Effects of Cash Transfers on Severe Acute Malnutrition
- Conditions
- Severe Malnutrition
- Interventions
- Other: Outpatient therapeutic program and counselingOther: Outpatient therapeutic program, counseling and cash transfer
- Registration Number
- NCT02460848
- Lead Sponsor
- UNICEF
- Brief Summary
Cash transfer, aims to strengthen food security for vulnerable households by giving families enough purchasing power to consume an adequate and balanced diet, maintain a good standard of hygiene, access health services, and invest in their own means of food production in addition to their children's growth and development.
While cash transfer to vulnerable households has shown a long-term positive impact on growth and on malnutrition-related mortality in children aged 0-5 years, there is little conclusive evidence their effectiveness in Sub-Saharan Africa that cash transfer has a direct effect on the Community-based Management of Acute Malnutrition (CMAM). Here, the investigators will perform a cluster-randomized trial to investigate during 6 months the effects of unconditional cash transfers on the management of severe acute malnutrition (SAM) in children from 6 to 59 months according to the national protocol in the Democratic Republic of Congo.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1600
- Living in the catchment area of one of the 20 outpatient therapeutic program site participating in this cluster randomized trial;
- 6-59 months of age;
- Weight for Height Zscore <-3 SD (WHO Growth Standards 2006) and/or Mid-Upper Arm Circumference <115mm and/or with bilateral edema;
- No major clinical complications;
- Positive appetite test;
- Accept to participate at the study.
- Not living in the catchment area of the outpatient therapeutic program site of the cluster randomized trial;
- Weight-for-Height Z-score ≥-3 (WHO Growth Standards 2006) and Mid-Upper Arm Circumference ≥115mm without bilateral edema;
- Major clinical complications;
- Failure to appetite test;
- Refuse to participate at the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Outpatient therapeutic program and counseling Outpatient therapeutic program and counseling Ten outpatient therapeutic program sites (OTP) will be randomly allocated for children admitted for treatment of SAM according to the integrated management of acute malnutrition national protocol which will be associated with counseling on infant and young child feeding (IYCF). Outpatient therapeutic program, counseling and cash transfer Outpatient therapeutic program, counseling and cash transfer Ten outpatient therapeutic program sites (OTP) will be randomly allocated to unconditional cash transfer for children admitted for treatment of SAM according to the integrated management of acute malnutrition national protocol which will be associated with counseling on infant and young child feeding (IYCF).
- Primary Outcome Measures
Name Time Method Recovery rate in the outpatient therapeutic program At 6 week Recovery is defined for patient of 6 to 59 months old as Weight-for-Height Z-score ≥-1.5 SD (WHO Growth Standards 2006) or Mid-Upper Arm Circumference ≥125mm at two consecutive visits and absence of bilateral edema for 14 days.
- Secondary Outcome Measures
Name Time Method Weight gain At 6 week, 8 week and 6 month Weight gain will be assessed every week in the outpatient therapeutic program and every month after discharge.
Mid-Upper Arm Circumference gain At 6 week, 8 week and 6 month Mid-upper arm circumference gain will be assessed every week in the outpatient therapeutic program and every month after discharge.
Change in the Individual Dietary Diversity Score (IDDS) At 6 week, 8 week and 6 month IDDS for measurement of food access of the children will be assessed with the household every week during the recovery period and every month after discharge by a locally pre-tested standardized questionnaire.
Default rate in the outpatient therapeutic program Two weeks Patient who failed to appear for two consecutive weeks during the follow-up visits.
Recovery rate in the outpatient therapeutic program At 8 week Transfer rate from outpatient therapeutic program to inpatient therapeutic program One month average Patient who develop signs of a serious medical complication according to the national protocol are transfer to the inpatient therapeutic program.
Length of stay in the outpatient therapeutic program One month (average) Relapse rate At 2, 3 and 4 months following discharge Patient who reach inclusion criteria within 2 months following discharge.
Failure rate in the outpatient therapeutic program Up to three months Patients who failed to reach after 3 months the recovery criteria.
Morbidity rate At 6 week, 8 week and 6 month ARI, diarrhoea, anaemia and malaria incidence. Morbidity will be assessed every week in the outpatient therapeutic program and every month after discharge by a locally pre-tested standardized questionnaire.
Death rate At 6 week, 8 week and 6 month Death from any cause during follow-up.
Change in Growth rates At 6 month Growth will be measured every week in the outpatient therapeutic program and every month after discharge.
Diet replacement & Intra-household dispatching of the therapeutic food One month average Diet replacement \& Intra-household dispatching of the therapeutic food will be assessed with the household every week during the recovery period by a locally pre-tested standardized questionnaire.
Change in the Household Dietary Diversity Score (HDDS) At 6 month HDDS for measurement of food access will be assessed with the household at the beginning and the end of the study by a locally pre-tested standardized questionnaire.
Satisfaction of parents and acceptability At 6 month Survey will be conducted in the households at the end of the study.
Trial Locations
- Locations (1)
Save the Children
🇨🇩Mbuji-Mayi, Kasaï Oriental, Congo, The Democratic Republic of the