History

Our intervention was co-developed with the University of California, San Francisco (UCSF), Kenya Medical Research Institute (KEMRI), and KickStart International, a non-governmental organization (NGO) based in sub Saharan Africa that has introduced a human-powered irrigation pump, enabling farmers to grow high yield crops year-round.

  • In 2007-2008, we demonstrated the feasibility of an income-generating micro-irrigation intervention among 30 HIV-positive patients in Kisumu. 
  • In 2012-2013, we carried out a pilot study of the intervention (PIs Cohen/Weiser) with 140 HIV-positive patients at two district hospitals in the Nyanza Region, one randomized to the intervention (n=72 participants) and one to the control arm (n=68 participants). We found a statistically significant increase in CD4+ cell counts and proportion virologically suppressed in the intervention arm compared with the control arm. Intervention participants also experienced significant improvements in food security and frequency of food consumption compared to controls.[1] A parallel study (PI Butler) was conducted with 200 children and their primary caregivers who resided in the households of the adults enrolled in the ‘parent’ study. Children who resided in intervention households had statistically significant gains in growth over a 1 year follow-up period.     
  • In June 2016, we began enrollment in Kisumu for the current, cluster-randomized trial. We plan to enroll up to 800 adults and a minimum of 352 children, with their primary caregiver, who reside in the households of adults enrolled in the parent study.   We anticipate that we will have completed enrollment by August 2017 and participant follow-up by August 2019. All participants will be followed for 2 years to assess intervention impacts on food and water security, nutritional and clinical outcomes amongst adults and nutritional, clinical and developmental outcomes amongst children.

Reference

1. Weiser, S.D., et al., Shamba Maisha: randomized controlled trial of an agricultural and finance intervention to improve HIV health outcomes. AIDS, 2015. 29(14): p. 1889-94.