Rojiroti microfinance and child nutrition: a cluster randomised trial: A cluster randomised trial

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

doi:10.1136/archdischild-2018-316471

Rojiroti microfinance and child nutrition: a cluster randomised trial: A cluster randomised trial

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

^*Corresponding author for this work

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

19 Citations (Scopus)

31 Downloads (Pure)

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 β=0.38, 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; β=0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 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.

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 - 01 Mar 2020
Externally published	Yes

Bibliographical note

Funding Information:
Funding This work was supported by the Medical Research Council; Wellcome Trust; the Department of Health and Social Care; and Department for International Development (both UK Government) as part of the joint global health trials scheme (grant number MR/M021904/1). The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Publisher Copyright:
© 2020 Author(s).

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

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1136/archdischild-2018-316471Licence: CC BY

Rojiroti microfinance and child nutrition: a cluster randomised trial
Copyright 2020 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.41 MBLicence: CC BY

Cite this

@article{95d0dafba35844de8bef59a6e9abb14b,

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

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 β=0.38, 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; β=0.27, 95\% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 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. ",

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 Allen, \{Stephen John\} and Sunil Choudhary and Smyth, \{Alan Robert\}",

note = "Funding Information: Funding This work was supported by the Medical Research Council; Wellcome Trust; the Department of Health and Social Care; and Department for International Development (both UK Government) as part of the joint global health trials scheme (grant number MR/M021904/1). The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Publisher Copyright: {\textcopyright} 2020 Author(s).",

year = "2020",

month = mar,

day = "1",

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

T2 - A cluster randomised trial

AU - Ojha, Shalini

AU - Szatkowski, Lisa

AU - Sinha, Ranjeet

AU - Yaron, Gil

AU - Fogarty, Andrew

AU - Allen, Stephen John

AU - Choudhary, Sunil

AU - Smyth, Alan Robert

N1 - Funding Information: Funding This work was supported by the Medical Research Council; Wellcome Trust; the Department of Health and Social Care; and Department for International Development (both UK Government) as part of the joint global health trials scheme (grant number MR/M021904/1). The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Publisher Copyright: © 2020 Author(s).

PY - 2020/3/1

Y1 - 2020/3/1

N2 - 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 β=0.38, 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; β=0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 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.

AB - 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 β=0.38, 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; β=0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 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.

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

C2 - 31601571

AN - SCOPUS:85073690743

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: A cluster randomised trial

Abstract

Bibliographical note

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this