Effectiveness of conditional cash transfers, subsidized child care, and life skills training on adolescent mothers' school reentry, sexual and reproductive health, and mental health in Malawi and Burkina Faso: The PROMOTE Project randomized control trial

Last registered on May 16, 2022

Pre-Trial

Trial Information

General Information

Title
Effectiveness of conditional cash transfers, subsidized child care, and life skills training on adolescent mothers' school reentry, sexual and reproductive health, and mental health in Malawi and Burkina Faso: The PROMOTE Project randomized control trial
RCT ID
AEARCTR-0009115
Initial registration date
May 15, 2022

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
May 16, 2022, 5:20 PM EDT

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

Last updated
May 16, 2022, 11:48 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

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Primary Investigator

Affiliation
African Population and Health Research Center

Other Primary Investigator(s)

PI Affiliation
Centre for Social Research, University of Malawi
PI Affiliation
Institut Superieur Des Sciences De la Population, Universite Joseph Ki-Zerbo, Burkina Faso
PI Affiliation
African Population and Health Research Center
PI Affiliation
African Population and Health Research Center
PI Affiliation
Centre for Social Research, University of Malawi

Additional Trial Information

Status
In development
Start date
2022-08-01
End date
2024-11-30
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
We will implement a randomized control trial in Blantyre (Malawi) and Ouagadougou (Burkina Faso) to estimate the incremental effect of three interventions aimed at facilitating adolescent mothers’ (re)entry into school or vocation training: a cash transfer conditioned on (re)enrollment into school or vocational training; subsidized childcare; and life skills training offered by community health workers that will cover nurturing childcare, sexual and reproductive health, and financial literacy. We will also examine the effect of the intervention on sexual and reproductive health outcomes and mental health.

Adolescent mothers (N=270, per site) will be randomized into one of three study arms. Adolescent mothers in all arms will receive life skills training through adolescent mothers’ clubs. The adolescent mothers’ clubs will be facilitated by community health workers. Given their role as a bridge between the community and the health sector, we expect that working with community health workers will also help increase access to sexual and reproductive health and child health services for adolescent mothers and their children. The second arm will also receive subsidized childcare, while the third arm will incorporate all three interventions. Comparing the first (mothers’ clubs only) and second (mothers’ clubs + subsidized childcare) will allow us to test the additional benefit of the childcare subsidy. Comparing the second and third (mothers’ clubs + subsidized childcare + cash transfer) will allow us to test the additional benefit of the cash transfer. Comparing the first and third will allow us to test the combined benefit of the subsidized childcare and cash transfers. At the endline, we will assess the average treatment effect across the three groups following intent-to-treat (ITT) analysis, comparing school or vocational training enrolment and retention, contraceptive use, and mental health at baseline and endline.
External Link(s)

Registration Citation

Citation
Ajayi, Anthony et al. 2022. "Effectiveness of conditional cash transfers, subsidized child care, and life skills training on adolescent mothers' school reentry, sexual and reproductive health, and mental health in Malawi and Burkina Faso: The PROMOTE Project randomized control trial." AEA RCT Registry. May 16. https://doi.org/10.1257/rct.9115
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Experimental Details

Interventions

Intervention(s)
Three interventions will be delivered over a 12-month period: conditional cash transfers, subsidized daycare, and adolescent mothers’ clubs. The cash transfer will be conditioned on (re)enrolment in primary or secondary school (junior and senior high school in Burkina Faso) or a vocational training program. Transfers will be made for every school term during the intervention period that an adolescent mother is enrolled and remains enrolled. Adolescent mothers eligible to receive the cash transfers will receive US$30 every three months (a total of 120 US$ per adolescent mother enrolled throughout the 12 months).

Adolescent mothers eligible for subsidized child care will receive vouchers for subsidized child care in select childcare centers. Adolescent mothers who receive the vouchers will be entitled to 12 months of subsidized childcare. Adolescent mothers will hand over a voucher to the respective childcare center at the beginning of every month. In each study setting, field staff will collect the vouchers from each childcare center to monitor the intervention, as well as to determine the exact amount to be transferred to each childcare center.

The adolescent mothers’ clubs will be held every two weeks in a variety of locations in the community considered by adolescent mothers to be safe and appropriate for the meeting. During the club meetings, adolescent mothers will receive life skills training facilitated by community health workers. We expect that the clubs will create a safe space where adolescent mothers can interact to discuss their common problems, learn about child care, sexual and reproductive health and rights (including harmful gender norms that raise the risk of experiencing and tolerating gender-based violence) and financial literacy. The club will also offer a safe space where these mothers can receive psychosocial support from community health workers and peers. The collectivism the club creates also has the potential to strengthen their self-esteem, a resource they need to address the stigma associated with adolescent childbearing. If needed, we also expect that community health workers facilitating the club sessions will also support adolescent mothers to access sexual and reproductive health and child health services.
Intervention Start Date
2022-09-01
Intervention End Date
2023-12-31

Primary Outcomes

Primary Outcomes (end points)
Education outcomes (enrollment in school or vocation training program)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Sexual and reproductive health; mental health
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
After the baseline survey, we will randomly assign adolescent mothers to one of three study arms. Adolescent mothers in all arms will receive life skills training through adolescent mothers’ clubs. Adolescent mothers in arm two will also receive subsidized child care, while those in arm three will receive all three interventions. Comparing arm one (mothers’ clubs only) and arm two (mothers’ clubs + subsidized child care) will allow us to test the additional benefit of the childcare subsidy. Comparing arms two and three (mothers’ clubs + subsidized child care + cash transfer) will also allow us to test the additional benefit of the cash transfer. Comparing arms one and three will allow us to test the combined benefit of the subsidized child care and cash transfers.
Experimental Design Details
Not available
Randomization Method
By computer
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
In each country, we will randomly assign 270 adolescent mother to one of three study arms (540 total)
Sample size: planned number of observations
270 adolescent mothers per country (540 total)
Sample size (or number of clusters) by treatment arms
90 adolescent mothers
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