StuntingREACTS-INNCT06362837
Evaluation of REACTS-IN, an Intervention to Improve Nutrition, Hygiene, and Sexual and Reproductive Health Services
A study testing Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights, school-based iron-folic acid supplement program and Health service training on equitable access to nutrition, health, and sexual and reproductive services in people with Stunting and Gender Equality, run by McGill University at 3 sites in 3 countries.
Trial summary
This is an independent evaluation of World VIsion's 7-year quasi-experimental intervention to improve nutrition, nutrition-related rights and gender equality for women, adolescent girls, and children under five years of age in rural Bangladesh, Kenya, and Tanzania. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Stunting, Gender Equality, Acceptability of Health Care
- What is being tested?
- Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights, school-based iron-folic acid supplement program and Health service training on equitable access to nutrition, health, and sexual and reproductive services
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 13,500 participants
- Where
- 3 sitesin 3 countries
- Study dates
- 1 Sep 2024to 31 Dec 2029
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- (i)Women:
- 15-49 y of age
- biological mother of child in the home who is 0-5.9, 6-23.9, or 24-59.9 months
- has lived in the community for at 12 months
- Husbands/partners:
- no age limit
Show all 15Show fewer
- lives in the home with index woman
- has lived in community for at least 12 months
- Adolescents:
- 10-19 years
- male or female
- has been in target school for at least 6 months
- lives in the target community
- Children:
- 0-5.9, 6-23.9, or 24-59.9 months
Who cannot join
- Children:
- no limitation on normal diet or growth (birth defects, illnesses)
Trial locations and contacts
3 sites in 3 countries. Contact the study team or a site near you to ask about taking part.
Aishat Abdu, PhD contact
3 sites in 3 countries
Bangladesh1 site, 1 recruiting
- Recruiting
Brac University
Dhaka
Malay K Mridha, PhD, malay.mridha@bracu.ac.bd
Kenya1 site, 1 recruiting
- Recruiting
Connar Consultants
Nairobi
Elizabeth Kamau, PhD, ekambu@gmail.com
Tanzania1 site, 1 recruiting
- Not yet recruiting
Ifakara Health Institute
Ifakara
Ester Elisaria, PhD, eelisaria@ihi.or.tz
About this study
Official title: Realizing Gender Equality, Attitudinal Change & Transformative Systems in Nutrition (REACTS-IN)
This is an independent evaluation of World VIsion's 7-year quasi-experimental intervention to improve nutrition, nutrition-related rights and gender equality for women, adolescent girls, and children under five years of age in rural Bangladesh, Kenya, and Tanzania. The evaluation will collect baseline, midline, and end-line data from intervention communities, schools, and health facilities. Only baseline and endline will be collected on the comparison communities. The evaluation objectives are to test if the intervention improved indicators for (i) child anthropometry, (ii) maternal and child dietary practices, (iii) women's empowerment, and (iv) equitable health service access for nutrition and sexual and reproductive needs. The evaluation analysis will take into account gender differences in the indicators.
Read the detailed description
This is an independent evaluation of World VIsion's 7-year quasi-experimental intervention ("Realizing Gender Equality, Attitudinal Change and Transformative Systems in Nutrition", REACTS-IN) to improve nutrition, nutrition-related rights and gender equality for women, adolescent girls, and children under five years of age in rural Bangladesh, Kenya, and Tanzania. REACTS-IN is a multi-sectoral approach, integrating nutrition-related determinants, such as water, sanitation, and hygiene (WASH) interventions and health systems strengthening, to improve access to quality and gender-responsive health systems with increased capacity to prevent and treat malnutrition, especially at the primary health care level. REACTS-IN includes both nutrition-specific (e.g., school-based iron-folic acid supplement program) and nutrition-sensitive (e.g., WASH education) activities delivered through local health systems and/or schools, and communities.
This independent evaluation will include three data collection at baseline, midpoint, and end-line to evaluate the performance indicators for the ultimate and intermediate outcomes. This includes indicators for child anthropometry, maternal and child dietary practices, women's empowerment, and equitable health service access for nutrition and sexual and reproductive needs. The evaluation analysis will take into account gender differences in the indicators.
The data collection will be carried out with intervention communities as well as with comparison communities. The estimated household sample is 463 households (women, husbands, child)/arm/country per time point, selected through a multi-stage cluster sampling methodology. The household baseline survey with a representative sample of mothers with children (0-5.9 mo; 6-23.9 mo; 24-59.9 mo) will be compared to the values at midpoint (to assess initial impact and the need for program adjustments) and at end-line (to assess the total impact of the project). The surveys will include sociodemographic, economic, and environmental information to assess the indicators for the local context. The evaluation also includes a sample of 500 school-going adolescents (250 boys, 250 girls)/arm/country per time point to assess indicators of knowledge about nutrition, menstrual hygiene management, and sexual and reproductive health. Finally, a sample of approximately 24 health staff and community leaders will provide qualitative data on gender-equitable access to services per arm/country for baseline and end-line.
Although the project also is working in Somalia, this independent evaluation does not include data collection in Somalia.
- Being tested
- Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights, school-based iron-folic acid supplement program, Health service training on equitable access to nutrition, health, and sexual and reproductive services, bio-fortified crops
- Keywords
- nutrition, gender equity, health services, sexual and reproductive rights, dietary diversity, anthropometry, sexual and reproductive health services, WASH
- Medical subject headings
- Growth Disorders, Patient Acceptance of Health Care, Malnutrition, Empowerment, Coitus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rightsBehavioural
Educational training on nutrition, gender equity, WASH, sexual and reproductive health rights will take place in communities (including schools) for women, men, and adolescents
school-based iron-folic acid supplement programDietary supplement
The program will help support and promote the school-based programs of weekly iron and folic acid supplementation for adolescent girls, in countries where it is allowed.
Health service training on equitable access to nutrition, health, and sexual and reproductive servicesBehavioural
Training and support activities to make gender-equitable nutrition, health, and sexual and reproductive services in the health facilities
bio-fortified cropsDietary supplement
The program promotes and distributes bio-fortified crops, including orange-fleshed sweet potatoes, rice, beans, and corn
| Study group | Role | What they receive |
|---|---|---|
| Intervention | Experimental | Includes multiple activities, depending on country, including support of school-based iron-folic acid supplementation program; promotion of bio-fortified crops (sweet potatoes, beans, rice, corn); training on nutrition, water \& sanitation, gender equity for rural communities through community groups and for health facility staff; support to improve gender-sensitive health services for nutrition, sexual and reproductive health, Receives: Behavioral: Education intervention on nutrition, gender equity, WASH, sexual and reproductive health rights; Dietary Supplement: school-based iron-folic acid supplement program; Behavioral: Health service training on equitable access to nutrition, health, and sexual and reproductive services; Dietary Supplement: bio-fortified crops |
| Comparison | No intervention | No intervention will take place. Standard of care will be available in the health facilities and schools. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Gender equality
Percent of households with children < 59.9 mo that have achieved gender equality
Measured: Change between baseline and study completion, an average of 5 years
Child anthropometry
Percent of children 6-59 mo of age who are stunted
Measured: Change between baseline and study completion, an average of 5 years
Secondary outcomes (19)
Antenatal care
Percent of mothers of children 0-6 months who attended at least four ante-natal visits during the last pregnancy from skilled health personnel
Measured: Change between baseline and study completion, an average of 5 years
Contraception use by women and partners
Percent of women aged 15-49 years married or in union, who are currently using, or whose sexual partner is using at least one modern contraception method
Measured: Change between baseline and study completion, an average of 5 years
Child diet
Percent of children 6-23.9 months of age, who receive minimum dietary diversity and minimum meal frequency
Measured: Change between baseline and study completion, an average of 5 years
Sexual and reproductive health services for adolescents
Percent of adolescent girls (10-19) who report that they were offered sexual and reproductive health services
Measured: Change between baseline and study completion, an average of 5 years
Gender equitable health services for nutrition, health, and sexual and reproductive health
Percent of health facilities promoting gender equitable and responsive nutrition, health, and sexual and reproductive services
Measured: Change between baseline and study completion, an average of 5 years
Exclusive breastfeeding
Percent of children 0-5.9 mo who are exclusively breastfed
Measured: Change between baseline and study completion, an average of 5 years
Use of family planning
Percent of women 15-49 y who decided to use family planning
Measured: Change between baseline and study completion, an average of 5 years
adolescent knowledge of nutrition, menstrual hygiene, and sexual and reproductive health
Percent of adolescent girls and boys with appropriate knowledge about nutrition, menstrual hygiene, and sexual and reproductive health
Measured: Change between baseline and study completion, an average of 5 years
maternal knowledge on nutrition
Percent of women 15-49 y with appropriate knowledge on good maternal nutrition
Measured: Change between baseline and study completion, an average of 5 years
Attended birth deliveries
Percent of deliveries attended by skilled birth personnel
Measured: Change between baseline and study completion, an average of 5 years
maternal knowledge of family planning
Percent of mothers who know at least 3 modern methods of family planning
Measured: Change between baseline and study completion, an average of 5 years
maternal knowledge of exclusive breastfeeding
Percent of mothers who know at least 3 benefits of exclusive breastfeeding
Measured: Change between baseline and study completion, an average of 5 years
mothers planting biofortified crops
Percent of mothers who have planted biofortified crops from REACTS-IN materials
Measured: Change between baseline and study completion, an average of 5 years
mothers planting nutrient dense local vegetables
Percent of mothers who have planted nutrient dense local vegetables from REACTS-IN seeds
Measured: Change between baseline and study completion, an average of 5 years
mothers planting trees
Percent of mothers who have planted fruit tress from REACTS-IN materials
Measured: Change between baseline and study completion, an average of 5 years
hygenic toilets
Percent of households with hygienic toilets
Measured: Change between baseline and study completion, an average of 5 years
community health worker visit
Percent of households that received at least one community health worker visit in last month
Measured: Change between baseline and study completion, an average of 5 years
Adolescent iron folic acid supplements
Percent of adolescent girls who received the recommended scheme of weekly iron-folic actic supplements
Measured: Change between baseline and study completion, an average of 5 years
health facility
Percent of health facilities scoring > 80 on planning assessment
Measured: Change between baseline and study completion, an average of 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Apr 2024
- Study start1 Sep 2024
- Primary completion30 Jun 2029 (estimated)
- Study completion31 Dec 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for StuntingStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- This is a quasi-experimental design for the evaluation of an intervention that is in the community (including schools) as well as in the local health service facilities. The data collection at baseline, midline, and end-line will occur simultaneously in the intervention and comparison selected communities. Comparison communities will not be visited during midline. Participants are unique at each time point.
- Masking
- None (open label)
- Enrolment
- 13,500 participants (estimated)
Sponsor and investigators
- Lead sponsor
- McGill University
- Sponsor type
- University, hospital or other
- Collaborators
- World Vision Canada, Global Affairs Canada
- Responsible party
- Principal investigator, Grace S. Marquis, McGill University
- Investigators
- Grace S Marquis, PhD, Principal investigator, McGill University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06362837
- Sponsor's protocol ID
- P0117910-001
- Acronym
- REACTS-IN
- Status last verified
- Apr 2026
- First submitted
- 4 Apr 2024
- Last updated
- 29 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No