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  Food and Agricultural Approaches to Reducing Malnutrition (FAARM): protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh

Wendt, A., Sparling, T. M., Waid, J. L., Müller, A. A., Gabrysch, S. (2019): Food and Agricultural Approaches to Reducing Malnutrition (FAARM): protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh. - BMJ Open, 9, 7, e031037.
https://doi.org/10.1136/bmjopen-2019-031037

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Wendt, Amanda1, Author              
Sparling, Thalia M.2, Author
Waid, Jillian L.2, Author
Müller, Anna A.2, Author
Gabrysch, Sabine1, Author              
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1Potsdam Institute for Climate Impact Research, ou_persistent13              
2External Organizations, ou_persistent22              

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 Abstract: Introduction: Chronic undernutrition affects over 150 million children worldwide and has serious consequences. The causes are complex and include insufficient dietary diversity and poor hygiene practices. Systematic reviews of nutrition-sensitive agricultural interventions concluded that while these hold promise, there is insufficient evidence for their impact on child growth. The Food and Agricultural Approaches to Reducing Malnutrition (FAARM) project is a 1:1 cluster-randomised trial aiming to evaluate the impact of a Homestead Food Production (HFP) programme implemented by Helen Keller International on women’s and children’s undernutrition. Methods and analysis: The HFP intervention comprises training of women’s groups and asset distribution to support year-round home gardening, poultry rearing and improved nutrition and hygiene practices. Formal trainings are supplemented by behaviour change communication during household visits, and facilitated links between producer groups and market actors. The FAARM trial will examine if and how this complex intervention reduces undernutrition. In 2015, FAARM enrolled married women and their children (0–3 years) in 96 rural settlements of Habiganj district in Sylhet division, Bangladesh. Covariate-constrained randomisation was used to assign 48 settlements to receive a 3-year HFP intervention, with the other 48 acting as controls, targeting over 2700 women. To study impact pathways, a surveillance system collects data on all participants every 2 months. In late 2019, children 0–3 years of age (born during the intervention period) will be surveyed, thus capturing impact during the critical first 1000 days of life. Children’s length/height-for-age z-scores will be compared between intervention and control arms using mixed-effects linear regression. Secondary outcomes include women’s and children’s micronutrient status, dietary intake, dietary diversity and other indicators of child growth, development and morbidity. Ethics and dissemination: Ethical approval was received in Bangladesh and Germany. Results will be disseminated through peer-reviewed publications and presentations in Bangladesh and internationally. Trial registration number: NCT02505711; Pre-results.

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 Dates: 2019
 Publication Status: Finally published
 Pages: -
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 Rev. Type: Peer
 Identifiers: DOI: 10.1136/bmjopen-2019-031037
PIKDOMAIN: RD2 - Climate Resilience
eDoc: 8557
Research topic keyword: Adaptation
Research topic keyword: Food & Agriculture
Research topic keyword: Health
Research topic keyword: Gender Aspects
Research topic keyword: Sustainable Development
Regional keyword: Asia
Organisational keyword: RD2 - Climate Resilience
Working Group: Climate Change and Health
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Title: BMJ Open
Source Genre: Journal, SCI, Scopus, oa
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Pages: - Volume / Issue: 9 (7) Sequence Number: e031037 Start / End Page: - Identifier: CoNE: https://publications.pik-potsdam.de/cone/journals/resource/bmj-open