Evaluating the Effectiveness of a Nutrition and Agricultural Linkages Project in Western Kenya: Design of the Mama SASHA Cohort Study of Vitamin A (COVA).
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Date
2015
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Abstract
Objectives: The 2013 Lancet Maternal and Child Nutrition series identified rigorous evaluations of
nutrition-sensitive agricultural interventions as a research priority. The Mama SASHA study in
Western Kenya links delivery of vitamin A (VA) rich orange-flesh sweet potato (OFSP) vines to
antenatal care to improve VA and nutritional status of pregnant and lactating women and their
children.
Methods: In addition to cross-sectional surveys in intervention and control communities at
baseline and endline, the evaluation strategy includes a nested longitudinal study that follows
women and their infants from pregnancy through 9 months postpartum. VA status of mothers and
their infants is assessed during four visits using infection-adjusted plasma retinol binding protein
and breast milk retinol (postpartum). Maternal and child iron and anemia status, anthropometry,
dietary intakes, agricultural practices, health services uptake, household food security and program
uptake are also measured
Results: 505 eligible pregnant women, attending ANC at 4 control and 4 intervention facilities, were consented and enrolled. At enrollment overall prevalence of infection adjusted vitamin A
deficiency was 21.8%. Women in control and intervention communities did not differ with respect to
VA, iron, anemia or anthropometric status; household food security or dietary diversity scores;
demographic characteristics; awareness of vitamin A; or consumption of vitamin A rich foods in the
past 7 days. Only 10 women had consumed OFSP in the previous 7 days; all in intervention
communities.
Conclusions: The longitudinal study will contribute to rigorous impact evaluation of the OFSP
intervention on maternal and child VA status and allow assessment of program impact pathways.
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Girard Amy Webb, Grant Frederick, Okuku Haile, Akelo Victor, Wanjala Rose, Levin Carol, Cole Donald, Low Jan. Evaluating the Effectiveness of a Nutrition and Agricultural Linkages Project in Western Kenya: Design of the Mama SASHA Cohort Study of Vitamin A (COVA). European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 1194-1195.