2 research outputs found
Effect of community health clubs on child diarrhoea in western Rwanda: cluster-randomised controlled trial
Background Community health clubs are multi-session village-level gatherings led by trained facilitators and designed
to promote healthy behaviours mainly related to water, sanitation, and hygiene. They have been implemented in
several African and Asian countries but have never been evaluated rigorously. We aimed to evaluate the effect of
two versions of the community health club model on child health and nutrition outcomes.
Methods We did a cluster-randomised trial in Rusizi district, western Rwanda. We defined villages as clusters.
We assessed villages for eligibility then randomly selected 150 for the study using a simple random sampling routine
in Stata. We stratified villages by wealth index and by the proportion of children younger than 2 years with caregiverreported
diarrhoea within the past 7 days. We randomly allocated these villages to three study groups: no intervention
(control; n=50), eight community health club sessions (Lite intervention; n=50), or 20 community health club sessions
(Classic intervention; n=50). Households in these villages were enrolled in 2013 for a baseline survey, then re-enrolled
in 2015 for an endline survey. The primary outcome was caregiver-reported diarrhoea within the previous 7 days in
children younger than 5 years. Analysis was by intention to treat and per protocol. This trial is registered with
ClinicalTrials.gov, number NCT01836731.
Findings At the baseline survey undertaken between May, 2013, and August, 2013, 8734 households with children
younger than 5 years of age were enrolled. At the endline survey undertaken between Sept 21, 2015, and
Dec 22, 2015, 7934 (91%) of the households were re-enrolled. Among children younger than 5 years, the prevalence
of caregiver-reported diarrhoea in the previous 7 days was 514 (14%) of 3616 assigned the control, 453 (14%)
of 3196 allocated the Lite intervention (prevalence ratio compared with control 0·97, 95% CI 0·81–1·16; p=0·74),
and 495 (14%) of 3464 assigned the Classic intervention (prevalence ratio compared with control 0·99, 0·85–1·15;
p=0·87).
Interpretation Community health clubs, in this setting in western Rwanda, had no effect on caregiver-reported
diarrhoea among children younger than 5 years. Our results question the value of implementing this intervention at
scale for the aim of achieving health gains
Child diarrhoea and nutritional status in rural Rwanda: a cross-sectional study to explore contributing environmental and demographic factors.
OBJECTIVE: To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda. METHODS: We obtained cross-sectional data from 8847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children <5, and anthropometry from children <2. We conducted log-binomial regression using diarrhoea, stunting and wasting as dependent variables. RESULTS: Among children <5, 8.7% reported diarrhoea in the previous 7Â days. Among children <2, stunting prevalence was 34.9% and wasting prevalence was 2.1%. Drinking water treatment (any method) was inversely associated with caregiver-reported diarrhoea in the previous 7Â days (PRÂ =Â 0.79, 95% CI: 0.68-0.91). Improved source of drinking water (PRÂ =Â 0.80, 95% CI: 0.73-0.87), appropriate treatment of drinking water (PRÂ =Â 0.88, 95% CI: 0.80-0.96), improved sanitation facility (PRÂ =Â 0.90, 95% CI: 0.82-0.97), and complete structure (having walls, floor and roof) of the sanitation facility (PRÂ =Â 0.65, 95% CI: 0.50-0.84) were inversely associated with stunting. None of the exposure variables were associated with wasting. A microbiological indicator of water quality was not associated with diarrhoea or stunting. CONCLUSIONS: Our findings suggest that in Rusizi district, appropriate treatment of drinking water may be an important factor in diarrhoea in children <5, while improved source and appropriate treatment of drinking water as well as improved type and structure of sanitation facility may be important for linear growth in children <2. We did not detect an association with water quality