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Impact of the Provision of Nutrition Knowledge in the CCT on Household's Food Consumption in the Philippines
Last registered on June 12, 2020

Pre-Trial

Trial Information
General Information
Title
Impact of the Provision of Nutrition Knowledge in the CCT on Household's Food Consumption in the Philippines
RCT ID
AEARCTR-0005957
Initial registration date
June 11, 2020
Last updated
June 12, 2020 12:56 PM EDT
Location(s)
Region
Primary Investigator
Affiliation
The University of Tokyo
Other Primary Investigator(s)
PI Affiliation
The University of Tokyo
Additional Trial Information
Status
Completed
Start date
2015-08-01
End date
2016-03-31
Secondary IDs
Abstract
Malnutrition will affect the base of the human capital including physical, mental and cognitive development negatively. Many children in developing countries have suffered from malnutrition because of insufficient access to foods and shortage of the nutrition knowledge. In order to solve the issues surrounding poor children and mothers, governments in developing countries and international organizations such as World Bank have launched the Conditional Cash Transfers (CCT) as one of the social protection policies. CCTs offer grants to mothers in poor families on the condition that they satisfy requirements related to childhood development such as attendance of periodic check-ups, vaccinations, and more than 85% of school attendance. In Latin American countries, it was empirically proved that CCTs have benefited on improvement of nutrition condition and cognitive and physical skills among children (World Bank, 2009). Particularly, the CCT recipients are shown to increase the share of food expenditure among the total expenditure (i.e., the Engel coefficient) relative to non-recipients. This is interesting because it is contrary to the standard prediction of economic theory, which demonstrates that the share of foods on the total consumption decreases if the income per capita increases (e.g. Attenasio et al. (2012), Angelucci & Attenasio (2013), Schady & Rosero (2008)). The literature attribute this surprising result to the fact that mothers are the recipients of the grant and that women possess different preferences and consumption patterns regarding foods relative to men (e.g. Doss (2006), Ward-Batts (2008)). That is, if women receive income and grants directly, and are in charge of determining the allocation of the resources, the Engel curve will shift upward, which is contrary to the common unitary-based Engel curve.

Owing to the effective results of the CCTs in Latin America, the Pantawid Pamilyang Pilipino Program (4Ps) started in 2008 in the Philippines. The 4Ps has been carefully designed for facilitating three-wave impact evaluation since the planning of the program. Chaudhury et al. (2013) implemented the impact evaluation of the 4Ps with the RCT method (IE2012). We exploit the data used in this IE2012, and estimate the Engel curve based on the collective model approach. Although we expect a positive impact of the treatment on the Engel curve, the result was the opposite, i.e., receiving 4Ps grants reduces the food share significantly. The results remain the same even if I control for the gender of the head of the household. On the other hand, I found that the treatment increases the ratio of medical consumption in total consumption. We presume this is due to the amount of health knowledge provided to mothers during the Family Development Session (FDS), which is offered as a part of the 4Ps. In the FDS, mothers learn about the growth of the childhood and child-rearing with the community members. Above all, the FDS has mainly provided the health information about the children. We assume that health consumption ratio increases because the parents can gain health knowledge more than nutrition knowledge in the FDS.

In response to these results, we examine the effects of provision of nutrition knowledge in the CCT program on the Engel coefficient and knowledge cultivation in CAR, the Philippines.
External Link(s)
Registration Citation
Citation
Nakamura, Nobuyuki and Aya Suzuki. 2020. "Impact of the Provision of Nutrition Knowledge in the CCT on Household's Food Consumption in the Philippines ." AEA RCT Registry. June 12. https://doi.org/10.1257/rct.5957-1.0.
Sponsors & Partners
Sponsor(s)
Partner(s)
Experimental Details
Interventions
Intervention(s)
To explicate the effects of nutrition information diffusion more in detail, we designed an original RCT, in which mothers in the treatment groups received the fliers on nutrition in the FDS and collected the follow-up data in Benguet province in November 2015.To include both rural and areas, we chose the clusters in Tuba (urban) and Kapangan (rural) municipalities in Benguet. Tuba is in the southern part of Benguet, and it takes between 30 to 60 minutes to travel from Baguio, the center of the region, by automobile.
Intervention Start Date
2015-09-11
Intervention End Date
2015-09-13
Primary Outcomes
Primary Outcomes (end points)
Engel coefficient
Primary Outcomes (explanation)
In the survey, we asked for monthly expenditure on non-durable goods, such as food or energy for the last month, and annual expenditure on durable goods, such as education or furniture. Finally, we calculate the monthly consumption ratio.
Secondary Outcomes
Secondary Outcomes (end points)
Nutrition knowledge
Secondary Outcomes (explanation)
The mini test score of the respondents
Experimental Design
Experimental Design
For the experiment, we provide nutrition information by distributing a flier to a treatment group during the Family Development Sessions (FDSs) in the CCT program. FDS is held at the cluster level in each barangay, and we selected the target clusters randomly in the study municipalities. In the context of Filipino nutrition, stunting, underweight, obesity, and anemia are severe issues (FNRI, 2015; Chaparro et al., 2014). Therefore, we prepare fliers to offer solutions to these issues. In Treatment Group A, we provide each mother with a flier containing basic nutrition knowledge (i.e., nutrition guide pyramid edited by FNRI (2015)) and information about nutritious foods containing protein, vitamin A, and iron, which are crucial nutrients for child growth. In Treatment Group B, we provide each mother with a flier about the connection between food intake and school performance and the risks of overconsumption of soft drinks, in addition to the contents provided to Treatment Group A. When fliers were distributed during the FDS, the 4Ps field staff explained the flier’s contents to the mothers in detail during the session, ensuring that each participant understood the content. We then asked them to attach the flier to the wall or refrigerator to check it every day. FDS attendance is a conditionality of the 4Ps; thus, there is little room for self-selection bias among FDS participants.
Experimental Design Details
Randomization Method
Among the clusters in Tuba and Kapangan municipalities, we chose 11 FDS clusters and assigned Treatment A to 4 clusters (67 households), Treatment B to 3 clusters (66 households), and the Control to 4 clusters (91 households), totaling 224 households at the sample selection. We ensured that FDSs about any nutrition topics had not been conducted in the past for these clusters. After pre-research with the DSWD-CAR in August 2015, the intervention was conducted from September 11 to 13, 2015 during the monthly FDS in each cluster.
Randomization Unit
As our treatment is information dissemination, which is relatively easy to spillover, we randomized samples at the cluster level.
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
224 households
Sample size: planned number of observations
224 housheolds
Sample size (or number of clusters) by treatment arms
Treatment A: 67 households
Treatment B: 66 households
Control: 91 households
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
IRB Approval Date
IRB Approval Number
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
Yes
Intervention Completion Date
November 13, 2015, 12:00 AM +00:00
Is data collection complete?
Yes
Data Collection Completion Date
November 13, 2015, 12:00 AM +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
171 households
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
171 households
Final Sample Size (or Number of Clusters) by Treatment Arms
Treatment A: 50 households Treatment B: 48 households Control: 73 households
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
No
Reports, Papers & Other Materials
Relevant Paper(s)
REPORTS & OTHER MATERIALS