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

Malnutrition, Child Clinical Trial

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04101487
• Other study ID #: P00031767
• Status: Completed
• Phase: N/A
• Start date: October 15, 2019
• Est. completion date: November 1, 2022

Study information

• Verified date: March 2023
• Source: Boston Children's Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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 information / eligibility

• Status: Completed
• Enrollment: 599
• Est. completion date: November 1, 2022
• Est. primary completion date: July 31, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 6 Months to 23 Months

Eligibility

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

Related Conditions & MeSH terms

• Child Nutrition Disorders
• Malnutrition
• Malnutrition, Child

Intervention

Other:
• Cash Transfer
Monthly cash transfers
• 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

Locations

Country	Name	City	State
Liberia	Grand Geddeh County Health Office	Zwedru

Sponsors (2)

Lead Sponsor	Collaborator
Boston Children's Hospital	UNICEF

Country where clinical trial is conducted

Liberia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	The DDS has been widely used to measure the sum of diverse food groups consumed in a 24-hour period	6 months
Secondary	Meal frequency	Mean self-reported meal frequency over the 24-hour period prior to monthly CHA visits	6 months
Secondary	Increase in child weight in kilograms	changes in child weight in kilograms during the study period measured with digital scale (UNISCALE)	6 months
Secondary	Increase in mid upper arm circumference in centimeters	changes in mid upper arm circumference in centimeters measured with MUAC tape measure	6 months
Secondary	Increase in child length/height in centimeters	changes in child length/height in centimeters during the study period measured with Height Board	6 months
Secondary	Health care utilization (clinic)	number of clinic visits for illnesses (including type of illness)	6 months
Secondary	Health care utilization (hospital)	hospitalizations (if any) during the study period	6 months
Secondary	Health care utilization (antimicrobials)	use of antibiotics/antimalarials during the study period	6 months
Secondary	Health care utilization (nutritional support)	if the child received supplementary nutritional support (e.g. ready to use therapeutic food RUTF)	6 months
Secondary	Knowledge, attitudes, and practices	caregiver's knowledge, attitudes, and practices (KAP) of infant and young child feeding	6 months