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Feasibility and pilot study of the effects of microfinance on mortality and nutrition in children under five amongst the very poor in India: study protocol for a cluster randomized controlled trial

机译:小额信贷对印度极度贫困五岁以下儿童死亡率和营养影响的可行性和初步研究:一项整群随机对照试验的研究方案

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摘要

Background: The United Nations Millennium Development Goals include targets for the health of children under five years old. Poor health is linked to poverty and microfinance initiatives are economic interventions that may improve health by breaking the cycle of poverty. However, there is a lack of reliable evidence to support this. In addition, microfinance schemes may have adverse effects on health, for example due to increased indebtedness. Rojiroti UK and the Centre for Promoting Sustainable Livelihood run an innovative microfinance scheme that provides microcredit via women’s self-help groups (SHGs). This pilot study, conducted in rural Bihar (India), will establish whether it is feasible to collect anthropometric and mortality data on children under five years old and to conduct a limited cluster randomized trial of the Rojiroti intervention.ududMethods/Design: We have designed a cluster randomized trial in which participating tolas (small communities within villages) will be randomized to either receive early (SHGs and microfinance at baseline) or late intervention (SHGs and microfinance after 18 months). Using predesigned questionnaires, demographic, and mortality data for the last year and information about participating mothers and their children will be collected and the weight, height, and mid upper arm circumference (MUAC) of children will be measured at baseline and at 18 months. The late intervention group will establish SHGs and microfinance support at this point and data collection will be repeated at 36 months.ududThe primary outcome measure will be the mean weight for height z-score of children under five years old in the early and late intervention tolas at 18 months. Secondary outcome measures will be the mortality rate, mean weight for age, height for age, prevalence of underweight, stunting, and wasting among children under five years of age.ududDiscussion: Despite economic progress, marked inequalities in child health persist in India and Bihar is one of the worst affected states. There is a need to evaluate programs that may alleviate poverty and improve health. This study will help to inform the design of a definitive trial to determine if the Rojiroti scheme can improve the nutrition and survival of children under five years of age in deprived rural communities.
机译:背景:联合国千年发展目标包括五岁以下儿童健康的指标。健康不良与贫困相关,小额信贷倡议是经济干预措施,可以通过打破贫困循环来改善健康状况。但是,缺乏可靠的证据来支持这一点。另外,小额信贷计划可能对健康产生不利影响,例如由于债务增加。英国Rojiroti和促进可持续生计中心运行一项创新的小额信贷计划,该计划通过妇女自助团体(SHG)提供小额信贷。这项在印度比哈尔(Bihar)农村进行的试点研究将确定是否可行的是,收集五岁以下儿童的人体测量和死亡率数据,并进行Rojiroti干预的有限集群随机试验。 ud udMethods / Design:我们设计了一项集群随机试验,其中将参与调查的图集(村庄内的小社区)随机分配为接受早期干预(基线时接受SHG和小额信贷)或接受后期干预(接受18个月之后的SHG和小额信贷)。使用预先设计的调查表,可以收集去年的人口统计数据和死亡率数据,以及有关参与母亲及其子女的信息,并在基线和18个月时测量儿童的体重,身高和上臂中围(MUAC)。晚期干预组将在此时建立SHG和小额信贷支持,并在36个月时重复数据收集。 ud ud主要结果指标将是5岁以下儿童在早期和中期的身高Z评分的平均体重。 18个月时的晚期介入治疗。次要结果指标是死亡率,五岁以下儿童的死亡率,年龄平均体重,年龄高低,体重不足的患病率,发育迟缓和消瘦。 ud ud讨论:尽管经济有所发展,但儿童健康方面的明显不平等现象依然存在。印度和比哈尔邦是受影响最严重的州之一。有必要评估可以减轻贫困和改善健康的方案。这项研究将有助于确定性试验的设计,以确定Rojiroti计划是否可以改善贫困农村社区中5岁以下儿童的营养和生存。

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