Procedures
diarrhoea, vomiting, fever, respiratory difficulties, cough, household‐level
BCC, LENS
The SELEVER project was designed by Tanager and implemented in partnership with in‐country NGOs, private institutions and government services in Burkina Faso. SELEVER aimed to improve poultry production and the diets and nutritional status of women and children in the targeted regions. Project implementation involved three main components focussing on poultry revenue generation, diets and nutrition and women's empowerment domains. Intervention activities included training and behaviour change communication (BCC), with no financial or in‐kind transfers for participants. The nutrition component included BCC on improved dietary and nutrition practices provided through women's groups by local NGOs trained by Tanager. The content of the BCC included the promotion of improved diets and basic hygiene practices. This included messaging on IYCF practices, diet diversification and hygiene‐related practices (including a total of 30 topics divided into 3 modules). The BCC materials promoted daily consumption of at least three key food groups, including energy‐giving foods (starchy staples and fats), protective foods (fruits and vegetables) and protein‐rich, body‐building foods (including animal source foods, legumes and nuts). The gender component, implemented alongside the nutrition activities, included sensitisation on women's empowerment through monthly community‐level training sessions, follow‐up home visits, peer‐group support and advocacy conducted by high‐profile community members such as religious or traditional community leaders and women leaders. The training curriculum focussed on strengthening women's role in decision‐making on topics including entrepreneurship, nutritious food production, consumption and sales, as well as on child health, feeding and care practices.The poultry component involved a set of training practices on poultry husbandry, including improved housing, vaccinations, feed, financing and marketing practices provided by micro‐finance institutions trained by Tanager. This curriculum was delivered to micro‐finance group members through 8 videos, typically screened over a series of 3 meetings. In addition, SELEVER trained village volunteer extension agents (VVVs) to improve the quality of their services, with a focus on poultry vaccination, to reduce mortality.The additional WASH behaviour change intervention aimed to enhance the impact of the SELEVER programme on children's health and nutrition status by improving the general WASH environment at the community and household level and specifically reducing the risk of exposure to livestock faeces for young children. In the SELEVER‐WASH arm, a poultry–livestock lens was applied to the Community‐Led Total Sanitation (CLTS) behaviour change approach (Chambers & Kar, Prior to the baseline survey, a household census was conducted in the targeted villages, including information on basic demographics and poultry flock size. Data from the census were used to construct a listing of households with women aged 15−49 years with children in the 2−4 years age group for the survey sample, stratified by larger/smaller poultry producers (with larger producers defined as those owning a poultry flock of over 20 birds). A sample of 15 poultry‐producing households was drawn to form the main study population (6 from larger poultry‐producing households). A second sample of 12 out of the 15 households was drawn to select participants for the pre‐specified seasonal substudy (with 5 out of 12 households drawn from larger producer strata). During the baseline survey interview, an index child in the 2−4 years age range was randomly selected for inclusion in the biomedical component of the analysis alongside their primary female caregiver.Data collection was performed using Computer Assisted Personal Interview surveys designed using SurveyBe software running on Android and Microsoft Windows tablets. Survey forms were written in French, and all enumerators also spoke the local languages. The survey included data on sociodemographic characteristics; IYCF, nutrition, health and hygiene practices and knowledge of caregivers; as well as a wide range of indicators at village, household, caregiver and child level. Intervention exposure was measured by the self‐reported recall of participation in activities related to the SELEVER intervention, including participation in group activities and follow‐up home visits. Information on programme participation over the previous 12 months was collected separately for index women, their husbands and any other household members. Individual responses were aggregated to obtain household‐level estimates of exposure (using means for continuous variables or Boolean OR operation for binary variables). Child weight was measured to the nearest 100 g using an electronic scale (SECA 876, Germany). The recumbent length of children <2 years of age and the standing height of children >2 year of age was measured to the nearest 0.1 cm using portable fixed base stadiometers or length boards (SECA 417). All measurements were taken in duplicate during the same session by an anthropometrist and an assistant and were practiced before the survey through standardisation exercises. From the standardisation sessions, inter and intraobserver variations of measurement error were documented, and the necessary corrections to procedures were made prior to data collection. Index child morbidity was assessed through caregiver recall of symptoms during the previous 7 days. Symptoms included vomiting, fever, cough, respiratory difficulties, blood in stool, liquid or semi‐liquid stools, other types of diarrhoea, or other illnesses.The trial included four rounds of data collection (including 2 preintervention rounds timed in different seasons) between 2017 and 2020, with a mixed‐methods process evaluation at midterm (Figure SELEVER study timeline in Burkina Faso.