Sustainability of Impacts of Cash Transfers, Food Transfers, and Behavior Change Communication in Bangladesh

Child Development Clinical Trial

— TMRI  

Official title:

Sustainability of Impacts of Cash Transfers, Food Transfers, and Behavior Change Communication in Bangladesh: Transfer Modality Research Initiative

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03810300
• Other study ID #: 12835
• Status: Completed
• Phase: N/A
• Start date: April 15, 2012
• Est. completion date: May 15, 2018

Study information

• Verified date: January 2019
• Source: International Food Policy Research Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study assesses the sustainability of impacts, 4 years post-program, from a pilot safety net program that was implemented from May 2012-April 2014. The intervention, called the Transfer Modality Research Initiative (TMRI), was assigned following a cluster-randomized controlled trial design in two zones of Bangladesh (north and south). Intervention arms were assigned at the village level, where arms were as follows: (1) cash transfers [north and south]; (2) cash transfers + nutrition behavior communication change (BCC) [north only]; (3) food transfers [north and south]; (4) food transfers + nutrition BCC [south only]; (4) food-cash split [north and south]; and (5) control [north and south]. Within treatment villages, women living in very poor households were targeted to receive benefits for two years.

Description:

The objective of the study is to assess, 4 years after a pilot safety net intervention ended in April 2014, the sustainability of the intervention's impacts on households, children, and women. The intervention, called the Transfer Modality Research Initiative (TMRI), was assigned following a cluster-randomized controlled trial design in two zones of Bangladesh (north and south). WFP-Bangladesh implemented the intervention, and the International Food Policy Research Institute (IFPRI) conducted the impact evaluation research. Intervention arms were assigned at the village level, where arms were as follows: (1) cash transfers [north and south]; (2) cash transfers + nutrition behavior communication change (BCC) [north only]; (3) food transfers [north and south]; (4) food transfers + nutrition BCC [south only]; (5) food-cash split [north and south]; and (5) control [north and south]. Within treatment villages, women living in very poor households were targeted to receive benefits for two years, from May 2012-April 2014. For the original impact evaluation, longitudinal data on 5000 households were collected from 2012-2015 (ClinicalTrials.gov Identifier: NCT02237144).

For the sustainability study in 2018, given available funding, the sampling frame will include 4000 households. This will include all households that were originally in the following arms: (1) cash transfers [north and south]; (2) cash transfers + nutrition BCC [north only]; (3) food transfers [north and south]; (4) food transfers + nutrition BCC [south only]; (5) control [north and south].

Recruitment information / eligibility

• Status: Completed
• Enrollment: 5000
• Est. completion date: May 15, 2018
• Est. primary completion date: May 15, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 15 Years to 65 Years

Eligibility

Inclusion Criteria:

• Former participant of Transfer Modality Research Initiative study (in cash, food, cash+BCC, food+BCC, or control arms)

Exclusion Criteria:

Related Conditions & MeSH terms

• Child Development
• Child Nutrition
• Food Security
• Gender Dynamics
• Intimate Partner Violence
• Poverty

Intervention

Other:
• Cash transfer
1500 taka ($18.75) per household distributed monthly
• Food transfer
30 kg rice, 2 kg lentils, and 2 kg micro-nutrient fortified cooking oil per household distributed monthly
• Food and cash transfer
15 kg of rice, 1 kg of lentils, and 1 kg of micronutrient-fortified cooking oil, and 750 taka cash per household, distributed monthly

Behavioral:
• Nutrition behavior Communication Change (BCC)
Weekly, group-based, one-hour meetings on maternal and child nutrition, sanitation and health knowledge, attitudes and practice; twice-a-month home visits; monthly community meetings

Other:
• Control
No transfer, no behavior change communication

Locations

Country	Name	City	State
n/a

Sponsors (4)

Lead Sponsor	Collaborator
International Food Policy Research Institute	Cornell University, Data Analysis and Technical Assistance Ltd, World Food Programme, Bangladesh

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Food Consumption Score	The Food Consumption Score, as defined by the World Food Programme, is calculated as the number of food groups consumed by the household in the previous 7 days, weighted by each food group's nutritional value and frequency of consumption. Scale range is 0 to 112, with higher values reflecting higher food consumption.	After 4 years post-intervention
Primary	Child height-for-age z-score	Calculated using the 2006 WHO growth reference. This is a continuous measure that represents the number of standard deviations from the mean among comparable children in the WHO growth reference.	After 4 years post-intervention
Primary	Prevalence of physical intimate partner violence	Prevalence of any physical intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument	After 4 years post-intervention
Secondary	Household dietary diversity	Measured by counting the number of food groups consumed by the household	After 4 years post-intervention
Secondary	Value of total household consumption	Aggregate value of household food and non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. "Guidelines for Constructing Consumption Aggregates for Welfare Analysis." Washington, DC : World Bank.	After 4 years post-intervention
Secondary	Value of household food consumption	Value of household food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. "Guidelines for Constructing Consumption Aggregates for Welfare Analysis." Washington, DC : World Bank.	After 4 years post-intervention
Secondary	Value of household non-food consumption	Value of household non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. "Guidelines for Constructing Consumption Aggregates for Welfare Analysis." Washington, DC : World Bank.	After 4 years post-intervention
Secondary	Household food insecurity	Measured using the Household Food Insecurity Access Scale. Scale range is 0 to 27, with higher values reflecting higher food insecurity.	After 4 years post-intervention
Secondary	Value of household labor income	Value of annual labor income over all household members	After 4 years post-intervention
Secondary	Value of household non-labor income	Value of annual non-labor income over all household members	After 4 years post-intervention
Secondary	Value of household asset ownership	Total value of all assets owned	After 4 years post-intervention
Secondary	Household land ownership	Area of land owned	After 4 years post-intervention
Secondary	Housing quality: interviews	Quality of housing stock. This is measured using a module developed for the study context, and information is collected through household enumerator observation during interviews.	After 4 years post-intervention
Secondary	Maternal nutrition knowledge score	Number answered correctly on a test of maternal knowledge regarding infant and young child feeding practices developed for the survey, based on the curriculum of training sessions in the intervention.	After 4 years post-intervention
Secondary	Maternal infant and young child feeding practices	Maternal adherence to WHO-recommended infant and young child feeding practices	After 4 years post-intervention
Secondary	Child score on Raven's Progressive Matrices	Measured using Raven's Progressive Matrices set A and set B. This is constructed following the test's protocol for scoring.	After 4 years post-intervention
Secondary	Child score on Early Grade Reading Assessment	Measured using Early Grade Reading Assessment adapted to local context. This is constructed following the test's protocol for scoring.	After 4 years post-intervention
Secondary	Child score on Early Grade Mathematics Assessment	Measured using Early Grade Mathematics Assessment adapted to local context. This is constructed following the test's protocol for scoring.	After 4 years post-intervention
Secondary	Child score on Strengths and Difficulties Questionnaire	Measured using Strengths and Difficulties Questionnaire, part of the Development and Well-Being Assessment family of mental heath measures. This is constructed following the test's protocol for scoring.	After 4 years post-intervention
Secondary	Child weight-for-height z-score	Calculated using the 2006 WHO growth reference. This is a continuous measure that represents the number of standard deviations from the mean among comparable children in the WHO growth reference.	After 4 years post-intervention
Secondary	Prevalence of child stunting	Calculated using the 2006 WHO growth reference	After 4 years post-intervention
Secondary	Prevalence of child wasting	Calculated using the 2006 WHO growth reference	After 4 years post-intervention
Secondary	Child illness	Mother's report of child illness in previous 2 weeks	After 4 years post-intervention
Secondary	Parental interaction with child	Time spent on child stimulation activities in previous 7 days, measured using modules developed for the survey	After 4 years post-intervention
Secondary	Parental discipline of the child	Disciplinary measures used in the past month, measured using modules developed for the survey	After 4 years post-intervention
Secondary	Community norms on gender	Community leaders' attitudes toward gender, measured using modules developed for the survey	After 4 years post-intervention
Secondary	Prevalence of emotional violence	Prevalence of any emotional intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument	After 4 years post-intervention
Secondary	Prevalence of controlling behaviors	Prevalence of any controlling behaviors in the past 12 months measured using the WHO Violence Against Women instrument	After 4 years post-intervention
Secondary	Prevalence of individual acts of intimate partner violence	Prevalence of individual acts of intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument	After 4 years post-intervention
Secondary	Individual decisionmaking	Measured using men's and women's decisionmaking modules adapted from pro-WEAI	After 4 years post-intervention
Secondary	Individual asset ownership	Measured using men's and women's asset ownership modules developed for the survey	After 4 years post-intervention
Secondary	Individual mobility	Measured using men's and women's mobility modules adapted from pro-WEAI	After 4 years post-intervention
Secondary	Individual labor force participation	Measured using men's and women's labor modules developed for the survey	After 4 years post-intervention
Secondary	Individual attitudes toward gender and intimate partner violence	Measured using men's and women's attitudes toward gender and intimate partner violence modules developed for the survey	After 4 years post-intervention
Secondary	Individual social capital	Measured using men's and women's social capital modules developed for the survey	After 4 years post-intervention
Secondary	Individual stress	Measured using men's and women's Perceived Stress Scale scores	After 4 years post-intervention
Secondary	Individual depression	Measured using men's and women's Patient Health Questionnaire-9 Depression Test scores	After 4 years post-intervention
Secondary	Individual aspirations	Measured using men's and women's aspirations modules developed for the survey	After 4 years post-intervention
Secondary	Spousal relationship	Measured using men's and women's relationship modules developed for the survey	After 4 years post-intervention