Cash Transfers to Increase Dietary Diversity in Grand Gedeh County, Liberia

Sponsor
Boston Children's Hospital (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT04101487
Collaborator
UNICEF (Other)
585
1
3
32.5
18

Study Details

Study Description

Brief Summary

The investigators aim to evaluate the efficacy of a cash transfer and nutrition education program delivered by community health assistants to increase dietary diversity among children 6 to 23 months of age in Grand Gedeh County, Liberia.

Condition or Disease Intervention/Treatment Phase
  • Other: Cash Transfer
  • Other: Cash Transfers and Nutrition Education
N/A

Detailed Description

Worldwide, more than one in five children suffer from chronic malnutrition. In Liberia, there are more than 230,000 children suffering from chronic malnutrition and 32% of children under five are stunted. Previous studies have shown that inadequate dietary diversity is strongly associated with stunting in children under two years of age. An interventional package including cash transfers and education has the potential to improve dietary diversity and long-term outcomes such as improved growth and reduced rates of stunting among children.

The investigators' objective is to evaluate the efficacy of a cash transfer and nutrition education program delivered by community health assistants to increase dietary diversity among children 6 to 23 months of age in Grand Gedeh County, Liberia. The investigators will conduct a pilot, cluster randomized trial in 45 communities. The investigators hypothesize that a multi-pronged interventional package aimed at strengthening the household environment will result in improved dietary diversity for children 6 to 23 months of age. Moreover, the investigators also hypothesize that unconditional cash transfers will result in improved dietary diversity for children 6 to 23 months of age in Grand Gedeh County, Liberia.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
585 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Cluster Randomized Trial to Study the Effect of Cash Transfers and Nutrition Education on Dietary Diversity Among Children 6-23 Months of Age in Grand Gedeh County, Liberia: A Pilot Study
Actual Study Start Date :
Oct 15, 2019
Actual Primary Completion Date :
Jul 31, 2021
Anticipated Study Completion Date :
Jul 1, 2022

Arms and Interventions

Arm Intervention/Treatment
No Intervention: Control

Participants in this arm will receive routine monthly visits along with survey administration and the regular package of health services provided at the facility level and at home by community health assistants

Experimental: Cash Transfers

Participants in this arm will receive routine monthly visits along with the regular package of health services provided at the facility level and at home by community health assistants and unconditional cash transfers every month

Other: Cash Transfer
Monthly cash transfers

Experimental: Cash Transfers and Nutrition Education

Participants in this arm will receive routine monthly visits along with the regular package of health services provided at the facility level and at home by community health assistants, unconditional cash transfers every month, and structured nutrition education provided at household level by community health assistants based on a structured nutrition education handbook.

Other: Cash Transfers and Nutrition Education
Cash transfers every month and structured nutrition education provided at household level by community health assistants based on a nutrition education handbook

Outcome Measures

Primary Outcome Measures

  1. Change in proportion of children 6 to 23 months of age who meet minimum dietary diversity scores (DDS) over the study period as reported by caregivers [6 months]

    The DDS has been widely used to measure the sum of diverse food groups consumed in a 24-hour period

Secondary Outcome Measures

  1. Meal frequency [6 months]

    Mean self-reported meal frequency over the 24-hour period prior to monthly CHA visits

  2. Increase in child weight in kilograms [6 months]

    changes in child weight in kilograms during the study period measured with digital scale (UNISCALE)

  3. Increase in mid upper arm circumference in centimeters [6 months]

    changes in mid upper arm circumference in centimeters measured with MUAC tape measure

  4. Increase in child length/height in centimeters [6 months]

    changes in child length/height in centimeters during the study period measured with Height Board

  5. Health care utilization (clinic) [6 months]

    number of clinic visits for illnesses (including type of illness)

  6. Health care utilization (hospital) [6 months]

    hospitalizations (if any) during the study period

  7. Health care utilization (antimicrobials) [6 months]

    use of antibiotics/antimalarials during the study period

  8. Health care utilization (nutritional support) [6 months]

    if the child received supplementary nutritional support (e.g. ready to use therapeutic food RUTF)

  9. Knowledge, attitudes, and practices [6 months]

    caregiver's knowledge, attitudes, and practices (KAP) of infant and young child feeding

Eligibility Criteria

Criteria

Ages Eligible for Study:
6 Months to 23 Months
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • Participants 6 to 23 months of age

  • Participants with consenting caregivers to have monthly visits and to participate in the program

  • Caregivers of all ages will be included

Exclusion Criteria:
  • Participants who are younger than 6 months of age (children < 6 months of age are encouraged to exclusively breastfeed, making dietary diversity irrelevant in this age group)

  • Participants older than 23 months of age

  • Participants with non-consenting caregivers

Contacts and Locations

Locations

Site City State Country Postal Code
1 Grand Geddeh County Health Office Zwedru Liberia

Sponsors and Collaborators

  • Boston Children's Hospital
  • UNICEF

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Michelle Niescierenko, Assistant Professor of Pediatrics and Emergency Medicine, Boston Children's Hospital
ClinicalTrials.gov Identifier:
NCT04101487
Other Study ID Numbers:
  • P00031767
First Posted:
Sep 24, 2019
Last Update Posted:
Feb 21, 2022
Last Verified:
Feb 1, 2022
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Michelle Niescierenko, Assistant Professor of Pediatrics and Emergency Medicine, Boston Children's Hospital
Additional relevant MeSH terms:

Study Results

No Results Posted as of Feb 21, 2022