Impact Evaluation of a Social Franchise Model for Improving Infant and Young Child Feeding and Child Nutrition in Vietnam

NCT01676623 | Completed

• 1 other identifier: IFPRI-S-01 (2)
• Study Type: interventional
• Target: 4,000
• Locations: 1 country
• Sites: 1

Brief Summary

Alive \& Thrive is an initiative that aims to improve infant and young child feeding practices and reduce childhood stunting. In Vietnam, Alive \& Thrive's primary intervention is implemented through a social franchise linked with the government's health system. The impact evaluation is conducted using a cluster-randomized design in which 20 commune health centers (CHC) were assigned to the social franchise model, and 20 CHC were assigned to routine government services. Repeated cross-sectional baseline and endline surveys will be used to assess the public health impact of this intervention. The baseline was in 2010 and an endline survey in the same communities will be conducted in 2014. Mixed methods process evaluation will be conducted in 2011, 2012 and 2013 to study the pathways through which the program impact is achieved.

Conditions

Child Nutrition; Stunting; Exclusive Breastfeeding; Complementary Feeding

Keywords

Child nutrition; Stunting; Exclusive breastfeeding; Complementary feeding; Social franchise; Mass media; Counseling; Facility-based

Outcome Measures

Primary Outcomes (3)

• Exclusive breastfeeding among children 0-6 months of age

  Exclusive breastfeeding in children 0-6 months of age is one of the eight WHO-recommended IYCF core indicators will be measured to capture breastfeeding and complementary feeding practices. It is measured using survey based recall by interviewing mothers of children in the age group for the indicator.

  4 years

• Child heights and weights (children 24-60 months of age)

  Heights and weights of children in the intervention and comparison communes covered by the CHCs in the study will be assessed in 2014. A new sample of children 24-60 months will be measured in the repeated cross-sectional endline survey to measure these outcomes and compute height-for-age, weight-for-age and weight-for-height z-scores based on the WHO growth reference standards.

  4 years

• Complementary feeding for children 6-23.9 months of age

  Indicators of complementary feeding - diet diversity, minimum acceptable diet, and minimum meal frequency, measured in children 6-23.9 months of age are one of the eight WHO-recommended IYCF core indicators will be measured to capture breastfeeding and complementary feeding practices. These are measured using survey based recall by interviewing mothers of children in the age group for the indicator.

  4 years

Secondary Outcomes (1)

• Early initiation of breastfeeding in children 0-24 months of age

  4 years

Study Arms (2)

Comparison area, only standard government services

ACTIVE COMPARATOR

This intervention arm will receive the standard government services offered at CHCs all over Vietnam. In addition, participants in this arm will be exposed to the nationwide mass media campaign.

Behavioral: Standard government health services; Behavioral: Mass media campaign

A&T Franchise

EXPERIMENTAL

In this arm, the 20 CHCs will offer Alive \& Thrive branded franchise services with enhanced quality of IYCF counseling through interpersonal contact between health workers at the commune level and clients who use the commune health services. In addition, the clients could also be exposed to the mass media campaign.

Behavioral: Standard government health services; Behavioral: Alive & Thrive IYCF franchise services; Behavioral: Mass media campaign

Interventions

Standard government health services BEHAVIORAL

This intervention will be basic preventive and curative health services provided by the commune health centers. This includes antenatal care, postnatal care and basic nutrition related counseling.

A&T Franchise; Comparison area, only standard government services

Alive & Thrive IYCF franchise services BEHAVIORAL

This intervention includes intensive behavioral counseling to improve infant and young child feeding. A package of 15 counseling contacts that are quality assured and branded will be offered to families of infants and young children. Services might also include user fees.

A&T Franchise

Mass media campaign BEHAVIORAL

Alive \& Thrive is implementing a nationwide mass media campaign in 2011, 2012 and 2013, with a focus on improving breastfeeding practices. The mass media intervention includes TV and radio spots as well as an internet site and a telephone hotline.

A&T Franchise; Comparison area, only standard government services

Eligibility Criteria

• Age: Up to 60 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children 0-60 months of age

You may not qualify if:

• None

Sponsors & Collaborators

• International Food Policy Research Institute: lead
• FHI 360: collaborator

Study Sites (1)

Alive & Thrive & International Food Policy Research Institute

Hanoi, Hanoi, Vietnam

Location

Related Publications (4)

• Kim SS, Nguyen PH, Tran LM, Alayon S, Menon P, Frongillo EA. Different Combinations of Behavior Change Interventions and Frequencies of Interpersonal Contacts Are Associated with Infant and Young Child Feeding Practices in Bangladesh, Ethiopia, and Vietnam. Curr Dev Nutr. 2019 Dec 9;4(2):nzz140. doi: 10.1093/cdn/nzz140. eCollection 2020 Feb.

  PMID: 31976385 DERIVED

• Nguyen PH, Kim SS, Tran LM, Menon P, Frongillo EA. Intervention Design Elements Are Associated with Frontline Health Workers' Performance to Deliver Infant and Young Child Nutrition Services in Bangladesh and Vietnam. Curr Dev Nutr. 2019 Jul 10;3(8):nzz070. doi: 10.1093/cdn/nzz070. eCollection 2019 Aug.

  PMID: 31346584 DERIVED

• Rawat R, Nguyen PH, Tran LM, Hajeebhoy N, Nguyen HV, Baker J, Frongillo EA, Ruel MT, Menon P. Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation. J Nutr. 2017 Apr;147(4):670-679. doi: 10.3945/jn.116.243907. Epub 2017 Feb 8.

  PMID: 28179488 DERIVED

• Menon P, Nguyen PH, Saha KK, Khaled A, Kennedy A, Tran LM, Sanghvi T, Hajeebhoy N, Baker J, Alayon S, Afsana K, Haque R, Frongillo EA, Ruel MT, Rawat R. Impacts on Breastfeeding Practices of At-Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, and Community Mobilization: Results of Cluster-Randomized Program Evaluations in Bangladesh and Viet Nam. PLoS Med. 2016 Oct 25;13(10):e1002159. doi: 10.1371/journal.pmed.1002159. eCollection 2016 Oct.

  PMID: 27780198 DERIVED

Related Links

• Alive \& Thrive's overall web page. Includes description of Vietnam program.

MeSH Terms

Conditions

Growth Disorders; Breast Feeding

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Feeding Behavior; Behavior

Study Officials

• Purnima Menon, PhD

  International Food Policy Research Institute

  PRINCIPAL INVESTIGATOR

• Rahul Rawat, PhD

  International Food Policy Research Institute

  PRINCIPAL INVESTIGATOR

• Phuong Nguyen, PhD

  International Food Policy Research Institute

  PRINCIPAL INVESTIGATOR

• Marie T Ruel, PhD

  International Food Policy Research Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 29, 2012
• First Posted: August 31, 2012
• Study Start: April 1, 2010
• Primary Completion: July 1, 2014
• Study Completion: December 1, 2014
• Last Updated: March 2, 2016

Record last verified: 2016-02

Locations

VN (1)