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Maternal Cash Transfers and Child Health: Evidence from India
Last registered on March 07, 2019

Pre-Trial

Trial Information
General Information
Title
Maternal Cash Transfers and Child Health: Evidence from India
RCT ID
AEARCTR-0002899
Initial registration date
April 14, 2018
Last updated
March 07, 2019 3:24 PM EST
Location(s)

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Primary Investigator
Affiliation
University of Southern California
Other Primary Investigator(s)
PI Affiliation
University of California, San Diego
PI Affiliation
University of California, San Diego
PI Affiliation
University of Virginia
Additional Trial Information
Status
On going
Start date
2017-09-15
End date
2020-10-15
Secondary IDs
Abstract
This study will evaluate whether framed, unconditional cash transfers (UCT) to pregnant women and lactating mothers are effective in improving the health of their children, as measured by incidence of stunting and wasting. This will be the first randomized evaluation in India of unconditional cash transfers for maternal and child health, and will be implemented by the Government of Jharkhand (GoJH) in eight districts. We will study the impact of a 24-month long UCT to pregnant and lactating mothers, testing how variation in the timing of transfers affects child health.
External Link(s)
Registration Citation
Citation
Muralidharan, Karthik et al. 2019. "Maternal Cash Transfers and Child Health: Evidence from India." AEA RCT Registry. March 07. https://doi.org/10.1257/rct.2899-2.0.
Former Citation
Muralidharan, Karthik et al. 2019. "Maternal Cash Transfers and Child Health: Evidence from India." AEA RCT Registry. March 07. https://www.socialscienceregistry.org/trials/2899/history/42638.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
n/a
Intervention Start Date
2018-03-01
Intervention End Date
2020-07-15
Primary Outcomes
Primary Outcomes (end points)
Child height and weight for age at age 2
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
na
Experimental Design Details
Not available
Randomization Method
randomization done in office by a computer
Randomization Unit
Anganwadi center (a community health center for a population of roughly 1000 individuals)
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
960 anganwadi centers
Sample size: planned number of observations
4800 pregnant women
Sample size (or number of clusters) by treatment arms
1200 pregnant women in each treatment arm and in the control group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We surveyed the literature on cash transfers to gauge the range of plausible effect sizes that we want to be powered to detect. Transfers are around 15% of household income, similar in magnitude to those studied in Schady and Rosero (2008) and Paxson and Schady (2010) in Ecuador, Amarante et al (2011) in Uruguay, and Macours et al (2012) in Nicaragua. The most comparable is the Ecuadorian program, in which there was an improvement in development of 0.18 standard deviations among the poorest quartile of children in their sample; given the higher income levels in Ecuador, that group should be roughly comparable to our sample in Jharkhand. We wish to detect effects of that size for each of the questions of interest. To be slightly conservative, our calculations focus on minimum detectable effect sizes of 0.15 standard deviations. Intracluster Correlation Calculations Since our randomization is clustered at the AWC level, we must account for intracluster correlation in our power calculations. We use the 2006 wave of the Indian National Family Health Survey and calculate the intra-village correlation in child height and weight for age within villages in Jharkhand and neighboring states (Bihar, Madhya Pradesh, Orissa). For these variables, the intracluster correlation is relatively high, at 0.06 and 0.09. To be conservative, we use 0.09 in our calculations. Number of Participants Per Cluster The average number of women per AWC is estimated to be 5, but in the first round of registrations, we observed substantial heterogeneity across AWCs. In some clusters, there were as many as 17 women registered, while in others, none registered. We calculate the coefficient of variation in number of registrations across AWCs (0.665), and take this into account in the power calculations. When we randomize, we will also stratify by number of registrations in an AWC to maximize power. One way of increasing power is to collect baseline data on variables that will be correlated with the outcome at endline (such as the outcome at baseline). We have elected not to do a baseline survey. There are two reasons that we will not be able to do this. First, it is not possible to identify beneficiaries until after they have registered, and the transfers must go out as soon as possible after registration. This does not afford time for a baseline survey. Second, the primary outcomes of interest, such as child weight and height are not possible to measure at baseline, since the child is still in utero. In the power calculations, we thus do not assume any power boost from a baseline survey. The power calculations are different for each of the questions of interest. For example, to calculate the effect of a single year of cash transfers, we can combine the two treatment groups that receive a year of transfers and compare them to the control group. However, to determine the effect of receiving two years of transfers, we can only compare that single treatment group to the control group. For all of the questions of interest, we seek to detect an effect of 0.15 standard deviations with 80% power. We thus determine our sample size for the questions on which the sample sizes will be smallest, and then calculate our power for the other questions of interest under this sample size. Based on this, a sample size of 240 AWCs per treatment arm allows us to detect an effect size of 0.15 standard deviations with 95% confidence at 80% power. Based on this sample size, the below table shows the level of power for different effect sizes. Question of Interest Effect size of 0.1 SD Effect size of 0.12 SD Effect size of 0.15 SD Comparison of 1 treatment arm to 1 treatment arm (e.g. effect of 1 year of transfers in utero vs. after child is born) 0.48 0.63 0.82 Comparison of 1 treatment arm to 2 treatment arms (e.g. effect of 1 year of transfers vs. 2 years of transfers) 0.66 0.82 0.95
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
University of California, San Diego
IRB Approval Date
2017-11-02
IRB Approval Number
171746S
Analysis Plan

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