BACKGROUND:The Nutrition Embedded Evaluation Programme Impact Evaluation (NEEP-IE) study is a cluster randomised controlled trial designed to evaluate the impact of a childcare centre-based integrated nutritional and agricultural intervention on the diets, nutrition and development of young children in Malawi. The intervention includes activities to improve nutritious food production and training/behaviour-change communication to improve food intake, care and hygiene practices. This paper presents the rationale and study design for this randomised control trial. METHODS:Sixty community-based childcare centres (CBCCs) in rural communities around Zomba district, Malawi, were randomised to either (1) a control group where children were attending CBCCs supported by Save the Children's Early Childhood Health and Development (ECD) programme, or (2) an intervention group where nutritional and agricultural support activities were provided alongside the routine provision of the Save the Children's ECD programme. Primary outcomes at child level include dietary intake (measured through 24-h recall), whilst secondary outcomes include child development (Malawi Development Assessment Tool (MDAT)) and nutritional status (anthropometric measurements). At household level, primary outcomes include smallholder farmer production output and crop-mix (recall of last production season). Intermediate outcomes along theorised agricultural and nutritional pathways were measured. During this trial, we will follow a mixed-methods approach and undertake child-, household-, CBCC- and market-level surveys and assessments as well as in-depth interviews and focus group discussions with project stakeholders. DISCUSSION:Assessing the simultaneous impact of preschool meals on diets, nutrition, child development and agriculture is a complex undertaking. This study is the first to explicitly examine, from a food systems perspective, the impact of a preschool meals programme on dietary choices, alongside outcomes in the nutritional, child development and agricultural domains. The findings of this evaluation will provide evidence to support policymakers in the scale-up of national programmes. TRIAL REGISTRATION:ISRCTN registry, ID: ISRCTN96497560 . Registered on 21 September 2016.

译文

背景:营养嵌入式评估计划影响评估(NEEP-IE)研究是一项集群随机对照试验,旨在评估基于托儿所的营养和农业综合干预对马拉维幼儿饮食,营养和发育的影响。干预措施包括改善营养食品生产的活动和培训/行为改变交流,以改善食物摄入,护理和卫生习惯。本文介绍了这项随机对照试验的原理和研究设计。
方法:将马拉维Zomba地区周边农村社区的60个社区托儿中心(CBCC)随机分为(1)对照组,在该组中,儿童参加了由Save the Children's Early Childhood Health and Development(ECD)计划支持的CBCC,或(2)一个干预小组,在该小组的日常服务之外,还提供了营养和农业支持活动。儿童一级的主要结局包括饮食摄入量(通过24小时召回来衡量),而次级一级的结局包括儿童发育(马拉维发育评估工具(MDAT))和营养状况(人体测量)。在家庭一级,主要成果包括小农户的农产品产量和作物结构(回顾上个生产季节)。测量了沿理论化的农业和营养途径的中间结果。在此试验期间,我们将采用混合方法,并进行儿童,家庭,CBCC和市场级别的调查和评估,以及与项目利益相关者的深入访谈和焦点小组讨论。
讨论:评估学龄前膳食对饮食,营养,儿童发育和农业的同时影响是一项复杂的工作。这项研究是第一个从食品系统的角度明确检查学龄前儿童饮食计划对饮食选择以及营养,儿童发育和农业领域的成果的影响的研究。评估的结果将为支持决策者扩大国家计划提供证据。
试用注册:ISRCTN注册,ID:ISRCTN96497560。 2016年9月21日注册。

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