Nutrition Education Package for Infants and Young Child Feeding and Health in Rural Tanzania

NCT02249754 | Unknown

• 1 other identifier: 879/13
• Study Type: interventional
• Target: 600
• Locations: 1 country
• Sites: 1

Brief Summary

Building on the success of community-based peer education and counselling in breastfeeding, it is possible to address young child feeding and health practices in the surveyed district. Opportunities that can optimise success and encourage behaviour change in the district include mothers willingness to modify some feeding options; support of family members; seasonal availability and accessibility of foods; established set-up of village peers and existence of health centres and health staff in some villages. This study has developed a feasible, context-specific nutrition education package for use in rural Tanzania. The package is composed of 4 components, namely 1) education and counselling of mothers, 2) training of community-based nutrition counsellors, 3) sensitisation meetings with health staff and family members, and 4) supervision of community-based nutrition counsellors. The intervention will use a parallel cluster-randomised controlled trial design where infants will be recruited when aged 6 months and followed up for 9 months. The intervention expects to provide information and, where appropriate, recommendations to strengthen the nutrition component in the health education programme of the Tanzania child health services. The study hypothesises that the nutrition education package will be more effective than the routine health education in improving feeding practices, dietary adequacy and growth of infants and young children. Specific objectives of the study include:

• To evaluate the effectiveness of a nutrition education package on feeding practices and dietary adequacy
• To determine the effectiveness of a nutrition education package in improving growth and health of infants and young children
• To document the process of implementation of the nutrition education package to promote optimal feeding and health practice

Conditions

Growth Retardation; Malnutrition

Keywords

Nutrition education; Maternal counselling; Complementary feeding; Infant growth; Micronutrients; Tanzania

Outcome Measures

Primary Outcomes (1)

• Linear growth: Mean change from baseline in length-for-age Z-scores at at 9-, 12- and 15-months-old

  Linear growth (length-for-age Z-scores): WHO 2006 Growth Standards

  Length-for-age Z-scores: Baseline (6 months-old), Month 9, Month 12 and Month 15

Secondary Outcomes (5)

• Weight-for-length: Mean change from baseline in weight-for-length Z-scores at 9-, 12- and 15-months-old

  Weight-for-length Z-scores: Baseline (6 months-old), Month 9, Month 12 and Month 15

• Mean intake of energy, fat, iron and zinc from complementary foods at 12 months-old

  Mean intake of energy, fat, iron and zinc from complementary foods: Baseline (6 months-old), Month 12

• Proportion of children consuming foods from 4 or more food groups at 9-, 12- and 15-months-old

  Proportion of children consuming foods from 4 or more food groups: Baseline (6 months-old), Month 9, Month 12 and Month 15

• Proportion of children consuming the recommended number of semi-solid/soft meals and snacks per day at 9-, 12- and 15-months-old

  Proportion of children consuming the recommended number of semi-solid/soft meals and snacks per day: Baseline (6 months-old), Month 9, Month 12 and Month 15

• Maternal level of knowledge and practice of recommended feeding and health practices at 9-, 12- and 15-months-old

  Maternal level of knowledge and practice of recommended feeding and health practices: Month 9, Month 12 and Month 15

Study Arms (2)

Routine health education

ACTIVE COMPARATOR

Routine health education alone

Behavioral: Routine health education

Nutrition education package

EXPERIMENTAL

Nutrition education package and routine health education

Behavioral: Nutrition education; Behavioral: Routine health education

Interventions

Nutrition education BEHAVIORAL

This group will receive the nutrition education package. The package is composed of: 1) education and counselling of mothers when the child is aged 6 (baseline), 9 and 12 months; 2) training community-based nutrition counsellors at baseline and 12 months and monthly home visits, 3) supervision of community-based nutrition counsellors' work every 2 months, and 4) sensitisation meetings with family members and health staff responsible for child health at baseline and repeated at 12 months. In addition, the group will continue to attend routine health education given at health facilities every month.

Nutrition education package

Routine health education BEHAVIORAL

This group will receive routine health education every month. It is a standard government health service offered monthly in all health facilities by health staff. It is given to mothers of children below the age of five years during growth monitoring and immunisation contacts. The sessions take 10-15 minutes focusing on general health issues including child feeding, prevention of diseases such as malaria and importance of immunisations.

Nutrition education package; Routine health education

Eligibility Criteria

• Age: 6 Months - 7 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Infants aged 6-7 months at the time of recruitment into the study
• Infants currently being breastfed
• Parents (or caregivers) anticipated local residence for the study duration

You may not qualify if:

• Congenital or chronic abnormalities impairing feeding or physical growth measurements
• Oedema
• Severely ill or clinical complications warranting hospitalisation

Sponsors & Collaborators

• Sokoine University of Agriculture: lead
• University Ghent: collaborator
• Institute of Tropical Medicine, Belgium: collaborator
• Schlumberger Foundation - Faculty for the Future Programme: collaborator
• Nutrition Third World, Belgium: collaborator
• Nestlé Foundation: collaborator

Study Sites (1)

Mpwapwa District

Mpwapwa, Dodoma, Tanzania

RECRUITING

Related Publications (1)

• Kulwa KB, Verstraeten R, Bouckaert KP, Mamiro PS, Kolsteren PW, Lachat C. Effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth of infants and young children in rural Tanzania: rationale, design and methods of a cluster randomised trial. BMC Public Health. 2014 Oct 16;14:1077. doi: 10.1186/1471-2458-14-1077.

  PMID: 25318980 DERIVED

MeSH Terms

Conditions

Malnutrition

Interventions

Nutrition Assessment

Condition Hierarchy (Ancestors)

Nutrition Disorders; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Epidemiologic Measurements; Public Health; Environment and Public Health

Study Officials

• Prof. Patrick W. Kolsteren, PhD

  Institute of Tropical Medicine (Belgium) and Ghent University (Belgium)

  STUDY CHAIR

• Kissa BM Kulwa, MSc.

  Sokoine University of Agriculture and Ghent University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Kissa BM Kulwa, MSc.

CONTACT

+255 23 2603511 -; kissakulwa@yahoo.com; kissa.kulwa@ugent.be

Prof. Patrick W. Kolsteren, PhD

CONTACT

+32 3 2476389; pkolsteren@itg.be

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: September 23, 2014
• First Posted: September 26, 2014
• Study Start: September 1, 2014
• Primary Completion: August 1, 2015
• Study Completion: August 1, 2015
• Last Updated: November 19, 2014

Record last verified: 2014-11

Locations

TA (1)