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Completed

NCT Number: NCT04101487

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

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.

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Key information

Age range

6 month–23 month

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Grand Geddeh County Health Office

Zwedru, Liberia

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Cash Transfer

Other

Monthly cash transfers

Cash Transfers and Nutrition Education

Other

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

Primary outcomes

  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

    Time frame: 6 months

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

Secondary outcomes

  1. Meal frequency

    Time frame: 6 months

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

  2. Increase in child weight in kilograms

    Time frame: 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

    Time frame: 6 months

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

  4. Increase in child length/height in centimeters

    Time frame: 6 months

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

  5. Health care utilization (clinic)

    Time frame: 6 months

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

  6. Health care utilization (hospital)

    Time frame: 6 months

    hospitalizations (if any) during the study period

  7. Health care utilization (antimicrobials)

    Time frame: 6 months

    use of antibiotics/antimalarials during the study period

  8. Health care utilization (nutritional support)

    Time frame: 6 months

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

  9. Knowledge, attitudes, and practices

    Time frame: 6 months

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

Sponsors and collaborators

Lead sponsor

Boston Children's Hospital

Other

Collaborators

  • UNICEF

Registry information

Official study 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

Important dates

Study start
2019
Primary completion
2021
Study completion
2022
First posted
Sep 24, 2019
Registry last updated
Jan 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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