The evaluation uses a cluster-randomized design where 20 geographic clusters (subdistricts) were randomized to allocate them to comparison area, MNP-only area, Behavior Change Communication (BCC)-only area and MNP+BCC areas. The design uses a repeated cross-sectional design, where a community-based random sample of children 6-59.9 months old was surveyed at baseline (April-June 2010). Children 6.23.9 months of age will be surveyed at endline for the MNP intervention in April-June 2013 and for the MNP + BCC intervention in April-June 2014. The impact evaluation design enables the following comparisons: 1) double-difference intent-to-treat estimates of public health impact on anemia, iron deficiency and vitamin A deficiency among the population of children 6-11.9 months of age; 2) end-line only intent-to-treat comparisons of children in each of the intervention arms with the comparison arm; 3) additional analyses of impact on the treated, by levels of exposure, among the MNP arms. Stunting will be assessed using before-after intervention-comparison group differences between 2010 and 2014. Infant feeding practices will be assessed using before-after intervention-comparison area group differences between 2010, and 2013 and 2014.
In addition, the investigators will evaluate the processes through which the BCC and MNP programs roll out using a mix of qualitative and quantitative research methods. Qualitative research methods will help to understand drivers of promotion and sales of MNPs by frontline health workers, as well as household level determinants and dynamics related to enabling purchase and use of the MNP and adhering to behavioral recommendations. Quantitative surveys of frontline health workers will help document their awareness about IYCF, MNPs, training, and sales, while quantitative surveys of the households will help document household level awareness, purchase and use of MNPs and awareness and adherence to IYCF practices for children in the target age range.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01678716