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| Name | Class |
|---|---|
| Carlos III Health Institute | OTHER_GOV |
| Action Contre la Faim | OTHER |
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The severity of the stunting in the provinces of Huíla and Cunene, Angola, in children aged 6 to 59 months is considered to be very high, as defined by the World Health Organization (WHO) classification of 2018. Some of the strategies that present promising results in the fight against chronic malnutrition have been specific nutritional interventions and money transfers. Among these, those that have so far had a greater impact in reducing chronic malnutrition indicators are fortified foods and lipid-based nutrient supplementation in small amounts.
The hypothesis of the study is that these interventions applied from pregnancy can significantly reduce chronic malnutrition, each of which may have different impacts.
The study intends, therefore, to evaluate an intervention that aims to obtain the highest quality scientific evidence on the best package of sensitive and specific measures that reduce chronic malnutrition and mortality in children under 2 years of age, maintaining the fundamental premises of sustainability, cost-benefit ratio, and scalability for other regions of the country.
To this end, it was designed a community trial randomized by clusters in which different strategies will be evaluated separately:
Study population: pregnant women with more than 16 years of age; however the target population of the interventions will be the household where the pregnant woman lives. The impacts of interventions on indicators of chronic malnutrition in children under 5 years of age belonging to the household will also be analyzed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Intervention | Experimental | The Standard package includes a series of actions carried out by the Community and Health Development Agents (ADECOS), who improves access to primary health care practices and promotes well-being behaviors at community levels. ADECOS has the potential to facilitate improvements in the health state and quality of life in rural communities. Activities performed by ADECOS can be grouped into two blocks:
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| Standard Intervention plus nutritional supplementation (Standard+NUT Arm) | Active Comparator | In addition to the services performed by the ADECOS, it is included a supply of complementary food rations (individual + family) at the relative level, being:
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| Standard Intervention plus money transfers (Standard+TM Arm) | Experimental | In addition to the services performed by the ADECOS, it will be delivered a total of 14,000.00 Kz per month and per relative with 4 or more people living in the same household by the end of the study. It will be delivered a total of 11,000.00 Kz per month and per relative with 3 or fewer people living in the same household by the end of the study. The monetary value will be delivered in cash with unconditional format, and it will not be determined by the investigator team the use and the destination of said amount and nothing will be requested in return. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nutritional Supplementation | Dietary Supplement | The Small-quantity lipid-based nutrient supplementation (SQ-LNS) consists of micronutrients delivered in a lipid-based vehicle. All pregnant women (as of 12 weeks self-referred) within households who were randomly included in the study in the nutritional supplementation arm and their children as of 6 months of age will receive the SQ-LNS. ● Pregnant women: 20-g sachets, 20 g (1 sachet) dose per day. Nutritional composition and caloric intake. Total = 12/13 months approximately. ● Children from 6 months of age: 20-g sachets, 20 g (1 sachet) dose per day. Nutritional composition and caloric intake. Total = 18 months. The distribution will be made by ADECOS on a fortnightly basis. A family ration will be distributed: family supplementation is presented in a basket of locally produced basic foods that complement the usual diet. The caloric distribution of the basket will be 45% of cereals, 30% of pulses, and 25% in oil, and 1 kg of iodized salt. |
| Measure | Description | Time Frame |
|---|---|---|
| ● Proportion of children with moderate an serious chronic malnutrition (indices below -2 and -3 Z- scores below the reference median) at 24 months of age in the provinces of Huíla and Cunene. | Effectiveness of three interventions (standard care, money transfers, and nutritional supplements) to reduce chronic malnutrition in children under two years of age in the provinces of Huíla and Cunene by the proportion of children with different degrees of malnutrition. | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| ● Proportion of children under 5 years of age with moderate and severe chronic malnutrition (indices below -2 and -3 Z-scores below the reference median) at the beginning and end of the study in the provinces of Huíla and Cunene. | Effectiveness of three interventions (standard care, money transfers, and nutritional supplements) individually to reduce chronic malnutrition in children under 5 years of age in the provinces of Huíla and Cunene will be assessed by measuring height/length per age score. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Israel Molina | Vall d'Hebron Institute Research | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cunene | Otchinjau; Mupa | Cunene Province | Angola | |||
| Huíla province |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42169396 | Derived | Martin-Canavate R, Pujol-de Castro A, Puett C, Trigo E, de Lourdes Faria M, Gerardo AS, Vargas A, Molina I, Custodio E. Understanding Opportunity Costs of Women Participating in Maternal and Child Nutrition Interventions in Southern Angola: Evidence From the MuCCUA Trial. Matern Child Nutr. 2026 Jul;22(3):e70199. doi: 10.1111/mcn.70199. | |
| 40457576 |
| Label | URL |
|---|---|
| Operational research against chronic child malnutrition in Angola (CRESCER Project) | View source |
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| Money transfers | Behavioral | The distribution of the amounts will be made through the corresponding financial providers, together with the Municipal or Communal Administration authorities, the Assistants of Community Activities, the Investigator's personnel, and the ADECOS. The distribution frequency will be every 3 months until the end of the study. |
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| Standard intervention | Behavioral | The activities included are the following:
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| 0-1 and 24 months |
| Mortality rate at 3, 6, 12, 18, and 24 months after enrollment in the study. | Mortality will be assessed during all study at selected time frames | 3, 6, 12, 18, and 24 months |
| Incidence rate in relevant comorbidities | Incidence of malaria, pneumonia, diarrhea, and anemia (Hemoglobin < 12g/dL) in children up to 2 years of age in the provinces of Huíla and Cunene will be measured. | 6, 12, 18, and 24 months |
| Increment of food diversity grade at the end of the study compared to baseline. | Attitudes and eating habits of families in the provinces of Huíla and Cunene will be quantified. | 0-1 and 24 months |
| Number of pre- and post-natal visits. | Pre- and post-natal care indicators such as exclusive breastfeeding rate in children up to 6 months of age and low birth weight will be assessed | 6 months |
| Cost-effectiveness incremental ratios (obtained dividing the incremental cost by the incremental benefit for health ). | The cost-effectiveness of different interventions will be measured. | 2 years |
| Proportion of children with moderate and severe chronic malnutrition (indices below -2 and -3 Z- scores below the reference median) at 3, 6, 12, 18, months of age in the provinces of Huíla and Cunene. | Effectiveness of three interventions (standard care, money transfers, and nutritional supplements) to reduce chronic malnutrition in children under two years of age in the provinces of Huíla and Cunene by the proportion of children with different degrees of malnutrition. | 3, 6, 12, 18 months |
| Libongue; Jamba Sede |
| Angola |
| Martin-Canavate R, Trigo E, Romay-Barja M, Faria LM, Gerardo AS, Aguado I, Iraizoz E, Marques T, Molina I, Custodio E. Dietary Diversity in Pregnant Women and Its Association With Household Food Security in Rural Southern Angola. Matern Child Nutr. 2025 Oct;21(4):e70051. doi: 10.1111/mcn.70051. Epub 2025 Jun 2. |
| 38341528 | Derived | Custodio E, Herrador Z, Trigo E, Romay-Barja M, Ramirez F, Aguado I, Iraizoz E, Silva-Gerardo A, Faria ML, Martin-Canavate R, Marques T, Vargas A, Gomez A, Molina I. Nutrition supplementation plus standard of care versus standard of care alone or standard of care plus unconditional cash transfer in the prevention of chronic malnutrition in Southern Angola: study protocol for the MuCCUA study, a cluster randomized controlled trial. BMC Public Health. 2024 Feb 10;24(1):429. doi: 10.1186/s12889-024-17858-7. |
| 38110392 | Derived | Martin-Canavate R, Custodio E, Trigo E, Romay-Barja M, Herrador Z, Aguado I, Ramirez F, Faria LM, Silva-Gerardo A, Lima JC, Iraizoz E, Marques T, Vargas A, Gomez A, Puett C, Molina I. Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial. BMJ Open. 2023 Dec 18;13(12):e073349. doi: 10.1136/bmjopen-2023-073349. |
| ID | Term |
|---|---|
| D015362 | Child Nutrition Disorders |
| ID | Term |
|---|---|
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D019587 | Dietary Supplements |
| ID | Term |
|---|---|
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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