Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial

Introduction Chronic malnutrition is a serious problem in southern Angola with a prevalence of 49.9% and 37.2% in the provinces of Huila and Cunene, respectively. The MuCCUA (Mother and Child Chronic Undernutrition in Angola) trial is a community-based randomised controlled trial (c-RCT) which aims...

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Main Authors: Rocio Martin-Canavate, Estefania Custodio, Elena Trigo, María Romay-Barja, Israel Molina, Zaida Herrador, Isabel Aguado, Ferran Ramirez, Lourdes Maria Faria, Ana Silva-Gerardo, Jose Carlos Lima, Eva Iráizoz, Tayná Marques, Antonio Vargas, Amador Gomez, Chloe Puett
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e073349.full
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author Rocio Martin-Canavate
Estefania Custodio
Elena Trigo
María Romay-Barja
Israel Molina
Zaida Herrador
Isabel Aguado
Ferran Ramirez
Lourdes Maria Faria
Ana Silva-Gerardo
Jose Carlos Lima
Eva Iráizoz
Tayná Marques
Antonio Vargas
Amador Gomez
Chloe Puett
author_facet Rocio Martin-Canavate
Estefania Custodio
Elena Trigo
María Romay-Barja
Israel Molina
Zaida Herrador
Isabel Aguado
Ferran Ramirez
Lourdes Maria Faria
Ana Silva-Gerardo
Jose Carlos Lima
Eva Iráizoz
Tayná Marques
Antonio Vargas
Amador Gomez
Chloe Puett
author_sort Rocio Martin-Canavate
collection DOAJ
description Introduction Chronic malnutrition is a serious problem in southern Angola with a prevalence of 49.9% and 37.2% in the provinces of Huila and Cunene, respectively. The MuCCUA (Mother and Child Chronic Undernutrition in Angola) trial is a community-based randomised controlled trial (c-RCT) which aims to evaluate the effectiveness of a nutrition supplementation plus standard of care intervention and a cash transfer plus standard of care intervention in preventing stunting, and to compare them with a standard of care alone intervention in southern Angola. This protocol describes the planned economic evaluation associated with the c-RCT.Methods and analysis We will conduct a cost-efficiency and cost-effectiveness analysis nested within the MuCCUA trial with a societal perspective, measuring programme, provider, participant and household costs. We will collect programme costs prospectively using a combined calculation method including quantitative and qualitative data. Financial costs will be estimated by applying activity-based costing methods to accounting records using time allocation sheets. We will estimate costs not included in accounting records by the ingredients approach, and indirect costs incurred by beneficiaries through interviews, household surveys and focus group discussions. Cost-efficiency will be estimated as cost per output achieved by combining activity-specific cost data with routine data on programme outputs. Cost-effectiveness will be assessed as cost per stunting case prevented. We will calculate incremental cost-effectiveness ratios comparing the additional cost per improved outcome of the different intervention arms and the standard of care. We will perform sensitivity analyses to assess robustness of results.Ethics and dissemination This economic evaluation will provide useful information to the Angolan Government and other policymakers on the most cost-effective intervention to prevent stunting in this and other comparable contexts. The protocol was approved by the República de Angola Ministério da Saúde Comité de Ética (27C.E/MINSA.INIS/2022). The findings of this study will be disseminated within academia and the wider policy sphere.Trial registration number ClinicalTrials.gov Registry (NCT05571280).
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spelling doaj-art-e5a680afa0654af5918ff0c0b5ab18fb2025-08-20T02:11:02ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-073349Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trialRocio Martin-Canavate0Estefania Custodio1Elena Trigo2María Romay-Barja3Israel Molina4Zaida Herrador5Isabel Aguado6Ferran Ramirez7Lourdes Maria Faria8Ana Silva-Gerardo9Jose Carlos Lima10Eva Iráizoz11Tayná Marques12Antonio Vargas13Amador Gomez14Chloe Puett15Escuela Internacional de Doctorado, Universidad Nacional de Educación a Distancia, Madrid, EspañaCentro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, SpainCentro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, SpainCentro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, SpainInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, SpainFundo Apoio Social-Local Development Institute, Luanda, AngolaFaculdade de Medicina da Universidade Mandume Ya Ndemufayo, Lubango, Huíla, AngolaFaculdade de Medicina da Universidade Mandume Ya Ndemufayo, Lubango, Huíla, AngolaAction Against Hunger Spain, Madrid, SpainInfectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, SpainAction Against Hunger Spain, Madrid, SpainAction Against Hunger Spain, Madrid, SpainStony Brook University Program in Public Health, Stony Brook, New York, USAIntroduction Chronic malnutrition is a serious problem in southern Angola with a prevalence of 49.9% and 37.2% in the provinces of Huila and Cunene, respectively. The MuCCUA (Mother and Child Chronic Undernutrition in Angola) trial is a community-based randomised controlled trial (c-RCT) which aims to evaluate the effectiveness of a nutrition supplementation plus standard of care intervention and a cash transfer plus standard of care intervention in preventing stunting, and to compare them with a standard of care alone intervention in southern Angola. This protocol describes the planned economic evaluation associated with the c-RCT.Methods and analysis We will conduct a cost-efficiency and cost-effectiveness analysis nested within the MuCCUA trial with a societal perspective, measuring programme, provider, participant and household costs. We will collect programme costs prospectively using a combined calculation method including quantitative and qualitative data. Financial costs will be estimated by applying activity-based costing methods to accounting records using time allocation sheets. We will estimate costs not included in accounting records by the ingredients approach, and indirect costs incurred by beneficiaries through interviews, household surveys and focus group discussions. Cost-efficiency will be estimated as cost per output achieved by combining activity-specific cost data with routine data on programme outputs. Cost-effectiveness will be assessed as cost per stunting case prevented. We will calculate incremental cost-effectiveness ratios comparing the additional cost per improved outcome of the different intervention arms and the standard of care. We will perform sensitivity analyses to assess robustness of results.Ethics and dissemination This economic evaluation will provide useful information to the Angolan Government and other policymakers on the most cost-effective intervention to prevent stunting in this and other comparable contexts. The protocol was approved by the República de Angola Ministério da Saúde Comité de Ética (27C.E/MINSA.INIS/2022). The findings of this study will be disseminated within academia and the wider policy sphere.Trial registration number ClinicalTrials.gov Registry (NCT05571280).https://bmjopen.bmj.com/content/13/12/e073349.full
spellingShingle Rocio Martin-Canavate
Estefania Custodio
Elena Trigo
María Romay-Barja
Israel Molina
Zaida Herrador
Isabel Aguado
Ferran Ramirez
Lourdes Maria Faria
Ana Silva-Gerardo
Jose Carlos Lima
Eva Iráizoz
Tayná Marques
Antonio Vargas
Amador Gomez
Chloe Puett
Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
BMJ Open
title Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
title_full Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
title_fullStr Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
title_full_unstemmed Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
title_short Preventing chronic malnutrition in children under 2 years in rural Angola (MuCCUA trial): protocol for the economic evaluation of a three-arm community cluster randomised controlled trial
title_sort preventing chronic malnutrition in children under 2 years in rural angola muccua trial protocol for the economic evaluation of a three arm community cluster randomised controlled trial
url https://bmjopen.bmj.com/content/13/12/e073349.full
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