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

Abstract

BackgroundOne 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.MethodsThere 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.DiscussionThis 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 registrationhttps://clinicaltrials.gov (NCT05254444).

Sustainable aquatic food systems: Multisectoral analysis of determinants of child nutrition in coastal Kenya

“…From the outset, we engaged stakeholders from these different sectors with a view toward designing and implementing a trial examining a large-scale multidisciplinary intervention, informed by this research. Ultimately, this formative research was used to design a multifaceted intervention involving several sectors and targeting the domains of education, livelihoods, sustainable fisheries, and public health nutrition communication (Blackmore et al, 2022). The results of this study were used to plan health promotion messages through social marketing in order to improve child nutrition and health outcomes through Samaki Salama Project.…”

Carrier bag storytelling with coastal Kenyan families: sharing food, illustrations, and knowledge for tangible environmental justice impacts

“…One of these insights is the critical interplay that various family members have in the cycle of malnutrition and food security. While the hope of other research in the area is that gear-based fisheries improvements will result in increased household food security and child nutrition (Blackmore et al, 2022), several women we spoke with cast doubts that these system feedbacks would occur due to the inequitable gender dynamics within their households. One mother's feedback stated directly that the role of men in household food security through the political-economic system may overpower the ability of mothers and caregivers to implement any nutrition knowledge gained through the project with their families.…”

“…In part for this reason, the United States Agency for International Development (USAID) has recently funded numerous sustainable development studies in the area to investigate childhood fish consumption and fisheries sustainability (Cartmill et al, 2022). The "Samaki Salama" ("secure fish" in Swahili) project, investigated the impacts of a nutrition social marketing campaign and fishing gear incentive intervention on fisheries productivity, dietary diversity, and child growth among subsistence fishing families in coastal Kenya (Blackmore et al, 2022). As an intervention strategy, sustainable fishing gear alongside fisheries and nutrition "social marketing" (education campaigns with cooking demonstration sessions and training) have potential to address local food security.…”

“…The story about food sovereignty highlights the impacts that individuals make in everyday interactions with their foodways and the diverse life or ecosystem services that this community is connected to. Sandwiched between are two recipes for mama (or baba, or bibi) to make for dinner with fresh fish, which were sourced from recipes prepared at the various cooking demonstrations that were part of local social-marketing interventions (Blackmore et al, 2022). As such, they use local ingredients to prepare culturally relevant and nutritious meals.…”

“…Even for these pregnant mothers too". Mothers reported seeing changes in their families in terms of health and growth of their children, which is a metric that other research plans to quantitatively validate (Blackmore et al, 2022). On a less material level though, participants also see that the messaging has educational, social, or economic development benefits for themselves and their families.…”