The Impact on School Feeding on Children's Growth and Development
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,006
- 主要终点
- Change from Baseline Children's weight at 14 months
研究概览
简要总结
In order to improve child nutrition, the Poverty Reduction Strategy adopted by the Government of Bangladesh (GoB) has called for the initiation of a school feeding programme for primary school children living in poor and disadvantaged families and communities where the prevalence of child malnutrition is high. Accordingly, a pilot feeding programme is planned for implementation in Government and NGO schools in 10 Upazilas in rural Bangladesh with the aim of: 1) enhancing the nutritional status and growth of younger school-going children by reducing micronutrient deficiencies and providing a protein/calorie supplement; 2) improving learning capacity and attentiveness in the classroom; 3) increasing enrollment, attendance and completion rates and 4) supporting the goals of achieving universal primary education and reducing gender disparity.
The objectives of the proposed baseline survey respond to GoB's aims:
- To assess the nutrition status of younger school-going children prior to the initiation of a school feeding programme, thus enabling the later assessment of programme impact on micronutrient deficiencies and anthropometric indicators.
- To assess the cognitive performance and school attendance of children prior to the initiation of a school feeding programme thus enabling the later assessment of programme impact on school enrollment and attendance, and learning capacity.
The baseline study will be conducted using a cluster randomized study design in which schools represent clusters. Seven schools will be randomly selected from each of 7 Upazilas out of 10 that have been selected for intervention. A control group will be included in study design consisting of 7 schools selected randomly from 7 comparable yet adjacent Upazilas not slated for inclusion in the feeding programme. Use of a control group will enable later evaluations to attribute possible improvements in key impact/outcome variables to the intervention itself. A mid term evaluation will be conducted 6 months after the baseline survey. Finally, an impact evaluation will be conducted on the same children 10-14 months after the baseline survey.
详细描述
To enable useful comparison, FSNSP will adapt the study design used by World Food Programme to evaluate a similar school feeding intervention undertaken in chronically food insecure areas in rural Bangladesh during the period 2002-04. The baseline study will be conducted using a cluster randomized study design in which schools represent clusters. Seven schools will be randomly selected from each of 7 Upazilas out of 10 that have been selected for intervention. A control group will be included in study design consisting of 7 schools selected randomly from 7 comparable yet adjacent Upazilas not slated for inclusion in the feeding programme. Control groups will share the same socio-economic, geographic background characteristics of adjacent intervention schools, but are located in Upazilas that have not been selected by GoB to be part of the pilot School Feeding Programme. Use of a control group will enable later evaluations to attribute possible improvements in key impact/outcome variables to the intervention itself. A mid-term followup and endline study will be conducted on the same children approximately 6 months and 10-12 months following baseline. The precise timing of follow-up will be a function of when biscuit distribution is initiated, and seasonal period. Care will be taken to capture the same season as the baseline (to control for seasonal availability of fruits and vegetables), and to ensure that follow-up occurs before the Ramadan period when normal food consumption patterns are disrupted.
The baseline study will consist of data collected at individual (child), household (mother) and institutional (school) levels. Study methods will include: 1) a structured survey questionnaire delivered to teachers, school children, and their mothers; 2) In-depth interviews/focus groups with teachers, community members and NGO implementers; 3) data abstraction from school records; 4) anthropometric and cognitive measures of all primary school students, and 5) biological measures on a sub-sample of children. Programme staff will be consulted in the design and piloting of study instruments, and in thinking about how to best accommodate monitoring and evaluation activities into project design.
- Structured Surveys The student survey questionnaire will comprise of a series of questions that assess what they have eaten recently, as well perceptions of satiety, hunger, energy levels, ability to concentrate, and whether there have been recent school absences.
The mother's questionnaire will cover background information concerning household food security and socio-economic status, as well as information on the child's eating practices, recent morbidity, and personal assessment of child's energy level, concentration and irritability.
A teacher's questionnaire queries their perceptions and experience in the classroom regarding the behavior of children in the classroom.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 5 Years 至 11 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •5-11 years of school children
- •Giving Consent
排除标准
- •More than 12 years of age
- •Refuse consent
研究组 & 干预措施
2
The baseline study will be conducted using a cluster randomized study design in which schools represent clusters. Seven schools will be randomly selected from each of 7 Upazilas out of 10 that have been selected for intervention. The school feeding intervention consists of a daily snack in the form of a fortified biscuit that provides 300 kcal per single 75 gm packet (approximately 15% of daily calorie requirements), and a range of micronutrients contributing to about 75% of the daily requirement of vitamin A, folate, iron, iodine, zinc and magnesium. Children whose cognitive abilities are are challenged by autism, mental issues or iodine deficiency will be excluded from the study.
干预措施: The school feeding intervention (Dietary Supplement)
Non Intervention
A control group will be included in study design consisting of 7 schools selected randomly from 7 comparable yet adjacent Upazilas not slated for inclusion in the feeding programme. Use of a control group will enable later evaluations to attribute possible improvements in key impact/outcome variables to the intervention itself. An equal number of boys and girls will be selected from each class to enable gender analysis. Children whose cognitive abilities are are challenged by autism, mental issues or iodine deficiency will be excluded from the study.No intervention had given in this group.
干预措施: The school feeding intervention (Dietary Supplement)
结局指标
主要结局
Change from Baseline Children's weight at 14 months
时间窗: Double time point (Baseline, September, 2011 and Endline, November, 2012; through study completion)
Children's weight were measured by WHO
Change from Baseline Children's Height at 14 months
时间窗: Double time point (Baseline, September, 2011 and Endline, November, 2012; through study completion)
Children's Height were measured by WHO
Change from Baseline Children's nutritional impact at 14 months
时间窗: Double time point (Baseline, September, 2011 and Endline, November, 2012; through study completion)
Child anaemia and micronutrient deficiency: biochemical analyses of blood specimens
次要结局
- Change from Baseline Children's cognitive performance and school attendance at 14 months(Double time point (Baseline, September, 2011 and Endline, November, 2012; through study completion))