Maternal Beliefs, Mental Health, and Economic Resources on Human Capital Accumulation in Early Life

We will have a single control group, and three treatment groups. Villages will be assigned to one these groups (see Sections ‘Experimental Design’ and ‘Experiment Characteristics’ below for details). Treatment households will receive information. Additional intervention includes psychological counselling in group sessions, which will be cross-randomized.

2023-10-01

2024-12-31

We will measure women’s empowerment, parental investment, mother’s physical and mental health, IPV, and child’s physical health and cognitive and socio-emotional development.

Women’s empowerment (women’s agency in fertility planning, personal expenditures and expenditures on children, children and household investment decisions, savings accounts, and participation in social programs and local leaderships); Women’s beliefs (about importance of early life conditions, self-efficacy in parenting, beliefs about modifiability of child skills); Parental Investment (time, monetary, and warmth); Physical health (self-reported physical health, body-mass index, and mid-upper arm circumference (MUAC)); Mental health (PHQ-9 a screener for depression, GAD-7 a screener for anxiety); IPV; and Stress (Cohen Stress Scale, Biomarkers of stress using hair samples. We plan to collect biomarkers of stress from mothers and their infants. Using hair samples, we can extract HPA axis hormones such as cortisol. Hair-derived biomarker measurement indicates HPA axis activity over the course of months (analytes in each centimeter of hair approximate hormone secretion over one month), and thus more accurately reflect chronic hormone secretion (see Baranov et al. 2022 for a discussion and an example of successful hair cortisol measurement with mother and child dyads in Pakistan). Hair sample collection will be funded with this proposal but further funding will be sought for laboratory extraction of analytes. Hair samples are easily storable and stable for 1-2 years.

Health at birth (birth weight and low birth weight); Developmental outcomes (Bayley Scales of Infant and Toddler Development that captures children’s cognitive, language, motor, adaptive); Health (weight-for-length, length-for-age, acute respiratory illnesses); Stress (Biomarkers of stress from hair samples).

We will have two information treatments and a single control group, consisting of 40, 40, 40 villages, respectively. In addition, a psychological counselling treatment will be cross-randomized with the information interventions (for details, see section "Intervention" above).

Not available

Randomization will be conducted in office by a computer.

Two-step randomization: first villages will be assigned to treatment and control groups. Second, treatment villages were further assigned to receive information treatment or information plus psychological counselling treatments.

Yes

120 villages

2,640

1. Information plus enrolment support: 40 villages, 22 households from each villages, 880 households in total.
2. Information on the importance of early life conditions: 40 villages, 22 households from each villages, 880 households in total.
3. Psychological counselling: 20 villages from treatment 1 and 20 villages from treatment 2, 880 households in total
4. Control group: 40 villages, 22 households from each villages, 880 households in total.

Given the sample sizes above and accounting for the varied clustered design, we would be powered to detect a Minimum Detectable Effect (MDE) size of 0.31 of a standard deviation (SD) change for the mental health intervention (randomized at the Health Centre (UHFWC) level with the conservative estimate of 20 centers). For the information arms, we would be powered to detect a 0.19SD change for either of the information interventions (main effects only). As benchmark for the MDEs on mental health interventions, Rahman et al. (2008) found that a mental health intervention similar to the one proposed here improved mothers’ mental health by 0.70SD, while Sikander et al. (2019) found that a more scalable, peer-delivered version of the intervention increased mothers’ mental health by 0.30SD. A tele-counseling intervention in Bangladesh improved mental health by 0.65SD (Vlassopolous et al. (2021)).