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Millennium Villages Project in Sub-Saharan Africa (MVP)

This study has been completed.
Sponsor:
Collaborators:
United Nations
Bill and Melinda Gates Foundation
Information provided by (Responsible Party):
Sonia Sachs, Columbia University
ClinicalTrials.gov Identifier:
NCT01125618
First received: May 12, 2010
Last updated: April 20, 2017
Last verified: April 2017
  Purpose

The Millennium Villages Project involves the coordinated and simultaneous delivery of a package of proven interventions in health, agriculture, infrastructure and education. The project works in partnership with governments in 10 African countries in areas where progress towards achieving the Millennium Development Goals has been insufficient.

The Project evaluation will test the following hypotheses:

  1. That after 5 years of operation, villages exposed to the MVP intervention will have a lower rate of under-5 mortality and parallel gains in MDG-related secondary outcomes when compared to similar villages not receiving the intervention.
  2. That the coordinated delivery a multi-sector package of health and development interventions implemented through a broad-based local partnership is feasible in a diversity of sub-Saharan African contexts, and;
  3. The intervention package can be delivered at a scalable cost of $40 per person per year in the health sector and $110 per person per year in total

Condition Intervention
Child Survival
Other: Health and development intervention package
Other: Routine services

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: No masking
Primary Purpose: Prevention
Official Title: A Pair-matched Community Intervention Trial to Assess the Impact of an Integrated Health and Development Intervention on Child Survival and the Millennium Development Goals in 10 Sub- Saharan African Countries

Further study details as provided by Columbia University:

Primary Outcome Measures:
  • Child Mortality Rate [ Time Frame: 5 years ]
    Under 5 Mortality Rate


Secondary Outcome Measures:
  • Prevalence of Stunting [ Time Frame: 5 years ]
    Proportion of under 5s who are stunted; Stunted = low height for age Z-score

  • Prevalence of Diarrhea [ Time Frame: 5 years ]
    Proportion of under 5's with diarrhea in past 2 weeks

  • Prevalence of Malaria [ Time Frame: 5 years ]
    Prevalence of malaria among under 5s at the time of survey

  • Prevalence of antenatal care [ Time Frame: 5 years ]
    Proportion of women who receive at least 4 ANC visits

  • Survival rate to last grade of primary education (School Quality) [ Time Frame: 5 years ]
  • Prevalence of improved sanitation utilization [ Time Frame: 5 years ]
    Proportion of the population using an improved sanitation source

  • Duration or breast feeding (Child feeding practices) [ Time Frame: 5 years ]
  • Age of introduction of complementary feeding (Child feeding practices) [ Time Frame: 5 years ]
  • Prevalence of bed net utilization [ Time Frame: 5 years ]
    Proportion of under 5s sleeping under Longlasting insecticide treated bednets in the night prior to the survey

  • Prevalence of malaria treatment [ Time Frame: 5 years ]
    Proportion of under 5s with a fever in the past 2 weeks who receive appropriate anti-malarial treatment

  • Prevalence of measles immunization [ Time Frame: 5 years ]
    Proportion under 1s immunized against measles

  • Prevalence of diarrhea management [ Time Frame: 5 years ]
    Proportion of under 5s with diarrhea in the past 2 weeks who received oral rehydration therapy

  • Prevalence of pneumonia management [ Time Frame: 5 years ]
    Proportion of under 5s treated for pneumonia in the past 2 weeks

  • Prevalence of newborn care [ Time Frame: 5 years ]
    Proportion of newborns receiving a post-natal check in the first week of life

  • Proportion of pregnant women who received and HIV test [ Time Frame: 5 years ]
    This measures the prevention of vertical transmission of HIV

  • Prevalence of food insecurity [ Time Frame: 5 years ]
    Proportion of households reporting not enough food for 1 of past 12 months

  • Institutional delivery rate [ Time Frame: 5 years ]
    Proportion of births attended by skilled health personnel

  • Prevalence of underweight [ Time Frame: 5 years ]
    Proportion of under 5s who are underweight; Underweight= weight for age Z score

  • Prevalence of wasting [ Time Frame: 5 years ]
    Proportion of under 5s who are wasted; Wasting = weight for height Z score

  • Prevalence of low mid-upper arm circumference [ Time Frame: 5 years ]
    Proportion of under 5s with a low mid-upper arm circumference

  • Household Asset Index (Household poverty) [ Time Frame: 5 years ]
    Survey of fixed and non-fixed assets, including recent purchases

  • Prevalence of improved water source utilization [ Time Frame: 5 years ]
    Proportion of the population using an improved drinking water source


Enrollment: 65000
Actual Study Start Date: January 2005
Study Completion Date: June 25, 2016
Primary Completion Date: June 25, 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: MVP village
Wealth stratified and randomly selected households residing in a village exposed to the Millennium Villages Project intervention (or health and development intervention package)
Other: Health and development intervention package
The timing and sequence of intervention vary by site, but include improved access to seed-fertilizer to increase agricultural production; improved market and capital access; proven maternal-newborn-child health interventions delivered free of cost at the point of service; improvements to school number and quality; and access to basic infrastructure including safe water, sanitation, electricity, transport and communication.
Other Names:
  • maternal-newborn-child health interventions
  • MVP
Active Comparator: Comparison village
Villages receiving routine services through established programs
Other: Routine services
Routine services and programs currently being administered using prevailing resources, at the current pace and with established partnerships. There is no attempt to limit the introduction of new interventions or agencies into comparison sites.
Other Name: standard of care services

Detailed Description:

Design and population The design is a pair-matched community intervention trial. Village clusters with high levels of malnutrition were selected from rural areas in ten sub-Saharan African countries to reflect a diverse range of agro-ecological zones, farming systems, disease profiles, and infrastructure challenges. MVP sites represent 80 villages in 14 clusters across 10 countries, covering nearly 500,000 people. For each intervention cluster, a matched comparison cluster has been selected at random to participate in the evaluation.

Outcomes The primary outcome is the under-5 mortality rate. Secondary outcomes are levels of coverage with essential maternal-child health interventions and related MDG indicators for poverty, nutrition, education, and environmental health.

Sample size calculation The assessment follows 6000 households across intervention and matched comparison villages at baseline, and after 3 and 5 years of intervention exposure. With 10 paired clusters, the study is powered to detect a 40% difference in the U5MR between the two groups.

Analysis plan The analysis will use a two-staged pair-matched cluster level analysis, and will be complemented with multilevel modeling. Reporting will adhere to Transparent Reporting of Evaluations with Non-randomized Designs (TREND) guidelines.

Implementation science A portfolio of qualitative implementation science (process evaluation) will complement the quantitative assessment, and involves interviews with implementers, partners, and project beneficiaries. This analysis will address questions about: the feasibility of the interventions; the timing and sequence of their introduction; key contextual barriers and facilitators to implementation; and potential synergies achieved from the integrated multisector approach.

Economic costing study One project hypothesis is that an annual per capita investment of $110 is required to achieve the MDGs. The aim of the economic costing study is to document the absolute and relative contribution of project partners (MVP, government, donors, and the community) to all priced and non-priced cluster-level activities, as well as the sector-specific breakdown of these inputs.

  Eligibility

Ages Eligible for Study:   15 Years and older   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Resident in a Millennium Village and consenting to periodic assessments

Exclusion Criteria:

  • Those not consenting to participate
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01125618

Locations
Ethiopia
Koraro
Koraro, Ethiopia
Ghana
Bonsasso
Bonsasso, Ghana
Kenya
Sauri
Sauri, Kenya
Malawi
Mwandama
Mwandama, Malawi
Mali
Tiby
Tiby, Mali
Nigeria
Ikaram
Ikaram, Nigeria
Pampaida
Pampaida, Nigeria
Rwanda
Mayange
Mayange, Rwanda
Senegal
Potou
Potou, Senegal
Tanzania
Mbola
Mbola, Tanzania
Uganda
Ruhiira
Ruhiira, Uganda
Sponsors and Collaborators
Columbia University
United Nations
Bill and Melinda Gates Foundation
Investigators
Study Chair: Jeffrey Sachs, PhD The Earth Institute, Columbia University
Study Director: Pedro Sanchez, PhD The Earth Institute, Columbia University
Principal Investigator: Cheryl Palm, PhD The Earth Institute, Columbia University
Principal Investigator: Sonia Sachs, MD, PhD Director of Health, The Earth Institute, Columbia University
  More Information

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Sonia Sachs, Director of Health, The Earth Institute, Columbia University
ClinicalTrials.gov Identifier: NCT01125618     History of Changes
Other Study ID Numbers: AAAA8202
Study First Received: May 12, 2010
Last Updated: April 20, 2017
Individual Participant Data  
Plan to Share IPD: Undecided

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Columbia University:
child mortality
intervention
Poverty
Africa
Millennium Development Goal
Millennium Development Goals

ClinicalTrials.gov processed this record on May 23, 2017