Millennium Villages Project in Sub-Saharan Africa
- Conditions
- Child Survival
- Interventions
- Other: Routine servicesOther: Health and development intervention package
- Registration Number
- NCT01125618
- Lead Sponsor
- Columbia University
- Brief Summary
The Millennium Villages Project involves the coordinated and simultaneous delivery of a package of proven interventions in health, agriculture, infrastructure and education. The project works in partnership with governments in 10 African countries in areas where progress towards achieving the Millennium Development Goals has been insufficient.
The Project evaluation will test the following hypotheses:
1. That after 5 years of operation, villages exposed to the MVP intervention will have a lower rate of under-5 mortality and parallel gains in MDG-related secondary outcomes when compared to similar villages not receiving the intervention.
2. That the coordinated delivery a multi-sector package of health and development interventions implemented through a broad-based local partnership is feasible in a diversity of sub-Saharan African contexts, and;
3. The intervention package can be delivered at a scalable cost of $40 per person per year in the health sector and $110 per person per year in total
- Detailed Description
Design and population The design is a pair-matched community intervention trial. Village clusters with high levels of malnutrition were selected from rural areas in ten sub-Saharan African countries to reflect a diverse range of agro-ecological zones, farming systems, disease profiles, and infrastructure challenges. MVP sites represent 80 villages in 14 clusters across 10 countries, covering nearly 500,000 people. For each intervention cluster, a matched comparison cluster has been selected at random to participate in the evaluation.
Outcomes The primary outcome is the under-5 mortality rate. Secondary outcomes are levels of coverage with essential maternal-child health interventions and related MDG indicators for poverty, nutrition, education, and environmental health.
Sample size calculation The assessment follows 6000 households across intervention and matched comparison villages at baseline, and after 3 and 5 years of intervention exposure. With 10 paired clusters, the study is powered to detect a 40% difference in the U5MR between the two groups.
Analysis plan The analysis will use a two-staged pair-matched cluster level analysis, and will be complemented with multilevel modeling. Reporting will adhere to Transparent Reporting of Evaluations with Non-randomized Designs (TREND) guidelines.
Implementation science A portfolio of qualitative implementation science (process evaluation) will complement the quantitative assessment, and involves interviews with implementers, partners, and project beneficiaries. This analysis will address questions about: the feasibility of the interventions; the timing and sequence of their introduction; key contextual barriers and facilitators to implementation; and potential synergies achieved from the integrated multisector approach.
Economic costing study One project hypothesis is that an annual per capita investment of $110 is required to achieve the MDGs. The aim of the economic costing study is to document the absolute and relative contribution of project partners (MVP, government, donors, and the community) to all priced and non-priced cluster-level activities, as well as the sector-specific breakdown of these inputs.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 65000
- Resident in a Millennium Village and consenting to periodic assessments
- Those not consenting to participate
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Comparison village Routine services Villages receiving routine services through established programs MVP village Health and development intervention package Wealth stratified and randomly selected households residing in a village exposed to the Millennium Villages Project intervention (or health and development intervention package)
- Primary Outcome Measures
Name Time Method Child Mortality Rate 5 years Under 5 Mortality Rate
- Secondary Outcome Measures
Name Time Method Prevalence of low mid-upper arm circumference 5 years Proportion of under 5s with a low mid-upper arm circumference
Prevalence of Diarrhea 5 years Proportion of under 5's with diarrhea in past 2 weeks
Survival rate to last grade of primary education (School Quality) 5 years Prevalence of improved sanitation utilization 5 years Proportion of the population using an improved sanitation source
Age of introduction of complementary feeding (Child feeding practices) 5 years Prevalence of measles immunization 5 years Proportion under 1s immunized against measles
Prevalence of bed net utilization 5 years Proportion of under 5s sleeping under Longlasting insecticide treated bednets in the night prior to the survey
Prevalence of malaria treatment 5 years Proportion of under 5s with a fever in the past 2 weeks who receive appropriate anti-malarial treatment
Prevalence of diarrhea management 5 years Proportion of under 5s with diarrhea in the past 2 weeks who received oral rehydration therapy
Prevalence of pneumonia management 5 years Proportion of under 5s treated for pneumonia in the past 2 weeks
Prevalence of newborn care 5 years Proportion of newborns receiving a post-natal check in the first week of life
Proportion of pregnant women who received and HIV test 5 years This measures the prevention of vertical transmission of HIV
Prevalence of food insecurity 5 years Proportion of households reporting not enough food for 1 of past 12 months
Institutional delivery rate 5 years Proportion of births attended by skilled health personnel
Prevalence of underweight 5 years Proportion of under 5s who are underweight; Underweight= weight for age Z score
Prevalence of wasting 5 years Proportion of under 5s who are wasted; Wasting = weight for height Z score
Prevalence of antenatal care 5 years Proportion of women who receive at least 4 ANC visits
Prevalence of Stunting 5 years Proportion of under 5s who are stunted; Stunted = low height for age Z-score
Prevalence of Malaria 5 years Prevalence of malaria among under 5s at the time of survey
Duration or breast feeding (Child feeding practices) 5 years Household Asset Index (Household poverty) 5 years Survey of fixed and non-fixed assets, including recent purchases
Prevalence of improved water source utilization 5 years Proportion of the population using an improved drinking water source
Trial Locations
- Locations (11)
Pampaida
🇳🇬Pampaida, Nigeria
Potou
🇸🇳Potou, Senegal
Bonsasso
🇬ðŸ‡Bonsasso, Ghana
Mwandama
🇲🇼Mwandama, Malawi
Koraro
🇪🇹Koraro, Ethiopia
Sauri
🇰🇪Sauri, Kenya
Tiby
🇲🇱Tiby, Mali
Ikaram
🇳🇬Ikaram, Nigeria
Mayange
🇷🇼Mayange, Rwanda
Mbola
🇹🇿Mbola, Tanzania
Ruhiira
🇺🇬Ruhiira, Uganda