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Thumbi SM, Muema J, Mutono N, Njuguna J, Jost C, Boyd E, Tewoldeberhan D, Mutua I, Gacharamu G, Wambua F, Allport R, Olesambu E, Osman AM, Souza D, Kimani I, Oyugi J, Bukania Z, Oboge H, Palmer GH, Yoder J. The Livestock for Health Study: A Field Trial on Livestock Interventions to Prevent Acute Malnutrition Among Women and Children in Pastoralist Communities in Northern Kenya. Food Nutr Bull 2023; 44:S119-S123. [PMID: 37850922 DOI: 10.1177/03795721231195427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Livestock-dependent communities in Africa's drylands disproportionately experience acute malnutrition, especially during drought seasons. We detail the design and implementation of the Livestock for Health (L4H) study aimed at determining the effect of providing livestock feed and nutritional counselling to prevent seasonal spikes of acute malnutrition. METHODS The L4H study employed a 3-arm cluster randomized controlled trial to compare households in pastoralist settings in northern Kenya receiving livestock feeds during critical dry periods, with or without nutritional counseling, with control households. Over 4 dry seasons, 2019 to 2021, the study collected data on household milk production, consumption patterns, mothers'/children's nutritional status, household socioeconomic status, herd dynamics, and human and animal health status every 6 weeks. RESULTS L4H recruited 1734 households, with 639, 585, and 510 households assigned to intervention arms 1 and 2 and control arm 3, respectively. From these households, 1734 women and 1748 children younger than 3 years were recruited. In total, 19 419 household visits were completed, obtaining anthropometric measures 9 times on average for each child and mother. Eighty-one households (5%) were lost from the study due to the mother's death, child's death, migration, and withdrawal for other reasons. DISCUSSION L4H's success in a challenging environment was possible due to strong community engagement, formative studies to inform trial design, collaboration with local authorities, and effective interdisciplinary collaboration. Subsequent manuscripts will report the study findings. TRIAL REGISTRATION The study was registered October 29, 2020, and is online at ClinicalTrials.gov (ID: NCT04608656).
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Affiliation(s)
- Samuel M Thumbi
- Paul G. Allen School for Global Health, Washington State University, Pullman, USA
- Center for Epidemiological Modelling and Analysis, University of Nairobi
- Feed the Future Innovation Lab for Animal Health, Washington State University
- Institute of Immunology and Infection Research, University of Edinburgh
| | - Josphat Muema
- Paul G. Allen School for Global Health, Washington State University, Pullman, USA
- Center for Epidemiological Modelling and Analysis, University of Nairobi
- Feed the Future Innovation Lab for Animal Health, Washington State University
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Nyamai Mutono
- Paul G. Allen School for Global Health, Washington State University, Pullman, USA
- Center for Epidemiological Modelling and Analysis, University of Nairobi
- Feed the Future Innovation Lab for Animal Health, Washington State University
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Joseph Njuguna
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Christine Jost
- Global Health Training, Advising, and Support Contract, Credence Management Solutions LLC, supporting the United States Agency for International Development (USAID) Bureau for Humanitarian Assistance
| | - Erin Boyd
- United States Agency for International Development's Bureau for Humanitarian Assistance (USAID/BHA), Washington, DC
| | | | - Immaculate Mutua
- Ministry of Health, Government of Marsabit County, Marsabit, Kenya
| | | | | | | | - Emmanuella Olesambu
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Abdal Monium Osman
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Darana Souza
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Irene Kimani
- United States Agency for International Development's Bureau for Humanitarian Assistance (USAID/BHA), Washington, DC
| | - Julius Oyugi
- Feed the Future Innovation Lab for Animal Health, Washington State University
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Zipporah Bukania
- Center for Epidemiological Modelling and Analysis, University of Nairobi
- Feed the Future Innovation Lab for Animal Health, Washington State University
| | - Harriet Oboge
- Center for Epidemiological Modelling and Analysis, University of Nairobi
- Feed the Future Innovation Lab for Animal Health, Washington State University
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Guy H Palmer
- Paul G. Allen School for Global Health, Washington State University, Pullman, USA
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Jonathan Yoder
- Feed the Future Innovation Lab for Animal Health, Washington State University
- School of Economic Sciences, Washington state University, Pullman, USA
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Muema J, Mutono N, Kisaka S, Ogoti B, Oyugi J, Bukania Z, Daniel T, Njuguna J, Kimani I, Makori A, Omulo S, Boyd E, Osman AM, Gwenaelle L, Jost C, Thumbi SM. The impact of livestock interventions on nutritional outcomes of children younger than 5 years old and women in Africa: a systematic review and meta-analysis. Front Nutr 2023; 10:1166495. [PMID: 37485389 PMCID: PMC10358768 DOI: 10.3389/fnut.2023.1166495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Background Nutrition-sensitive livestock interventions have the potential to improve the nutrition of communities that are dependent on livestock for their livelihoods by increasing the availability and access to animal-source foods. These interventions can also boost household income, improving purchasing power for other foods, as well as enhance determinants of health. However, there is a lack of synthesized empirical evidence of the impact and effect of livestock interventions on diets and human nutritional status in Africa. Objective To review evidence of the effectiveness of nutrition-sensitive livestock interventions in improving diets and nutritional status in children younger than 5 years old and in pregnant and lactating women. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of published studies reporting on the effect of livestock interventions on maternal and child nutrition in Africa. Data were extracted, synthesized, and summarized qualitatively. Key outcomes were presented in summary tables alongside a narrative summary. Estimation of pooled effects was undertaken for experimental studies with nutritional outcomes of consumption of animal-source foods (ASFs) and minimum dietary diversity (MDD). Fixed effects regression models and pooled effect sizes were computed and reported as odds ratios (ORs) together with their 95% confidence intervals (CI). Results After the screening, 29 research papers were included in the review, and of these, only 4 were included in the meta-analysis. We found that nutrition-sensitive livestock interventions have a significant positive impact on the consumption of ASFs for children < 5 years (OR = 5.39; 95% CI: 4.43-6.56) and on the likelihood of meeting minimum dietary diversity (OR = 1.89; 95% CI: 1.51-2.37). Additionally, the impact of livestock interventions on stunting, wasting, and being underweight varied depending on the type of intervention and duration of the program/intervention implementation. Therefore, because of this heterogeneity in reporting metrics, the pooled estimates could not be computed. Conclusion Nutrition-sensitive livestock interventions showed a positive effect in increasing the consumption of ASFs, leading to improved dietary diversity. However, the quality of the evidence is low, and therefore, more randomized controlled studies with consistent and similar reporting metrics are needed to increase the evidence base on how nutrition-sensitive livestock interventions affect child growth outcomes.
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Affiliation(s)
- Josphat Muema
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
| | - Nyamai Mutono
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Stevens Kisaka
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Brian Ogoti
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Zipporah Bukania
- Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Joseph Njuguna
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Irene Kimani
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Anita Makori
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Sylvia Omulo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Washington State University Global Health Program–Kenya, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
| | - Erin Boyd
- United States Agency for International Development’s Bureau for Humanitarian Assistance, Washington, DC, United States
| | - Abdal Monium Osman
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Luc Gwenaelle
- Emergency and Resilience Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Christine Jost
- United States Agency for International Development’s Bureau for Humanitarian Assistance, Washington, DC, United States
- Global Health Support Initiative III, Social Solutions International, Washington, DC, United States
| | - SM Thumbi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Feed the Future Innovation Lab for Animal Health, Washington State University, Pullman, WA, United States
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, United States
- South African Center for Epidemiological Modelling and Analysis, Stellenbosch, South Africa
- Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, United Kingdom
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