Gendered Misallocation of Labor: Evidence From Malawian Farmers

The investigators will conduct a cluster randomized controlled trial across districts in Malawi to evaluate the effect of providing free casual labor to pregnant farmers and female farmers on agricultural output, maternal and child health outcomes, child development, and social networks.

Study Overview

• Status: Completed
• Conditions: Maternal and Child Health Outcomes
• Intervention / Treatment: Other: Casual labor subsidy

Detailed Description

This will be a cluster randomized control trial (RCT), where 75 of the districts in which One Acre Fund (1AF) currently operates within in Malawi will be randomly selected for inclusion in this study. Of these 75 districts, 38 will be randomly selected to implement the intervention. The intervention constitutes a voucher offered to all female famers who are currently enrolled in the 1AF program who are pregnant and/or have a child ages 1 years and below that entitles the recipient to a set number of days of labor from casual workers employed by local 1AF offices. The remaining 37 districts will serve as the control group.

Data will be collected at baseline during the planting season and endline at the conclusion of the harvest season. Data collected will pertain to agricultural output, individual and household demographics, obstetric history and outcomes, mental health, maternal health, child health and development, and social networks.

• Study Type: Interventional
• Enrollment (Actual): 989
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Malawi
  • Zomba
    • Zomba, Zomba, Malawi
      • One Acre Fund

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Pregnant at time of One Acre Fund program rollout
• Mother to at least one child aged below 1 years of age

Exclusion Criteria:

-None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment arm with casual labor voucher program; Eligible members (pregnant and/or mother of at least one child aged 1 years or younger) of 1AF in the randomly selected treatment districts receive vouchers for a set number of days of free work from casual laborers employed by local 1AF offices. This is in addition to standard 1AF programming.	Other: Casual labor subsidy; Eligible participants will be offered a voucher that can be redeemed for a set number of days of agricultural labor from casual laborers hired by local One Acre Fund offices. Casual laborers receive standard training in line with the trainings currently offered by the organization to participating farmers.
No Intervention: Control arm; Eligible members will only receive standard 1AF programming in randomly selected control districts. They will not receive the labor subsidy during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Agricultural Output	A continuous measure of the value of the participant's agricultural yield, measured in Malawian Kwacha	Assessed after harvest season (6 - 8 months after intervention initiation)
Antenatal care seeking	A continuous variable of number of antenatal care visits for those pregnancies that overlap with the index agricultural season	Assessed after harvest season (6 - 8 months after intervention initiation)
Care seeking for child health	Two continuous variables measuring number of routine postnatal care and sick child visits	Assessed after harvest season (6 - 8 months after intervention initiation)
Reach of social networks	A social networks module that collects data on the extent and characteristics of the participant's social networks. Measured by the number of people reported in the participant's network, with a higher number indicating a larger network.	Assessed after harvest season (6 - 8 months after intervention initiation)
Labor inputs	A pair of recall questions repeated for each household member aged 10 years or older (including the respondent) that ask about the average number of days a week and the average number of hours per day the individual works on the respondent's farm, both measured continuously.	Assessed after harvest season (6 - 8 months after intervention initiation)
Postnatal care seeking	A continuous variable of number of postnatal care visits for those pregnancies that overlap with the index agricultural season	Assessed after harvest season (6 - 8 months after intervention initiation)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maternal consumption short term recall: number of meals	Two questions regarding the number of meals consumed the day before and the number of meals consumed two days before	Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal mental health	Patient Health Questionnaire-2 (PHQ-2): a 2-item Likert scale questionnaire for assessing depressive symptoms. Score can range between 0 and 6, with higher scores indicating more severe depressive symptoms.	Assessed after harvest season (6 - 8 months after intervention initiation)
Barriers to perinatal care	A set of four Likert style questions asking to respondents to how much they agree with the following statements as reasons to not visit a health facility for ANC and/or PNC: "The health facility is too far away," "I have to work on my farm," "I am too unwell/sick," "and "I do not think the quality of care is worth it"	Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal hunger	Question about how often the respondent went to bed hungry in the past month: "Never," "A few times," "Nearly every other night," and "Most nights"	Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal consumption medium term recall: protein intake	Four questions regarding the number of times the participant consumed fish, meat, eggs, and usipa.	Assessed after harvest season (6 - 8 months after intervention initiation)
Child birth weight	A continuous variable measured in grams of the reported birthweight of each child born during most delivery	Assessed after harvest season (6 - 8 months after intervention initiation)
Child consumption	A set of four questions concerning the frequency of breastfeeding; meat, egg, or fish; fruits or vegetables; and porridge, bread, rice, pap, or pasta consumption in the past month for the youngest child.	Assessed after harvest season (6 - 8 months after intervention initiation)
Willingness to hire causal labor	Likert scale question on how likely the participant is to hire a casual worker during the upcoming agricultural season	Assessed after harvest season (6 - 8 months after intervention initiation)

Collaborators and Investigators

• Sponsor: Nicholas Rahim
• Investigators: Principal Investigator: Gabriella Fleischman, Harvard Kennedy School; Principal Investigator: Nicholas Rahim, Harvard School of Public Health (HSPH)

Study record dates

Study Major Dates

• Study Start (Actual): August 16, 2025
• Primary Completion (Actual): September 7, 2025
• Study Completion (Actual): September 7, 2025

Study Registration Dates

• First Submitted: October 1, 2024
• First Submitted That Met QC Criteria: October 7, 2024
• First Posted (Actual): October 8, 2024

Study Record Updates

• Last Update Posted (Estimated): September 16, 2025
• Last Update Submitted That Met QC Criteria: September 14, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Maternal and child health; Agriculture; Social networks
• Other Study ID Numbers: IRB24-1234

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: After manuscript publication, fully de-identified data may be shared with researchers upon request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No