The investigators will conduct a cluster randomized controlled trial across districts in Malawi to evaluate the effect of providing free casual labor to pregnant farmers and female farmers on agricultural output, maternal and child health outcomes, child development, and social networks.
This will be a cluster randomized control trial (RCT), where 75 of the districts in which One Acre Fund (1AF) currently operates within in Malawi will be randomly selected for inclusion in this study. Of these 75 districts, 38 will be randomly selected to implement the intervention. The intervention constitutes a voucher offered to all female famers who are currently enrolled in the 1AF program who are pregnant and/or have a child ages 1 years and below that entitles the recipient to a set number of days of labor from casual workers employed by local 1AF offices. The remaining 37 districts will serve as the control group. Data will be collected at baseline during the planting season and endline at the conclusion of the harvest season. Data collected will pertain to agricultural output, individual and household demographics, obstetric history and outcomes, mental health, maternal health, child health and development, and social networks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
989
Eligible participants will be offered a voucher that can be redeemed for a set number of days of agricultural labor from casual laborers hired by local One Acre Fund offices. Casual laborers receive standard training in line with the trainings currently offered by the organization to participating farmers.
One Acre Fund
Zomba, Zomba, Malawi
Agricultural Output
A continuous measure of the value of the participant's agricultural yield, measured in Malawian Kwacha
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Labor inputs
A pair of recall questions repeated for each household member aged 10 years or older (including the respondent) that ask about the average number of days a week and the average number of hours per day the individual works on the respondent's farm, both measured continuously.
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Antenatal care seeking
A continuous variable of number of antenatal care visits for those pregnancies that overlap with the index agricultural season
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Care seeking for child health
Two continuous variables measuring number of routine postnatal care and sick child visits
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Reach of social networks
A social networks module that collects data on the extent and characteristics of the participant's social networks. Measured by the number of people reported in the participant's network, with a higher number indicating a larger network.
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Postnatal care seeking
A continuous variable of number of postnatal care visits for those pregnancies that overlap with the index agricultural season
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
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Maternal consumption short term recall: number of meals
Two questions regarding the number of meals consumed the day before and the number of meals consumed two days before
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal consumption medium term recall: protein intake
Four questions regarding the number of times the participant consumed fish, meat, eggs, and usipa.
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal mental health
Patient Health Questionnaire-2 (PHQ-2): a 2-item Likert scale questionnaire for assessing depressive symptoms. Score can range between 0 and 6, with higher scores indicating more severe depressive symptoms.
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Child birth weight
A continuous variable measured in grams of the reported birthweight of each child born during most delivery
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Barriers to perinatal care
A set of four Likert style questions asking to respondents to how much they agree with the following statements as reasons to not visit a health facility for ANC and/or PNC: "The health facility is too far away," "I have to work on my farm," "I am too unwell/sick," "and "I do not think the quality of care is worth it"
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal hunger
Question about how often the respondent went to bed hungry in the past month: "Never," "A few times," "Nearly every other night," and "Most nights"
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Child consumption
A set of four questions concerning the frequency of breastfeeding; meat, egg, or fish; fruits or vegetables; and porridge, bread, rice, pap, or pasta consumption in the past month for the youngest child.
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Willingness to hire causal labor
Likert scale question on how likely the participant is to hire a casual worker during the upcoming agricultural season
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)