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| Name | Class |
|---|---|
| UNICEF | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | Participants in this arm will receive routine monthly visits along with survey administration and the regular package of health services provided at the facility level and at home by community health assistants | |
| Cash Transfers | Experimental | 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 |
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| Cash Transfers and Nutrition Education | Experimental | 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cash Transfer | Other | Monthly cash transfers |
| |
| Cash Transfers and Nutrition Education |
| Measure | Description | Time Frame |
|---|---|---|
| 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Meal frequency | Mean self-reported meal frequency over the 24-hour period prior to monthly CHA visits | 6 months |
| Increase in child weight in kilograms | changes in child weight in kilograms during the study period measured with digital scale (UNISCALE) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Grand Geddeh County Health Office | Zwedru | Liberia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36350714 | Result | Rees CA, Cleon D, Davis AB, Sammy AM, Britto CD, Massaquoi W, Forkpa OW, Johnson AJ, Hook VF, MaCauley JA, Pewu GF, Gorpue M, Gborie A, Brown TT, Fannieh A, Dweh T, Marley RB, Baysah MK, Nowine NN, Niescierenko M, Zaizay L. Cash transfers and nutrition education to improve dietary diversity among children aged 6-23 months in Grand Gedeh County, Liberia: a cluster-randomized trial. J Trop Pediatr. 2022 Oct 6;68(6):fmac096. doi: 10.1093/tropej/fmac096. |
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| ID | Term |
|---|---|
| D015362 | Child Nutrition Disorders |
| D006130 | Growth Disorders |
| ID | Term |
|---|---|
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D015596 | Nutrition Assessment |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| Other |
Cash transfers every month and structured nutrition education provided at household level by community health assistants based on a nutrition education handbook |
|
| 6 months |
| Increase in mid upper arm circumference in centimeters | changes in mid upper arm circumference in centimeters measured with MUAC tape measure | 6 months |
| Increase in child length/height in centimeters | changes in child length/height in centimeters during the study period measured with Height Board | 6 months |
| Health care utilization (clinic) | number of clinic visits for illnesses (including type of illness) | 6 months |
| Health care utilization (hospital) | hospitalizations (if any) during the study period | 6 months |
| Health care utilization (antimicrobials) | use of antibiotics/antimalarials during the study period | 6 months |
| Health care utilization (nutritional support) | if the child received supplementary nutritional support (e.g. ready to use therapeutic food RUTF) | 6 months |
| Knowledge, attitudes, and practices | caregiver's knowledge, attitudes, and practices (KAP) of infant and young child feeding | 6 months |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D015991 | Epidemiologic Measurements |
| D011634 | Public Health |
| D004778 | Environment and Public Health |