Child Development, Child Nutrition, Food Security, Gender Dynamics, Intimate Partner Violence, Poverty
Conditions
Keywords
Cash transfers, Food transfers, Behavior change communication, Sustainability, Social protection, Nutrition, Gender
Brief summary
This study assesses the sustainability of impacts, 4 years post-program, from a pilot safety net program that was implemented from May 2012-April 2014. The intervention, called the Transfer Modality Research Initiative (TMRI), was assigned following a cluster-randomized controlled trial design in two zones of Bangladesh (north and south). Intervention arms were assigned at the village level, where arms were as follows: (1) cash transfers \[north and south\]; (2) cash transfers + nutrition behavior communication change (BCC) \[north only\]; (3) food transfers \[north and south\]; (4) food transfers + nutrition BCC \[south only\]; (4) food-cash split \[north and south\]; and (5) control \[north and south\]. Within treatment villages, women living in very poor households were targeted to receive benefits for two years.
Detailed description
The objective of the study is to assess, 4 years after a pilot safety net intervention ended in April 2014, the sustainability of the intervention's impacts on households, children, and women. The intervention, called the Transfer Modality Research Initiative (TMRI), was assigned following a cluster-randomized controlled trial design in two zones of Bangladesh (north and south). WFP-Bangladesh implemented the intervention, and the International Food Policy Research Institute (IFPRI) conducted the impact evaluation research. Intervention arms were assigned at the village level, where arms were as follows: (1) cash transfers \[north and south\]; (2) cash transfers + nutrition behavior communication change (BCC) \[north only\]; (3) food transfers \[north and south\]; (4) food transfers + nutrition BCC \[south only\]; (5) food-cash split \[north and south\]; and (5) control \[north and south\]. Within treatment villages, women living in very poor households were targeted to receive benefits for two years, from May 2012-April 2014. For the original impact evaluation, longitudinal data on 5000 households were collected from 2012-2015 (ClinicalTrials.gov Identifier: NCT02237144). For the sustainability study in 2018, given available funding, the sampling frame will include 4000 households. This will include all households that were originally in the following arms: (1) cash transfers \[north and south\]; (2) cash transfers + nutrition BCC \[north only\]; (3) food transfers \[north and south\]; (4) food transfers + nutrition BCC \[south only\]; (5) control \[north and south\].
Interventions
OTHERCash transfer
1500 taka ($18.75) per household distributed monthly
OTHERFood transfer
30 kg rice, 2 kg lentils, and 2 kg micro-nutrient fortified cooking oil per household distributed monthly
15 kg of rice, 1 kg of lentils, and 1 kg of micronutrient-fortified cooking oil, and 750 taka cash per household, distributed monthly
BEHAVIORALNutrition behavior Communication Change (BCC)
Weekly, group-based, one-hour meetings on maternal and child nutrition, sanitation and health knowledge, attitudes and practice; twice-a-month home visits; monthly community meetings
OTHERControl
No transfer, no behavior change communication
Sponsors
Cornell University
Data Analysis and Technical Assistance Ltd
World Food Programme, Bangladesh
International Food Policy Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
15 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Former participant of Transfer Modality Research Initiative study (in cash, food, cash+BCC, food+BCC, or control arms)
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Food Consumption Score | After 4 years post-intervention | The Food Consumption Score, as defined by the World Food Programme, is calculated as the number of food groups consumed by the household in the previous 7 days, weighted by each food group's nutritional value and frequency of consumption. Scale range is 0 to 112, with higher values reflecting higher food consumption. |
| Child height-for-age z-score | After 4 years post-intervention | Calculated using the 2006 WHO growth reference. This is a continuous measure that represents the number of standard deviations from the mean among comparable children in the WHO growth reference. |
| Prevalence of physical intimate partner violence | After 4 years post-intervention | Prevalence of any physical intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Child score on Early Grade Mathematics Assessment | After 4 years post-intervention | Measured using Early Grade Mathematics Assessment adapted to local context. This is constructed following the test's protocol for scoring. |
| Household dietary diversity | After 4 years post-intervention | Measured by counting the number of food groups consumed by the household |
| Value of total household consumption | After 4 years post-intervention | Aggregate value of household food and non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. Guidelines for Constructing Consumption Aggregates for Welfare Analysis. Washington, DC : World Bank. |
| Value of household food consumption | After 4 years post-intervention | Value of household food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. Guidelines for Constructing Consumption Aggregates for Welfare Analysis. Washington, DC : World Bank. |
| Value of household non-food consumption | After 4 years post-intervention | Value of household non-food consumption expenditures. This is a continuous measure calculated from household survey responses on consumption behavior, using the methodology and questionnaire modules described in Deaton and Zaidi (2002). Citation: A.Deaton,, and S. Zaidi. 2002. Guidelines for Constructing Consumption Aggregates for Welfare Analysis. Washington, DC : World Bank. |
| Household food insecurity | After 4 years post-intervention | Measured using the Household Food Insecurity Access Scale. Scale range is 0 to 27, with higher values reflecting higher food insecurity. |
| Value of household labor income | After 4 years post-intervention | Value of annual labor income over all household members |
| Value of household non-labor income | After 4 years post-intervention | Value of annual non-labor income over all household members |
| Value of household asset ownership | After 4 years post-intervention | Total value of all assets owned |
| Household land ownership | After 4 years post-intervention | Area of land owned |
| Housing quality: interviews | After 4 years post-intervention | Quality of housing stock. This is measured using a module developed for the study context, and information is collected through household enumerator observation during interviews. |
| Maternal nutrition knowledge score | After 4 years post-intervention | Number answered correctly on a test of maternal knowledge regarding infant and young child feeding practices developed for the survey, based on the curriculum of training sessions in the intervention. |
| Child score on Strengths and Difficulties Questionnaire | After 4 years post-intervention | Measured using Strengths and Difficulties Questionnaire, part of the Development and Well-Being Assessment family of mental heath measures. This is constructed following the test's protocol for scoring. |
| Child weight-for-height z-score | After 4 years post-intervention | Calculated using the 2006 WHO growth reference. This is a continuous measure that represents the number of standard deviations from the mean among comparable children in the WHO growth reference. |
| Prevalence of child stunting | After 4 years post-intervention | Calculated using the 2006 WHO growth reference |
| Prevalence of child wasting | After 4 years post-intervention | Calculated using the 2006 WHO growth reference |
| Maternal infant and young child feeding practices | After 4 years post-intervention | Maternal adherence to WHO-recommended infant and young child feeding practices |
| Parental interaction with child | After 4 years post-intervention | Time spent on child stimulation activities in previous 7 days, measured using modules developed for the survey |
| Parental discipline of the child | After 4 years post-intervention | Disciplinary measures used in the past month, measured using modules developed for the survey |
| Community norms on gender | After 4 years post-intervention | Community leaders' attitudes toward gender, measured using modules developed for the survey |
| Prevalence of emotional violence | After 4 years post-intervention | Prevalence of any emotional intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument |
| Prevalence of controlling behaviors | After 4 years post-intervention | Prevalence of any controlling behaviors in the past 12 months measured using the WHO Violence Against Women instrument |
| Prevalence of individual acts of intimate partner violence | After 4 years post-intervention | Prevalence of individual acts of intimate partner violence in the past 12 months measured using the WHO Violence Against Women instrument |
| Individual decisionmaking | After 4 years post-intervention | Measured using men's and women's decisionmaking modules adapted from pro-WEAI |
| Individual asset ownership | After 4 years post-intervention | Measured using men's and women's asset ownership modules developed for the survey |
| Individual mobility | After 4 years post-intervention | Measured using men's and women's mobility modules adapted from pro-WEAI |
| Individual labor force participation | After 4 years post-intervention | Measured using men's and women's labor modules developed for the survey |
| Individual attitudes toward gender and intimate partner violence | After 4 years post-intervention | Measured using men's and women's attitudes toward gender and intimate partner violence modules developed for the survey |
| Individual social capital | After 4 years post-intervention | Measured using men's and women's social capital modules developed for the survey |
| Individual stress | After 4 years post-intervention | Measured using men's and women's Perceived Stress Scale scores |
| Individual depression | After 4 years post-intervention | Measured using men's and women's Patient Health Questionnaire-9 Depression Test scores |
| Individual aspirations | After 4 years post-intervention | Measured using men's and women's aspirations modules developed for the survey |
| Spousal relationship | After 4 years post-intervention | Measured using men's and women's relationship modules developed for the survey |
| Child illness | After 4 years post-intervention | Mother's report of child illness in previous 2 weeks |
| Child score on Raven's Progressive Matrices | After 4 years post-intervention | Measured using Raven's Progressive Matrices set A and set B. This is constructed following the test's protocol for scoring. |
| Child score on Early Grade Reading Assessment | After 4 years post-intervention | Measured using Early Grade Reading Assessment adapted to local context. This is constructed following the test's protocol for scoring. |
Outcome results
None listed