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MalnutritionFAARMNCT02505711

Food and Agricultural Approaches to Reducing Malnutrition

A study testing Homestead Food Production program in people with Malnutrition, run by Sabine Gabrysch.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study is to evaluate the potential of reducing young child undernutrition in low-income countries through an integrated program that trains women's groups in agriculture, nutrition, child care and hygiene. Read more about this study

Who is it for?
Ages 15 to 30 years, women onlyHealthy volunteers can take part
Conditions the study is for
Malnutrition
What is being tested?
Homestead Food Production program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,705 participants
Where
No sites listed yet
Study dates
14 Mar 2015to 30 Aug 2021
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 to 30 years
  • Women only
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • For settlements:
  • Located in selected unions of Habiganj District, Sylhet Division, North East Bangladesh
  • Minimum distance to adjacent settlement at least 400 m
  • Judged to be suitable for Homestead Food Production program by the NGO HKI Bangladesh (dry land year-round, at least 10 women eligible and interested)
  • For women:
  • Married and aged 30 years or less at enumeration
Show all 11Show fewer
  • Woman's husband stays overnight in household at least once a year
  • Access to at least 1 decimal of land, ideally 0.25 decimal near the house
  • For children:
  • Biological child of a participant woman
  • Aged 0-35 months at survey start or surveillance visit

Who cannot join

  • For women:
  • Lack of interest in participating in a gardening program

About this study

Official title: Reducing Young Child Undernutrition Through an Integrated Agricultural Project With Women's Groups: A Cluster-randomized Trial in Rural Bangladesh

The aim of this study is to evaluate the potential of reducing young child undernutrition in low-income countries through an integrated program that trains women's groups in agriculture, nutrition, child care and hygiene.

Read the detailed description

An estimated 165 million children worldwide suffer from chronic undernutrition which leads to compromised physical and cognitive development and prevents them from reaching their full potential. Nutrition-sensitive agricultural interventions that aim to increase dietary diversity, empower women and include an educational behaviour change component focused on nutrition and hygiene are a promising and sustainable approach to addressing undernutrition. However, evidence on the impact of such interventions is still scarce due to a lack of rigorous long-term evaluations.

This study will test the hypothesis that integrated agriculture, nutrition and hygiene interventions can reduce undernutrition when children benefit in their crucial first 1000 days. The investigators will conduct an impact evaluation of Helen Keller International's Homestead Food Production program in Bangladesh that trains women's groups in vegetable and fruit gardening, poultry rearing, hygiene, child care and nutrition. Furthermore, the investigators will assess the program impact pathway to discern how any impact is achieved (through improved food production, income, food security, health service use, female empowerment, feeding and hygiene practices).

The study design is a cluster-randomized controlled field trial in two sub-districts of Habiganj District, Sylhet Division, Bangladesh, including 2700 young women in 96 settlements. After the baseline survey in 2015, settlements will be randomized into 48 intervention and 48 control settlements. Women in the intervention settlements will receive training and support in Homestead Food Production during the following four years. A surveillance system will collect data on pregnancies, births, child development, nutrition and infections as well as pathway indicators. In 2019, the investigators will conduct the endline survey to assess the nutritional status of the 2700 women and their then approximately 1500 children below 3 years of age and compare between intervention and control.

Conditions
Malnutrition
Being tested
Homestead Food Production program
Keywords
Agriculture, Food, Micronutrients, Pregnancy, Infants, Women's groups, Bangladesh
Medical subject headings
Malnutrition

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Homestead Food Production programBehavioural

    Also called Agriculture, Home gardening, Nutrition education

    Training and support for vegetable gardening and poultry rearing, and education on young child nutrition, hygiene and health topics, in women's groups, as designed by the international non-governmental organization (NGO) Helen Keller International (HKI).

Study groups in NCT02505711
Study groupRoleWhat they receive
Homestead Food ProductionExperimentalEnrolled in Homestead Food Production program from 2015 to 2019, 48 clusters, approx. 1350 women and 750 children
Receives: Behavioral: Homestead Food Production program
ControlNo intervention(Health system strengthening in the study area), 48 clusters, approx. 1350 women and 750 children

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Linear growth in children below 3 years of age

    Length/height-for-age Z-score

    Measured: Measured 50 months after randomization (endline survey 2019)

Secondary outcomes (20)
  1. Linear growth in children aged 6-30 months

    Length/height-for-age Z-score

    Measured: Measured 50 months after randomization

  2. Intrauterine growth retardation: length

    Length-for-gestational-age

    Measured: Measured within 3 days of birth, 15-57 months after randomization

  3. Intrauterine growth retardation: small-for-gestational age

    Weight-for-gestational-age adjusted for time since birth

    Measured: Measured within 3 days of birth, 15-57 months after randomization

  4. Intrauterine growth retardation: head size

    Head circumference-for-gestational-age

    Measured: Measured within 3 days of birth, 15-57 months after randomization

  5. Wasting in children below 3 years of age

    Weight-for-length/height Z-score

    Measured: Measured 50 months after randomization

  6. Head circumference in children below 3 years of age

    Head circumference-for-age Z-score

    Measured: Measured 50 months after randomization

  7. Underweight in women

    Body Mass Index (BMI, non-pregnant women), mid-upper-arm circumference (MUAC, pregnant women)

    Measured: Measured 50 months after randomization

  8. Gestational weight gain

    Gestational weight gain Z-score

    Measured: Measured every 2 months during pregnancy, 6-57 months after randomization

  9. Anemia in women and children below 3 years of age

    Hemoglobin concentration

    Measured: Measured 50 months after randomization

  10. Micronutrients: Vitamin A deficiency in women and in children below 3 years of age

    Retinol-binding protein, corrected for inflammation (CRP, AGP)

    Measured: Measured 50 months after randomization

  11. Micronutrients: Iron deficiency in women and in children below 3 years of age

    Ferritin and soluble transferrin receptor, corrected for inflammation (CRP, AGP)

    Measured: Measured 50 months after randomization

  12. Micronutrients: Zinc deficiency in women and in children below 3 years of age

    Serum zinc, corrected for inflammation (CRP, AGP)

    Measured: Measured 50 months after randomization

  13. Early child development (adapted WHO milestones)

    Gross and fine motor, cognitive, personal-social and communication skills

    Measured: Measured at appropriate ages for milestones, 6-50 months after randomization

  14. Diarrhea in children below 3 years of age

    Period and point prevalence of diarrhea

    Measured: Measured every 2 months, 6-50 months after randomization

  15. Acute respiratory infection in children below 3 years of age

    Period prevalence of acute respiratory infection

    Measured: Measured every 2 months, 6-50 months after randomization

  16. Enteropathy in children below 18 months of age

    Biomarkers: faecal myeloperoxidase, faecal α1-antitrypsin, faecal neopterin, serum C-reactive protein, serum α-1-acid glycoprotein

    Measured: Measured 36 and 50 months after randomization

  17. Dietary adequacy in women and children below 3 years of age

    Mean probability of adequate micronutrient intake (MPA)

    Measured: Measured every 2 months, 6-50 months after randomization

  18. Dietary diversity in women and children below 3 years of age

    Individual dietary diversity score, breastfeeding behaviors

    Measured: Measured every 2 months, 6-50 months after randomization

  19. Fecal contamination of complementary food for children 6-18 months of age

    Log-transformed counts of total coliforms and E. coli in complementary food samples

    Measured: Measured 36 months after randomization

  20. Food hygiene behaviour in mothers of children aged 6-18 months

    Hygiene score from structured observation of mothers

    Measured: Measured 36 months after randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jul 2015 (estimated)
  2. Study start14 Mar 2015
  3. Primary completion15 Feb 2020
  4. Study completion30 Aug 2021

Resources

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
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
2,705 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02505711
Sponsor's protocol ID
01ER1201
Acronym
FAARM
Status last verified
May 2022
First submitted
17 Jul 2015
Last updated
18 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Sparling TM, Cornejo C, Offner C, Mayer A, Waid JL, Kadiyala S, Gabrysch S. Nutrition-sensitive agriculture programme impacts women's mental health via food security in rural Bangladesh. BMJ Glob Health. 2026 May 5;11(5):e020509. doi: 10.1136/bmjgh-2025-020509.

    PubMed 42086300
  • Wendt AS, Waid JL, Muller-Hauser AA, Lambrecht NJ, Huda TMN, Kyei NNA, Gabrysch S. Impacts of a Homestead Food Production Intervention on Anaemia and Micronutrient Deficiencies Among Women and Children in Rural Bangladesh: A Cluster-Randomized Controlled Trial. Matern Child Nutr. 2025 Oct;21(4):e70043. doi: 10.1111/mcn.70043. Epub 2025 May 19.

    PubMed 40387380
  • Sobhan S, Muller-Hauser AA, Gon G, Nurul Huda TM, Waid JL, Wendt AS, Rahman M, Gabrysch S. Effect of a behaviour change intervention on household food hygiene practices in rural Bangladesh: A cluster-randomised controlled trial. Int J Hyg Environ Health. 2024 Jan;255:114291. doi: 10.1016/j.ijheh.2023.114291. Epub 2023 Nov 18.

    PubMed 37983985
  • Waid JL, Wendt AS, Kader A, Sobhan S, Gabrysch S. Impact of a Homestead Food Production Program on Dietary Diversity: Seasonal and Annual Results from the Cluster-Randomized FAARM Trial in Sylhet, Bangladesh. J Nutr. 2024 Jan;154(1):191-201. doi: 10.1016/j.tjnut.2023.10.014. Epub 2023 Oct 21.

    PubMed 37871747
  • Muller-Hauser AA, Huda TMN, Sobhan S, Lambrecht NJ, Waid JL, Wendt AS, Ali S, Rahman M, Gabrysch S. Effect of a Homestead Food Production and Food Hygiene Intervention on Biomarkers of Environmental Enteric Dysfunction in Children Younger Than 24 Months in Rural Bangladesh: A Cluster-Randomized Controlled Trial. Am J Trop Med Hyg. 2023 Oct 2;109(5):1166-1176. doi: 10.4269/ajtmh.23-0153. Print 2023 Nov 1.

    PubMed 37783459
  • Lambrecht NJ, Muller-Hauser AA, Sobhan S, Schmidt WP, Huda TMN, Waid JL, Wendt AS, Kader A, Gabrysch S. Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial. Am J Trop Med Hyg. 2023 Aug 14;109(4):945-956. doi: 10.4269/ajtmh.23-0152. Print 2023 Oct 4.

    PubMed 37580032
  • Dupuis S, Hennink M, Wendt AS, Waid JL, Kalam MA, Gabrysch S, Sinharoy SS. Women's empowerment through homestead food production in rural Bangladesh. BMC Public Health. 2022 Jan 19;22(1):134. doi: 10.1186/s12889-022-12524-2.

    PubMed 35045859
  • Wendt AS, Waid JL, Gabrysch S. Dietary Factors Moderate the Relation between Groundwater Iron and Anemia in Women and Children in Rural Bangladesh. Curr Dev Nutr. 2019 Aug 6;3(10):nzz093. doi: 10.1093/cdn/nzz093. eCollection 2019 Oct.

    PubMed 31620671
  • Wendt AS, Sparling TM, Waid JL, Mueller AA, Gabrysch S. Food and Agricultural Approaches to Reducing Malnutrition (FAARM): protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh. BMJ Open. 2019 Jul 4;9(7):e031037. doi: 10.1136/bmjopen-2019-031037.

    PubMed 31278109

Questions about this trial

What is this clinical trial studying?

A study testing Homestead Food Production program in people with Malnutrition, run by Sabine Gabrysch.

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 11 inclusion and 2 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 18 May 2022. Status can change between updates, so confirm with the study contact before making plans.

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?

Linear growth in children below 3 years of age (time frame: Measured 50 months after randomization (endline survey 2019)). 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 NCT02505711, which also lists 9 linked publications.

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 18 May 2022.

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