Improving school feeding programming in Yemen
| ISRCTN | ISRCTN12225603 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN12225603 |
- Submission date
- 27/10/2023
- Registration date
- 01/11/2023
- Last edited
- 27/08/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English Summary
Background and study aims
Even before the onset of the current civil war, Yemen was one of the poorest countries in the world ranking 183 out of 191 countries and territories on the UN Human Development Index. The World Food Programme (WFP) estimates that currently 17 million Yemeni (half the population) are food insecure and 2.2 million preschool children are acutely malnourished (World Food Programme, 2023a). In 2022, 17% of school children in Yemen received school meals (WFP, 2022) and in 2023, the humanitarian response will cover only 8% of the needs of education sector, leaving it with the second highest unmet need (OCHA, 2023). WFP provides nutritious snacks (imported or locally procured), either fortified date bars or fortified high energy biscuits, to 1.55 million school children. There is an urgent need to understand how to improve access to nutritious school meals to support students and schools throughout the country. The aim of this study is to evaulate the effectiveness and cost-efficacy of adding a daily drink of milk to an ongoing school feeding program to improve children's diet.
Who can participate?
Children 6-8 years of age attending one of the schools included in the study
What does the study involve?
Schools will be randomly allocated to one of two groups to receive:
1. Standard of care: the standard WFP school feeding program involving daily distribtuion of high energy biscuits
2. The standard of care intervention with addition of a daily drink of milk
The intervention lasts approximately one school year (~7 months).
What are the possible benefits and risks of participating?
The intervention is expected to improve children's diets, cognition, learning scores, and nutritional status by providing additional protein and micronutritients through the milk distribution in addition to the high energy buscuits. The intervention is also expect to improve children's attendance and caregivers perceptions and willingness to pay for school meals. There are no known risks related to the intervention involved.
Where is the study run from?
International Food Policy Research Institute (USA, Egypt)
When is the study starting and how long is it expected to run for?
August 2023 to July 2024
Who is funding the study?
1. CGIAR Initiative on Fragility, Conflict, and Migration (USA)
2. HSA Group (USA)
Who is the main contact?
Dr Aulo Gelli, A.Gelli@cgiar.org
Contact information
Public, Scientific, Principal Investigator
1201 Eye Street NW
Washington
20005
United States of America
| Phone | +1 202-862-5600 |
|---|---|
| a.gelli@cgiar.org |
Study information
| Study design | Longitudinal cluster-randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | School |
| Study type | Other |
| Participant information sheet | Not available in web format, please use the contact details to request a participant information sheet |
| Scientific title | Impact evaluation of an added milk intervention to a micronutrient fortified school feeding program: An effectiveness pilot trial in Yemen |
| Study hypothesis | The study will evaluate the cost, cost-efficiency and impact of adding a daily drink of milk to an ongoing school feeding program. The hypothesis is that the addition of milk will improve school-aged children's diet, nutrition, health, and education outcomes. |
| Ethics approval(s) |
Approved 28/09/2023, International Food Policy Research Institute (1201 Eye Street NW, Washington, 20005, United States of America; +1 (202) 862-5600; IFPRI-IRB@cgiar.org), ref: NDH-23-0942 |
| Condition | Improvement of dietary diversity in primary school-aged children |
| Intervention | 1. Control - standard of care school feeding program which involves the distribution of high-energy biscuits 2. Intervention - standard of care school feeding program consisting of the distribution of high-energy biscuits plus distribution of 100 ml cartons of ultra high temperature (UHT) milk The total duration of the intervention will be ~7 months from November 2023 to May 2024. Both study arms will be followed-up for ~7 months and interviewed at baseline and follow-up. Schools were randomly assigned to intervention and control in Stata 18, stratifying by school size. |
| Intervention type | Other |
| Primary outcome measure | Diet diversity score in children 6-8 years of age, measured using the Minimum dietary diversity for women (MDD-W) guidelines at baseline and endline |
| Secondary outcome measures | 1. Cognition in children 6-8 years of age, measured using the forward and backward digit span and the standard progressive matrices at baseline and endline 2. Learning in children 6-8 years of age, measured using literacy and numeracy scores at baseline and endline 3. Nutritional status, measuring using body mass index and height-for-age Z-score at baseline and endline 4. School attendance, measured using school observations at baseline and endline 5. Perceptions of school feading program, measured using caregiver self-report at baseline and endline 6. Child health, measured using caregiver report of child morbidity symptoms at baseline and endline |
| Overall study start date | 01/08/2023 |
| Overall study end date | 31/07/2024 |
Eligibility
| Participant type(s) | Learner/student |
|---|---|
| Age group | Mixed |
| Lower age limit | 6 Years |
| Upper age limit | 100 Years |
| Sex | Both |
| Target number of participants | 1,200 |
| Total final enrolment | 1299 |
| Participant inclusion criteria | 1. Children aged 6-8 years at baseline enrolled in schools involved in the study 2. Adult caregivers (≥18 years of age) of children aged 6-8 included in the study |
| Participant exclusion criteria | Household head, child, parent or guardian unwilling to participate in the study |
| Recruitment start date | 04/11/2023 |
| Recruitment end date | 30/11/2023 |
Locations
Countries of recruitment
- United States of America
- Yemen
Study participating centre
Washington
20005
United States of America
Sponsor information
Research organisation
1201 Eye Street NW
Washington, DC
20005
United States of America
| Phone | +1 202-862-5600 |
|---|---|
| ifpri@cgiar.org | |
| Website | https://www.ifpri.org/ |
"ROR" |
https://ror.org/03pxz9p87 |
Funders
Funder type
Research organisation
No information available
No information available
Results and Publications
| Intention to publish date | 31/07/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Available on request |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be available upon request from a.gelli@cgiar.org |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | 22/05/2024 | No | No | ||
| Statistical Analysis Plan | 27/08/2024 | 27/08/2024 | No | No |
Additional files
Editorial Notes
27/08/2024: Statistical analysis plan added.
22/05/2024: Protocol and total final enrolment added.
31/10/2023: Trial's existence confirmed by International Food Policy Research Institute.
