Protocols

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Browsing Protocols by Author "Kalumikiza, Zione"

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    Enhancing pathways from agriculture-to-nutrition
    (Kamuzu University of Health Sciences, 2021-12-03) Kalumikiza, Zione
    Study TitleType of research study: Women’s empowerment in nutrition and maternal nutrition outcomes: examination of linkages and identification of strategies for optimising outcomes among beneficiaries of a feeding trial in a rural agro-based community in Malawi The proposed study is a cross-survey that determines associations between Women’s empowerment and maternal nutrition outcomes in a rural Malawian community. Consensus exists that addressing malnutrition, a problem of public health significance in Malawi, will require a combination of both nutrition specific and sensitive interventions. Women’s empowerment, alone, or through the agriculture impact pathway, has generated considerable interest within various sectors, nutrition inclusive, despite limited evidence of its impacts on nutrition. The proposed study to be conducted in Kasungu District under Wimbe Traditional Authority, involves research to this effect. Problem: The nature, strength, and direction of associations between women’s empowerment and nutrition outcomes seems to vary widely and is ambiguous. No local research has assessed comprehensively associations between women’s empowerment and maternal nutrition or attempted to measure women’s empowerment in the realm of nutrition. Using a measure closely related to nutrition, the proposed study will provide data on the status of women’s empowerment and propose actions to facilitate nutrition empowerment and outcomes. This ambiguity largely stems from differences in the measures used for women’s empowerment. This is further compounded by a lack of local data in the field to inform actions. No research in Malawi has attempted to measure women’s empowerment in the realm of nutrition or assessed comprehensively associations between women’s empowerment and maternal nutrition. This study, therefore, will not only add to the body of knowledge in the relevant fields, but will generate evidence with policy and programmatic implications. proposes research which can support and guide national strategies and policies in these dimensions. Objectives: Broadly, the study seeks to identify strategies for optimising maternal nutrition outcomesdetermine the status of nutritional empowerment among women of reproductive age in a rural Malawian community using a novel index, the Women’s Empowerment in Nutrition Index (WENI) and assess its associations with nutrition outcomes. Specific study objectives are; (i) to determine the level and extent to whichstatus of nutritional women are empowered in nutrition using a novel index,empowerment in the study population the Women’s Empowerment in Nutrition Index (WENI); (ii) to measure determine associations between the WENI and the Body Mass Index (BMI), Mid Upper Arm Circumference, and, dietary diversity of women in the study area; (iii) to examine assess the effect of provision of a staple food (maize flour) on dietary diversity, and intakes of energy, protein, iron and folate; and, (iv) to examine assess changes in dietary quality (diversity) among the WRA 2 years after participation in a feeding trial. Methodology: The study combines a cross sectional survey designed to collect and measure status of women’s empowerment in nutrition and its associations with maternal nutrition outcomes, and, secondary analysis of data from an intervention study, the “Alleviating Hidden Hunger with Agronomy (AHHA)” conducted within the Geo Nutrition project (reference: P.05/18/2393). The analysis of the AHHA data will measure changes in diversity and intakes of energy, protein, iron, and folate following receipt of a staple food (maize flour). The changes in diversity over time will also be assessed to see to what extent benefits, if any, are sustained over time. For the WENI survey, face-to-face interviews will be conducted with women who participated in the AHHA study (n=180), guided by a semi-structured interviewer administered questionnaire. Microsoft Excel, IBM SPSS Statistics version 25, will be used in the data entry and analyses phase respectively. In addition to general descriptive statistics, Fischer’s LSD test and the Dunnett’s test will be used to examine assess changes in nutrient intakes. To test for associations between women’s empowerment in nutrition and nutrition outcomes, chi-square analyses will be used. Multivariate logistic regression will be employed to identify specific empowerment domains closely related to nutrition outcomes. This study is part of a Doctoral Research for Ms Zione Kalumikiza. Expected Findings and Dissemination. The study is expected to measure the level of women’s empowerment in nutrition and identify areas of disempowerment, which provides a basis for the type of interventions needed to improve nutrition and health of women in similar contexts. By investigating associations between women’s empowerment in nutrition and maternal nutrition outcomes, the study helps to understand the extent to which the empowerment index (WENI) can be used as a predictor of nutritional status hence its application in both nutrition programming and assessments. Variations are expected in empowerment across the different domains with most participants demonstrating empowerment in the knowledge domain as opposed to resources and control domains. This is largely because women are the main targets for nutrition education and are less often provided with resource support or linkages to institutions. In addition, rural communities often favour males on control of resources. Overall, this study will identify specific areas of disempowerment and provide a basis for the type of interventions needed to improve nutrition and health of women in similar contexts. It will further help to understand the extent to which the empowerment index (WENI) can be used as a predictor of nutritional status hence its application in both nutrition programming and assessments. We further test the influence of empowerment in a single domain-dimension (food/maize flour provision) and hope this generates evidence for informing the design of similar nutrition-sensitive interventions for better impact. Finally, the study will explore whether dietary changes resulting from the AHHA intervention are sustained over time. Taken together, this study will identify barriers to nutrition empowerment and thus propose actions to facilitate nutrition empowerment and outcomes. The study, therefore, will not only add to the body of knowledge about nutrition and empowerment, but generate evidence with policy and programmatic implications. Study findings will be presented to the scientific community through publications in peer reviewed journals and presentations at national and international conferences. The Kasungu local council and concerned Traditional Authority will also be presented with key findings from this research. A copy of the thesis and all published work from this study will be shared with the College of Medicine Library, the College of Medicine Research Ethics Committee, and other relevant committees in line with requirements by the College of Medicine.
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    Enhancing pathways from agriculture-to-nutrition: a study of women’s empowerment in nutrition, nutrition outcomes, and, strategies for optimising nutrition among beneficiaries of a feeding trial in rural Malawi
    (Kamuzu University of Health Sciences, 3-12-21) Kalumikiza, Zione
    The proposed study is a cross-survey that determines associations between Women’s empowerment and maternal nutrition outcomes in a rural Malawian community. Problem: The nature, strength, and direction of associations between women’s empowerment and nutrition outcomes seems to vary widely and is ambiguous. No local research has assessed comprehensively associations between women’s empowerment and maternal nutrition or attempted to measure women’s empowerment in the realm of nutrition. Using a measure closely related to nutrition, the proposed study will provide data on the status of women’s empowerment and propose actions to facilitate nutrition empowerment and outcomes. This study, therefore, will not only add to the body of knowledge in the relevant fields, but will generate evidence with policy and programmatic implications. Objectives: Broadly, the study seeks to determine the status of nutritional empowerment among women of reproductive age in a rural Malawian community using a novel index, the Women’s Empowerment in Nutrition Index (WENI) and to assess its associations with nutrition outcomes. Specific study objectives are; (i) to determine the to etermine associations between the WENI and the Body Mass Index (BMI), Mid Upper Arm Circumference, and, dietary diversity of women in the study area; (iii) to assess the effect of provision of a staple food (maize flour) on dietary diversity, and intakes of energy, protein, iron and folate; and, (iv) to assess changes in dietary quality (diversity) among the WRA 2 years after participation in a feeding trial. Methodology: The study combines a cross sectional survey designed to collect and measure status of women’s empowerment in nutrition and its associations with maternal nutrition outcomes, and, secondary analysis of data from an intervention study, the “Alleviating Hidden Hunger with Agronomy (AHHA)” conducted within the Geo Nutrition project (reference: P.05/18/2393). The analysis of the AHHA data will measure changes in diversity and intakes of energy, protein, iron, and folate following receipt of a staple food (maize flour). The changes in diversity over time will also be assessed to see to what extent benefits, if any, are sustained over time. For the WENI survey, face-to-face interviews will be conducted with women who participated in the AHHA study (n=180), guided by a semi-structured interviewer administered questionnaire. Microsoft Excel, IBM SPSS Statistics version 25, will be used in the data entry and analyses phase respectively. In addition to general descriptive statistics, Fischer’s LSD test and the Dunnett’s test will be used to assess changes in nutrient intakes. To test for associations between women’s empowerment in nutrition and nutrition outcomes, chi-square analyses will be used. Multivariate logistic regression will be employed to identify specific empowerment domains closely related to nutrition outcomes.