Evaluation of REACTS-IN, an Intervention to Improve Nutrition, Hygiene, and Sexual and Reproductive Health Services (REACTS-IN)

April 9, 2024 updated by: Grace S. Marquis, McGill University

Realizing Gender Equality, Attitudinal Change & Transformative Systems in Nutrition (REACTS-IN)

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 and comparison communities, schools, and health facilities. 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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Estimated)

13500

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

(i)Women:

  • 15-49 y of age
  • biological mother of child in the home who is 0-5.9, 6-23.9, or 24-59.9 months
  • has lived in the community for at 12 months

(ii) Husbands/partners:

  • no age limit
  • lives in the home with index woman
  • has lived in community for at least 12 months

(iii) Adolescents:

  • 10-19 years
  • male or female
  • has been in target school for at least 6 months
  • lives in the target community

(iv) Children:

  • 0-5.9, 6-23.9, or 24-59.9 months

Exclusion Criteria:

(i) Children:

  • no limitation on normal diet or growth (birth defects, illnesses)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention
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,
Behavioral: Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights
Educational training on nutrition, gender equity, WASH, sexual and reproductive health rights will take place in communities (including schools) for women, men, and adolescents
Dietary supplement: school-based iron-folic acid supplement program
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.
Behavioral: Health service training on equitable access to nutrition, health, and sexual and reproductive services
Training and support activities to make gender-equitable nutrition, health, and sexual and reproductive services in the health facilities
Dietary supplement: bio-fortified crops
The program promotes and distributes bio-fortified crops, including orange-fleshed sweet potatoes, rice, beans, and corn
No Intervention: Comparison
No intervention will take place. Standard of care will be available in the health facilities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gender equality
Time Frame: Change between baseline and study completion, an average of 5 years
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
Time Frame: Change between baseline and study completion, an average of 5 years
Percent of children 6-59 mo of age who are stunted
Change between baseline and study completion, an average of 5 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Antenatal care
Time Frame: Change between baseline and study completion, an average of 5 years
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
Time Frame: Change between baseline and study completion, an average of 5 years
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
Time Frame: Change between baseline and study completion, an average of 5 years
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
Time Frame: Change between baseline and study completion, an average of 5 years
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
Time Frame: Change between baseline and study completion, an average of 5 years
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

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

McGill University

Collaborators

Global Affairs Canada
World Vision Canada

Investigators

  • Principal Investigator: Grace S Marquis, PhD, McGill University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2024

Primary Completion (Estimated)

June 30, 2029

Study Completion (Estimated)

May 24, 2030

Study Registration Dates

First Submitted

April 4, 2024

First Submitted That Met QC Criteria

April 9, 2024

First Posted (Actual)

April 12, 2024

Study Record Updates

Last Update Posted (Actual)

April 12, 2024

Last Update Submitted That Met QC Criteria

April 9, 2024

Last Verified

April 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P0117910-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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