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Rojiroti microfinance and child nutrition: a cluster randomised trial
  1. Shalini Ojha1,
  2. Lisa Szatkowski2,
  3. Ranjeet Sinha3,
  4. Gil Yaron4,
  5. Andrew Fogarty2,
  6. Stephen John Allen5,
  7. Sunil Choudhary6,
  8. Alan Robert Smyth7
  1. 1Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK
  2. 2Division of Epidemiology & Public Health, University of Nottingham, Nottingham, UK
  3. 3Department of Community Medicine, Patna Medical College, Patna, Bihar, India
  4. 4GY Associates Ltd and Trustee, Harpenden, UK
  5. 5Department of Child Health, The Liverpool School of Tropical Medicine, Liverpool, UK
  6. 6Centre for Promoting Sustainable Livelihood (CPSL), Patna, Bihar, India
  7. 7Division of Child Health, Obstetrics & Gynaecology, Nottingham University, Nottingham, UK
  1. Correspondence to Professor Alan Robert Smyth, Child Health, Nottingham Unversity, Nottingham NG7 2UH, UK; alan.smyth{at}nottingham.ac.uk

Abstract

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.

  • microfinance
  • low & middle income countries
  • wasting
  • child growth
  • weight for height z score

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Footnotes

  • Twitter @shaliniojha7, @AlanRSmyth

  • Contributors Study design: SO, LS, AF, SJA and ARS. Organisation and conduct: RS, GY and SC. Analysis: LS, SO, AF and ARS. Manuscript written by SO and ARS and revised by all the authors.

  • Funding This work was supported by the Medical Research Council; Wellcome Trust; the Department of Health and Social Care; and Department for International Development (both UK Government) as part of the joint global health trials scheme (grant number MR/M021904/1). The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Disclaimer Funders had no role in design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

  • Competing interests GY is a Trustee of Rojiroti UK. SC is CEO of the Centre for Promoting Sustainable Livelihood.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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