Money or Knowledge? Behavioral Aspects of Malnutrition

President and Fellows of Harvard College

Status

Completed

Conditions

Malnutrition

Treatments

Behavioral: Labeled cash transfer

Behavioral: Personalized information

Study type

Interventional

Funder types

Other

Identifiers

NCT02903641

14-3255-1

Details and patient eligibility

About

Malnutrition accounts for nearly half of child deaths worldwide. Children who are well-nourished are better able to learn in school, grow into more physically capable adults, and require less health care during childhood and adulthood. Moreover, it is difficult to make up for poor childhood nutrition later in life. I present here the proposal for an intervention that builds on a larger study in Ethiopia and will generate insights into the importance of behavioral factors related to persistent malnutrition in low-income settings, allowing for more targeted, cost-effective interventions in the future.

Existing data from the study region, Oromia, Ethiopia, suggest that many mothers know how to correctly respond to a hypothetical situation where a young child exhibits poor growth. On the other hand, however, mothers frequently appear unaware about their own children's growth deficiencies. Together, these facts suggest that false beliefs about the appropriateness of a child's physical size are a more likely contributor to malnutrition, rather than a weak understanding of how to help a malnourished child.

The proposed intervention will provide evidence on the relationship between caregiver beliefs about child nutritional status and the caregiver's behavior, ultimately analyzing how this relationship influences important nutritional choices for young children in a setting with limited resources. The study uses a two-by-two randomized trial; the first treatment is a cash transfer labeled for child food consumption, and the second is the provision of personalized information about the quality of the child's height compared to other children like those of the same age and gender in East Africa. Together the two treatment arms will provide evidence about the relative importance of behavioral versus resource barriers to improved nutrition. Better understanding of the interaction between these key factors is essential in addressing one of the foremost health issues facing developing countries today.

Enrollment

506 patients

Sex

All

Ages

14 to 55 months old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Households for this study were selected from among those who were included in any of the three study groups from a larger study and for whom relevant data had been collected.

Inclusion Criteria:

inclusion in the larger study required the household to have a child who was 6-35 months old for the main study's baseline survey in July-August 2015 (referred to as the index child) and for the household to have land for crop cultivation

Exclusion Criteria:

Households that did not meet the inclusion restriction or those who did not have anthropometric data collected during the larger study.

Trial design

506 participants in 4 patient groups

Control

No Intervention group

Description:

All households in the study were given general child nutrition educational messaging, immediately after the baseline survey and prior to any treatments. This messaging focused on appropriate feeding habits complemented by breastfeeding and ways to maintain proper hygiene during food preparation and consumption.

Personalized information only

Experimental group

Description:

Household received the personalized information about the index child's height.

Treatment:

Behavioral: Personalized information

Labeled cash transfer only

Experimental group

Description:

Household received the labeled cash transfer.

Treatment:

Behavioral: Labeled cash transfer