title: The MAM'Out project: a randomized controlled trial to assess multiannual and seasonal cash transfers for the prevention of acute malnutrition in children under 36 months in Burkina Faso.
abstract: BACKGROUND
  Wasting is a public health issue but evidence gaps remain concerning preventive strategies not primarily based on food products. Cash transfers, as part of safety net approach, have potential to prevent under-nutrition. However, most of the cash transfer programs implemented and scientifically evaluated do not have a clear nutritional objective, which leads to a lack of evidence regarding their nutritional benefits.
  
  
  METHODS
  The MAM'Out research project aims at evaluating a seasonal and multiannual cash transfer program to prevent acute malnutrition in children under 36 months, in terms of effectiveness and cost-effectiveness in the Tapoa province (Eastern region of Burkina Faso, Africa). The program is targeted to economically vulnerable households with children less than 1 year old at the time of inclusion. Cash is distributed to mothers and the transfers are unconditional, leading to beneficiaries' self-determination on the use of cash. The study is designed as a two-arm cluster randomized intervention trial, based on the randomization of rural villages. One group receives cash transfers via mobile phones and one is a control group. The main outcomes are the cumulative incidence of acute malnutrition and the cost-effectiveness. Child anthropometry (height, weight and MUAC) is followed, as well as indicators related to dietary diversity, food security, health center utilization, families' expenses, women empowerment and morbidities. 24 h-food recalls are also carried out. Individual interviews and focus group discussions allow collecting qualitative data. Finally, based on a theory framework built a priori, the pathways used by the cash to have an effect on the prevention of under-nutrition will be assessed.
  
  
  CONCLUSIONS
  The design chosen will lead to a robust assessment of the effectiveness of the proposed intervention. Several challenges appeared while implementing the study and discrepancies with the research protocol, mainly due to unforeseen events, can be highlighted, such as delay in project implementation, switch to e-data collection and implementation of a supervision process.
  
  
  BACKGROUND
  ClinicalTrials.gov, identifier: NCT01866124, registered May 7, 2013.
authors.affiliation: Research and Analyses Department, Action Contre la Faim, Paris, France. apapucci@actioncontrelafaim.org.|Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium. apapucci@actioncontrelafaim.org.|AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France. apapucci@actioncontrelafaim.org.|NRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France. apapucci@actioncontrelafaim.org.
authors.forename: Audrey
authors.initials: A
authors.lastname: Tonguet-Papucci
authors.affiliation: Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium. L.Huybregts@cgiar.org.|Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA. L.Huybregts@cgiar.org.
authors.forename: Lieven
authors.initials: L
authors.lastname: Huybregts
authors.affiliation: Research and Analyses Department, Action Contre la Faim, Paris, France. maitaissa@actioncontrelafaim.org.
authors.forename: Myriam
authors.initials: M
authors.lastname: Ait Aissa
authors.affiliation: AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France. jean-francois.huneau@agroparistech.fr.|NRA, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France. jean-francois.huneau@agroparistech.fr.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Huneau
authors.affiliation: Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium. PKolsteren@itg.be.|Child Health and Nutrition Unit, Institute of Tropical Medicine, Antwerp, Belgium. PKolsteren@itg.be.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kolsteren
mesh_terms: D001837:Body Weights and Measures; D002050:Burkina Faso; D015362:Child Nutrition Disorders / Q000517:prevention & control*; D002675:Child, Preschool; D004032:Diet; D005191:Family Characteristics; D005523:Food Supply; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D009035:Mothers; D009752:Nutritional Status; D011632:Public Assistance / Q000458:organization & administration*; D012424:Rural Population; D012621:Seasons