NCT06362837

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

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

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 13,500 (estimated)
• Sponsor: McGill University · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

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.

Conditions

• Stunting
• Gender Equality
• Acceptability of Health Care
• Diet; Deficiency
• Empowerment

Interventions

Type	Name	Description
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

Timeline

• Start date: 2024-09-01
• Primary completion: 2029-06-30
• Completion: 2030-05-24
• First posted: 2024-04-12
• Last updated: 2024-11-20

Locations

3 sites across 3 countries: Bangladesh, Kenya, Tanzania