Rojiroti microfinance and child nutrition: a cluster randomised trial
Shalini Ojha1, Lisa Szatkowski2, Ranjeet Sinha3
1Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
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.
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