Cash Plus Interventions for Prevention of Acute Malnutrition in Children Under 5 and Their Mothers in Somalia

Johns Hopkins Bloomberg School of Public Health

Status: Completed

Conditions: Malnutrition, Child; Malnutrition; Wasting Disease; Stunting; Malnutrition, Mother

Treatments: Other: Cash + Social Behavior Change Communication; Other: Cash only; Other: Cash + top-up cash

Study type: Interventional

Funder types: Other

Identifiers

NCT06642012

IRB00024476

200011671 (Other Grant/Funding Number)

Details and patient eligibility

About

This trial studied different combinations of cash assistance to families that live in food insecure areas of Somalia and aimed to understand if this cash assistance provided reduced malnutrition of children and mothers.

Full description

This study was a mixed-methods cluster-randomized controlled trial implemented in the Bay and Hiran regions of Somalia to study monthly cash assistance interventions across 3 study arms. The intervention was provided for 6 months and included cash plus social and behavior change communication intervention. The investigators studied which combination of assistance was most effective and cost-effective at reducing and preventing child and maternal malnutrition (wasting, stunting, etc.). Enrolled participants were children under 5 and mothers of children under 5. The investigators collected qualitative, quantitative, and cost data to study the intervention across study arms, household experiences with receiving cash, and household factors related to malnutrition. Quantitative household data and anthropometry was collected at baseline, 3 months, and 6 months. Qualitative data was collected through focus group discussions on health/nutrition topics with mothers and fathers of children under 5 who participated in the study. Cost data was collected in consultation with study and program staff to evaluate the cost-efficiency, cost-effectiveness, and societal costs of the intervention. Investigators also monitored the local markets for food availability and price fluctuations to understand its impact on malnutrition in the communities where the trial was being implemented.

Enrollment: 3,384 patients

Sex: All

Ages: 6+ months old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for Child Participants:

• Enrolled in Save the Children Cash Plus for Nutrition Program
• Ages 6-59 months at baseline
• Mother is enrolled in the study

Exclusion Criteria for Child Participants:

• Received treatment for wasting at baseline
• Had an episode of severe acute malnutrition in the past 12 months

Inclusion Criteria for Mothers:

• Enrolled in Save the Children Cash Plus for Nutrition Program
• At least 18 years old at baseline
• Have a child that is 6-59 months old at baseline
• Voluntarily willing to participant through signed consent form.

Exclusion Criteria for Mothers:

• Currently receiving treatment for wasting
• Had an episode of severe acute malnutrition in the past 12 months

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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3,384 participants in 3 patient groups

Arm 1: Cash only

Active Comparator group

Description:

Arm 1 participants received the cash only intervention. Households in this arm received 1 mobile cash transfer per month for 6 months.

Treatment:

Other: Cash only

Arm 2: Cash + Social Behavior Change Communication (SBCC)

Experimental group

Description:

Arm 2 participants received the cash + social behavior change communication intervention. Household received 1 mobile cash transfer per month for 6 months but mothers also received an SBCC package that included interpersonal communication (1:1 consultations for mothers), bi-monthly group sessions on key health and nutrition topics, and cooking demonstrations.

Treatment:

Other: Cash + Social Behavior Change Communication

Arm 3: Cash + top-up cash

Experimental group

Description:

Arm 3 participants received the cash + top-up cash intervention. Households received 1 mobile cash transfer per month for 6 months, receiving the base cash amount plus an additional cash top-up amount.

Treatment:

Other: Cash + top-up cash