Abstract
BackgroundMalnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal. However, specific health-related data in school-aged children in these two countries are scarce. In the frame of a larger multi-stakeholder project entitled “Vegetables go to School: Improving Nutrition through Agricultural Diversification” (VgtS), a study has been designed with the objectives to: (i) describe schoolchildren’s health status in Burkina Faso and Nepal; and to (ii) provide an evidence-base for programme decisions on the relevance of complementary school garden, nutrition, water, sanitation and hygiene (WASH) interventions.Methods/DesignThe studies will be conducted in the Centre Ouest and the Plateau Central regions of Burkina Faso and the Dolakha and Ramechhap districts of Nepal. Data will be collected and combined at the level of schools, children and their households. A range of indicators will be used to examine nutritional status, intestinal parasitic infections and WASH conditions in 24 schools among 1144 children aged 8–14 years at baseline and a 1-year follow-up. The studies are designed as cluster randomised trials and the schools will be assigned to two core study arms: (i) the ‘complementary school garden, nutrition and WASH intervention’ arm; and the (ii) ‘control’ arm with no interventions. Children will be subjected to parasitological examinations using stool and urine samples and to quality-controlled anthropometric and haemoglobin measurements. Drinking water will be assessed for contamination with coliform bacteria and faecal streptococci. A questionnaire survey on nutritional and health knowledge, attitudes and practices (KAP) will be administered to children and their caregivers, also assessing socioeconomic, food-security and WASH conditions at household level. Focus group and key-informant interviews on children’s nutrition and hygiene perceptions and behaviours will be conducted with their caregivers and school personnel.DiscussionThe studies will contribute to fill a data gap on school-aged children in Burkina Faso and Nepal. The data collected will also serve to inform the design of school-based interventions and will contribute to deepen the understanding of potential effects of these interventions to improve schoolchildren’s health in resource-constrained settings. Key findings will be used to provide guidance for the implementation of health policies at the school level in Burkina Faso and Nepal.Trial registrationISRCTN30840 (date assigned: 17 July 2015)
Highlights
Malnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal
Inadequate WASH conditions play an important role in the high burden of communicable diseases [21, 57]
According to Masset et al (2011), who undertook to date the largest systematic review on agricultural intervention to improve the nutritional status of children, there is “no evidence of the impact [of agricultural interventions] on prevalence rates of stunting, wasting and underweight among children under five” [62]
Summary
Malnutrition and intestinal parasitic infections are a major burden on children’s health globally and in LMIC, including Burkina Faso and Nepal. The two studies in Burkina Faso and Nepal within the frame of the overall VgtS project that we describe here will support the reinforcement of this recent attention on schoolchildren’s nutrition and health by focusing on schools as an entry point for health promotion, infection control and life-skills education. With the two particular study designs as suggested in Burkina Faso and Nepal, we will be able to analyse the different types of school garden, nutrition and WASH intervention packages. Authors’ contributions All listed authors contributed to the development of the study design, essential study documents and standard operating procedures to be employed for the two intervention studies According to their different areas of expertise, the authors critically revised specific parts of this manuscript (clinical aspects: SD, PO, JU, GC; data management: SE, AK, JG, CS; diagnostic techniques: SD, PO, JU, GC; methodology: SE, AS, AK, PO, JU, GC; study country-specific issues: AS, SD, SS). All authors read and approved the final version of the paper prior to submission
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