An interventional study of Cash only and Cash + Social Behavior Change Communication in Malnutrition, Child, Wasting Disease and Stunting, sponsored by Johns Hopkins Bloomberg School of Public Health. Completed at 2 sites in 2 countries. Open to participants aged 6 Months and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-09-08.
Sponsored by Johns Hopkins Bloomberg School of Public Health · Not applicable, Interventional, and Prevention
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.
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.
164 studies on the registry are indexed under Child Nutrition Disorders; 34 are open to participants now.
This study's enrollment of 3,384 is above the median of 428 across 130 interventional studies indexed under Child Nutrition Disorders.
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Inclusion Criteria for Child Participants:
Exclusion Criteria for Child Participants:
Inclusion Criteria for Mothers:
Exclusion Criteria for Mothers:
Arm 1 participants received the cash only intervention. Households in this arm received 1 mobile cash transfer per month for 6 months.
Other: Cash only
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.
Other: Cash + Social Behavior Change Communication
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.
Other: Cash + top-up cash
Households received 1 mobile cash transfer per month for 6 months.
Households 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.
Households received 1 mobile cash transfer per month for 6 months, receiving the base cash amount plus an additional cash top-up amount.
Child Wasting Prevalence
Child under 5 wasting prevalence was an aggregate measure of children's nutritional status based on the child's MUAC, weight-for-height z-score (WHZ) measurements, and the present of edema. Using the 2013 WHO guidelines on management of severe acute malnutrition in infants and children, at each study timepoint, children were measured and classified as: 1. without acute malnutrition (MUAC \>= 125 mm and WHZ \>= -2 SD and no edema), 2. with moderate acute malnutrition (115 mm \<= MUAC \< 124.9 mmm and/or -3\<=WHZ\<-2 and no edema), 3. severe acute malnutrition (MUAC \< 115 mm and/or WHZ \<-3 and/or edema). Prevalence was estimated with 95% confidence intervals and changes in prevalence were calculated between baseline, 3 months, and 6 months.
Time frame: Baseline, 3 months, and 6 months
Maternal Wasting Prevalence
Aggregate measure of maternal mid-upper arm circumference (MUAC) measured at each time point using standard MUAC tape to the nearest 0.1cm. Mothers were classified as 1) Overweight (MUAC \> 300 mm), 2) Normal (300\>MUAC\>=230mm) or 3) With moderate acute malnutrition (MUAC \< 230 mm). Prevalence was estimated with 95% confidence intervals and changes in prevalence were calculated between baseline, 3 months, and 6 months.
Time frame: Baseline, 3 months, and 6 months
Child Mid-Upper Arm Circumference
Child mid-upper arm circumference (MUAC) was measured to the nearest 0.1 cm by program staff at each study timepoint using standard MUAC tape.
Time frame: Baseline, 3 months, and 6 months
Child Weight-for-Height
Child weight-for-height is an aggregate measure using standard anthropometric measures for weight and height. Child weight was measured to the nearest 0.01 kg using a stand on scale and child height was measured to the nearest 0.1 cm using a wooden length board. Weight-for-height z-scores (WHZ) were calculated using 2006 Word Health Organization child growth standards module in STATA. Weight-for-height compares a child's weight to the weight of a child of the same height and sex from a standard 2006 WHO reference population. This weight-for-height z-score is measured in standard deviations from the median weight for children of the same height and sex. The calculation for Z-score is (X-m)/SD; X is the participant child's weight, m is the median weight for children of the same height and sex in the WHO reference population, and SD is the standard deviation of the weight of the reference population. Z-scores range from -5 to 5.
Time frame: Baseline, 3 months, and 6 months
Plan to share: No — This data was collected on a vulnerable population linked to a large scale cash assistance program in Somalia. The data may be available upon request with permission from local study investigators.
This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.
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Johns Hopkins Bloomberg School of Public Health