Effectiveness Study During the First 1,000 Days in Kenya

Summary

Malnutrition is a public health problem in Kenya, with 26% of children underfive years of age stunted, and 26% of pre-school children, 26% of women of reproductive age and 42% of pregnant women being anaemic, respectively. Agriculture is the main source of income, food and nutrients for the majority of rural families in Sub-Saharan Africa including Kenya. Most farmers are smallholders and are vulnerable to poor nutrition. Thus far, programmes have mostly focused on increasing yields and household income, but not on improving nutritional status. One Acre Fund (1AF) has over the past 10 years successfully introduced an agriculture programme to smallholder farmers in Western Kenya focusing on improving harvest. 1AF is therefore well placed to transform an existing and successful agriculture programme into the world's largest 'nutrition network' for farmers, and it is the hope that a partnership between Children's Investment Fund Foundation (CIFF) and 1AF will create a strong voice for nutrition within the agriculture sector. The project aims to use an integrated programme by introducing nutrition-sensitive (improved water, sanitation and hygiene (WASH): e.g. soap for hand washing) and nutritionspecific (e.g. micronutrient supplements) components to 1AF's agricultural programme. The impact of such an integrated programme will be assessed in a cluster randomized intervention study in pregnant women and - after delivery - their offspring until they reach two years of age comparing one group receiving the integrated intervention to another group receiving the agricultural intervention (already in place).

Conditions

• Stunting
• Anemia
• Micronutrient Deficiency

Interventions

DIETARY_SUPPLEMENT

Intervention (integrated package)

During whole study (pregnant women and offspring): * Soap (for daily hand washing) * Chlorine solution (for daily drinking water treatment) * Life stage-appropriate (pregnancy, lactation, IYCF) monthly nutrition and WASH trainings During pregnancy and up to when offspring turns 6 months old: * LNS (Enov' Mum, 20g sachet daily) * Anthelminthic treatment (single-dose mebendazole (500mg), once during second trimester of pregnancy) Children 6-24 months of age * MNP (MixMe, 1g sachet every three days) * ORS + zinc * 1 egg per day All families in the intervention group will receive the same agriculture-focused package (see section 'control intervention' below) as those in the control group. All women will follow regular antenatal care as provided by the Kenyan government as part of their routine health system (e.g. intermittent preventive malaria treatment and iron-folic acid-supplements).

OTHER

Control

Active control: The families living in the control clusters will receive the agriculture-focused package that is already in place in all participating clusters through the 1AF programme. This agriculture focused package consists of: - Agricultural training (every 2 weeks on average) for all - Free to enrol for the following products on credit: o Compost boosters * Cook stoves o Seeds (onions, maize, indigenous greens, beans) o Maize storage bags o Drying tarps * Trees o Solar lights o Fertilizer o Actellic dust (insecticide) o Re-usable sanitary pads

Sponsors & Collaborators

• One Acre Fund

  collaborator UNKNOWN

• Children's Investment Fund Foundation

  collaborator OTHER

• Fabian Rohner

  lead OTHER

Principal Investigators

• Rita Wegmüller, PhD · GroundWork

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

99 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2018-06-08

Primary Completion

2021-08-31

Completion

2021-08-31

Countries

• Kenya

Study Locations