The goal of this clinical trial is to learn if a conditional social transfer works to improve rates of complementary breastfeeding. It will also learn about the impacts of social transfers on maternal and child health and development. The main questions it aims to answer are: * Does the social transfer increase complementary breastfeeding rates at 24-months postpartum? * Does the social transfer increase complementary breastfeeding duration? * Does the social transfer impact child health and development? * Does the social transfer impact maternal physical and mental health? Researchers will compare a conditional social transfer to a control group that only receives education about breastfeeding recommendations to see if a conditional social transfers works to increase complementary breastfeeding. Participants will: Receive a pamphlet explaining the current recommendations of breastfeeding Receive instructions that if they meet the recommendation to breastfeed until 24-months postpartum they receive a social transfer or receive no additional information Complete home visits at 12- and 24-months postpartum Complete detailed questionnaire
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
1,040
A social transfer will be given conditioned upon breastfeeding at 24-months postpartum.
Taabo Health and Demographic Surveillance
Taabo, Côte d’Ivoire
Prevalence of Complementary Breastfeeding
Prevalence of complementary breastfeeding at 24 months postpartum.
Time frame: from 12 to 24 months postpartum
Complementary Breastfeeding Duration
Duration of complementary breastfeeding in weeks.
Time frame: from 12 to 24 months postpartum
Weight-for-Age z-score
Infants will be weighed in kilograms by a mobile weighing scale. Measurements will be analyzed as age standardized z-scores.
Time frame: 12 months; 24 months
Child Health Outcomes
We will assess the child's health outcomes by using a questionnaire administered to the caregiver. The questionnaire will ask a range of yes or no questions about child diarrhea, respiratory illness, fever, and child antibiotic use.
Time frame: 12 months; 24 months
Percent weight loss
Percent weight loss will use body weight (kg) and pregnancy weight of the mother controlling for time of measurement. Percent weight loss will be calculated as ((current weight - pregnancy weight) / pregnancy weight) × 100.
Time frame: 12 months; 24 months;
Mother and Child Hemoglobin Levels
We will assess the mother and child anemia levels. The HemoCue Hb 301 will be used to give an instant measurement of the Haemoglobin (Hb) level of the patient. Capillary blood will be collected through a finger prick. Blood samples drawn for the haemoglobin assessment will be discarded after the test. Iron levels will be analyzed as a continuous outcome.
Time frame: 12 months; 24 months
Maternal Depression
Maternal postpartum depression will be assessed using the Patient Health Questionnaire-9 (PHQ-9); categorized as a binary: no depression (score \<10) or depression present (score ≥10).
Time frame: 12 months; 24 months
Height-for-age z-score
Height will be measured in centimeters by using a Height Measuring Device, stadiometer, 20-205cm. All measurements will be analyzed as age standardized z-scores
Time frame: 12 months; 24 months
Mid-upper arm circumference (MUAC)
Infants will be measured for mid-upper arm circumference (MUAC) using non-stretchable measuring tape. All measurements will be analyzed as age standardized z-scores.
Time frame: 12 months; 24 months
Mother and Child Anemia
The HemoCue Hb 301 will be used to give an instant measurement of the Haemoglobin (Hb) level of the patient. Capillary blood will be collected through a finger prick. Blood samples drawn for the haemoglobin assessment will be discarded after the test. Hemoglobin levels (gm/dL) will be used to categorize mothers and children into a binary variable: anemic or not anemic.
Time frame: 12 months; 24 months
Maternal weight change
Weight weight change will use body weight (kg) and pregnancy weight of the mother controlling for time of measurement. Maternal weight change will be calculated as the difference between postpartum weight and pregnancy weight. Because pregnancy weight varies by gestational age, analyses will control for gestational age at pregnancy weight measurement and time postpartum at outcome measurement. Categorized as: no weight loss (0 kg); moderate weight loss (\<0 to \>-5 kg); high weight loss (≥-5 kg); moderate weight gain (\>0 to \<5 kg); high weight gain (≥5 kg).
Time frame: 12 months; 24 months;
Change in systolic and diastolic blood pressure (mmHg)
Change in systolic and diastolic blood pressure (mmHg) from baseline of the mothers will be categorized as low, normal, or high according to standard clinical thresholds.
Time frame: 12 months; 24 months;
Change in systolic and diastolic blood pressure (mmHg)
Change in systolic and diastolic blood pressure (mmHg) from baseline of the mothers will be analyzed as a continuous measure.
Time frame: 12 months; 24 months;
Caregiver Reported Early Development Instruments (CREDI) cognitive z-score
The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
Time frame: 12 months; 24 months
CREDI language z-score
The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
Time frame: 12 months; 24 months
CREDI motor z-score
The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
Time frame: 12 months; 24 months
CREDI social-emotional z-score
The CREDI long-form will be administered. Raw item data will be converted to norm-referenced z-scores using the CREDI scoring procedure.
Time frame: 12 months; 24 months
Maternal Anxiety
Maternal postpartum anziety will be assessed using the the GAD-7 (Generalized Anxiety Disorder-7); a seven-item self-report questionnaire designed to measure the severity of anxiety; categorized as: Minimal Anxiety: score 0-4; Mild Anxiety: score 5-9; Moderate Anxiety: score 10-14; Severe Anxiety: score 15-21
Time frame: 12 months; 24 months
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