Enhancing Access to Safe and Nutritious Diets (ENSAND) Evaluation Nigeria

Impact and Process Evaluation of the Global Alliance for Improved Nutrition (GAIN) Enhancing Access to Safe and Nutritious Diets (ENSAND) Program in Nigeria

The Global Alliance for Improved Nutrition (GAIN) is implementing a program in 4 countries to increase consumption of healthy foods by improving supply, increasing demand, and improving the enabling environment for different targeted foods by operating at multiple levels - individuals, households, markets, producers, and policies. In Nigeria, the program is called Enhancing Access to Safe and Nutritious Diets (ENSAND). RTI and local partners propose to conduct impact and process evaluations of GAIN's program tailored to the theory of change and the target food for Nigeria. The evaluation in Nigeria will include a mix of quantitative and qualitative methods and will be guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) evaluation framework.

Study Overview

• Status: Terminated
• Conditions: Egg Consumption
• Intervention / Treatment: Behavioral: Food system and demand generation

Detailed Description

ENSAND seeks to increase the frequency of egg consumption among students in classes 1-3 in public primary schools and their younger siblings aged 6-59 months in local government areas (LGAs) with a high proportion of bottom of the pyramid (BoP) households. GAIN's intervention is two-pronged in Kaduna State. One component will involve improving the egg value chain supplying the Home-Grown School Feeding Program (HGSFP) for primary school children and the other will involve using a social marketing approach to increase parents' willingness to purchase and feed eggs to their young children aged 6-59 months. In Federal Capital Territory (FCT) and Kebbi States, GAIN's intervention will focus only on supplying eggs to primary school children.

This evaluation of the ENSAND program will use a parallel group mixed-methods quasi-experimental before-after design to assess the effectiveness of the intervention on children's frequency of egg consumption in Kaduna (intervention) and Kano (control) States. The evaluation will be carried out in 3 intervention and 3 control LGAs, with clustering at the level of the school. Data will be collected through household surveys with caregivers and school-aged children (N=1,332 at baseline and endline), egg value chain actor key informant interviews (KIIs, N=3) and semi-structured interviews (N=191) at baseline, midline, and endline, and focus group discussions (FGDs, N=9 FGDs at midline and endline) with caregivers of young children. Households with school- and pre-school aged children will be identified through the sampled public primary schools, and caregivers and school-aged children will be interviewed at baseline and endline in intervention and control LGAs. The same schools will be used at both times points but cross-sectional samples will be drawn at baseline and endline. Egg value chain actors will be identified in the intervention LGAs in Kaduna to participate in KIIs and semi-structured interviews at baseline, midline, and endline to assess changes in the functioning of the value chain over time. FGDs with caregivers of young children will be conducted at midline and endline. The qualitative findings will be used to understand experiences with the interventions and findings will be triangulated with results from the household and egg value chain interviews.

In FCT and Kebbi, the evaluation will be limited to KIIs (N=4) and semi-structured interviews (N=102) with egg value chain actors at baseline, midline, and endline. The findings will be used to validate and triangulate with the monitoring data GAIN will be collecting from value chain actors.

• Study Type: Interventional
• Enrollment (Actual): 1625
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Nigeria
  • Abuja, Nigeria
    • Datametrics Associates Ltd.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Different populations will be targeted for different data collection methods. Eligibility criteria are detailed below for each data collection method.

Household Surveys

Inclusion Criteria:

• Adult caregiver who will be interviewed is 18 years or older;
• The household has a child in public primary school class 1-3 aged 6 - 9 years AND has a child 6-59 months
• The household earns <$3.20 per person per day;
• Able to speak English or Hausa;
• Provide informed consent to participate in the study.

Egg Value Chain Interviews

Inclusion Criteria:

• Be a PAN state manager, national or state HGSFP manager, poultry farmer, school-level HGSFP manager, health teacher, or egg retailer or wholesaler in the local government areas selected for the evaluation;
• Be 18 years or older;
• Able to speak English or Hausa;
• Provide informed consent to participate in the study.

Focus Group Discussions with Caregivers

Inclusion criteria:

• Caregivers with a child in class 1-3 and a child 6-59 months;
• Be 18 years or older;
• Able to speak English or Hausa;
• Provide informed consent to participate in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Intervention	Behavioral: Food system and demand generation; The project is focused on improving egg consumption through enhanced availability, accessibility, and improved demand. To achieve this goal, the project intervention mix will work through three pathways: access, enabling environment, and demand. The access pathway aims to sustain availability and consumption of eggs by school children (age 6-9 years) from BoP households through interventions targeted at the Poultry Association of Nigeria (PAN) and state lead egg aggregators for the HGSFP. The enabling environment pathway focuses on the broader institutional, governance, and political factors to support accessibility, availability, improved consumption, and increased consumer demand for eggs. The demand pathway will be addressed by mass media and interpersonal communication to increase the willingness and motivation of parents/caregivers in BoP households to support and sustain egg consumption by pre-school children in Kaduna State.
No Intervention: Control/No intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of egg consumption by primary school children	Change in the mean frequency of egg consumption during the last 7 days by children in primary school classes 1-3 in BoP households	Baseline (August 2023), Endline (August 2026) (3 years)
Frequency of egg consumption by pre-school children	Change in the mean frequency of egg consumption during the last 7 days by children 6-59 months in BoP households	Baseline (August 2023), Endline (August 2026) (3 years)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of egg purchase	Change in frequency of eggs purchased for children	Baseline (August 2023), Endline (August 2026) (3 years)
Number of eggs purchased	Change in number of eggs purchased for children	Baseline (August 2023), Endline (August 2026) (3 years)

Collaborators and Investigators

• Sponsor: RTI International
• Collaborators: University of Abuja; Datametrics Associates Ltd; University of Nigeria Nsukka
• Investigators: Principal Investigator: Abiodun F Ipadeola, Datametrics Associates Ltd

Study record dates

Study Major Dates

• Study Start (Actual): October 9, 2023
• Primary Completion (Actual): November 6, 2023
• Study Completion (Actual): February 6, 2025

Study Registration Dates

• First Submitted: June 14, 2023
• First Submitted That Met QC Criteria: July 12, 2023
• First Posted (Actual): July 20, 2023

Study Record Updates

• Last Update Posted (Actual): April 9, 2025
• Last Update Submitted That Met QC Criteria: April 7, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: children; infants; diet; Nigeria; eggs; market intervention; social and behavior change communication intervention
• Other Study ID Numbers: 424602

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Dataset will be shared through Nesstar.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No