Tomedi 2012.
| Methods | Study date: 2012. Study design: Quasi‐experimental design. Cluster controlled cohort. 20 villages intervention and 20 villages control | |
| Participants | SES or context: Low‐ and middle‐income country: Rural Kenya. Subsistence farmers who rely on rain‐fed agriculture (maize and beans as staple foods as well as cowpeas and pigeon peas). Small‐scale horticulture and animal husbandry are also practised. 23.9% unemployment in household. 98.1% and 96.6% of the caregivers attended school and had 7.8 years and 8.0 years of school in intervention and control areas, respectively Nutritional status: All children with WHZ ≧ ‐2 at baseline. Average WAZ was ‐0.51 and ‐0.37 Average HAZ was ‐1.23 and ‐1.21 Age: 6 ‐ 20 months Sex: Both Number: Experimental = 139, control = 147 |
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| Interventions | Intervention: Feeding: Monthly rations given to family for child and the rest of family. Millet (150 g), pigeon peas (25 g), milk (125 g), eggs (50 g), vegetable oil (10 g), mango (100 g), and sugar (15 g) Energy: 4058 kj Intensity: Monthly but no information on time of day Duration: 7 months % DRI for energy: 6 ‐ 12 months = 136.2%, 12 ‐ 24 months = 111.7% % DRI for protein: Inestimable in all groups Control: Usual diet Provider: Global Health Partnership Supervised: Workers visited monthly Compliance: Caregiver reported that the index child was given at least 50% of the food. The index child was the only person in the household consuming the milk 79% of the time and the only person consuming eggs 78% of the time Intervention included education session on appropriate complementary feeding and hygiene |
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| Outcomes | Physical: Weight, length, WAZ, HAZ, WHZ | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Non‐randomised |
| Allocation concealment (selection bias) | High risk | Non‐randomised |
| Baseline outcome measurements | Low risk | No significant differences in outcome measures at baseline |
| Baseline characteristics | Low risk | Both sub‐locations are governed by the same local chief and have community health workers (CHW) who participate in the screening of the households with children under 5 years of age for acute malnutrition |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | For the children who were lost to follow‐up, there were no significant differences in anthropometric measurements at baseline between those in the intervention group and those in the non‐intervention group |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not mentioned |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Parents, children, and personnel not blinded to the fact that children were being fed |
| Protection from contamination | Low risk | Allocated by village. Food was given at home so unlikely that it was shared between villages |
| Selective reporting (reporting bias) | Unclear risk | No protocol available |