Integrating Moringa Oleifera Hedgerows into Home Gardens: A Protocol for a Cluster Randomised Trial on Nutritional Security in HIV-Affected Households of the Eastern Cape

{ "background": "In the Eastern Cape, HIV-affected households face significant nutritional insecurity. Home gardens are a common livelihood strategy, yet their potential is often limited by the seasonal availability of nutrient-dense foods. Integrating perennial, nutrient-rich Moringa oleifera as hedgerows presents a potential agroforestry intervention to enhance dietary diversity and micronutrient intake year-round.", "purpose and objectives": "This protocol details a cluster randomised trial to evaluate the effect of integrating Moringa oleifera hedgerows into existing home gardens on the nutritional security of HIV-affected households. Primary objectives are to assess impacts on household dietary diversity score (HDDS) and women's minimum dietary diversity (MDD-W). Secondary objectives include measuring changes in household food consumption and moringa utilisation.", "methodology": "A two-arm, parallel cluster randomised controlled trial will be conducted. Forty villages will be randomised (1:1) to either the intervention (training and resources to establish moringa hedgerows) or a control arm (standard garden support). We will enrol 15 households per village (n=600). Data on socio-demographics, dietary intake, and agricultural practices will be collected at baseline and at two follow-ups. The primary analysis will use a mixed-effects linear model: Yij = \β0 + \β1 Tj + \γ Xij + uj + \εij, where Yij is the outcome for household i in village j, $Tj$ is the treatment assignment, Xij are covariates, $uj$ is the village random effect, and \εij the error term. Inference will be based on 95% confidence intervals.", "findings": "As this is a protocol, no empirical findings are presented. The anticipated primary outcome is a statistically significant increase in the mean HDDS in the intervention arm compared to the control, with an expected mean difference of at least 1.5 points.",