The Effect of a Cash Transfer Program and Preventive Nutrition Packages on Household Welfare and Child Nutritional Status in Mali

NCT ID: NCT02858011

Last Updated: 2019-09-06

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 4320 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-09-30
• Study Completion Date: 2019-08-10

Brief Summary

In the last two decades, cash transfer (CT) programs have emerged as a popular approach to long-term poverty alleviation. While the main goal of cash transfer programs is to reduce poverty, they also have the potential to improve many development outcomes, such as health and education.

While many studies, mainly in Latin America and Asia, have investigated the impacts of CTs on poverty and food security and have, for the most part, found positive impacts, less is known about the impacts of CTs in Africa south of the Sahara, and, in particular, West Africa. Moreover, despite the fact that cash transfers have been shown to lead to decreases in poverty, improvements in household food security, and increases in health service utilization, impacts on children's nutritional status (including anthropometric measures) are generally small (Manley, Gitter, and Slavchevska 2013). Consequently, policymakers and governments are left with the question of how to design social safety nets, such as cash transfers, to achieve greater impact on diet quality, health, and nutrition.

The overall goal of this research is to generate evidence and knowledge on an integrated program implemented by the Government of Mali that includes a combination of cash transfers and targeted nutrition interventions. The information generated will inform program implementers and policymakers about best options to improve food security and nutrition among vulnerable groups and individuals in West Africa. Specifically, the main objectives of the research are

1. To provide evidence on the contribution of integrated social transfer programs to enhancing household welfare, food security, dietary diversity, and maternal and child nutrition in West Africa.

2. To test different features and combinations of cash transfers and targeted nutrition interventions, and assess their impact on food security and maternal and child nutrition and health outcomes in Mali.

3. To generate knowledge regarding the pathways of impact of these different program packages, identify the most effective and efficient modalities in the context of Mali, and derive lessons learned for other countries in the region.

Detailed Description

The research entails two study designs: i) a repeated cross-sectional survey (baseline, midline and endline) in a sample of 1,440 children between 6 and 24 months of age, mainly to asses the program's impact on child nutrition and health outcomes; ii) a panel study following a cohort of 2,880 children over 3 years mainly focusing on the evaluation of household welfare outcomes. The study will be conducted in the 96 communes where the Jigisemejiri program is being implemented, situated in 5 regions of Mali: Sikasso, Koulikoro, Segou, Mopti and Kayes. Data will be collected at baseline (2014, T=0), midline (2016, T=~24 months) and endline (2018, T=~48 months).

The program is implemented for 48 months. The experimental group receives the cash transfer and group counselling intervention for 36 months. During the last 12 months the experimental group does not receive any intervention. The control group receives no intervention during the first 36 months, but receives the cash transfer and group counselling during the last 12 months. In a subsample of communes from the experimental group, villages were randomized to either receive Preventive Nutrition Packages (PNP) or nothing. The impact of PNP is analyzed by comparing villages that received PNP and villages that did not receive PNP during the last 12 months of the program.

Conditions

Poverty; Child Malnutrition

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Control and comparison group -cash transfer program

The program is implemented during 48 months. During the first 36 months the control group does not receive any intervention. During the last 12 months eligible beneficiaries receive cash transfer and accompanying information sessions on health, child nutrition, household economics every three months (identical to experimental group).

Group Type: ACTIVE_COMPARATOR

Cash distribution during the last 12 months

Intervention Type: OTHER

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Accompanying information sessions on health, child nutrition, household economics and education during the last 12 months

Intervention Type: BEHAVIORAL

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Jigisemejiri cash transfer program

Unconditional cash is distributed every 3 months to beneficiaries of the Jigisemejiri program. During cash handouts, information sessions on health, child nutrition, households economics and education are organized by local NGOs.

Group Type: EXPERIMENTAL

Cash distribution during first 36 months

Intervention Type: OTHER

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Accompanying information sessions on health, child nutrition, household economics and education during first 36 months

Intervention Type: BEHAVIORAL

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Jigisemejiri - Preventive Nutrition packages

Households belonging to the experimental group who previously received Cash transfer and information sessions on health, child nutrition, households economics and education for 36 months, with children and/or pregnant/lactating women receiving rations of fortified flour (PNP) during the last 12 months of the project

Group Type: EXPERIMENTAL

Cash distribution during first 36 months

Intervention Type: OTHER

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Accompanying information sessions on health, child nutrition, household economics and education during first 36 months

Intervention Type: BEHAVIORAL

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Preventive Nutrition Packages during last 12 months

Intervention Type: DIETARY_SUPPLEMENT

Fortified flour supplements for children (Supercereal Plus)and pregnant/lactating mothers (super Cereal)

Control and comparison group - Preventive Nutrition packages

Households belonging to the experimental group who previously received Cash transfer and information sessions on health, child nutrition, households economics and education for 36 months, with children and/or pregnant/lactating women

Group Type: ACTIVE_COMPARATOR

Cash distribution during first 36 months

Intervention Type: OTHER

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Accompanying information sessions on health, child nutrition, household economics and education during first 36 months

Intervention Type: BEHAVIORAL

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Interventions

Cash distribution during first 36 months

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Intervention Type: OTHER

Accompanying information sessions on health, child nutrition, household economics and education during first 36 months

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Intervention Type: BEHAVIORAL

Preventive Nutrition Packages during last 12 months

Fortified flour supplements for children (Supercereal Plus)and pregnant/lactating mothers (super Cereal)

Intervention Type: DIETARY_SUPPLEMENT

Cash distribution during the last 12 months

Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.

Intervention Type: OTHER

Accompanying information sessions on health, child nutrition, household economics and education during the last 12 months

Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Being a Household that is beneficiary of the Jigisemejiri program
• Having a child between 6 and 24 months of age

Exclusion Criteria

• Congenital malformations that hamper anthropometric measurements

• Minimum Eligible Age: 6 Months
• Maximum Eligible Age: 5 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Institut de Recherche pour le Developpement

OTHER_GOV

Sponsor Role: collaborator

Implementation management committee of the Jigisemejiri program (Ministry of Economics and Finance, Government of Mali)

UNKNOWN

Sponsor Role: collaborator

International Food Policy Research Institute

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Dan Gilligan, PhD

Role: STUDY_CHAIR

IFPRI

Marie Ruel, PhD

Role: STUDY_CHAIR

IFPRI

Melissa Hidrobo, PhD

Role: PRINCIPAL_INVESTIGATOR

IFPRI

Shalini Roy, PhD

Role: PRINCIPAL_INVESTIGATOR

IFPRI

Lieven Huybregts, PhD

Role: PRINCIPAL_INVESTIGATOR

IFPRI

Locations

Bamako, , Mali

Countries

Mali

Other Identifiers

2014-26-PHND-M

Identifier Type: -

Identifier Source: org_study_id