Migori

Researchers are evaluating a two-way text-message (SMS) system called the Maternally Administered Malnutrition Monitoring System with Infant and Young Child Feeding (MAMMS-IYCF) education. This program aims to help caregivers in Kenya monitor the nutritional status of HIV-exposed children aged 6 to 24 months at home, with the goal of reducing malnutrition, hospitalizations, severe malnutrition cases, and deaths. The study also investigates the cost-effectiveness of the intervention and how it influences caregiver behavior, feeding practices, trust in healthcare, and care-seeking intentions. Caregivers and their children are randomly assigned to either the MAMMS-IYCF group or a standard of care (SOC) group for 180 days. Those in the MAMMS-IYCF group receive weekly two-way SMS messages with education on age-appropriate feeding and reminders to measure their child’s mid-upper arm circumference (MUAC) using provided tapes. Caregivers send back the color result via SMS and can ask health questions. If a child shows signs of wasting, caregivers are prompted to visit the clinic for confirmation and possible treatment. The SOC group receives one-way SMS reminders for clinic visits, and their children’s MUAC is measured during routine visits with follow-up care provided as needed. Participants attend study visits at enrollment, day 90, and day 180 for clinical exams, anthropometric measurements, and surveys about child health and caregiver knowledge. Caregivers in the intervention group complete an acceptability questionnaire at the end, and focus groups and interviews are conducted to assess experiences with the SMS system. The study measures outcomes like incidence and duration of wasting, recovery time, and hospitalizations over the 180-day follow-up period.

Researchers are evaluating a youth-led, data-driven implementation strategy to expand an evidence-based Adolescent Transition Package (ATP) designed to improve the transition from pediatric to adult HIV care for youth living with HIV in Kenya. This study builds on a previous trial and aims to improve the number of youth receiving the ATP, provider adoption, and consistent use of the ATP over time. The study also assesses the cost-effectiveness of this implementation approach and its impact on health outcomes such as viral suppression and retention in care. The study will involve 32 HIV clinics randomized to either the standard of care implementation strategy (Trainer of Trainers) or an enhanced strategy called ATP-Youth Enhanced Strategy (ATP-YES), which adds youth-led data audits, feedback, and collaborative learning. The ATP is delivered by healthcare workers during routine clinic visits for youth aged 10 to 24 years. Older youth (15-24 years) will participate in surveys and focus groups, while healthcare workers will engage in surveys, interviews, and quality improvement activities throughout the 36-month study period. Participants will have their routine medical records reviewed, and healthcare workers and youth will provide feedback on implementation experiences. The study will measure outcomes including ATP reach, effectiveness on viral suppression and retention, adoption by healthcare workers, fidelity to ATP processes, and maintenance of the intervention. Costs and budget impact will also be examined over the 42 months from enrollment through 6 months after study end.