Rojiroti microfinance and child nutrition: a cluster randomised trial

Arch Dis Child. 2020 Mar;105(3):229-235. doi: 10.1136/archdischild-2018-316471. Epub 2019 Oct 10.

Abstract

Objective: To determine whether Rojiroti microfinance, for poor Indian women, improves child nutrition.

Design: Cluster randomised trial.

Setting: Tolas (village communities) in Bihar State.

Participants: Women and children under 5 years.

Interventions: With Rojiroti microfinance, women form self-help groups and save their money to provide loans to group members. After 6 months, they receive larger external loans. Tolas were randomised to receive Rojiroti immediately or after 18 months.

Outcome measures: The primary analysis compared the mean weight for height Z score (WHZ) of children under 5 years in the intervention versus control tolas who attended for weight and height measurement 18 months after randomisation. Secondary outcomes were weight for age Z score (WAZ), height for age Z score, mid-upper arm circumference (MUAC), wasting, underweight and stunting.

Results: We randomised 28 tolas to each arm and collected data from 2469 children (1560 mothers) at baseline and 2064 children (1326 mothers) at follow-up. WHZ was calculated for 1718 children at baseline and 1377 (674 intervention and 703 control) at follow-up. At 18 months, mean WHZ was significantly higher for intervention (-1.02) versus controls (-1.37; regression coefficient adjusted for clustering β=0.38, 95% CI 0.16 to 0.61, p=0.001). Significantly fewer children were wasted in the intervention group (122, 18%) versus control (200, 29%; OR=0.46, 95% CI 0.28 to 0.74, p=0.002). Mean WAZ was better in the intervention group (-2.13 vs -2.37; β=0.27, 95% CI 0.11 to 0.43, p=0.001) as was MUAC (13.6 cm vs 13.4 cm; β=0.22, 95% CI 0.03 to 0.40, p=0.02). In an analysis adjusting for baseline nutritional measures (259 intervention children and 300 control), only WAZ and % underweight showed significant differences in favour of the intervention.

Conclusion: In marginalised communities in rural India, child nutrition was better in those who received Rojiroti microfinance, compared with controls.

Trial registration number: NCT01845545.

Keywords: child growth; low & middle income countries; microfinance; wasting; weight for height z score.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Height / physiology
  • Body Weight / physiology
  • Child Nutrition Disorders / economics*
  • Child Nutrition Disorders / prevention & control
  • Child, Preschool
  • Cluster Analysis
  • Feasibility Studies
  • Female
  • Financing, Personal / economics*
  • Growth Disorders / economics
  • Growth Disorders / prevention & control
  • Humans
  • India
  • Male
  • Nutritional Status
  • Poverty
  • Residence Characteristics
  • Rural Health / economics
  • Self-Help Groups
  • Treatment Outcome
  • Wasting Syndrome / economics
  • Wasting Syndrome / prevention & control

Associated data

  • ClinicalTrials.gov/NCT01845545