Grant: Doctoral Research Award: Canada Graduate Scholarships

Prevention of stunting is critical to lower the child's mortality and neuro-impairment risks. Stunting occurs more often in sub-Saharan African nations such as Rwanda, where the fertility rates also happen to be high. In regions outside of the capital city, Rwanda has a high burden of stunting with rates varying from 24-41% among children aged 6-24 months, a period also known as complementary feeding period (CFP). Stunting has multiple causes with malnutrition, repeated infection, poor gut health and inadequate psychosocial stimulation all playing a role. Yet, the majority of trials studying this problem has only focused on a single intervention domain (e.g. micronutrients). Given multifaceted determinants of poor linear growth, there is a need to come up with multi-component intervention packages. There are multiple possible options of packages that can be formulated, so using an innovative approach in platform trials that offers flexibility and efficiency is more appropriate than conventional approaches that only allow for assessment of a fixed number of interventions after the last participant has completed their participation. My PhD project is to develop a master protocol for an adaptive platform trial that can test the effectiveness of multiple intervention packages for the CFP on child stunting in Rwanda. I plan to conduct a comprehensive review of platform trials and other master protocols for an overall landscape analysis. I plan to complement this with another review and network meta-analysis of published trials reporting on stunting prevention to identify a list of evidence-based and compelling interventions to be tested. These efforts will inform the development of the platform trial design for Rwanda's stunting problem. There is a need for further development of more innovative methods for global health research. This project will provide more effective evaluation options to inform policies that can be used to improve the health of young children.