Evaluation of a Cash Transfer Program in Low-Income Families in Guinea-Bissau

This pilot study will test the effect of a cash transfer program aiming to improve family food consumption patterns, family health and schooling, with resulting benefits for childhood growth and cognition.

Study Overview

• Status: Unknown
• Conditions: Diabetes; Anemia; Per Capita Food Consumption Expenditure; Childhood Growth; Childhood Cognition; School Registration and Attendence
• Intervention / Treatment: Behavioral: Cash Transfer

Detailed Description

Cash transfer (CT) programs in low-income countries that allow recipients to receive cash designated for specific household expenditures such as food and family health and education typically show significant program benefits. In particular, several programs have shown positive impacts on use of health care resources, nutrition status and self-reported health, along with significant improvements in the motor and cognitive development of young children.

Guinea-Bissau is currently the 11th poorest country and is thus an appropriate target for a cash transfer program. This project will pilot test the effect of a 2 year cash transfer program aiming to improve family food consumption patterns, family health and schooling, with resulting benefits for childhood growth and cognition. Family-wide assessment will be conducted to examine the impact in all family members. Baseline and 3 follow up assessments will be completed.

• Study Type: Interventional
• Enrollment (Anticipated): 34148
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Guinea-Bissau
  • Bissau, Guinea-Bissau
    • PDDC

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: ADULT; OLDER_ADULT; CHILD
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Families (defined as groups of individuals who routinely eat together) in 3 regions of Guinea-Bissau.
• Identified by developing scale based upon household characteristics and assets per capita. As well as access to services such as water, electricity and sanitation.
• Families having the lowest score identified as lowest income were recruited.

Exclusion Criteria:

• Families with high scores on asset scale.
• Families uninterested in participating.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: OTHER
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Families assigned to this arm will be assessment only controls that do not receive the cash transfer.
Experimental: Intervention; Families assigned to this arm will recieve a cash transfer following an in-depth conversation with the head of household and the signing of a contract stating they understand the purpose of the study.	Behavioral: Cash Transfer; The heads of households will receive a cash transfer for up to 7 family members in the home every quarter. Head of households will be expected to attend meetings every 4 months at their local community health centers led by Community Health Workers (CHW). Meetings will have 2 components: 1) children under 5 will be measured to identify children at risk of malnutrition and 2) group education sessions. There will also be monthly growth monitoring and education sessions led by CHW for a subgroup of head of households with children identified as risk of malnutrition with rapid referrals to regional tertiary clinics for any children with health problems that cannot be addressed by CHW.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in per capita food expeditures	change in per capita food expenditure per family will be calculated.	Baseline, year 1, year 2 and year 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in family demographics	Changes in family demographics will be tracked.	Baseline, year 1, year 2 and year 3
Change in weight	Change in weight for all participants in the study and children born after cash transfer program starts.	Baseline, year 1, year 2 and year 3
Change in height	Change in height for all participants in the study and children born after cash transfer program starts.	Baseline, year 1, year 2 and year 3
Change in mid-upper arm circumference (MUAC)	Change in MUAC for all participants in the study and children born after cash transfer program starts.	Baseline, year 1, year 2 and year 3
Change in waist circumference	Change in waist circumference for all participants in the study and children born after cash transfer program starts.	Baseline, year 1, year 2 and year 3
Change in hemoglobin	Change in hemoglobin for pregnant women, children born after the program begins, older children born in 2003, 2010, 2014.	Baseline, year 1, year 2 and year 3
Change in blood pressure	Change in blood pressure will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.	Baseline, year 1, year 2 and year 3
Change in HbA1c	Change in HbA1c will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.	Baseline, year 1, year 2 and year 3
Food intake	Food intake assessment	Year 1, year 2 and year 3
Cognition function	Children born after the cash transfer progam will have a single cognitive function test at 18 months of age.	When children are 18th months
Change in school attendence	School enrollment, attendance, drop out and grade graduation will be assessed for all children through data extraction from school records.	Each semester of school in year 1, 2 and 3 of study
Change in head circumference	Children born after the cash transfer progam will have head circumference taken.	After birth, year 1, year 2, year 3
Change in Literacy	Children 7 and 14 will complete literacy testing.	Year 1, year 2, year 3
Change in Grip Strength	Change in grip strength will be measured in 100 randomly selected families in each region with a family size 2-4 and 5-8.	Baseline, year 1, year 2 and year 3

Collaborators and Investigators

• Sponsor: Ministry of Finance, Guinea-Bissau
• Collaborators: World Bank; International Partnership for Human Development (IPHD); National Institute of Statistics (INE)
• Investigators: Principal Investigator: Alfa U Jalo, MS, Ministry of Finance

Study record dates

Study Major Dates

• Study Start (Actual): April 25, 2017
• Primary Completion (Anticipated): December 1, 2020
• Study Completion (Anticipated): December 1, 2020

Study Registration Dates

• First Submitted: February 21, 2018
• First Submitted That Met QC Criteria: February 27, 2018
• First Posted (Actual): March 6, 2018

Study Record Updates

• Last Update Posted (Actual): March 6, 2018
• Last Update Submitted That Met QC Criteria: February 27, 2018
• Last Verified: February 1, 2018

More Information

Terms related to this study

• Other Study ID Numbers: 1234 (Department of Defense)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No