Effectiveness of approaches to deliver integrated solutions for optimal child growth and development in Tanzania

ISRCTN ISRCTN10323949
DOI https://doi.org/10.1186/ISRCTN10323949
Secondary identifying numbers R-SB-POC-1707-09024
Submission date
01/10/2017
Registration date
03/10/2017
Last edited
29/04/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
It is estimated that that 20 million low-birth-weight babies are born each year, 314 million children under 5 years of age experience mild to severe stunting, and over 200 million children are not meeting their developmental and cognitive potential. Reducing the number of Tanzanian children facing these early life adversities is vital given the large negative long-term consequences of early developmental delays in terms of individual earnings and social capital. Children experiencing in utero or early childhood adversity generally enrol later in school (if they enrol at all), perform poorly on academic tests, complete less education than their peers, and have reduced personal income later in life. Accordingly, improving early life environments will likely not only improve child growth and development in the short run, but also contribute to more educated and productive future societies. The aim of this study is to assess a child growth and development intervention package delivered by community health workers (CHWs) in Morogoro Region, Tanzania. The study also looks at whether conditional cash transfers for antenatal care and well-child clinic visits improve child growth and development.

Who can participate?
Pregnant women and mothers/caregivers of infants under 1 year of age

What does the study involve?
Participating villages are randomly allocated to one of three groups. In the first group CHWs deliver the intervention package once a month in the home. In the second group CHWs deliver the intervention package once a month in the home and also conditional cash transfers to promote antenatal care and child growth monitoring clinic visits. The third group receive standard care. Participants receive the interventions for a duration of 18 months. The total duration of follow-up is 18 months. Child development and height are assessed at 9 and 18 months.

What are the possible benefits and risks of participating?
The benefit of participating is that children may receive health and development benefits from the intervention. There are no expected risks associated with participation.

Where is the study run from?
Ifakara Health Institute (Tanzania)

When is the study starting and how long is it expected to run for?
March 2017 to May 2019

Who is funding the study?
Grand Challenges Canada

Who is the main contact?
1. Dr Honorati Masanja
2. Dr Christopher Sudfeld

Contact information

Dr Honorati Masanja
Scientific

Ifakara Health Institute
Plot 463, Kiko Avenue
Mikocheni
Dar es Salaam
PO Box 78 373
Tanzania

Dr Christopher Sudfeld
Scientific

677 Huntington Ave
Boston
02115
United States of America

Study information

Study designSingle-centre cluster-randomized trial
Primary study designInterventional
Secondary study designCluster randomised trial
Study setting(s)Community
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleEffectiveness of approaches to deliver integrated solutions for optimal child growth and development in Tanzania
Study objectives1. Community health worker (CHW) delivery of evidence-based nutrition and responsive stimulation intervention package improves child growth and development.
2. Cash transfers conditioned on antenatal care and well-child clinic visits improve child growth and development.
Ethics approval(s)1. Ifakara Health Institute IRB, 31/03/2017, ref: 007-2017
2. National Health Research Ethics Sub-Committee, 17/07/2017, ref: NIMR/HQ/R.8a/Vol.IX/2538
3. Harvard School of Public Health IRB, 20/07/2017, ref: IRB17-1001
Health condition(s) or problem(s) studiedChild growth and development
InterventionThis study is a pilot cluster-randomized trial to evaluate integrated supply and demand sided platforms to deliver a child growth and development intervention package in Morogoro Region, Tanzania. 12 villages will be randomized within strata of peri-urban (6 villages) and rural (6 villages) to one of three study arms:

1. CHWs Only: CHWs deliver a nutrition and responsive stimulation caregiver intervention package once a month in the home
2. CHWs + CCT: CHWs deliver a nutrition and responsive stimulation caregiver intervention package once a month in the home plus conditional cash transfers to promote ANC and child growth monitoring clinic visits
3. Control: Participants will receive standard of care

Villages receive the randomized treatment for a duration of 18 months. The total duration of follow-up is 18 months.
Intervention typeBehavioural
Primary outcome measure1. Child development measured by the Bayley Scale of Child Development, 3rd edition at 9 and 18 months
2. Child height-for-age z-score assessed at 9 and 18 months
Secondary outcome measures1. Attendance to ANC and child health visits assessed by health cards at 9 and 18 months
2. Caregiver parenting knowledge assessed by the Caregiver Knowledge of Child Development Inventory at 9 and 18 months
3. Child weight-for-height z-score assessed at 9 and 18 months
4. Child weight-for-age z-score assessed at 9 and 18 months
Overall study start date01/03/2017
Completion date10/05/2019

Eligibility

Participant type(s)Healthy volunteer
Age groupMixed
SexBoth
Target number of participants12 village clusters with an estimated 50 mother/caregiver-infant pairs in each cluster
Total final enrolment593
Key inclusion criteria1. The trial will be conducted in 12 village clusters which will include ~600 mother/caregiver-infant pairs
2. During the study recruitment time period, pregnant women and mother/primary caregiver of an infant <1 year of age are eligible for enrollment
3. All mothers/primary caregivers must provide informed consent
Key exclusion criteriaInfants <1 years at the time of enrollment with signs of severe physical or mental impairments
Date of first enrolment14/09/2017
Date of final enrolment31/10/2017

Locations

Countries of recruitment

  • Tanzania

Study participating centre

Morogoro Region, Tanzania
-
Tanzania

Sponsor information

Ifakara Health Institute
Research organisation

Plot 463, Kiko Avenue Mikocheni
Dar es Salaam
PO Box 78 373
Tanzania

Website http://ihi.or.tz/
ROR logo "ROR" https://ror.org/04js17g72

Funders

Funder type

Government

Grand Challenges Canada
Government organisation / National government
Alternative name(s)
Grands Défis Canada, GCC
Location
Canada

Results and Publications

Intention to publish date31/08/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planThe trialists plan to publish the results in a high-impact peer-reviewed journal around 1 year after trial end.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from csudfeld@hsph.harvard.edu. Deidentified individual participant data (including data dictionaries) may be made available, in addition to study protocols, the statistical analysis plan, and the informed consent form. The data may be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal and obtain the necessary ethical approvals.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 27/05/2019 29/05/2019 Yes No
Results article results 13/12/2020 02/02/2021 Yes No
Results article 01/04/2021 29/04/2021 Yes No

Editorial Notes

29/04/2021: Publication reference added.
02/02/2021: Publication reference, total final enrolment and IPD sharing statement added.
03/06/2020: The following changes were made to the trial record:
1. The overall trial end date was changed from 30/06/2019 to 10/05/2019.
2. The recruitment start date was changed from 25/09/2017 to 14/09/2017.
3. The recruitment end date was changed from 10/11/2017 to 31/10/2017.
4. The intention to publish date was changed from 28/02/2020 to 31/08/2020.
11/02/2020: The overall trial end date has been changed from 28/02/2019 to 30/06/2019 and the plain English summary has been updated to reflect this change.
29/05/2019: Publication reference added.