communities is not well established. The objective of this study is to test the effectiveness of local egg production intervention on maternal and child diets and child nutrition status. This project takes place in the Luangwa Valley, Zambia in partnership with a local non-governmental organization, COMACO. Twenty communities will be assigned to the intervention, and 20 matched communities will be selected as controls. In each intervention community, an egg production facility will be built, owned, and operated by trained COMACO farmers. Households (HHs) in each community will be sampled twice annually for 1 year pre-intervention (baseline) and 1 year post-intervention to assess dietary diversity and nutritional status. Data analysis will test for a change in these outcomes from baseline in each intervention community compared to the matched control community.
Detailed Description
The objective of this study is to test the effectiveness of an intervention establishing local egg production on maternal and child diets and nutrition status. The investigators hypothesize that this intervention, combined with appropriate agricultural extension and nutrition education programs, will result in: 1) increased total household, maternal, and child consumption of eggs; 2) improved maternal and child dietary quality; and 3) improved infant/ young child nutritional status. The investigators will test this hypothesis in the Luangwa Valley, Zambia in partnership with a local non-governmental organization, Community Markets for Conservation (COMACO). The forty study sites are located in four geographic clusters (Chiefdoms) in Eastern Province Zambia. These Chiefdoms are located in two districts: Mambwe (Mnkhanya, Jumbe, and Nsefu Chiefdoms) and Lundazi (Mwanya Chiefdom). Twenty communities will be assigned to the intervention (egg production), and 20 matched communities will be selected as controls (no intervention). In each intervention community, an egg production facility will be built, each owned and operated by trained COMACO farmers, mostly women. Each group will be provided layer pullets at point-of-lay and layer mash. Facility owners will make all business decisions, retain all profits, and will be responsible for all upkeep costs. In a repeated cross-sectional study design, indicators of food security, wealth, diet, nutritional status (anthropometrics), and health and wellbeing will be assessed in all egg-producing HHs and in women/child dyads (children aged 6-36 months) residing in the area surrounding each facility or central control point. Data will be collected twice annually for 1 year pre-intervention (baseline) and 1 year post-intervention. The exposure of interest is living in an egg-producing community. In the primary analysis, the investigators will use hierarchical mixed effects modeling to analyze the effect of the program on each of the outcomes of interest (see Outcome Measures section for details).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malnutrition, Child, Malnutrition, Infant
Keywords
community development; poultry; animal-source food; stunting

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
3546 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Title
Control
Arm Type
No Intervention
Intervention Type
Other
Intervention Name(s)
Egg production
Intervention Description
Establishment and support of a community-owned and -operated egg production facility located at a central location in the community
Primary Outcome Measure Information:
Title
Change in child height-for-age Z-score
Description
Recumbent length for children < 24 months and standing height for those 24-36 months, with WHO Child Growth Standards as the reference population.
Time Frame
6, 12, 18, and 24 months after intervention
Secondary Outcome Measure Information:
Title
Change in household egg consumption
Description
7 day recall on total number of chicken or other eggs consumed in the household
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in maternal egg consumption
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in child egg consumption
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in maternal dietary diversity
Description
Measured by Women's Dietary Diversity Score, a 24 hour recall of all foods consumed, organized into 9 food groups
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in child dietary diversity
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in child stunting
Description
Defined as having a height-for-age z-score < -2.0, with WHO Growth Standards as the reference population.
Time Frame
6, 12, 18, and 24 months after intervention
Other Pre-specified Outcome Measures:
Title
Change in household food security
Description
Measure by Household Food Insecurity Access Scale (HFIAS), Household Hunger Scale (HHS) and/or Months of inadequate household food provisioning (MIHFP)
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in producer household and poultry incomes
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in maternal physical and emotional health
Description
Measured through a 6-item index adapted from RAND short form
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in maternal nutritional status
Description
Measured by mid-upper arm circumference and body mass index
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in child weight-for-height Z-score
Time Frame
6, 12, 18, and 24 months after intervention
Title
Change in child weight-for-age Z-score
Time Frame
6, 12, 18, and 24 months after intervention

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
36 Months
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: the HH dwelling is ≤1.5 km from the egg production facility or central control point; there is a child 6-36 months of age in the HH; and, Additionally, all HHs that include a member of the egg production group will be enrolled in the study, regardless of whether or not they meet the above inclusion criteria. Exclusion Criteria: the mother/primary caretaker or head of HH cannot converse with the field staff because of language; the mother/primary caretaker or head of HH is unable to give informed consent or complete an interview without assistance; or, the child is deformed, disabled, severely ill, or unable to cooperate for anthropometric measures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexander J Travis, VMD, PhD
Organizational Affiliation
Cornell University
Official's Role
Principal Investigator
Facility Information:
Facility Name
COMACO
City
Mfuwe
State/Province
Eastern Province
Country
Zambia

12. IPD Sharing Statement

Links:
URL
http://www.itswild.org
Description
Community Markets for Conservation (COMACO) official website

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Assessing the Effect of Sustainable Small-scale Egg Production on Maternal and Child Nutrition in Rural Zambia

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