Millennium Villages Project in Sub-Saharan Africa (MVP)
A Pair-matched Community Intervention Trial to Assess the Impact of an Integrated Health and Development Intervention on Child Survival and the Millennium Development Goals in 10 Sub- Saharan African Countries
The Millennium Villages Project involves the coordinated and simultaneous delivery of a package of proven interventions in health, agriculture, infrastructure and education. The project works in partnership with governments in 10 African countries in areas where progress towards achieving the Millennium Development Goals has been insufficient.
The Project evaluation will test the following hypotheses:
- That after 5 years of operation, villages exposed to the MVP intervention will have a lower rate of under-5 mortality and parallel gains in MDG-related secondary outcomes when compared to similar villages not receiving the intervention.
- That the coordinated delivery a multi-sector package of health and development interventions implemented through a broad-based local partnership is feasible in a diversity of sub-Saharan African contexts, and;
- The intervention package can be delivered at a scalable cost of $40 per person per year in the health sector and $110 per person per year in total
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Yksityiskohtainen kuvaus
Design and population The design is a pair-matched community intervention trial. Village clusters with high levels of malnutrition were selected from rural areas in ten sub-Saharan African countries to reflect a diverse range of agro-ecological zones, farming systems, disease profiles, and infrastructure challenges. MVP sites represent 80 villages in 14 clusters across 10 countries, covering nearly 500,000 people. For each intervention cluster, a matched comparison cluster has been selected at random to participate in the evaluation.
Outcomes The primary outcome is the under-5 mortality rate. Secondary outcomes are levels of coverage with essential maternal-child health interventions and related MDG indicators for poverty, nutrition, education, and environmental health.
Sample size calculation The assessment follows 6000 households across intervention and matched comparison villages at baseline, and after 3 and 5 years of intervention exposure. With 10 paired clusters, the study is powered to detect a 40% difference in the U5MR between the two groups.
Analysis plan The analysis will use a two-staged pair-matched cluster level analysis, and will be complemented with multilevel modeling. Reporting will adhere to Transparent Reporting of Evaluations with Non-randomized Designs (TREND) guidelines.
Implementation science A portfolio of qualitative implementation science (process evaluation) will complement the quantitative assessment, and involves interviews with implementers, partners, and project beneficiaries. This analysis will address questions about: the feasibility of the interventions; the timing and sequence of their introduction; key contextual barriers and facilitators to implementation; and potential synergies achieved from the integrated multisector approach.
Economic costing study One project hypothesis is that an annual per capita investment of $110 is required to achieve the MDGs. The aim of the economic costing study is to document the absolute and relative contribution of project partners (MVP, government, donors, and the community) to all priced and non-priced cluster-level activities, as well as the sector-specific breakdown of these inputs.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
-
-
-
Koraro, Etiopia
- Koraro
-
-
-
-
-
Bonsasso, Ghana
- Bonsasso
-
-
-
-
-
Sauri, Kenia
- Sauri
-
-
-
-
-
Mwandama, Malawi
- Mwandama
-
-
-
-
-
Tiby, Mali
- Tiby
-
-
-
-
-
Ikaram, Nigeria
- Ikaram
-
Pampaida, Nigeria
- Pampaida
-
-
-
-
-
Mayange, Ruanda
- Mayange
-
-
-
-
-
Potou, Senegal
- Potou
-
-
-
-
-
Mbola, Tansania
- Mbola
-
-
-
-
-
Ruhiira, Uganda
- Ruhiira
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Resident in a Millennium Village and consenting to periodic assessments
Exclusion Criteria:
- Those not consenting to participate
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Ennaltaehkäisy
- Jako: Ei satunnaistettu
- Inventiomalli: Tehtävätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: MVP village
Wealth stratified and randomly selected households residing in a village exposed to the Millennium Villages Project intervention (or health and development intervention package)
|
The timing and sequence of intervention vary by site, but include improved access to seed-fertilizer to increase agricultural production; improved market and capital access; proven maternal-newborn-child health interventions delivered free of cost at the point of service; improvements to school number and quality; and access to basic infrastructure including safe water, sanitation, electricity, transport and communication.
Muut nimet:
|
|
Active Comparator: Comparison village
Villages receiving routine services through established programs
|
Routine services and programs currently being administered using prevailing resources, at the current pace and with established partnerships.
There is no attempt to limit the introduction of new interventions or agencies into comparison sites.
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Child Mortality Rate
Aikaikkuna: 5 years
|
Under 5 Mortality Rate
|
5 years
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Prevalence of Stunting
Aikaikkuna: 5 years
|
Proportion of under 5s who are stunted; Stunted = low height for age Z-score
|
5 years
|
|
Prevalence of Diarrhea
Aikaikkuna: 5 years
|
Proportion of under 5's with diarrhea in past 2 weeks
|
5 years
|
|
Prevalence of Malaria
Aikaikkuna: 5 years
|
Prevalence of malaria among under 5s at the time of survey
|
5 years
|
|
Prevalence of antenatal care
Aikaikkuna: 5 years
|
Proportion of women who receive at least 4 ANC visits
|
5 years
|
|
Survival rate to last grade of primary education (School Quality)
Aikaikkuna: 5 years
|
5 years
|
|
|
Prevalence of improved sanitation utilization
Aikaikkuna: 5 years
|
Proportion of the population using an improved sanitation source
|
5 years
|
|
Duration or breast feeding (Child feeding practices)
Aikaikkuna: 5 years
|
5 years
|
|
|
Age of introduction of complementary feeding (Child feeding practices)
Aikaikkuna: 5 years
|
5 years
|
|
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Prevalence of bed net utilization
Aikaikkuna: 5 years
|
Proportion of under 5s sleeping under Longlasting insecticide treated bednets in the night prior to the survey
|
5 years
|
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Prevalence of malaria treatment
Aikaikkuna: 5 years
|
Proportion of under 5s with a fever in the past 2 weeks who receive appropriate anti-malarial treatment
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5 years
|
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Prevalence of measles immunization
Aikaikkuna: 5 years
|
Proportion under 1s immunized against measles
|
5 years
|
|
Prevalence of diarrhea management
Aikaikkuna: 5 years
|
Proportion of under 5s with diarrhea in the past 2 weeks who received oral rehydration therapy
|
5 years
|
|
Prevalence of pneumonia management
Aikaikkuna: 5 years
|
Proportion of under 5s treated for pneumonia in the past 2 weeks
|
5 years
|
|
Prevalence of newborn care
Aikaikkuna: 5 years
|
Proportion of newborns receiving a post-natal check in the first week of life
|
5 years
|
|
Proportion of pregnant women who received and HIV test
Aikaikkuna: 5 years
|
This measures the prevention of vertical transmission of HIV
|
5 years
|
|
Prevalence of food insecurity
Aikaikkuna: 5 years
|
Proportion of households reporting not enough food for 1 of past 12 months
|
5 years
|
|
Institutional delivery rate
Aikaikkuna: 5 years
|
Proportion of births attended by skilled health personnel
|
5 years
|
|
Prevalence of underweight
Aikaikkuna: 5 years
|
Proportion of under 5s who are underweight; Underweight= weight for age Z score
|
5 years
|
|
Prevalence of wasting
Aikaikkuna: 5 years
|
Proportion of under 5s who are wasted; Wasting = weight for height Z score
|
5 years
|
|
Prevalence of low mid-upper arm circumference
Aikaikkuna: 5 years
|
Proportion of under 5s with a low mid-upper arm circumference
|
5 years
|
|
Household Asset Index (Household poverty)
Aikaikkuna: 5 years
|
Survey of fixed and non-fixed assets, including recent purchases
|
5 years
|
|
Prevalence of improved water source utilization
Aikaikkuna: 5 years
|
Proportion of the population using an improved drinking water source
|
5 years
|
Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Opintojen puheenjohtaja: Jeffrey Sachs, PhD, The Earth Institute, Columbia University
- Opintojohtaja: Pedro Sanchez, PhD, The Earth Institute, Columbia University
- Päätutkija: Cheryl Palm, PhD, The Earth Institute, Columbia University
- Päätutkija: Sonia Sachs, MD, PhD, Director of Health, The Earth Institute, Columbia University
Julkaisuja ja hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
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Avainsanat
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