Child SurvivalMVPNCT01125618
Millennium Villages Project in Sub-Saharan Africa
A study testing Health and development intervention package and Routine services in people with Child Survival, run by Columbia University at 11 sites in 10 countries.
Trial summary
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… Read more about this study
- Who is it for?
- Ages 15 years and olderHealthy volunteers can take part
- Conditions the study is for
- Child Survival
- What is being tested?
- Health and development intervention package and Routine services
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 65,000 participants
- Where
- 11 sitesin 10 countries
- Study dates
- Jan 2005to 25 Jun 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 years and older
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Resident in a Millennium Village and consenting to periodic assessments
Who cannot join
- Those not consenting to participate
Trial locations and contacts
11 sites in 10 countries.
11 sites in 10 countries
About this study
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
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:
- 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.
- 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;
- 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
Read the 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.
- Conditions
- Child Survival
- Being tested
- Health and development intervention package, Routine services
- Keywords
- child mortality, intervention, Poverty, Africa, Millennium Development Goal, Millennium Development Goals
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Health and development intervention packageOther
Also called maternal-newborn-child health interventions, MVP
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.
Routine servicesOther
Also called standard of care 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.
| Study group | Role | What they receive |
|---|---|---|
| MVP village | Experimental | Wealth stratified and randomly selected households residing in a village exposed to the Millennium Villages Project intervention (or health and development intervention package) Receives: Other: Health and development intervention package |
| Comparison village | Active comparator | Villages receiving routine services through established programs Receives: Other: Routine services |
What is being measured
The primary outcome is the main question the study is designed to answer.
Child Mortality Rate
Under 5 Mortality Rate
Measured: 5 years
Secondary outcomes (22)
Prevalence of Stunting
Proportion of under 5s who are stunted; Stunted = low height for age Z-score
Measured: 5 years
Prevalence of Diarrhea
Proportion of under 5's with diarrhea in past 2 weeks
Measured: 5 years
Prevalence of Malaria
Prevalence of malaria among under 5s at the time of survey
Measured: 5 years
Prevalence of antenatal care
Proportion of women who receive at least 4 ANC visits
Measured: 5 years
Survival rate to last grade of primary education (School Quality)
Measured: 5 years
Prevalence of improved sanitation utilization
Proportion of the population using an improved sanitation source
Measured: 5 years
Duration or breast feeding (Child feeding practices)
Measured: 5 years
Age of introduction of complementary feeding (Child feeding practices)
Measured: 5 years
Prevalence of bed net utilization
Proportion of under 5s sleeping under Longlasting insecticide treated bednets in the night prior to the survey
Measured: 5 years
Prevalence of malaria treatment
Proportion of under 5s with a fever in the past 2 weeks who receive appropriate anti-malarial treatment
Measured: 5 years
Prevalence of measles immunization
Proportion under 1s immunized against measles
Measured: 5 years
Prevalence of diarrhea management
Proportion of under 5s with diarrhea in the past 2 weeks who received oral rehydration therapy
Measured: 5 years
Prevalence of pneumonia management
Proportion of under 5s treated for pneumonia in the past 2 weeks
Measured: 5 years
Prevalence of newborn care
Proportion of newborns receiving a post-natal check in the first week of life
Measured: 5 years
Proportion of pregnant women who received and HIV test
This measures the prevention of vertical transmission of HIV
Measured: 5 years
Prevalence of food insecurity
Proportion of households reporting not enough food for 1 of past 12 months
Measured: 5 years
Institutional delivery rate
Proportion of births attended by skilled health personnel
Measured: 5 years
Prevalence of underweight
Proportion of under 5s who are underweight; Underweight= weight for age Z score
Measured: 5 years
Prevalence of wasting
Proportion of under 5s who are wasted; Wasting = weight for height Z score
Measured: 5 years
Prevalence of low mid-upper arm circumference
Proportion of under 5s with a low mid-upper arm circumference
Measured: 5 years
Household Asset Index (Household poverty)
Survey of fixed and non-fixed assets, including recent purchases
Measured: 5 years
Prevalence of improved water source utilization
Proportion of the population using an improved drinking water source
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 May 2010 (estimated)
- Study startJan 2005
- Primary completion25 Jun 2016
- Study completion25 Jun 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Child SurvivalStudies of the same condition, open and under way.
- More trials run by Columbia UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Enrolment
- 65,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- Columbia University
- Sponsor type
- University, hospital or other
- Collaborators
- United Nations, Bill and Melinda Gates Foundation
- Responsible party
- Principal investigator, Sonia Sachs, Columbia University
- Investigators
- Jeffrey Sachs, PhD, Study chair, The Earth Institute, Columbia UniversityPedro Sanchez, PhD, Study director, The Earth Institute, Columbia UniversityCheryl Palm, PhD, Principal investigator, The Earth Institute, Columbia UniversitySonia Sachs, MD, PhD, Principal investigator, Director of Health, The Earth Institute, Columbia University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01125618
- Sponsor's protocol ID
- AAAA8202
- Acronym
- MVP
- Status last verified
- Apr 2017
- First submitted
- 12 May 2010
- Last updated
- 21 Apr 2017
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Pronyk PM, Muniz M, Nemser B, Somers MA, McClellan L, Palm CA, Huynh UK, Ben Amor Y, Begashaw B, McArthur JW, Niang A, Sachs SE, Singh P, Teklehaimanot A, Sachs JD; Millennium Villages Study Group. The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment. Lancet. 2012 Jun 9;379(9832):2179-88. doi: 10.1016/S0140-6736(12)60207-4. Epub 2012 May 8.
PubMed 22572602
Study at a glance
From the registry record, last updated by the sponsor on 21 Apr 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- 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
- ClinicalTrials.gov ID
- NCT01125618
- Acronym / sponsor ID
- MVP / AAAA8202
- Conditions
- Child Survival
- Keywords
- child mortality, intervention, Poverty, Africa, Millennium Development Goal, Millennium Development Goals
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 65,000 participants (actual)
- Lead sponsor
- Columbia UniversityUniversity, hospital or other
- Collaborators
- United Nations, Bill and Melinda Gates Foundation
- Study start
- Jan 2005 (actual)
- Primary completion
- 25 Jun 2016 (actual)
- Study completion
- 25 Jun 2016 (actual)
- First posted
- 18 May 2010 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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:
- 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.
- 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;
- 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
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.
Study design
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| MVP village | Experimental | Other: Health and development intervention packageWealth stratified and randomly selected households residing in a village exposed to the Millennium Villages Project intervention (or health and development intervention package) |
| Comparison village | Active comparator | Other: Routine servicesVillages receiving routine services through established programs |
Who may qualify
- Ages
- 15 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Resident in a Millennium Village and consenting to periodic assessments
Key exclusion criteria (1 listed)
- Those not consenting to participate
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Health and development intervention packageAlso: maternal-newborn-child health interventions, MVPThe 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 | MVP village |
| Routine servicesAlso: standard of care servicesRoutine 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 | Comparison village |
Primary outcome
Child Mortality Rate
Time frame: 5 years
Under 5 Mortality Rate
22 secondary outcomes
Prevalence of Stunting
Time frame: 5 years
Prevalence of Diarrhea
Time frame: 5 years
Prevalence of Malaria
Time frame: 5 years
Prevalence of antenatal care
Time frame: 5 years
Survival rate to last grade of primary education (School Quality)
Time frame: 5 years
Prevalence of improved sanitation utilization
Time frame: 5 years
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
Prevalence of malaria treatment
Time frame: 5 years
Prevalence of measles immunization
Time frame: 5 years
Prevalence of diarrhea management
Time frame: 5 years
Prevalence of pneumonia management
Time frame: 5 years
Prevalence of newborn care
Time frame: 5 years
Proportion of pregnant women who received and HIV test
Time frame: 5 years
Prevalence of food insecurity
Time frame: 5 years
Institutional delivery rate
Time frame: 5 years
Prevalence of underweight
Time frame: 5 years
Prevalence of wasting
Time frame: 5 years
Prevalence of low mid-upper arm circumference
Time frame: 5 years
Household Asset Index (Household poverty)
Time frame: 5 years
Prevalence of improved water source utilization
Time frame: 5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Apr 2017.
- Derived from this study: PubMed 22572602Pronyk PM, Muniz M, Nemser B, Somers MA, McClellan L, Palm CA, Huynh UK, Ben Amor Y, Begashaw B, McArthur JW, Niang A, Sachs SE, Singh P, Teklehaimanot A, Sachs JD; Millennium Villages Study Group. The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment. Lancet. 2012 Jun 9;379(9832):2179-88. doi: 10.1016/S0140-6736(12)60207-4. Epub 2012 May 8.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jeffrey Sachs, PhD study chair
The Earth Institute, Columbia University
Pedro Sanchez, PhD study director
The Earth Institute, Columbia University
Cheryl Palm, PhD principal investigator
The Earth Institute, Columbia University
11 sites in 10 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Health and development intervention package and Routine services in people with Child Survival, run by Columbia University at 11 sites in 10 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Apr 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 11 sites in Nigeria, Ethiopia, Ghana, Kenya, Malawi and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Child Mortality Rate (time frame: 5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01125618, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Apr 2017.