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Introducing a method of iron supplementation to Anganwadi Centres in Madhepura, Bihar, India
Last registered on August 18, 2020

Pre-Trial

Trial Information
General Information
Title
Introducing a method of iron supplementation to Anganwadi Centres in Madhepura, Bihar, India
RCT ID
AEARCTR-0005449
Initial registration date
February 11, 2020
Last updated
August 18, 2020 5:52 AM EDT
Location(s)
Region
Primary Investigator
Affiliation
University of Göttingen
Other Primary Investigator(s)
PI Affiliation
University of Göttingen
PI Affiliation
University of Göttingen
PI Affiliation
University of Göttingen
Additional Trial Information
Status
Completed
Start date
2019-11-19
End date
2020-08-15
Secondary IDs
Abstract
Anaemia prevalence among children is high in rural Bihar, India. As anaemia has adverse effects on attentiveness and the ability to concentrate as well as cognitive development of children, finding channels to combat anaemia is a key concern of the central and state governments of India. Iron-deficiency is a major factor contributing to anaemia in general and it is presumed to be the case in Bihar as well.
We implement an iron-supplementation intervention targeted at children aged 3 to 6 years who attend pre-primary childcare centres, called Anganwadi Centres, in Madhepura district in Bihar, India. Anganwadi Centres are part of the Integrated Child Development Services Scheme, a government programme aiming to improve child health and development. The study evaluates the introduction of a sustainable method of low-dosed iron supplementation, a reusable iron ingot, in the institution of Anganwadi Centres and its potential to reduce iron-deficiency anaemia among children.

This study is currently on hold due to the corona pandemic. It is not possible to conduct the study in Anganwadi Centres at the moment.
External Link(s)
Registration Citation
Citation
Bogler, Lisa et al. 2020. "Introducing a method of iron supplementation to Anganwadi Centres in Madhepura, Bihar, India." AEA RCT Registry. August 18. https://doi.org/10.1257/rct.5449-2.0.
Experimental Details
Interventions
Intervention(s)
Our intervention introduces a reusable iron ingot as a method of iron supplementation to Anganwadi Centres. The iron ingot releases a constant, low dose of bio-absorbable iron when boiled in water with some drops of lemon juice. Regular consumption of this iron-enriched drinking water can increase the haemoglobin content in the blood, reducing iron-deficiency anaemia.
In the light intervention treatment group, Anganwadi Workers (Sevikas) were invited to a two-hour training led by local female facilitators. They were introduced to the reusable iron ingot as a method of iron supplementation. Each Anganwadi Worker received five iron ingots for use at her Anganwadi Centre. They were instructed to provide the iron-enriched drinking water to the children attending the Anganwadi Centre every day.
In the intensive intervention treatment group, Anganwadi Workers were invited to a four-hour training led by local female facilitators. The content was similar to the training in the light intervention, but additionally contained elements aimed to increase motivation and confidence in overcoming challenges among the Anganwadi Workers. The helpers of these Anganwadi Workers (Sahikas) were invited to a two-hour training about the iron ingot following the four-hour session. Anganwadi Workers in this treatment group received iron ingots for use at the Anganwadi Centres as well as a regular supply of lemons and sugar required for using the iron ingots. In addition, they received a follow-up call to clarify potential questions.

The implementation of workshops was completed by January 2020. The delivery of sugar and lemons stopped in March 2020, when Anganwadi Centres were closed due to the Corona pandemic. While Anganwadi Centres are closed, Anganwadi Workers are not able to provide iron-enriched drinking water to the children.
Intervention Start Date
2020-01-04
Intervention End Date
2020-05-16
Primary Outcomes
Primary Outcomes (end points)
Adoption of iron-supplementation method in Anganwadi Centres, haemoglobin level and anaemia among children
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Functionality of Anganwadi Centres
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The study included one control and two treatment arms. One treatment arm received a light intervention, representing a potential government role-out of the programme. The second treatment arm received a more intensive intervention. The control group did not receive any intervention.
Experimental Design Details
Randomization Method
Randomization was done by a computer, assignment into treatment or control groups was done with equal probability
Randomization Unit
Anganwadi Centres
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
800 Anganwadi Centres
Sample size: planned number of observations
36.000 children
Sample size (or number of clusters) by treatment arms
265 Anganwadi Centres in each arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Ethikkommission der Georg-August-Universität Göttingen
IRB Approval Date
2019-10-16
IRB Approval Number
NA
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports, Papers & Other Materials
Relevant Paper(s)
REPORTS & OTHER MATERIALS