| Literature DB >> 35802640 |
Alexander Tilley1, Kendra A Byrd1, Lauren Pincus1, Katherine Klumpyan2, Katherine Dobson2, Joctan Dos Reis Lopes3, Kelvin Mashisia Shikuku1.
Abstract
Timor-Leste is one of the world's most malnourished nations where micronutrient-deficient diets are a contributing factor to the prevalence of child stunting, currently estimated to be 45.6% of children under five. Fish are an important source of nutrients and one that may assist the country's predominantly rural population of agriculturalists to exit poverty and malnutrition. However, a small national fishing fleet producing low catch volumes places fish out of reach of most inland and upland populations where it is needed most. Fish consumption is very low in rural, inland areas compared to coastal, regional, and global averages. This study is a one-year, partially masked, cluster-randomized controlled trial among families living in rural, inland Timor-Leste. We aim to test and compare the effects of two treatments, alone and in combination, on the frequency and volume of household fish consumption in rural, inland areas as a proxy for improved dietary diversity and micronutrient intake. Treatment 1 is the installation of nearshore, moored fish aggregating devices (FADs) to improve catch rates with existing fishing gears. Treatment 2 is a social and behaviour change (SBC) activity to promote fish consumption. Villages in inland communities will be randomized to receive treatment 1, treatment 2, both treatments, or neither treatment. Data will be collected at baseline (prior to the rollout of the treatments) and endline. Our study will determine the impact of an improved supply of fish, along with nutrition-oriented SBC activities, on the fish purchasing and consumption practices of rural, inland households. Findings from this study are urgently needed by Small Island Developing States to guide policy and investment decisions on how best to improve households' diets using locally available, nutrient-dense foods such as fish. Investments such as these are needed to break the cycle of malnutrition. This trial is registered at clinicaltrials.gov (NCT04729829). Trial registration: Trial registered at clinicaltrials.gov Identifier: NCT04729829.Entities:
Mesh:
Year: 2022 PMID: 35802640 PMCID: PMC9269458 DOI: 10.1371/journal.pone.0269221
Source DB: PubMed Journal: PLoS One ISSN: 1932-6203 Impact factor: 3.752
Fig 1A CONSORT flow diagram of the progress through the phases of the parallel randomised trial.
Fig 2Map of Timor-Leste showing municipalities.
Red shading shows the municipalities represented by coastal producer sites. Map data adapted from © OpenStreetMap contributors.
Fig 3A sketch representation of the two treatment levels of the randomised controlled trial.
1. Coastal nearshore fish aggregating devices and 2. Social and behaviour change activities in rural inland communities in Timor-Leste. This diagram is a visualization only and does not represent the location of villages in the study. Diagram and icons ©A.Tilley (created using Affinity Designer software (https://affinity.serif.com/en-us/designer/).
Fig 4A diagram of a nearshore fish aggregating device (FAD) (not to scale).
Diagram and icons © A.Tilley (created using Affinity Designer software (https://affinity.serif.com/en-us/designer/)).
Fig 5Timeline of interventions and data collection in the study.
Description of study arms and their exposures.
| Arm | Exposures |
|---|---|
| FAD + SBC | • Mercy Corps VSLA site |
| FAD only | • Mercy Corps VSLA site |
| SBC only | • Mercy Corps VSLA site |
| No FAD, No SBC (control) | • Mercy Corps VSLA site |
Baseline characteristics by experiment arm.
| Variable | SBC only | FAD only | SBC + FAD | Control (no SBC & no FAD) |
|---|---|---|---|---|
| Panel A: | ||||
| Per capita household fish consumption | ||||
| Frequency of fish consumed at household level | ||||
| Frequency of fish consumption in women | ||||
| Frequency of fish consumption in children | ||||
| Knowledge about nutrition benefits of fish | ||||
| Dietary diversity | ||||
| Panel B: | ||||
| Age of respondent | ||||
| Sex of respondent | ||||
| Education of respondent | ||||
| Household size | ||||
| Number of women of reproductive age (15–49) | ||||
| Number of infants | ||||
| Per capita household income | ||||
| Food insecurity | ||||
| Asset score | ||||
| Participation in other community projects | ||||
| Number of nutrition information exchange links |