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| Name | Class |
|---|---|
| World Vision Canada | OTHER |
| Global Affairs Canada | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | 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, |
|
| Comparison | No Intervention | No intervention will take place. Standard of care will be available in the health facilities and schools. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights | Behavioral | Educational training on nutrition, gender equity, WASH, sexual and reproductive health rights will take place in communities (including schools) for women, men, and adolescents |
| Measure | Description | Time Frame |
|---|---|---|
| Gender equality | Percent of households with children < 59.9 mo that have achieved gender equality | Change between baseline and study completion, an average of 5 years |
| Child anthropometry | Percent of children 6-59 mo of age who are stunted | Change between baseline and study completion, an average of 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Antenatal care | Percent of mothers of children 0-6 months who attended at least four ante-natal visits during the last pregnancy from skilled health personnel | Change between baseline and study completion, an average of 5 years |
| Contraception use by women and partners |
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Inclusion Criteria:
(i)Women:
(ii) Husbands/partners:
(iii) Adolescents:
(iv) Children:
Exclusion Criteria:
(i) Children:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Grace S Marquis, PhD | Contact | 1-514-398-7839 | grace.marquis@mcgill.ca | |
| Aishat Abdu, PhD | Contact | aishat.abdu@mail.mcgill.ca |
| Name | Affiliation | Role |
|---|---|---|
| Grace S Marquis, PhD | McGill University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brac University | Recruiting | Dhaka | Bangladesh |
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This is a quasi-experimental design for the evaluation of an intervention that is in the community (including schools) as well as in the local health service facilities. The data collection at baseline, midline, and end-line will occur simultaneously in the intervention and comparison selected communities. Comparison communities will not be visited during midline. Participants are unique at each time point.
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| school-based iron-folic acid supplement program | Dietary Supplement | The program will help support and promote the school-based programs of weekly iron and folic acid supplementation for adolescent girls, in countries where it is allowed. |
|
| Health service training on equitable access to nutrition, health, and sexual and reproductive services | Behavioral | Training and support activities to make gender-equitable nutrition, health, and sexual and reproductive services in the health facilities |
|
| bio-fortified crops | Dietary Supplement | The program promotes and distributes bio-fortified crops, including orange-fleshed sweet potatoes, rice, beans, and corn |
|
Percent of women aged 15-49 years married or in union, who are currently using, or whose sexual partner is using at least one modern contraception method |
| Change between baseline and study completion, an average of 5 years |
| Child diet | Percent of children 6-23.9 months of age, who receive minimum dietary diversity and minimum meal frequency | Change between baseline and study completion, an average of 5 years |
| Sexual and reproductive health services for adolescents | Percent of adolescent girls (10-19) who report that they were offered sexual and reproductive health services | Change between baseline and study completion, an average of 5 years |
| Gender equitable health services for nutrition, health, and sexual and reproductive health | Percent of health facilities promoting gender equitable and responsive nutrition, health, and sexual and reproductive services | Change between baseline and study completion, an average of 5 years |
| Exclusive breastfeeding | Percent of children 0-5.9 mo who are exclusively breastfed | Change between baseline and study completion, an average of 5 years |
| Use of family planning | Percent of women 15-49 y who decided to use family planning | Change between baseline and study completion, an average of 5 years |
| adolescent knowledge of nutrition, menstrual hygiene, and sexual and reproductive health | Percent of adolescent girls and boys with appropriate knowledge about nutrition, menstrual hygiene, and sexual and reproductive health | Change between baseline and study completion, an average of 5 years |
| maternal knowledge on nutrition | Percent of women 15-49 y with appropriate knowledge on good maternal nutrition | Change between baseline and study completion, an average of 5 years |
| Attended birth deliveries | Percent of deliveries attended by skilled birth personnel | Change between baseline and study completion, an average of 5 years |
| maternal knowledge of family planning | Percent of mothers who know at least 3 modern methods of family planning | Change between baseline and study completion, an average of 5 years |
| maternal knowledge of exclusive breastfeeding | Percent of mothers who know at least 3 benefits of exclusive breastfeeding | Change between baseline and study completion, an average of 5 years |
| mothers planting biofortified crops | Percent of mothers who have planted biofortified crops from REACTS-IN materials | Change between baseline and study completion, an average of 5 years |
| mothers planting nutrient dense local vegetables | Percent of mothers who have planted nutrient dense local vegetables from REACTS-IN seeds | Change between baseline and study completion, an average of 5 years |
| mothers planting trees | Percent of mothers who have planted fruit tress from REACTS-IN materials | Change between baseline and study completion, an average of 5 years |
| hygenic toilets | Percent of households with hygienic toilets | Change between baseline and study completion, an average of 5 years |
| community health worker visit | Percent of households that received at least one community health worker visit in last month | Change between baseline and study completion, an average of 5 years |
| Adolescent iron folic acid supplements | Percent of adolescent girls who received the recommended scheme of weekly iron-folic actic supplements | Change between baseline and study completion, an average of 5 years |
| health facility | Percent of health facilities scoring > 80 on planning assessment | Change between baseline and study completion, an average of 5 years |
| Connar Consultants | Recruiting | Nairobi | Kenya |
|
| Ifakara Health Institute | Not yet recruiting | Ifakara | Tanzania |
|
| ID | Term |
|---|---|
| D006130 | Growth Disorders |
| D010342 | Patient Acceptance of Health Care |
| D044342 | Malnutrition |
| D000079102 | Empowerment |
| D003075 | Coitus |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D012919 | Social Behavior |
| D012725 | Sexual Behavior |
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| ID | Term |
|---|---|
| D000084803 | Gender Equity |
| D007507 | Therapeutic Irrigation |
| D012723 | Sex |
| D006262 | Health |
| ID | Term |
|---|---|
| D000091682 | Health Inequities |
| D006304 | Health Status |
| D003710 | Demography |
| D011154 | Population Characteristics |
| D006875 | Hydrotherapy |
| D026741 | Physical Therapy Modalities |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
| D008919 | Investigative Techniques |
| D055703 | Reproductive Physiological Phenomena |
| D012101 | Reproductive and Urinary Physiological Phenomena |
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