Evaluation of REACTS-IN, an Intervention to Improve Nutrition, Hygiene, and Sexual and Reproductive Health Services
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights, school-based iron-folic acid supplement program, Health service training on equitable access to nutrition, health, and sexual and reproductive services, bio-fortified crops.
- Who it may be relevant to
- Registry conditions: Stunting, Gender Equality, Acceptability of Health Care, Diet; Deficiency. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Bangladesh, Kenya, Tanzania
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Realizing Gender Equality, Attitudinal Change & Transformative Systems in Nutrition (REACTS-IN)
Overview
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 communities, schools, and health facilities. Only baseline and endline will be collected on the comparison communities. 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.
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.
Interventions
- 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
Primary outcome measures
- Gender equality [Time frame: 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]
Secondary outcome measures (12)
- Antenatal care [Time frame: 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]
- Child diet [Time frame: 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]
- 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]
- Exclusive breastfeeding [Time frame: Change between baseline and study completion, an average of 5 years]
- Use of family planning [Time frame: Change between baseline and study completion, an average of 5 years]
- adolescent knowledge of nutrition, menstrual hygiene, and sexual and reproductive health [Time frame: Change between baseline and study completion, an average of 5 years]
- maternal knowledge on nutrition [Time frame: Change between baseline and study completion, an average of 5 years]
- Attended birth deliveries [Time frame: Change between baseline and study completion, an average of 5 years]
- maternal knowledge of family planning [Time frame: Change between baseline and study completion, an average of 5 years]
- maternal knowledge of exclusive breastfeeding [Time frame: Change between baseline and study completion, an average of 5 years]
Eligibility criteria
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)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Non-randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Other
Study locations
Bangladesh · 1 center
- Brac University — Dhaka
Kenya · 1 center
- Connar Consultants — Nairobi
Tanzania · 1 center
- Ifakara Health Institute — Ifakara
Identifiers
NCT: NCT06362837 · P0117910-001