Assessing the Impact, Implementation and Cost of Empowering Community Health Promoters to Improve Wasting Treatment Coverage in Turkana County Through Family-led MUAC Scale-up, Weight-for-age Screening, and Defaulters' Follow-up

Status: Recruiting
Location: See location...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Child wasting is a type of malnutrition which occurs when a child becomes too thin. This medical condition increases the risk of becoming sick or dying. A child with severe wasting needs to be seen in a medical consultation to check on health status and to receive some medicine and a medical food supplement for daily consumption until cured. Yet, only a small proportion of children suffering from severe wasting are presently receiving appropriate treatment. In Kenya, there is an opportunity to build on the existing network of community health promoters (CHPs) to increase the number of children with wasting who are identified and treated. In intervention areas, CHPs will be equipped with smartphones and an application which provides guidance on household members to visit and simple actions to take, related to health. CHPs will distribute color-coded mid-upper arm circumference tapes to households with young children and train caregivers on how to use it. After training, CHPs will send Short Message Services (SMS) to remind caregivers to regularly measure the arm circumference of the child. In addition, CHPs will receive a scale to measure the weight of children every month. Finally, wasted children registered in the treatment program who fail to attend a planned consultation will be flagged to their CHP through the phone application, and CHPs will conduct a specific home visit to investigate and help solve potential issues. The study will assess whether this community intervention (called SWITCH) allows to identify and treat more children suffering from severe wasting. Before the start of the intervention, the proportion of wasted children receiving treatment in 40 community units in Turkana South, Turkana East and Aroo will be assessed. After this survey, a computer will randomly select 20 community units where the intervention will be scaled up. The survey will be repeated after 2 years to assess if the proportion of severely wasted children receiving treatment is higher in the area where the intervention was scaled up compared to the area where it was not scaled up. In addition, after 1 year of implementation, the study will assess how the intervention was scaled up, what are the main challenges, and what are the overall perceptions on the intervention in the community among those who receive it and those who deliver it. Finally, costs of the various components of the intervention will be measured for all actors involved, including for caregivers.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 6 months
Maximum Age: 5
Healthy Volunteers: t
View:

• Household in a village of the study area covered by a CHP (although the child may or may not be registered by a CHP) AND

• Child is 6-59.9 months of age AND

• Caregiver consents to be part of the study AND

• any of the following:

‣ WHZ \< -3 (relative to WHO 2006 reference) OR

⁃ MUAC \<115 mm OR

⁃ Presence of bilateral edema OR

⁃ receiving treatment as follow-up for an initial SAM condition on the way to full recovery

Locations
Other Locations
Kenya
Turkana South and Turkana East and Aroo
RECRUITING
Lodwar
Contact Information
Primary
Elodie Becquey, PhD
e.becquey@cgiar.org
778487085
Backup
Sophie Ochola, PhD
ocholasa55@gmail.com
0721449803
Time Frame
Start Date: 2024-06-03
Estimated Completion Date: 2027-06-30
Participants
Target number of participants: 1600
Treatments
No_intervention: Standard of Care
* Register-based household registration (census) by CHP every 12 months~* Some family MUAC of variable and unknown coverage/frequency, national guidance developed.~* Some passive screening using weight-for-height z-score at Health Facility and during outreach during Malezi bora (child health week every 6 months).~* Monthly compilation by CHA (supervisors) of the list of defaulters and non-respondents for transmission to relevant community health promoter (CHP) during monthly in-person meeting.
Experimental: SWITCH intervention package
* Addition of digital monitoring \& supervision by CHA~* Digitized registration of households by CHPs every 6 months~* Digital reminders to CHP to conduct home visit if a child has never been visited in 3 mo.~* Digital reminder for timely training to family MUAC of all family members through home visit by CHP when child turns 6 months of age.~* Platform for 2-ways messaging: biweekly SMS reminders to caregivers through the CHP's app; feedback by caregiver~* Community level screening based on weight and weight-for-age (WAZ) led by CHP every other month (aligned with Community Action Days),~* Digital calculation of WAZ.~* CHP and Growth Monitoring and Promotion refer to health facility if WAZ\<-3 to check on WHZ eligibility~* At the end of every wasting treatment consultation, compilation of the list of defaulters and non-respondents, for immediate transmission by CHA to relevant CHP through digital task of an instruction for immediate follow-up.
Related Therapeutic Areas
Sponsors
Leads: International Food Policy Research Institute
Collaborators: UNICEF, Kenyatta University

This content was sourced from clinicaltrials.gov