Rojiroti microfinance and child nutrition: a cluster randomised trial.

Shalini Ojha; Lisa Szatkowski; Ranjeet Sinha; Gil Yaron; Andrew Fogarty; Stephen Allen; Sunil Choudhary; Alan Robert Smyth

doi:10.1136/archdischild-2018-316471

Rojiroti microfinance and child nutrition: a cluster randomised trial.

Shalini Ojha
, Lisa Szatkowski
, Ranjeet Sinha
, Gil Yaron
, Andrew Fogarty
, Stephen Allen
, Sunil Choudhary
, Alan Robert Smyth

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

OBJECTIVE

To determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.

DESIGN

Cluster randomised trial.

SETTING

Tolas (village communities) in Bihar State.

PARTICIPANTS

Women and children under 5 years.

INTERVENTIONS

With Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.

OUTCOME MEASURES

The primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.

RESULTS

We randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β0.38, 95% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18%) versus control (200, 29%; OR=0.46, 95% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β0.22, 95% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and % underweight showed significant differences in favour of the intervention.

CONCLUSION

In marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.

TRIAL REGISTRATION NUMBER

NCT01845545.

Original language	English
Pages (from-to)	229-235
Number of pages	7
Journal	Archives of Disease in Childhood
Volume	105
Issue number	3
Early online date	10 Oct 2019
DOIs	https://doi.org/10.1136/archdischild-2018-316471
Publication status	Published - 20 Feb 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 1 No Poverty
SDG 5 Gender Equality
SDG 8 Decent Work and Economic Growth

Keywords

child growth
low & middle income countries
microfinance
wasting
weight for height z score

Access to Document

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Rojiroti microfinance - SAllenAccepted author manuscript, 1.64 MBLicence: CC BY

Cite this

@article{ddf92d2649ee4d35ac89d8603cd171da,

title = "Rojiroti microfinance and child nutrition: a cluster randomised trial.",

abstract = "OBJECTIVETo determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.DESIGNCluster randomised trial.SETTINGTolas (village communities) in Bihar State.PARTICIPANTSWomen and children under 5 years.INTERVENTIONSWith Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.OUTCOME MEASURESThe primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.RESULTSWe randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β0.38, 95\% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18\%) versus control (200, 29\%; OR=0.46, 95\% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β0.27, 95\% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β0.22, 95\% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and \% underweight showed significant differences in favour of the intervention.CONCLUSIONIn marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.TRIAL REGISTRATION NUMBERNCT01845545.",

keywords = "child growth, low \& middle income countries, microfinance, wasting, weight for height z score",

author = "Shalini Ojha and Lisa Szatkowski and Ranjeet Sinha and Gil Yaron and Andrew Fogarty and Stephen Allen and Sunil Choudhary and Smyth, \{Alan Robert\}",

year = "2020",

month = feb,

day = "20",

doi = "10.1136/archdischild-2018-316471",

language = "English",

volume = "105",

pages = "229--235",

journal = "Archives of Disease in Childhood",

issn = "0003-9888",

publisher = "BMJ Publishing Group",

number = "3",

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TY - JOUR

T1 - Rojiroti microfinance and child nutrition: a cluster randomised trial.

AU - Ojha, Shalini

AU - Szatkowski, Lisa

AU - Sinha, Ranjeet

AU - Yaron, Gil

AU - Fogarty, Andrew

AU - Allen, Stephen

AU - Choudhary, Sunil

AU - Smyth, Alan Robert

PY - 2020/2/20

Y1 - 2020/2/20

N2 - OBJECTIVETo determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.DESIGNCluster randomised trial.SETTINGTolas (village communities) in Bihar State.PARTICIPANTSWomen and children under 5 years.INTERVENTIONSWith Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.OUTCOME MEASURESThe primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.RESULTSWe randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β0.38, 95% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18%) versus control (200, 29%; OR=0.46, 95% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β0.22, 95% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and % underweight showed significant differences in favour of the intervention.CONCLUSIONIn marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.TRIAL REGISTRATION NUMBERNCT01845545.

AB - OBJECTIVETo determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.DESIGNCluster randomised trial.SETTINGTolas (village communities) in Bihar State.PARTICIPANTSWomen and children under 5 years.INTERVENTIONSWith Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.OUTCOME MEASURESThe primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.RESULTSWe randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β0.38, 95% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18%) versus control (200, 29%; OR=0.46, 95% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β0.22, 95% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and % underweight showed significant differences in favour of the intervention.CONCLUSIONIn marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.TRIAL REGISTRATION NUMBERNCT01845545.

KW - child growth

KW - low & middle income countries

KW - microfinance

KW - wasting

KW - weight for height z score

U2 - 10.1136/archdischild-2018-316471

DO - 10.1136/archdischild-2018-316471

M3 - Article

SN - 0003-9888

VL - 105

SP - 229

EP - 235

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

IS - 3

ER -

Rojiroti microfinance and child nutrition: a cluster randomised trial.

Abstract

UN SDGs

Keywords

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