MAM'Out Project - Evaluation of Multiannual and Seasonal Cash Transfers to Prevent Acute Malnutrition
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,278
- 试验地点
- 2
- 主要终点
- Cumulative incidence of child wasting
研究概览
简要总结
The MAM'Out research project aims at evaluating a seasonal and multi-annual cash transfer program in the framework of a safety net to prevent acute malnutrition by children under 24 months, in terms of effectiveness and cost-effectiveness in the Tapoa province (East region of Burkina Faso, Africa). The program will be targeted to economically vulnerable households with children less than 1 year old at the time of inclusion and the cash distributed to mothers. The transfers will be assimilated to unconditional ones, leading to beneficiaries' self-determination on the use that will be made of cash. This study will be designed as a two-arm cluster randomized intervention trial, based on randomization of rural villages of the Tapoa province. One arm will receive the intervention and one will be a control arm. The main outcomes will be the cumulative incidence of acute malnutrition (or wasting) and the cost-effectiveness. Anthropometric measures (height, weight and MUAC) will be measured, as well as indicators of dietary diversity, food security, health center frequentation, families' expenses and morbidities. Questionnaires and 24-hour food recalls will also be analyzed. Finally, based on a model theory framework built a priori, the pathways used by the cash to have an effect on the prevention of under-nutrition will be assessed.
详细描述
At international level, the WHO formulated guidelines for the treatment of severe acute malnutrition (or wasting) (WHO 1999, and more recently ACF 2011), and guidelines for moderate acute malnutrition (or wasting) are in the process of formulation. In contrast, surprisingly little is known on preventive schemes for acute malnutrition. In Haiti, Ruel et al (2008) found that targeting nutrition interventions to prevent children from becoming malnourished might be more effective than curative treatment to reduce child wasting. In addition, recent preventive trials in humanitarian settings focused on the use of food-based strategies, especially ready-to-use food (Isanaka, 2009; Hendricks, 2010; Parikh, 2010; Imbad, 2011; Huybregts, 2012). However, it is well known that the causes of under-nutrition are numerous and also relate to inadequate health and care practices, lack of food diversification, food insecurity... Therefore, the MAM'Out research project aims at assessing a context-adapted preventive approach, which is likely to influence several underlying causes of under-nutrition and not based primarily on food supplementation. The objective is to provide an evidence base for this alternative approach, in order that proven intervention be taken into account for scale-up at policy-making levels.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- — 至 12 Months（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Poor or very poor household (HEA criteria)
- •Having at least one children under 1 year old at the time of inclusion
排除标准
- •Medium or rich economic status (HEA criteria)
- •no child under one year old at the time of inclusion
- •not living in one of the 32 selected villages in the Tapoa province
结局指标
主要结局
Cumulative incidence of child wasting
时间窗: 3-monthly until 24 months after inclusion
Record of the child's height, weight to compute Weight for Height Z-scores (WHZ scores) (wasting defined as WHZ\<-2 or Edema)
Incremental cost-effectiveness ratio
时间窗: 24 months after inclusion
Calculation of a cost-effectiveness ratio at the end of the study
次要结局
- cumulative incidence of the state of stunting(3-monthly until 24 months after inclusion)
- mid-upper arm circumference (MUAC)(3-monthly until 24 months after inclusion)
- Prevalence of diarrhea(3-monthly until 24 months after inclusion)
- mean height-for-age Z-score(3-monthly until 24 months after inclusion)
- mean weight-for-length Z-score(3-monthly until 24 months after inclusion)
- Reported measle(3-monthly until 24 months after inclusion)
- edema(3-monthly until 24 months after inclusion)
- Prevalence of acute respiratory infections(3-monthly until 24 months after inclusion)