Upcoming research shared at ACF research conference
At the ACF research conference, November 6th, 2016, experiences were shared from a number of studies where final results will be made available in 2017. A snapshot of what to expect, video footage of the conference presentations and contacts for the studies, are included below.
Effectiveness of adding a household WASH-package to a routine outpatient programme for severe acute malnutrition in Chad – the Ouadi’nut study
Action Contre la Faim is currently implementing a cluster randomised controlled trial in Mao and Mondo health districts, Kanem region in Chad, in partnership with the Institute of Tropical Medicine in Antwerp, Belgium, and the Sahel Association of Applied Research for Sustainable Development (ASRADD) in Chad. The study is investigating the effectiveness of adding a household water, sanitation and hygiene (WASH) package to a routine outpatient programme for severe acute malnutrition. The aim is to protect children against new episodes of diarrhoea and other WASH-related infections, and to contribute to nutritional recovery. The household WASH-package includes: 1) Household water treatment and hygiene kit (water container, water disinfection consumables, soap, cup, simple hygiene promotion leaflet with images); 2) Weekly hygiene promotion sessions at health centre level with others/caretakers of children admitted to the programme. Primary evaluation outcomes are recovery and relapse proportions. Secondary outcomes include time-to-recovery, weight gain, longitudinal prevalence of morbidity (diarrhoea, vomiting, cough, and fever), and adherence to the household WASH-package, hygiene and care practices of the mothers/caretakers.
The trial is registered at clinicaltrials.gov under the identifier: NCT02486523. The final results and recommendations will be published in 2017.
For more information, contact: Mathias Altmann, maltmann@actioncontrelafaim.org
Effects of multi-annual seasonal unconditional cash transfers on young children’s nutritional status and morbidity in Burkina Faso: the MAM’Out trial
The MAM’Out research project aims to test the effectiveness and cost-effectiveness of a seasonal and multiannual cash transfer programme, likely to influence multiple underlying causes of undernutrition. The two-arm cluster randomised controlled trial was implemented in 2015 and 2016 in Burkina Faso. The study was informed by a Nutrition Causal Analysis that identified a number of perceived causes of undernutrition in the population: women’s financial insecurity, inadequate birth spacing and poor access to potable water. A formative research was conducted to assess the relevance of a cash based intervention and provided detailed operational guidance on the target population, the type of cash transfer, the seasonality, the delivery mechanism and the amount to transfer. Participating households in the intervention group were offered seasonal unconditional cash transfers (UCTs) from July to November, over two years (2013 and 2014). A monthly allowance of 10,000 XOF (≈US$17) was given by mobile phone to mothers, identified as primary recipients of the transfers. Mothers were told that the cash transfer was to support their child’s development and to prevent undernutrition. Trained data collectors performed home visits on a quarterly basis to collect quantitative data such as child anthropometrics and morbidity, socio economic and demographic indicators. Results will be published in 2017.
Video footage of the conference presentation is available here.
For more information, contact: Freddy Houngbé, email: fhoungbe@actioncontrelafaim.org
The PROMIS project: integrating the prevention of child undernutrition into community-based management of acute malnutrition programmes in Senegal, Mali and Burkina Faso
Innovative Approaches for the Prevention of Undernutrition (PROMIS) is a three-year (2014-16) project funded by Global Affairs Canada that seeks to prevent and improve the treatment coverage of acute in children in Burkina Faso, Mali, and Senegal. The intervention is implemented Helen Keller International and evaluated by the International Food Policy Research Institute (IFPRI) using mixed study designs. The PROMIS project looks to improve performance and beneficiary coverage of current community-based management of acute malnutrition (CMAM) programmes by integrating a package of preventive measures into child acute malnutrition (AM) screening offered by different delivery platforms. Impacts on child AM prevalence and incidence are hypothesised. In Mali and Burkina Faso, the programme’s impact is assessed using a cluster randomised controlled design, while in Senegal, a smaller study assesses the programme’s feasibility in a peri-urban setting.
In Mali, the delivery platform consists of monthly community health volunteers-led village gatherings of caregivers with children 6-23 months of age to screen children for AM and to deliver the enhanced preventive package (strengthened Behaviour Change Communication (BCC) on nutrition and health, and a small quantity of lipid-based nutrient supplement (SQ-LNS)). The comparison group receives monthly village-based group BCC and screening for child AM. In Burkina Faso, well-baby consultations (WBC) in health centres is the primary platform to offer monthly screening for AM among infants starting at birth. Caregivers of infants from 0-6 months allocated to the intervention group that participate in WBC receive strengthened BCC on nutrition and health after regular child AM screening. From the age of six months onwards, the provision of preventive SQ-LNS is added. The comparison group receives unspecific BCC as prescribed by the national policy. In Senegal, community health workers trained by local NGOs organise group BCC, screen children for AM and distribute SQ-LNS to caregivers of children 6-23 months of age.
In Mali and Burkina Faso, the programme’s impact is assessed by two study designs. A baseline-endline comparison study assesses the programme’s impact on the prevalence of acute malnutrition, whereas a longitudinal study with monthly follow-up measurements during 18 months evaluates the preventive impact on the incidence of child AM. A mixed methods process evaluation assesses the programme’s impact pathways and feasibility. Finally, a cost-effectiveness study will provide insight into the economic dimension of this integrated programme. Results will be available at the end of 2017 and throughout 2018.
Video footage of the conference presentation is available here.
For more information, contact: Lieven Huybregts, email: L.Huybregts@cgiar.org
Delivering SAM treatment through community health workers in Mali
Community-based management of severe acute malnutrition (SAM) has increased access to treatment, but coverage of cases remains inadequate. Experience from other platforms show that modifications to the service delivery model, such as the delivery of malaria, pneumonia and diarrhoea health services by Community Health Workers (CHWs) at community level, can lead to over 90% coverage of affected cases. More evidence is needed to develop a similar model using CHW for the treatment of SAM, to allow Ministry of Health to adapt treatment models to deliver higher coverage and performance. A clinical, prospective, multi-centre cohort study was conducted between February 2015 and February 2016 by ACF in Kita in Southwest Mali, to investigate if SAM treatment delivered through CHWs is as effective as treatment delivered at health facilities. Secondary objectives were to assess the coverage, quality of care and cost-effectiveness of the intervention compared to routine outpatient care. One cohort (consisting of four health centres) followed a traditional outpatient model of treating SAM (control group) and the second cohort (consisting of three health centres) used CHWs to treat uncomplicated SAM cases in the community (intervention group). The allocation of treatment between the two groups was randomised. Clinical outcomes (cure, death and defaulter rates), cost effectiveness, treatment coverage and quality of care were examined in both the control and intervention groups. Results will be made available in 2017.
Video footage of the conference presentation is available here.
For more information, contact: Pilar Charle, email: pcharle@accioncontraelhambre.org