Milk safety and child nutrition: Impacts of the MoreMilk project’s training scheme for informal dairy vendors

Objective In Kenya, like most developing countries, majority rely on informal milk markets to meet their dairy needs. In those markets, there are food safety concerns that elicit interventions ranging from policy change to research, aimed at improving the food safety in the value chain. The MoreMilk project employs cRCT study design to estimate the impact of an intervention on improving food safety on informal dairy markets and promoting increased dairy intake by children. Methods MoreMilk intervention is a two-arm cluster-randomized control trial. Study clusters were randomly assigned to: Treatment arm (Training, certification, and marketing scheme for vendors); Control arm: Delayed intervention. A baseline survey was conducted and an endline survey will be done for each arm after 12 months targeting same vendors and households. The unit of randomization is a cluster of 1-4 vendors and the households consuming milk from those vendors. The study aims at measuring the effect of the intervention on two primary outcomes: microbiological quality of milk sold by vendors, measured as total bacterial counts (TBC) per mL of milk, and mean dietary adequacy of protein, Ca, and vitamin B12. The vendor surveys include questionnaire modules on operations, milk handling practices, and business performance. The household surveys assess milk and food expenditure, milk handling and consumption practices, and a 24hr dietary recall for an index child. Impact A nutrition-sensitive approach to a market-based intervention could potentially increase the consumption of safe, nutritious foods leading to better health outcomes for children. MoreMilk intervention is envisaged to reduce TBC in the milk of the vendors offered the intervention compared to a control group. It also envisages increasing the mean adequacy of three micronutrients (calcium, protein and vitamin B12) in the households buying milk from a vendor offered the intervention compared to households buying milk from control group vendors.