Health education for microcredit clients in Peru: a randomized controlled trial
Last registered on May 05, 2016

Pre-Trial

Trial Information
General Information
Title
Health education for microcredit clients in Peru: a randomized controlled trial
RCT ID
AEARCTR-0001134
Initial registration date
May 05, 2016
Last updated
May 05, 2016 5:33 PM EDT
Location(s)
Region
Primary Investigator
Affiliation
Northwestern University
Other Primary Investigator(s)
PI Affiliation
School of Public Health University of California Berkeley Berkeley, USA
PI Affiliation
Joint Medical Program, University of California Berkeley – University of California San Francisco, Berkeley, USA
Additional Trial Information
Status
Completed
Start date
2007-02-01
End date
2008-02-01
Secondary IDs
NCT01047033
Abstract
BACKGROUND: Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization’s Integrated Management of Childhood Illness (IMCI) community intervention.

METHODS: Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855) and their children (n = 598). Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization’s loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels). To explore the effects of treatment (i.e., participation in the health education sessions) on the key outcome variables, multivariate regressions were implemented using ordinary least squares.

RESULTS: Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status.

CONCLUSIONS: Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply that the intervention did not have sufficient intensity to change behavior, or that microcredit organizations may not be an appropriate setting for the administration of child health educational interventions of this type.
External Link(s)
Registration Citation
Citation
Fernald, Lia, Rita Hamad and Dean Karlan. 2016. "Health education for microcredit clients in Peru: a randomized controlled trial." AEA RCT Registry. May 05. https://doi.org/10.1257/rct.1134-1.0.
Former Citation
Fernald, Lia et al. 2016. "Health education for microcredit clients in Peru: a randomized controlled trial." AEA RCT Registry. May 05. http://www.socialscienceregistry.org/trials/1134/history/8113.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
The intervention involved 30 minutes of health education, facilitated by loan officers at the end of monthly group meetings over the course of eight months for randomly selected loan groups. Control groups continued regular meetings without any health education.
Intervention Start Date
2007-02-01
Intervention End Date
2008-02-01
Primary Outcomes
Primary Outcomes (end points)
(1) Anthropometric measures
(2) Client health knowledge about child health
(3) Child health status
Primary Outcomes (explanation)
(1) Anthropometric measures: height, weight, and blood hemoglobin level
(2) Client health knowledge about child health: diarrhea and cough danger signs and care
(3) Child health status: days of diarrhea, presence of bloody diarrhea, presence of severe cough, days of fever, etc.
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Researchers approached all the clients of PRISMA’s Pucallpa branch and conducted a baseline with all those who agreed (1,855 clients). After baseline, half the loan groups were allocated to treatment – the health education – and the other half to control. Existing loan officers were trained to teach the health modules. A followup was conducted a year later with 1,501 clients from the baseline survey.
Experimental Design Details
Randomization Method
Computerized random number generator.
Randomization Unit
Loan group
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
139 loan groups
Sample size: planned number of observations
1,855 clients, 598 children
Sample size (or number of clusters) by treatment arms
Treatment: 920 clients
Control: 935 clients
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials

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IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Innovations for Poverty Action Ethics Committee
IRB Approval Date
2008-05-01
IRB Approval Number
08May-001
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
Yes
Intervention Completion Date
February 01, 2008, 12:00 AM +00:00
Is data collection complete?
Yes
Data Collection Completion Date
February 01, 2008, 12:00 AM +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
Was attrition correlated with treatment status?
Final Sample Size: Total Number of Observations
1,501 clients, 454 children
Final Sample Size (or Number of Clusters) by Treatment Arms
Treatment: 757 clients Control: 744 clients
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
No
Reports and Papers
Preliminary Reports
Relevant Papers
Abstract
HEALTH EDUCATION FOR MICROCREDIT CLIENTS IN PERU: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND: Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization’s Integrated Management of Childhood Illness (IMCI) community intervention.

METHODS: Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855) and their children (n = 598). Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization’s loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels). To explore the effects of treatment (i.e., participation in the health education sessions) on the key outcome variables, multivariate regressions were implemented using ordinary least squares.

RESULTS: Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status.

CONCLUSIONS: Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply that the intervention did not have sufficient intensity to change behavior, or that microcredit organizations may not be an appropriate setting for the administration of child health educational interventions of this type.
Citation
Hamad, Rita, Lia C. H. Fernald, and Dean S. Karlan. 2011. "Health Education for Microcredit Clients in Peru: A Randomized Controlled Trial." BMC Public Health 11(51): 1-23.