Samaki Salama - Promoting healthy child growth and sustainable fisheries in coastal Kenya: A study protocol

Ivy Blackmore, Andrew Wamukota, Elizabeth Kamau-Mbuthia, Austin Humphries, Carolyn Lesorogol, Rachel Cohn, Catherine Sarange, Francis Mbogholi, Clay Obata, Christopher Cheupe, Joaquim Cheupe, Lisa Sherburne, Melissa Chapnick, Mary Kate Cartmill, Lora L Iannotti, Ivy Blackmore, Andrew Wamukota, Elizabeth Kamau-Mbuthia, Austin Humphries, Carolyn Lesorogol, Rachel Cohn, Catherine Sarange, Francis Mbogholi, Clay Obata, Christopher Cheupe, Joaquim Cheupe, Lisa Sherburne, Melissa Chapnick, Mary Kate Cartmill, Lora L Iannotti

Abstract

Background: One in five young children globally suffer the consequences of stunted growth and development and millions experience deficiencies in zinc, iron, iodine, vitamins A and B12, nutrients found bioavailable in fish foods. Small-scale fisheries have the potential to generate income and augment fish consumption while being environmentally sustainable if appropriately managed. However, those engaged in small-scale fisheries are often marginalized, poor, and malnourished. The Samaki Salama project seeks to better understand and address these challenges through a three-arm, longitudinal matched cluster study which evaluates the impact of an integrated nutrition social marketing and modified fishing trap intervention.

Methods: There will be 400 small-scale fisher households enrolled from Kilifi County, Kenya and residing in communities matched on location (rural), livelihoods, and child nutritional status. The sample will include mothers and other caregivers, children 6-60 months, and fishers in the family. Applying a cluster design, the matched communities will be divided into three groups: (1) control (n = 200); (2) multi-component nutrition social marketing intervention to fishers, mothers, and health workers (n = 100); and (3) multi-component nutrition social marketing intervention plus modified fishing traps and training (n = 100). Primary outcomes include child growth, fish food intakes, and fisheries yield of mature fish. Secondary outcomes are diet diversity, child diarrheal morbidity, and fisheries revenue. A process evaluation will be used to monitor and ensure fidelity of intervention delivery.

Discussion: This study builds on a growing body of literature illustrating the effectiveness of nutrition focused social marketing campaigns to promote active engagement of participants, high compliance to the intervention, and sustained behavior change. The second intervention element of modified fishing traps that allow immature fish to escape enables participants to act on the messaging they receive and promotes sustainable fishing through increased harvest efficiency and reduced catch of immature fish. The integrated approach of the Samaki Salama intervention provides an example of how to leverage multiple disciplines to address key challenges to human and environmental health and illustrates a pathway for scaling study innovations to other small-scale fisheries systems.

Trial registration: https://ichgcp.net/clinical-trials-registry/NCT05254444" title="See in ClinicalTrials.gov">NCT05254444).

Keywords: fisheries; food security; nutrition; social marketing; stunting; sustainability.

Conflict of interest statement

Author LS was employed by JSI Research & Training Institute, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Blackmore, Wamukota, Kamau-Mbuthia, Humphries, Lesorogol, Cohn, Sarange, Mbogholi, Obata, Cheupe, Cheupe, Sherburne, Chapnick, Cartmill and Iannotti.

Figures

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Figure 1
Logical framework.
Figure 2
Figure 2
Study design.
Figure 3
Figure 3
Study area (Source: Google Earth).

References

    1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. . Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. (2013) 382:427–451. 10.1016/S0140-6736(13)60937-X
    1. Iannotti LL, Blackmore I, Cohn R, Chen F, Gyimah EA, Chapnick M, et al. . Aquatic animal foods for nutrition security and child health. Food Nutr Bull. (2022) 43:127–47. 10.1177/03795721211061924
    1. FAO . The State of Food Security and Nutrition in the World 2020. Transforming Food Systems for Affordable Healthy Diets. Rome, Italy: (2020). Available online at: (accessed December 20, 2020).
    1. Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, et al. . Food in the anthropocene : the EAT – Lancet Commission on healthy diets from sustainable food systems. Lancet. (2019) 393:447–92. 10.1016/S0140-6736(18)31788-4
    1. Béné C, Arthur R, Norbury H, Allison EH, Beveridge M, Bush S, et al. . Contribution of fisheries and aquaculture to food security and poverty reduction: assessing the current evidence. World Dev. (2016) 79:177–96. 10.1016/j.worlddev.2015.11.007
    1. UNEP . Smallholders, Food Security and the Environment. Rome, Italy: (2013).
    1. World Bank Food and Agriculture Organization WorldFish . Hidden Harvests: The Global Contribution of Capture Fisheries, Economic and Sector Work Report No. 66469-GLB. Washington DC: (2012).
    1. Bennett NJ, Govan H, Satterfield T. Ocean grabbing. Mar Policy. (2015) 57:61–8. 10.1016/j.marpol.2015.03.026
    1. Bavinck M, Berkes F, Charles A, Dias ACE, Doubleday N, Nayak P, et al. . The impact of coastal grabbing on community conservation–a global reconnaissance. Marit Stud. (2017) 16:1–17. 10.1186/s40152-017-0062-8
    1. Cohen PJ, Allison EH, Andrew NL, Cinner J, Evans LS, Fabinyi M, et al. . Securing a just space for small-scale fisheries in the blue economy. Front Mar Sci. (2019) 6:1–8. 10.3389/fmars.2019.00171
    1. Worm B, Barbier EB, Beaumont N, Duffy JE, Folke C, Halpern BS, et al. . Impacts of biodiversity loss on ocean ecosystem services. Science. (2006) 314:787–91. 10.1126/science.1132294
    1. McCauley DJ, Pinsky ML, Palumbi SR, Estes JA, Joyce FH, Warner RR. Marine defaunation: animal loss in the global ocean. Science. (2015) 347:1255641. 10.1126/science.1255641
    1. IPBES . Global Assessment Report on Biodiversity and Ecosystem Services of the Intergovernmental Science- Policy Platform on Biodiversity and Ecosystem Services. Brondizio ES, Settele J, Díaz S, Ngo HT. editors. Bonn: IPBES Secretariat; (2019).
    1. Kolding J, Bene C, Bavinck M. Small-scale fisheries - importance, vulnerability, and deficient knowledge. In:Garcia S, Rice J, Charles A, editors. Governance for Marine Fisheries and Biodiversity Conservation: Interaction and Co-evolution. Hoboken, NJ: Wiley-Blackwell; (2014), p. 317–32. 10.1002/9781118392607.ch22
    1. Selgrath JC, Gergel SE, Vincent A. Shifting gears: diversification, intensification, and effort increases in small-scale fisheries. PLoS ONE. (2018) 13:e0190232. 10.1371/journal.pone.0190232
    1. McClanahan TR, Hicks C, Darling E. Malthusian overfishing and efforts to overcome it on Kenyan coral reefs. Ecol Appl. (2008) 18:1516–29. 10.1890/07-0876.1
    1. Samoilys M, Osuka K, Maina GW, Obura D. Artisanal fisheries on Kenyas to overcome it on Kenyan cor reveal management needs. Fish Res. (2017) 186:177–91. 10.1016/j.fishres.2016.07.025
    1. Njiru M, Nzungi P, Getabu A, Wakwabi E, Othina A, Jembe T, et al. . Are fisheries management, measures in Lake Victoria successful? The case of Nile perch and Nile tilapia fishery. Afr J Ecol. (2007) 45:315–23. 10.1111/j.1365-2028.2006.00712.x
    1. McClanahan TR. Marine reserve more sustainable than gear restriction in maintaining long-term coral reef fisheries yields. Mar Policy. (2021) 128:1–9. 10.1016/j.marpol.2021.104478
    1. Kenya DHS. Kenya National Bureau of Statistics, Ministry of Health, the National AIDS Control Council, the National Council for Population and Development, Kenya. (2014).
    1. Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. . Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. (2013) 382:452–77. 10.1016/S0140-6736(13)60996-4
    1. County Government of Kilifi . Integrated Development Plan 2018-2022: Towards Realizing People-Focused Transformation for Wealth Creation. Kilifi: (2018).
    1. Kenya National Bureau of Statistics . 2019 Kenya Population and Housing Census Volume 1: Population by County and Sub-County. (2019). Available online at: (accessed February 5, 2020).
    1. Kenya Institute for Public Policy Research and Analysis . Kenya Economic Report 2020: Creating an Enabling Environment for Inclusive Growth in Kenya. Nairobi, Kenya: (2020).
    1. Gallegos-Riofrío C, Waters W, Salvador J, Carrasco A, Lutter C, Stewart C, et al. . The Lulun Project's social marketing strategy in a trial to introduce eggs during complementary feeding in Ecuador. Matern Child Nutr. (2018) 14(Suppl 3):e12700. 10.1111/mcn.12700
    1. Iannotti L, Lutter CK, Stewart CP, Gallegos Riofrn a trial to introduce eg, et al. . Eggs in early complementary feeding and child growth: a randomized controlled trial. Pediatrics. (2017) 140:e20163459. 10.1542/peds.2016-3459
    1. Mangold WG, Faulds DJ. Social media: the new hybrid element of the promotion mix. Bus Horiz. (2009) 52:357–65. 10.1016/j.bushor.2009.03.002
    1. Iannotti L, Chapnick M, Nicholas J, Gallegos-Riofrio C, Moreno P, Douglas K, et al. . Egg intervention effect on linear growth no longer present after two years. Matern Child Nutr. (2020) 16:e12925. 10.1111/mcn.12925
    1. Gomes I, Erzini K, McClanahan TR. Trap modification opens new gates to achieve sustainable coral reef fisheries. Aquat Conserv Mar Freshw Ecosyst. (2014) 24:680–95. 10.1002/aqc.2389
    1. Allison EH, Horemans B. Putting the principles of the sustainable livelihoods approach into fisheries development policy and practice. Mar Policy. (2006) 30:757–66. 10.1016/j.marpol.2006.02.001
    1. Cinner JE, Huchery C, Darling ES, Humphries AT, Graham NA, Hicks CC, et al. . Evaluating social and ecological vulnerability of coral reef fisheries to climate change. PLoS ONE. (2013) 8:e74321. 10.1371/journal.pone.0074321
    1. Hu FB, Rimm E, Smith-Warner SA, Feskanich D, Stampfer MJ, Ascherio A, et al. . Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr. (1999) 69:243–9. 10.1093/ajcn/69.2.243
    1. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, et al. . Outcomes for implementation research: conceptual distinctions, measurement challenges, and research Agenda. Adm Policy Ment Heal Ment Heal Serv Res. (2011) 38:65–76. 10.1007/s10488-010-0319-7
    1. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl. (2006) 450:76–85. 10.1111/j.1651-2227.2006.tb02378.x
    1. Wamukota A, Brewer TD, Crona B. Market integration and its relation to income distribution and inequality among fishers and traders: the case of two small-scale Kenyan reef fisheries. Mar Policy. (2014) 48:93–101. 10.1016/j.marpol.2014.03.013
    1. Guo SY, Fraser MW. Propensity Score Analysis: Statistical Methods and Applications, 1st ed. Thousand Oaks, CA: Sage Publications; (2010).
    1. Miles MB, Huberman AM, Saldana J. Qualitative Data Analysis A Methods Sourcebook. 3rd ed. Thousand Oaks, CA: Sage Publications; (2014), p. 408.

Source: PubMed

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