Improving diets and nutrition through an integrated poultry value chain and nutrition intervention (SELEVER) in Burkina Faso: study protocol for a randomized trial

Abstract

BackgroundThe SELEVER study is designed to evaluate the impact of an integrated agriculture–nutrition package of interventions (including poultry value chain development, women’s empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design.MethodsThe impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso. Communities will be randomly assigned to one of three treatment arms, including: (1) SELEVER intervention group; (2) SELEVER with an intensive WASH component; and (3) control group without intervention. Primary outcomes include the mean probability of adequacy of diets for women and children (aged 2–4 years at baseline), infant and young child feeding practices of caregivers of children aged 0–2 years, and household poultry production and sales. Intermediate outcomes along the agriculture and nutrition pathways will also be measured, including child nutrition status and development. The evaluation will follow a mixed-methods approach, including a panel of child-, household-, community-, and market-level surveys, and data collection points during post-harvest and lean seasons, as well as one year after implementation completion to examine sustainability.DiscussionTo our knowledge, this study is the first to rigorously examine from a food systems perspective, the simultaneous impact of scaling-up nutrition-specific and nutrition-sensitive interventions through a livestock value-chain and community-intervention platform, across nutrition, health, and agriculture domains. The findings of this evaluation will provide evidence to support the design of market-based nutrition-sensitive interventions.Trial registrationISRCTN registry, ISRCTN16686478. Registered on 2 December 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2156-4) contains supplementary material, which is available to authorized users.

A scoping review of social‐behaviour change techniques applied in complementary feeding interventions

“…Twenty‐two interventions occurred in sub‐Saharan Africa (Aidam et al, n.d.; Aubel, Touré, & Diagne, ; Alive and Thrive Ethiopia, ; Berti, Mildon, Siekmans, Main, & Macdonald, ; Bruyeron, Denizeau, Berger, & Trèche, ; Chiutsi‐Phiri et al, ; Crossman et al, ; Fernald et al, ; Gelli et al, ; Gelli et al, ; Guyon et al, ; Harris et al, ; Kim et al, ; Kimani‐Murage et al, ; Kulwa et al, ; Leroy, Olney, & Ruel, ; Mukuria, Martin, Egondi, Bingham, & Thuita, ; Mulualem, Henry, Berhanu, & Whiting, ; Nikiema et al, ; Olney, Pedehombga, Ruel, & Dillon, ; Parvanta, Thomas, & Zaman, ; Sarrassat et al, ; Save the Children, ; Webb Girard et al, ; Alive and Thrive, 2016) and 11 in Bangladesh (Aboud & Akhter, ; Aboud, Moore, & Akhter, ; Aboud, Shafique, & Akhter, ; Frongillo et al, ; Hoddinott, Ahmed, Ahmed, & Roy, ; Kimmons et al, ; Owais et al, ; Parvanta et al, ; Roy et al, ; Roy et al, ; TANGO International, ). Of the remaining, nine occurred in India (Alive & Thrive India, n.d.; Bhandari et al, ; Bhandari et al, ; Dongre, Deshmukh, & Garg, ; Kadiyala, Morgan, Cyriac, Margolies, & Roopnaraine, ; Kilaru, Griffiths, Ganapathy, & Ghosh, ; Palwala et al, ; Singh et al, ; Vazir et al, ) and eight Central/South American or Mexico (Bonvecchio, Pelto, Escalante, & Monterrubio, ; de Oliveira, Giugliani, Santo, & Nunes, ; Iannotti et al, ; Jensen, Frongillo, Leroy, & Blake, ; Leroy et al, ; Monterrosa et al, ; Penny et al, ; Santos et al, ).…”

“…We next sought to assess whether patterns emerged between the type and/or quantity of BCT used and intervention effectiveness. Of the 64 unique interventions identified, six (Alive & Thrive India, n.d.; Fernald et al, ; Gelli, Becquey, et al, ; Gelli, Margolies, et al, ; Kadiyala et al, ; Kulwa et al, ) were in progress and had not reported evaluation data as of August 2018. Forty‐two were randomized controlled or quasi‐experimental studies, and one was a propensity score matched impact evaluation; the remaining interventions applied evaluation strategies that consisted of pre/post designs with no control group ( n = 15), cross‐sectional surveys ( n = 1), or were missing baseline data ( n = 1) and were excluded from these analyses.…”

Poultry husbandry, water, sanitation, and hygiene practices, and child anthropometry in rural Burkina Faso

“…These regions were prioritized by the SELEVER implementers on the basis of the poultry production sector's potential to meet the demand for poultry in urban markets through greater commercialization (Some, ). The SELEVER trial protocol has been described in detail elsewhere (Gelli, Becquey, et al, ). Briefly, during the preparation stages of the SELEVER cRCT, 60 communes were selected from a pool of 79 communes that were available for scale‐up of the SELEVER intervention in the three targeted regions (Figure ).…”

“…We adopted the use of the “restricted household” definition involving family members who normally share their meals together, which reflects the Living Standard Measurement Survey experience in collecting data in developing countries. Prior to the survey, a household census was conducted to identify all restricted households, all the large poultry producing households (defined as owning a poultry flock of over 20 chickens/fowls) in the community, and households with women aged 15–35 years with children in the 2–4 age group (see Gelli, Becquey, et al, for full details and the study protocol). Fifteen restricted households were then randomly selected from the household census for the survey interviews.…”

“…In light of the limited evidence base on the linkages between poultry rearing, WASH, and child nutrition, this study aimed to examine associations between these factors using rich survey data from rural Burkina Faso. The “Soutenir l'Exploitation Familiale pour Lancer l'Élevage des Volailles et Valoriser l'Économie Rurale” (SELEVER) cluster randomized control trial (cRCT) is an ongoing 5‐year study designed to evaluate the impact of an integrated agriculture–nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behaviour change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso (Gelli, Becquey, et al, ). Unlike standard household surveys, the SELEVER baseline survey includes a rich set of indicators around poultry husbandry and livestock‐related WASH factors, as well as child anthropometry and relevant determinants of child nutrition.…”