Cash Transfers to Increase Dietary Diversity in Grand Gedeh County, Liberia
- Conditions
- Malnutrition, Child
- Interventions
- Other: Cash TransferOther: Cash Transfers and Nutrition Education
- Registration Number
- NCT04101487
- Lead Sponsor
- Boston Children's Hospital
- 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.
- 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 599
- 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
- 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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cash Transfers Cash Transfer 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 Cash Transfers and Nutrition Education 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.
- Primary Outcome Measures
Name Time Method 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
Name Time Method Increase in child weight in kilograms 6 months changes in child weight in kilograms during the study period measured with digital scale (UNISCALE)
Health care utilization (antimicrobials) 6 months use of antibiotics/antimalarials during the study period
Health care utilization (nutritional support) 6 months if the child received supplementary nutritional support (e.g. ready to use therapeutic food RUTF)
Increase in mid upper arm circumference in centimeters 6 months changes in mid upper arm circumference in centimeters measured with MUAC tape measure
Health care utilization (clinic) 6 months number of clinic visits for illnesses (including type of illness)
Health care utilization (hospital) 6 months hospitalizations (if any) during the study period
Meal frequency 6 months Mean self-reported meal frequency over the 24-hour period prior to monthly CHA visits
Increase in child length/height in centimeters 6 months changes in child length/height in centimeters during the study period measured with Height Board
Knowledge, attitudes, and practices 6 months caregiver's knowledge, attitudes, and practices (KAP) of infant and young child feeding
Trial Locations
- Locations (1)
Grand Geddeh County Health Office
🇱🇷Zwedru, Liberia