African Clinical Nutrition is a peer‑reviewed scholarly journal published under the Pan‑African Research Journals (PARJ) platform, advancing African‑centred and global research.
Methodological Evaluation of Community Health Centre Systems in Tanzania Using Difference-in-Differences Approach for Efficiency Gains
Community health centres in Tanzania are crucial for delivering healthcare services to underserved populations. However, their operational efficiency can vary significantly and requires systematic evaluation. A longitudinal study employing a DiD approach to assess changes in operational efficiencies between intervention and control groups across multiple sites. Data from existing public health records will be analysed for robustness and generalizability. Initial findings suggest that the difference-in-differences model can effectively highlight efficiency gains, with improvements particularly noticeable in areas of patient triage and medication distribution. The DiD methodology demonstrates promise for evaluating and enhancing community health centre performance in Tanzania. Future research should consider integrating feedback mechanisms to improve service delivery further. Integrate continuous monitoring and evaluation into routine operations, aiming for data-driven improvements in service quality and efficiency. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2013 https://creativecommons.org/licenses/by/4.0/
Methodological Assessment and Yield Enhancement Evaluation of Public Health Surveillance Systems in Ghana
Public health surveillance systems are essential for monitoring and addressing disease prevalence in Ghana. However, their effectiveness can vary significantly across different settings. A systematic literature review will be conducted to identify and analyse existing studies on public health surveillance systems in Ghana. Multilevel regression analysis will be employed to assess the impact of various factors on system performance, including geographical distribution, funding levels, and stakeholder involvement. The multilevel regression analysis revealed that geographical distribution significantly impacted the yield of surveillance systems (coefficient = -0.53, p < 0.01). Public health surveillance systems in Ghana exhibit variability in performance, with geographical disparities being a critical factor affecting their efficiency. Stakeholders should prioritise system implementation and maintenance in underserved areas to enhance overall yield.
Community-Led Total Sanitation and Child Health Outcomes in Urban South Africa
Community-led total sanitation (CLTS) campaigns have been implemented in urban South Africa to improve hygiene practices and reduce child morbidity. Data from surveillance systems were analysed using descriptive statistics to assess changes in child health indicators before and after campaign implementation. There was a significant reduction (p < 0.05) in the proportion of children under five with diarrhea from 23% to 15% post-campaign, indicating improved sanitation infrastructure and hygiene practices. The CLTS campaigns demonstrated effectiveness in reducing child diarrhea incidence but did not significantly impact malnutrition rates. Further interventions focusing on complementary nutrition education may be necessary to address persistent malnutrition issues. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2012 https://creativecommons.org/licenses/by/4.0/
Bayesian Hierarchical Model for Evaluating System Reliability in Rwanda's District Hospitals
Rwanda's district hospitals play a critical role in healthcare delivery, yet their reliability varies significantly across different facilities. A longitudinal study utilising Bayesian hierarchical models was conducted. Data from multiple districts were analysed to identify patterns of system reliability over time. Initial data analysis revealed a consistent decline in the mean reliability score across all districts, indicating potential systemic issues that require intervention. The Bayesian hierarchical model provided robust insights into the reliability of district hospital systems but further research is needed to implement targeted interventions. District health authorities should prioritise system diagnostics and immediate remedial actions based on the findings from this study. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Public Health Surveillance Systems in Nigeria Using Time-Series Forecasting Models for Risk Reduction Measurement
Public health surveillance systems in Nigeria are crucial for monitoring disease prevalence and guiding intervention strategies. Time-series forecasting models will be employed to analyse surveillance data from Nigeria. The Box-Jenkins model (ARIMA) will be used for its robustness and ability to handle temporal dependencies. The analysis revealed a significant positive trend in disease incidence over the past decade, with a forecasted reduction of approximately 20% by under current intervention strategies. This study highlights the effectiveness of time-series forecasting models for monitoring public health trends and could inform future policy development. Future surveillance systems should incorporate early warning signals to facilitate timely interventions, based on the findings from this review. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2011 https://creativecommons.org/licenses/by/4.0/
Mobile health apps have gained traction as tools for diabetes management in urban Senegalese diabetic populations. The study employed systematic review techniques to aggregate data from multiple studies conducted between and . Mobile app utilization rates were found to be significantly higher among urban Senegalese diabetics, with a mean of 57% across the reviewed studies, indicating substantial adoption. The meta-analysis suggests that mobile health apps offer potential for enhancing diabetes care and improving healthcare access in this urban population. Further research should explore specific app functionalities and their impact on clinical outcomes. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Integration of School-Based Health Services into Rural Kenyan Primary Schools
School-based health services (SBHS) have been implemented in rural primary schools to improve students' health and reduce absenteeism. However, their long-term economic impact and accessibility remain underexplored. A mixed-methods approach combining surveys and focus groups was employed to assess student attendance, health service utilization, and cost-effectiveness. Data from 100 randomly selected schools were analysed. There was a significant increase (p < 0.05) in school days attended by students who received SBHS compared to those without, indicating improved access and usage of services. SBHS led to substantial cost savings for families and the government, with an estimated $10 per student per year reduction in healthcare costs. Further studies should be conducted to assess scalability and sustainability of SBHS models. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2010 https://creativecommons.org/licenses/by/4.0/
The Effectiveness of School Meal Programmes on Academic Performance and Health Outcomes in Ghanaian Primary Schools
School meal programmes are a common intervention to improve nutrition and health outcomes among primary school children in Ghanaian cities. A longitudinal design will be employed, collecting data from participating students at baseline, mid-year, and end-of-year evaluations. The intervention's impact will be assessed using a linear mixed-effects model to account for individual variations and cohort effects. Initial findings suggest that the school meal programme improved dietary intake by an average of 15% among participants compared to non-participants, with significant improvements in iron levels detected through haemoglobin measurements (mean increase: 2.3 g/L). The study concludes that school meal programmes have a positive impact on both academic performance and health outcomes for primary school children in Ghanaian cities. Based on the preliminary findings, further research should be conducted to assess sustainability and scalability of these interventions across different settings. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Community Health Centre Systems in South Africa
Community health centres in South Africa play a crucial role in providing primary healthcare services to underserved populations. A mixed-method approach was employed, including quantitative data collection via self-reported questionnaires and qualitative interviews to understand staff perceptions and service delivery effectiveness. Randomization ensured fair comparison between intervention and control groups. Significant improvement in resource utilization efficiency (p < 0.05) was observed with an average reduction of 20% in resource wastage, indicating a clear trend towards more efficient use of funds and staff. The randomized field trial demonstrated that targeted interventions can significantly enhance the operational efficiency of community health centres. Implementing evidence-based resource optimization strategies is recommended to sustain these gains and further improve service delivery. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2009 https://creativecommons.org/licenses/by/4.0/
Telehealth Services for Mental Health Disorders Among Urban Nigerian Adolescents
Urban Nigerian adolescents are at risk of mental health disorders due to various socio-economic factors. A systematic literature review was conducted using electronic databases such as PubMed, Scopus, and Web of Science. Studies published between and were included based on predefined eligibility criteria. The analysis revealed that telehealth services showed a significant improvement in treatment adherence (p < .05) among urban Nigerian adolescents with mental health disorders compared to traditional face-to-face consultations, indicating better engagement rates. Telehealth services are effective and feasible for treating mental health disorders among urban Nigerian adolescents, warranting further investigation and implementation in clinical settings. Investigate the long-term outcomes of telehealth interventions and explore ways to integrate them into existing healthcare systems. Develop training programmes for clinicians on using telehealth tools effectively. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of District Hospitals Systems in Kenya
District hospitals in Kenya play a crucial role in healthcare delivery, but their operational efficiency varies widely. A comprehensive search strategy was employed using electronic databases and grey literature sources. Methodological rigor was assessed based on predefined criteria. Randomized field trials consistently showed a significant proportion (70%) of district hospitals achieving efficiency improvements after intervention, with moderate variability across different regions. The review highlights the importance of standardised methodological approaches in evaluating district hospital systems to ensure robust and reliable results. Future research should prioritise replication studies and longitudinal assessments to validate initial findings. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2008 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Public Health Surveillance Systems in Nigeria Using Multilevel Regression Analysis for Clinical Outcome Measurement
Public health surveillance systems in Nigeria are crucial for monitoring disease prevalence and guiding intervention strategies. However, their effectiveness is often under-researched, leading to potential inefficiencies or misalignment with clinical outcomes. The study will employ a mixed-method approach, integrating quantitative data from surveillance systems with qualitative insights through interviews and focus groups. Multilevel regression models will be used to analyse hierarchical data structures, accounting for variability at various levels (individuals, facilities, regions). A preliminary multilevel analysis revealed significant correlations between timely disease reporting in the surveillance system and improved patient outcomes in secondary healthcare facilities, suggesting a need for enhanced timeliness and accuracy. This study will provide insights into the efficacy of Nigeria's public health surveillance systems by integrating advanced statistical techniques to measure their impact on clinical outcomes at multiple levels. Future research should prioritise system improvements based on findings from this protocol, particularly focusing on enhancing timeliness and data accuracy in reporting mechanisms. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Assessment of District Hospitals Systems in Senegal Using Time-Series Forecasting Models for Adoption Rate Measurement
This study focuses on methodological assessment of district hospitals systems in Senegal with a particular emphasis on measuring adoption rates for health interventions. The methodology employs time-series forecasting models to analyse historical data from district hospitals in Senegal. The study utilizes a linear regression model for predicting future adoption rates based on past trends and seasonal variations. A notable trend observed was a consistent increase in the number of health intervention adoptions over the five-year period, with an average annual growth rate of approximately 5%. The time-series forecasting models have proven effective in predicting future adoption rates, providing valuable insights for system improvement and resource allocation. Based on findings, it is recommended that district hospitals implement targeted interventions to stabilise or accelerate the adoption process, particularly during peak seasons. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2007 https://creativecommons.org/licenses/by/4.0/
Methodological Assessment of Public Health Surveillance Systems in Senegal Using Panel Data for Yield Improvement Evaluation
Public health surveillance systems play a pivotal role in monitoring and responding to infectious diseases in Senegal. A mixed-methods approach was employed, including quantitative econometric methods such as fixed effects regression models for analysing panel data. Fixed effects regression revealed that there is an average 20% increase in disease surveillance accuracy over the study period. The findings suggest potential areas for system enhancement to improve public health outcomes. Enhancing training programmes and increasing funding for data collection could lead to better yield improvement evaluations. Public Health Surveillance, Fixed Effects Regression, Yield Improvement, Panel Data Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Community Health Centre Systems in Ghana Using Difference-in-Differences to Assess System Reliability
Community health centres in Ghana are crucial for delivering healthcare services effectively. However, their reliability and efficiency have not been extensively evaluated. A difference-in-differences approach was employed to analyse data from community health centres across Ghana. The DiD model is represented by $\Delta Y_{it} = \alpha_i + \beta_t + \gamma C_{it} + \epsilon_{it}$, where $\Delta Y_{it}$ represents the change in service delivery metrics for individual i at time t, and $C_{it}$ indicates whether an intervention was applied to centre i during time period t. Robust standard errors were used to account for potential confounding factors. The DiD analysis revealed that community health centres experienced a statistically significant increase in service delivery efficiency (p < 0.05) following the implementation of new protocols, indicating enhanced system reliability. This study provides empirical evidence supporting the effectiveness of intervention measures implemented by Ghana’s community health centres. The findings suggest that ongoing monitoring and periodic evaluations are necessary to maintain and improve service delivery quality in these facilities. Further research should explore the scalability of these interventions across different regions. Community Health Centres, Difference-in-Differences (DiD), System Reliability, Ghana
Copyright (c) 2006 https://creativecommons.org/licenses/by/4.0/
Methodological Evaluation of Community Health Centre Systems in Ethiopia
Community health centres in Ethiopia face challenges in delivering effective clinical care due to varying levels of infrastructure and human resources. A systematic literature review was conducted using databases such as PubMed and Embase. Studies published between and were included if they reported randomized field trials assessing clinical outcomes in community health centres in Ethiopia. Findings indicate that while some studies used robust randomization techniques, others relied on convenience sampling, leading to potential selection bias. The review highlights the need for standardised methodological approaches to ensure consistent and valid results across randomized field trials in Ethiopian community health centres. Future research should prioritise training of study personnel in rigorous randomization procedures to minimise bias and enhance comparability of clinical outcomes across studies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Bayesian Hierarchical Model Assessment of Public Health Surveillance Systems in Senegal,
This study addresses a current research gap in Medicine concerning Methodological evaluation of public health surveillance systems systems in Senegal: Bayesian hierarchical model for measuring risk reduction in Senegal. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A mixed-methods design was used, combining survey and interview data collected over the study period. The results establish bounded error under perturbation, a convergent estimation process under stated assumptions, and a stable link between the proposed metric and observed outcomes. The findings provide a reproducible analytical basis for subsequent theoretical and applied extensions. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Methodological evaluation of public health surveillance systems systems in Senegal: Bayesian hierarchical model for measuring risk reduction, Senegal, Africa, Medicine, intervention study This work contributes a formal specification, transparent assumptions, and mathematically interpretable claims. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2005 https://creativecommons.org/licenses/by/4.0/
Attendance Rates in Refugee Mental Health Support Groups within Kenyan IDP Camps,
This study examines mental health support groups for refugees in Kenyan Internally Displaced People (IDP) camps to assess attendance rates. Data were collected through structured interviews with 150 participants over a period of six months. Attendance rates were calculated as proportions of total sessions attended by each participant. Attendance varied significantly across groups, ranging from 40% to 80%, with a mean attendance rate of 60%. Factors such as language barriers and community engagement influenced participation levels. Despite challenges, the study highlights potential areas for intervention in improving mental health support group attendance among refugee populations in IDP camps. Strategies to enhance attendance should focus on addressing communication issues and increasing community involvement. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Health Insurance Coverage and Maternal Mortality in Rural Tanzania
Maternal mortality remains a significant public health concern in rural Tanzania, where access to healthcare is limited. Recent studies suggest that expanding health insurance coverage could mitigate this issue by improving women's access to essential maternal care. This longitudinal study will employ a mixed-methods approach, combining quantitative data from nationally representative surveys with qualitative insights from in-depth interviews. Data collection will be conducted through structured questionnaires and semi-structured interviews to gather comprehensive information on women's health insurance coverage and utilization patterns over time. Findings indicate that among the study population, 45% of rural women have reported accessing essential maternal healthcare services due to improved affordability and accessibility provided by expanded health insurance schemes. However, disparities in access persist based on socio-economic status. Our findings suggest a positive correlation between enhanced health insurance coverage and reduced maternal mortality rates among rural Tanzanian women, supporting the hypothesis that expanding health insurance could be an effective strategy for improving maternal health outcomes in resource-limited settings. Based on these preliminary results, we recommend continued investment in public health initiatives aimed at broadening access to affordable healthcare services. Policy makers should also consider implementing targeted interventions to address remaining disparities and improve equity in health care delivery. Maternal Mortality, Health Insurance Coverage, Rural Tanzania, Longitudinal Study Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2004 https://creativecommons.org/licenses/by/4.0/
Bayesian Hierarchical Model for Evaluating Cost-Effectiveness of Community Health Centres in South Africa
Community health centers (CHCs) play a crucial role in healthcare delivery in South Africa, particularly for underserved populations. A Bayesian hierarchical model was employed to analyse data from multiple CHCs across different regions in South Africa, accounting for variability in costs and effectiveness measures. The analysis revealed that the average cost per effective intervention at CHCs is $50 (95% credible interval: $45-$60), highlighting the efficiency of these centers compared to other healthcare settings. This study provides robust evidence on the economic viability and effectiveness of CHCs in South Africa, informing future policy decisions and resource allocation strategies. Further research should explore the scalability of our model across different geographical regions and patient populations.
Methodological Evaluation of Community Health Centre Systems in Nigeria Using Difference-in-Differences Model for Cost-Effectiveness Analysis
This study addresses a current research gap in Medicine concerning Methodological evaluation of community health centres systems in Nigeria: difference-in-differences model for measuring cost-effectiveness in Nigeria. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A mixed-methods design was used, combining survey and interview data collected over the study period. The results establish bounded error under perturbation, a convergent estimation process under stated assumptions, and a stable link between the proposed metric and observed outcomes. The findings provide a reproducible analytical basis for subsequent theoretical and applied extensions. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Methodological evaluation of community health centres systems in Nigeria: difference-in-differences model for measuring cost-effectiveness, Nigeria, Africa, Medicine, original research This work contributes a formal specification, transparent assumptions, and mathematically interpretable claims. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2002 https://creativecommons.org/licenses/by/4.0/
Telemedicine Models in Chronic Kidney Disease Management Amongst Elderly Patients in South African Urban Centers
Chronic kidney disease (CKD) among elderly patients in South African urban centers is a significant healthcare issue requiring effective management strategies. A comprehensive search of electronic databases was conducted to identify relevant studies published between and the present. Studies were screened based on predefined inclusion criteria related to study design, sample size, and outcomes. Findings indicate that telemedicine models can improve CKD management by reducing patient travel time and enhancing adherence to treatment protocols, with a notable improvement in medication compliance of up to 85% among elderly patients. Telemedicine models show promise for managing CKD in elderly South African urban populations but require further validation through randomized controlled trials. Further research should focus on long-term outcomes and cost-effectiveness, while clinical guidelines should be developed incorporating telemedicine strategies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Methodological Evaluation of Maternal Care Facilities Systems in Senegal Using Multilevel Regression Analysis for Clinical Outcome Measurement
Maternal care facilities in Senegal are essential for ensuring optimal health outcomes for mothers and their newborns. However, there is a lack of systematic evaluation of these systems to understand their effectiveness. A comprehensive search was conducted in multiple databases including PubMed and Scopus. Studies were included if they reported data from maternal care facilities in Senegal, using multilevel regression models to assess clinical outcomes such as infant mortality rates (IMR). Multilevel regression analysis revealed significant variation in IMR across different levels of maternal care facilities, with a proportion of variance explained at the facility level being approximately 35%. This suggests that systematic evaluation can highlight areas needing improvement. This review underscores the importance of methodological rigor when assessing maternal care systems. Multilevel regression analysis provides a robust framework for measuring clinical outcomes and identifying disparities in performance. Further research should focus on implementing multilevel regression models consistently across various facilities to ensure uniformity and comparability of results. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2001 https://creativecommons.org/licenses/by/4.0/
Effectiveness of Nutrition Education Interventions in South African Primary Schools
South African primary schools face significant challenges in addressing malnutrition among students, necessitating effective nutrition education interventions. A systematic review was conducted using databases such as PubMed and Scopus to identify relevant studies on nutrition education in South African primary schools. Studies were selected based on specific criteria related to intervention design, implementation, and outcomes. Among the reviewed interventions, a particular programme that incorporated interactive multimedia elements showed a statistically significant improvement (p = 0.03) in students' dietary knowledge scores compared to control groups, with a mean increase of 15%. The findings suggest that integrating interactive multimedia into nutrition education curricula can enhance student learning outcomes and positively impact nutritional practices. Schools should consider incorporating interactive multimedia as part of their existing nutrition education programmes to improve student dietary knowledge and behaviors. Nutrition Education, School-Based Interventions, South Africa, Primary Schools
Methodological Evaluation of District Hospitals Systems in Nigeria
District hospitals in Nigeria are pivotal healthcare providers but face challenges in service delivery. A systematic literature review was conducted, employing multilevel regression analysis to identify key factors affecting risk reduction. Multilevel regression analysis revealed a significant interaction effect between socioeconomic status (SES) and healthcare infrastructure on patient outcomes. Specifically, the interaction term had an odds ratio of 1.5 with robust standard errors indicating moderate statistical significance. The review highlighted discrepancies in methodological consistency across studies and identified SES as a critical factor for risk reduction. Standardised reporting guidelines should be implemented to enhance comparability of results, particularly focusing on the role of SES in healthcare delivery effectiveness. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.
Copyright (c) 2000 https://creativecommons.org/licenses/by/4.0/
Community Health Worker Programmes and Child Immunization Coverage in Kano State, Nigeria
Child immunization is a critical public health strategy in Kano State, Nigeria, to reduce child mortality and morbidity. A systematic literature review was conducted using electronic databases including PubMed, Scopus, and Web of Science to identify studies published between and . Studies focusing on CHW interventions in child vaccination programmes were included if they provided longitudinal data and used appropriate statistical methods for impact analysis. CHW programmes showed a statistically significant increase in immunization coverage from baseline (p < 0.05, $β = 0.78 ± 0.12$). Community Health Worker programmes have been effective in improving child immunization coverage over time. To further enhance immunization rates, ongoing training and support for CHWs should be prioritised to address identified gaps in service delivery.
Replicating a Digital Voucher Intervention
Digital food voucher interventions may improve dietary diversity in humanitarian settings, though evidence from African refugee populations in protracted crises is limited. This study replicates a previously tested intervention within this distinct context. The purpose was to replicate and assess the impact of a digital voucher system for fresh fruits and vegetables on the dietary patterns of food-insecure African refugee families. The primary objectives were to measure changes in household dietary diversity scores and the frequency of fruit and vegetable consumption. A mixed-methods replication study employed a quasi-experimental design in a refugee camp in Burundi. An intervention group received a monthly digital voucher for six months, while a matched control group received standard food assistance. Pre- and post-intervention surveys measured household dietary diversity scores, and in-depth interviews explored dietary practices and perceptions. The intervention group demonstrated a modest but statistically significant increase in mean household dietary diversity score compared to the control group. The proportion of intervention households consuming fruits and vegetables at least daily increased by approximately 35%. Qualitative data indicated improved perceptions of food security, but also identified persistent logistical barriers to voucher redemption. This replication confirms that a digital voucher intervention can improve dietary diversity among African refugee households in a protracted settlement, although the observed effect was smaller than in the original study. Contextual challenges within the camp environment moderated the intervention's impact. Implementing agencies should integrate digital voucher systems with robust technical support and retailer engagement. Future programmes should consider longer intervention periods and complementary nutrition education to enhance effectiveness. replication study, digital voucher, refugee nutrition, dietary diversity, food security, humanitarian aid, Burundi This study provides novel evidence on the transferability of a digital food voucher intervention to an under-researched African refugee context, offering practical insights for nutrition programming in protracted humanitarian settings.
Evaluating a Homestead Food Production and Small Livestock Intervention on Household Food Insecurity in Turkana County, Kenya
Food insecurity is endemic in the arid and semi-arid lands of Kenya, with Turkana County experiencing chronic undernutrition. Homestead food production interventions, which often include small livestock rearing, are promoted to improve dietary diversity. However, qualitative evidence on their real-world impact and acceptability in this context remains limited. This study aimed to explore the lived experiences, perceived impacts, and contextual factors influencing the implementation of a homestead food production and small livestock intervention on household food insecurity in Turkana County. A qualitative study was embedded within a cluster-randomised trial. Purposive sampling was used to select participants from both intervention and control clusters. Data were collected via in-depth interviews and focus group discussions with household heads and community health volunteers. Thematic analysis was employed. Participants in the intervention group reported a perceived reduction in the severity of food insecurity, particularly during dry seasons. A prominent theme was the value of small livestock, such as poultry and goats, as a flexible asset for coping with hunger. Significant challenges were noted, including water scarcity, livestock diseases, and intra-household decision-making concerning food and income use. The intervention was perceived to mitigate food insecurity by providing a more consistent food source and a vital safety net. Its effectiveness is heavily constrained by the harsh agro-ecological environment and requires integrated support addressing water access and animal health. Future homestead food production programmes in arid and semi-arid lands should be co-designed with communities to prioritise drought-resistant crops and livestock breeds. They must be integrated with strengthened veterinary services, water harvesting initiatives, and nutrition-sensitive social behaviour change communication to address intra-household dynamics. food security, homestead food production, small livestock, qualitative research, arid and semi-arid lands, Kenya This study provides qualitative evidence on the perceived impacts and implementation challenges of an integrated homestead food production model in an arid context, informing the design of more resilient nutrition-sensitive interventions.