Realizing Gender Equality, Attitudinal Change & Transformative Systems in Nutrition (REACTS-IN)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 13,500
- 试验地点
- 3
- 主要终点
- Gender equality
研究概览
简要总结
This is an independent evaluation of World VIsion's 7-year quasi-experimental intervention to improve nutrition, nutrition-related rights and gender equality for women, adolescent girls, and children under five years of age in rural Bangladesh, Kenya, and Tanzania. The evaluation will collect baseline, midline, and end-line data from intervention communities, schools, and health facilities. Only baseline and endline will be collected on the comparison communities. The evaluation objectives are to test if the intervention improved indicators for (i) child anthropometry, (ii) maternal and child dietary practices, (iii) women's empowerment, and (iv) equitable health service access for nutrition and sexual and reproductive needs. The evaluation analysis will take into account gender differences in the indicators.
详细描述
This is an independent evaluation of World VIsion's 7-year quasi-experimental intervention ("Realizing Gender Equality, Attitudinal Change and Transformative Systems in Nutrition", REACTS-IN) to improve nutrition, nutrition-related rights and gender equality for women, adolescent girls, and children under five years of age in rural Bangladesh, Kenya, and Tanzania. REACTS-IN is a multi-sectoral approach, integrating nutrition-related determinants, such as water, sanitation, and hygiene (WASH) interventions and health systems strengthening, to improve access to quality and gender-responsive health systems with increased capacity to prevent and treat malnutrition, especially at the primary health care level. REACTS-IN includes both nutrition-specific (e.g., school-based iron-folic acid supplement program) and nutrition-sensitive (e.g., WASH education) activities delivered through local health systems and/or schools, and communities.
This independent evaluation will include three data collection at baseline, midpoint, and end-line to evaluate the performance indicators for the ultimate and intermediate outcomes. This includes indicators for child anthropometry, maternal and child dietary practices, women's empowerment, and equitable health service access for nutrition and sexual and reproductive needs. The evaluation analysis will take into account gender differences in the indicators.
The data collection will be carried out with intervention communities as well as with comparison communities. The estimated household sample is 463 households (women, husbands, child)/arm/country per time point, selected through a multi-stage cluster sampling methodology. The household baseline survey with a representative sample of mothers with children (0-5.9 mo; 6-23.9 mo; 24-59.9 mo) will be compared to the values at midpoint (to assess initial impact and the need for program adjustments) and at end-line (to assess the total impact of the project). The surveys will include sociodemographic, economic, and environmental information to assess the indicators for the local context. The evaluation also includes a sample of 500 school-going adolescents (250 boys, 250 girls)/arm/country per time point to assess indicators of knowledge about nutrition, menstrual hygiene management, and sexual and reproductive health. Finally, a sample of approximately 24 health staff and community leaders will provide qualitative data on gender-equitable access to services per arm/country for baseline and end-line.
Although the project also is working in Somalia, this independent evaluation does not include data collection in Somalia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •15-49 y of age
- •biological mother of child in the home who is 0-5.9, 6-23.9, or 24-59.9 months
- •has lived in the community for at 12 months
- •(ii) Husbands/partners:
- •no age limit
- •lives in the home with index woman
- •has lived in community for at least 12 months
- •(iii) Adolescents:
- •10-19 years
- •male or female
- •has been in target school for at least 6 months
- •lives in the target community
- •(iv) Children:
- •0-5.9, 6-23.9, or 24-59.9 months
排除标准
- •(i) Children:
- •no limitation on normal diet or growth (birth defects, illnesses)
研究组 & 干预措施
Intervention
Includes multiple activities, depending on country, including support of school-based iron-folic acid supplementation program; promotion of bio-fortified crops (sweet potatoes, beans, rice, corn); training on nutrition, water & sanitation, gender equity for rural communities through community groups and for health facility staff; support to improve gender-sensitive health services for nutrition, sexual and reproductive health,
干预措施: Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights (Behavioral)
Intervention
Includes multiple activities, depending on country, including support of school-based iron-folic acid supplementation program; promotion of bio-fortified crops (sweet potatoes, beans, rice, corn); training on nutrition, water & sanitation, gender equity for rural communities through community groups and for health facility staff; support to improve gender-sensitive health services for nutrition, sexual and reproductive health,
干预措施: school-based iron-folic acid supplement program (Dietary Supplement)
Intervention
Includes multiple activities, depending on country, including support of school-based iron-folic acid supplementation program; promotion of bio-fortified crops (sweet potatoes, beans, rice, corn); training on nutrition, water & sanitation, gender equity for rural communities through community groups and for health facility staff; support to improve gender-sensitive health services for nutrition, sexual and reproductive health,
干预措施: Health service training on equitable access to nutrition, health, and sexual and reproductive services (Behavioral)
Intervention
Includes multiple activities, depending on country, including support of school-based iron-folic acid supplementation program; promotion of bio-fortified crops (sweet potatoes, beans, rice, corn); training on nutrition, water & sanitation, gender equity for rural communities through community groups and for health facility staff; support to improve gender-sensitive health services for nutrition, sexual and reproductive health,
干预措施: bio-fortified crops (Dietary Supplement)
Comparison
No intervention will take place. Standard of care will be available in the health facilities and schools.
结局指标
主要结局
Gender equality
时间窗: Change between baseline and study completion, an average of 5 years
Percent of households with children \< 59.9 mo that have achieved gender equality
Child anthropometry
时间窗: Change between baseline and study completion, an average of 5 years
Percent of children 6-59 mo of age who are stunted
次要结局
- mothers planting biofortified crops(Change between baseline and study completion, an average of 5 years)
- maternal knowledge of exclusive breastfeeding(Change between baseline and study completion, an average of 5 years)
- mothers planting nutrient dense local vegetables(Change between baseline and study completion, an average of 5 years)
- mothers planting trees(Change between baseline and study completion, an average of 5 years)
- hygenic toilets(Change between baseline and study completion, an average of 5 years)
- community health worker visit(Change between baseline and study completion, an average of 5 years)
- Adolescent iron folic acid supplements(Change between baseline and study completion, an average of 5 years)
- health facility(Change between baseline and study completion, an average of 5 years)
- Antenatal care(Change between baseline and study completion, an average of 5 years)
- Contraception use by women and partners(Change between baseline and study completion, an average of 5 years)
- Child diet(Change between baseline and study completion, an average of 5 years)
- Sexual and reproductive health services for adolescents(Change between baseline and study completion, an average of 5 years)
- Gender equitable health services for nutrition, health, and sexual and reproductive health(Change between baseline and study completion, an average of 5 years)
- Exclusive breastfeeding(Change between baseline and study completion, an average of 5 years)
- Use of family planning(Change between baseline and study completion, an average of 5 years)
- adolescent knowledge of nutrition, menstrual hygiene, and sexual and reproductive health(Change between baseline and study completion, an average of 5 years)
- maternal knowledge on nutrition(Change between baseline and study completion, an average of 5 years)
- Attended birth deliveries(Change between baseline and study completion, an average of 5 years)
- maternal knowledge of family planning(Change between baseline and study completion, an average of 5 years)
研究者
Grace S. Marquis
Associate Professor
McGill University