Text Messaging to Caregivers to Improve Early Child Development in Ecuador

Last registered on September 02, 2021


Trial Information

General Information

Text Messaging to Caregivers to Improve Early Child Development in Ecuador
Initial registration date
August 31, 2021

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 02, 2021, 10:12 AM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.



Primary Investigator

Tufts University and The World Bank

Other Primary Investigator(s)

PI Affiliation

Additional Trial Information

In development
Start date
End date
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Some 24 percent of children under the age of five in Ecuador are stunted, according to World Bank figures, and reversing this in the early years is critical to building human capital so all children can thrive and succeed. The Government of Ecuador is seeking to improve child development and nutrition during the first 1000 days of life, by revamping existing nationwide programs where program staff discuss prenatal care, early child development, healthy nutrition, breastfeeding, and hygiene. Due to COVID-19 these services are being provided virtually or in hybrid modalities. Previous evidence from Chimborazo, Ecuador shows that families can be unaware of their child’s under nutrition and they lack information about behaviors that can improve their child's health and development. This evaluation will test whether sending text messages to caregivers increase their knowledge about early childhood development, nutrition, and healthy behaviors and leads to improved health and development outcomes for their children.
External Link(s)

Registration Citation

Namen, Olga and Megan Rounseville. 2021. "Text Messaging to Caregivers to Improve Early Child Development in Ecuador." AEA RCT Registry. September 02. https://doi.org/10.1257/rct.4251-1.0
Experimental Details


Within a national early childhood development program that provides support to caregivers of children 0-36 months and pregnant women, we will send text messages to caregivers of children from 0 to 12 months old, with age-specific contents. These text messages aim to promote changes in knowledge, actions, and attitudes of caregivers in the following topics: breastfeeding (exclusive from 0-6 months old and continued through two years old), the importance of attending regular child health checkups (vaccination, anthropometric measures, counseling), correct timing to initiate complementary feeding, dietary diversity, handwashing, good hygiene and water practices, ensuring safe spaces, attachment and child development, among others.
Intervention Start Date
Intervention End Date

Primary Outcomes

Primary Outcomes (end points)
Our primary outcome measure will be caregiver knowledge about exclusive breastfeeding, the timing of complementary feeding, healthy water, sanitation, and hygiene practices, diet diversity, and child development. These indicators will be constructed using information from an endline phone survey and administrative records.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Child development, health, and nutrition.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The study participants are drawn from an eligible population of approximately 7,500 households that are beneficiaries of a nationwide early child development program that provides individual counseling to households with children under three years of age and pregnant women through home visits and virtual support. From the beneficiaries that give their consent to participate in the study we will draw a sample of approximately 5,000 caregivers of children under 12 months. This sample will be divided into two groups: a control group that will receive the regular ECD services (approx. 2,500 caregivers) and a treatment group that will receive weekly text messages with age-specific information about child development, nutrition and healthy behaviors in addition to their regular ECD services (approx. 2,500 caregivers).
Experimental Design Details
Randomization Method
Randomization will be done in office by computer
Randomization Unit
Randomization will be carried out at the attention center level, these centers provide services to several beneficiaries. From each one of the centers assigned to the treatment group, all beneficiaries will receive the SMS treatment intervention. All beneficiaries from the attention centers assigned to control group will not receive the SMS intervention.
Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters
Approximately 2,000 attention centers
Sample size: planned number of observations
Approximately 5,000 caregivers
Sample size (or number of clusters) by treatment arms
Approximately, 1,000 attention centers assigned to treatment group and 1,000 assigned to control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Institutional Review Boards (IRBs)

IRB Name
Innovations for Poverty Action IRB
IRB Approval Date
IRB Approval Number


Post Trial Information

Study Withdrawal

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Is the intervention completed?
Data Collection Complete
Data Publication

Data Publication

Is public data available?

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials