The Invisible Fishers

NCT03498755 | Completed

• 1 other identifier: HUM00138934
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot study aims to introduce three interventions directed toward mitigating anemia among women in Ghana, including: 1) multi-sectoral behavior change, 2) strengthening market engagement of fish processors, 3) improving fish smoking technology and practices. These interventions will be implemented among female fish processors, a population that represents a promising focal area for intervention within fisheries value chains, which have been identified as a uniquely promising sector for intervention to mitigate anemia among women. The investigators expect that the findings from this study will inform understanding of how best to design, implement, and evaluate interventions into fisheries and other animal-source food value chains in Ghana and across sub-Saharan Africa to address anemia and other nutritional and health concerns.

Conditions

Anemia

Keywords

fisheries; Ghana; sub-Saharan Africa; value chain; fish processing; fish smoking

Outcome Measures

Primary Outcomes (1)

• Change in anemia over time

  Hemoglobin (Hb) \<120 g/L, based on analysis of blood and stool samples

  Change from baseline anemia status over the 9 months of the intervention

Secondary Outcomes (18)

• Change in knowledge and value of animal-source foods for health over time

  Change from baseline knowledge over the 9 months of the intervention

• Change in amount of processed fish kept for own consumption

  Change from baseline amount of fish over the 9 months of the intervention

• Change in animal-source food purchases

  Change from baseline purchases over the 9 months of the intervention

• Change in consumption of animal-source food

  Change from baseline consumption over the 9 months of the intervention

• Change in understanding and valuation of the importance of specific practices for improving environmental and personal hygiene and minimizing risk of infection

  Change from baseline understanding over the 9 months of the intervention

Study Arms (3)

Multi-sectoral anemia behavior change

EXPERIMENTAL

Address multiple behavioral determinants of anemia by promoting the identification, knowledge, valuation and practice of four behavioral domains: 1) consumption of micronutrient-rich animal-source foods; 2) malaria and soil-transmitted helminth infection control practices; 3) water, sanitation and hygiene (WASH) best practices; and 4) women's autonomy in decision-making and control of the use of earned income.

Behavioral: Mobile phone audio messaging; Behavioral: Peer-to-peer learning

Strengthening market engagement of fish processors

EXPERIMENTAL

Assist women in overcoming limited access to credit, inadequate storage facilities, and insufficient information about market prices, which constrain the timeliness and amount of market-ready product available for sale, through a three-pronged approach that includes: 1) a conditional cash transfer; 2) entrepreneurship training; and 3) enhanced access to market price information.

Behavioral: Mobile phone audio messaging; Behavioral: Peer-to-peer learning; Behavioral: Conditional cash transfer; Behavioral: Entrepreneurship training; Behavioral: Market price information

Improving fish smoking technology and practices

EXPERIMENTAL

Introduce and promote a recently developed fish smoking oven known as the Ahotor, which was explicitly designed to reduce emission from biomass fuel combustion, decrease polycyclic aromatic hydrocarbon (PAH) levels of smoked fish, and increase fuel efficiency. Use of this oven will reduce workload, increase earnings, and reduce harmful occupational exposures. Introduction of this improved fish smoking oven will be combined with behavior change education focused on promoting optimal fish smoking and handling practices.

Behavioral: Mobile phone audio messaging; Behavioral: Peer-to-peer learning; Behavioral: Improved smoke ovens

Interventions

Mobile phone audio messaging BEHAVIORAL

Audio messages will be "pushed" to participants' mobile phones twice weekly on a set schedule in discrete modules that include basic information related to each of the four behavioral domains followed by an integration of the information across behaviors through relatable, character-driven narratives that enable message recipients to engage with the content through a real-world context.

Improving fish smoking technology and practices; Multi-sectoral anemia behavior change; Strengthening market engagement of fish processors

Peer-to-peer learning BEHAVIORAL

Women participants in each community will meet twice monthly for peer-to-peer learning sessions to reinforce the content of audio messages. These sessions will further use women's empowerment approaches including critical examination of gender dynamics, and discussions of solutions for equitable decision-making and control of resources within households. These discussions will be facilitated with male household members and grandmothers in separate learning sessions that will be held three times throughout the intervention period.

Improving fish smoking technology and practices; Multi-sectoral anemia behavior change; Strengthening market engagement of fish processors

Conditional cash transfer BEHAVIORAL

Participants will receive a conditional cash transfer to support their fish smoking business. The payment will be conditional on their participation in entrepreneurship trainings and the use of the investment into their fish smoking business.

Strengthening market engagement of fish processors

Entrepreneurship training BEHAVIORAL

Entrepreneurship training will focus on commonly lacking business knowledge, with an emphasis on establishing fundamental entrepreneurial skills (i.e., customer care, accounting), sound business management and decision-making, building strong and sustainable business relationships, and encouraging the use of loans for their intended purposes. This training will be introduced during the credit and savings group (CSG) meetings that will occur twice per month.

Strengthening market engagement of fish processors

Market price information BEHAVIORAL

Average market prices for fresh and processed fish at community, district, and regional markets will be disseminated via audio message calls (using Viamo's Infoline platform) to the mobile phones of women with the price information in their preferred language. These market prices will be collected twice weekly by Viamo field enumerators and sent to regional coordinators for validation. A second, independent validation will be carried out to ensure that there are no discrepancies.

Strengthening market engagement of fish processors

Improved smoke ovens BEHAVIORAL

Local private sector artisans will construct and serve as suppliers of the new ovens. The promotion, uptake and impact of these improved Ahotor ovens will be tested among study participants. Awareness-raising workshops held in each community will promote the Ahotor in concert with a public retrofitting of a Chorkor stove. Immediately following this event, one month later, and three months later, study participants will receive additional one-on-one counseling to provide further support on the proper use of the smoke oven, as well as on optimal handling and smoking practices to enhance product quality.

Improving fish smoking technology and practices

Eligibility Criteria

• Age: 15 Years - 49 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Not pregnant
• Not planning to move from the community during the project period
• Engaged in fish processing as primary livelihood

You may not qualify if:

• Pregnant
• Planning to move from the community during the project period
• Not engaged in fish processing as primary livelihood

Sponsors & Collaborators

• University of Michigan: lead
• University of Ghana: collaborator
• Innovations for Poverty Action: collaborator
• Netherlands Development Organization: collaborator
• Viamo: collaborator
• Bill and Melinda Gates Foundation: collaborator

Study Sites (1)

University of Ghana, Legon

Accra, Ghana

Location

Related Publications (129)

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Related Links

• International Food Policy Research Institute. Women's Empowerment in Agriculture Index.
• Netherlands Development Organization. Introducing the Ahotor oven in the Volta region of Ghana. 2017.

MeSH Terms

Conditions

Anemia

Condition Hierarchy (Ancestors)

Hematologic Diseases; Hemic and Lymphatic Diseases

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: Assistant Professor

Model Details: Two communities in each of two study regions will be assigned to one of the three treatments (i.e., six communities in total per region). Assigning two communities to the same treatment in each region will allow us to assess differential intervention design and implementation needs for communities in similar geographic areas. Ten women in each community will be purposefully selected for participation to ensure intra-community variation on participant age, socioeconomic status, years of experience with fish smoking, and the scale of fish smoking enterprises. Across both regions, 120 women will be recruited from a total of 12 communities. While the interventions will be delivered to individual women, treatment assignment will be carried out at the community-level given the risk of sharing information and inputs within communities that could contaminate intervention exposure and bias observed treatment effects.

Study Record Dates

• First Submitted: March 12, 2018
• First Posted: April 17, 2018
• Study Start: May 21, 2018
• Primary Completion: August 17, 2019
• Study Completion: August 17, 2019
• Last Updated: August 26, 2019

Record last verified: 2019-08

Locations

GH (1)