This pilot study will test the effect of a cash transfer program aiming to improve family food consumption patterns, family health and schooling, with resulting benefits for childhood growth and cognition.
Cash transfer (CT) programs in low-income countries that allow recipients to receive cash designated for specific household expenditures such as food and family health and education typically show significant program benefits. In particular, several programs have shown positive impacts on use of health care resources, nutrition status and self-reported health, along with significant improvements in the motor and cognitive development of young children. Guinea-Bissau is currently the 11th poorest country and is thus an appropriate target for a cash transfer program. This project will pilot test the effect of a 2 year cash transfer program aiming to improve family food consumption patterns, family health and schooling, with resulting benefits for childhood growth and cognition. Family-wide assessment will be conducted to examine the impact in all family members. Baseline and 3 follow up assessments will be completed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
34,148
The heads of households will receive a cash transfer for up to 7 family members in the home every quarter. Head of households will be expected to attend meetings every 4 months at their local community health centers led by Community Health Workers (CHW). Meetings will have 2 components: 1) children under 5 will be measured to identify children at risk of malnutrition and 2) group education sessions. There will also be monthly growth monitoring and education sessions led by CHW for a subgroup of head of households with children identified as risk of malnutrition with rapid referrals to regional tertiary clinics for any children with health problems that cannot be addressed by CHW.
PDDC
Bissau, Guinea-Bissau
Change in per capita food expeditures
change in per capita food expenditure per family will be calculated.
Time frame: Baseline, year 1, year 2 and year 3
Changes in family demographics
Changes in family demographics will be tracked.
Time frame: Baseline, year 1, year 2 and year 3
Change in weight
Change in weight for all participants in the study and children born after cash transfer program starts.
Time frame: Baseline, year 1, year 2 and year 3
Change in height
Change in height for all participants in the study and children born after cash transfer program starts.
Time frame: Baseline, year 1, year 2 and year 3
Change in mid-upper arm circumference (MUAC)
Change in MUAC for all participants in the study and children born after cash transfer program starts.
Time frame: Baseline, year 1, year 2 and year 3
Change in waist circumference
Change in waist circumference for all participants in the study and children born after cash transfer program starts.
Time frame: Baseline, year 1, year 2 and year 3
Change in hemoglobin
Change in hemoglobin for pregnant women, children born after the program begins, older children born in 2003, 2010, 2014.
Time frame: Baseline, year 1, year 2 and year 3
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Change in blood pressure
Change in blood pressure will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.
Time frame: Baseline, year 1, year 2 and year 3
Change in HbA1c
Change in HbA1c will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.
Time frame: Baseline, year 1, year 2 and year 3
Food intake
Food intake assessment
Time frame: Year 1, year 2 and year 3
Cognition function
Children born after the cash transfer progam will have a single cognitive function test at 18 months of age.
Time frame: When children are 18th months
Change in school attendence
School enrollment, attendance, drop out and grade graduation will be assessed for all children through data extraction from school records.
Time frame: Each semester of school in year 1, 2 and 3 of study
Change in head circumference
Children born after the cash transfer progam will have head circumference taken.
Time frame: After birth, year 1, year 2, year 3
Change in Literacy
Children 7 and 14 will complete literacy testing.
Time frame: Year 1, year 2, year 3
Change in Grip Strength
Change in grip strength will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.
Time frame: Baseline, year 1, year 2 and year 3