The Impact of a Voice and Text Messaging Intervention on Hemoglobin and Anemia Status in Senegal: The IIMAANJE Cluster Randomized Controlled Trial

Objectives: To examine the impact of a mobile voice and text messaging intervention aimed at improving infant and young child feeding (IYCF) practices among children 6-23 months in Senegal. Methods: A cluster randomized control trial was conducted with children (n=488) living in 102 villages in three regions of Senegal in May-December 2022. Mothers and fathers of children in the experimental group voice and text messages over the course of the 16-week intervention (1 voice and text message per week). Primary outcomes for the RCT included anemia based on hemoglobin measurement using Hemocue finger prick machines. Household surveys were conducted at baseline and endline with parents in the experimental and control groups. Separate regression models were fitted for each outcome [linear regression for hemoglobin and logistic regression for anemia] and adjusted for intervention, time, and intervention by time interaction (of primary importance). The data were analyzed at the individual level and accounted for clustering. Results: At baseline, most of the children (69.3%) had anemia. The only statistical differences in the experimental and control households at baseline were their religious and ethnic backgrounds. In adjusted models, the intervention by time interaction term was significant in the hemoglobin model (p=0.04) but not in the anemia (p=0.18) models. This indicates that the intervention increased hemoglobin levels over time in children in the intervention group whilst it decreased in children in the control group. Conclusions: We found a significant increase in hemoglobin levels within the experimental group over the intervention period, indicating that the intervention likely had beneficial impacts on children included in the experimental group. Future work should combine voice and text messaging with interventions that improve food access to generate larger impacts on child nutrition. Funding Sources: Research reported in this publication was supported by the Eunice Kennedy Shriver National Institutes of Child Health & Human Development (1R21HD105067-01).