Integrated Research on Acute Malnutrition in Mali (IRAM-MALI)

Summary

The IRAM MALI impact evaluation uses a cluster-randomized controlled study design to assess the impact of the package of integrated interventions aimed at reducing the longitudinal prevalence of wasting by reducing the incidence of child wasting, enhancing the recovery/cure rate from wasting treatment and reducing the relapse rate determined three months after post-treatment recovery from wasting. These interventions include, among other things, strengthening of community care groups (NASGs); home visits with delivery of behavioral change communication about nutrition, health and hygiene (WASH) for young children; distribution of a preventive nutritional supplement; and improved coverage of wasting screening (family MUAC and community screening), management, adherence to treatment and prevention of relapse in the health district of Koutiala, Sikasso region, Mali, West Africa.

Conditions

• Acute Malnutrition in Childhood
• Wasting

Interventions

BEHAVIORAL

Strengthened SBCC

Social and Behavioral Change Communication related to prenatal, postnatal, IYCF practices as well as on the care of young children at several specific ages, hygiene, and health will be delivered during monthly home visits by pairs of NASG members.

DIETARY_SUPPLEMENT

Preventive nutritional supplement

Monthly delivery by NAGS pairs of a nutritional supplement: SQ-LNS, at a dose of 28 bags of 20g per month per beneficiary child. The nutritional supplement is limited to : \- \[6-17\]months old children diagnosed as non-wasted (MUAC\>=125mm)

BEHAVIORAL

Family MUAC

MUAC screening of children 6 to 59 months of age by family members will be introduced. This will involve distributing Shakir MUAC tapes to all intervention households and training mothers/guardians, or any other family member expressing an interest, in the screening of wasting with the MUAC criterion. The training will be carried out by the members of the NASGs and during each home visit, they will be able to ensure that the MUAC measurement technique is well mastered by the mother (or another member) and correct the technique if necessary. They will also explain the procedure to be followed if the child is diagnosed as wasted by a family.

BEHAVIORAL

Active screening by NASGs

Monthly screening by the NASG members of the children they follow, using the MUAC. Referral to the health center of \[6-17\] months old children screened as malnourished (result of MUAC orange or red), and follow-up on referral to confirm child was enrolled.

BEHAVIORAL

Intensified followup of children with wasting referred to and enrolled in CMAM treatment

NASG members will conduct biweekly follow-up visits in the households of children with wasting referred to and enrolled in CMAM treatment programs to ensure adherence to the outpatient treatment schedule.

BEHAVIORAL

Relapse prevention

NASG members will conduct biweekly home visits to monitor the nutritional status of children aged 9 to 17 months who were discharged from CMAM treatment after recovery. NASGs members will provide additional counseling to prevent relapse and screen these children for wasting to detect possible relapse.

BEHAVIORAL

Cooking demonstrations

NASGs members will also be supported by the IRAM project in the organization of cooking demonstrations with nutrient-rich foods in the community, during which passive screening of children will be carried out.

Sponsors & Collaborators

• UNICEF

  collaborator OTHER

• World Vision

  collaborator OTHER

• AFRICSante

  collaborator UNKNOWN

• International Food Policy Research Institute

  lead OTHER

Principal Investigators

• Lieven Huybregts, PHD · IFPRI

• Elodie Becquey, PHD · IFPRI

• Jef Leroy · IFPRI

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

6 Months

Max Age

23 Months

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-05-06

Primary Completion

2022-07-15

Completion

2022-10-15

Countries

• Mali

Study Locations