Maternal and Child Health OutcomesNCT06631768
Gendered Misallocation of Labor: Evidence From Malawian Farmers
A study testing Casual labor subsidy in people with Maternal and Child Health Outcomes, run by Nicholas Rahim at 1 site in Malawi.
Trial summary
The investigators will conduct a cluster randomized controlled trial across districts in Malawi to evaluate the effect of providing free casual labor to pregnant farmers and female farmers on agricultural output, maternal and child health outcomes, child development, and social networks. Read more about this study
- Who is it for?
- Ages 18 years and older, women onlyHealthy volunteers can take part
- Conditions the study is for
- Maternal and Child Health Outcomes
- What is being tested?
- Casual labor subsidy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 989 participants
- Where
- 1 siteMalawi
- Study dates
- 16 Aug 2025to 7 Sep 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Pregnant at time of One Acre Fund program rollout
- Mother to at least one child aged below 1 years of age
Who cannot join
- -None
Trial locations and contacts
1 site in 1 country.
About this study
The investigators will conduct a cluster randomized controlled trial across districts in Malawi to evaluate the effect of providing free casual labor to pregnant farmers and female farmers on agricultural output, maternal and child health outcomes, child development, and social networks.
Read the detailed description
This will be a cluster randomized control trial (RCT), where 75 of the districts in which One Acre Fund (1AF) currently operates within in Malawi will be randomly selected for inclusion in this study. Of these 75 districts, 38 will be randomly selected to implement the intervention. The intervention constitutes a voucher offered to all female famers who are currently enrolled in the 1AF program who are pregnant and/or have a child ages 1 years and below that entitles the recipient to a set number of days of labor from casual workers employed by local 1AF offices. The remaining 37 districts will serve as the control group.
Data will be collected at baseline during the planting season and endline at the conclusion of the harvest season. Data collected will pertain to agricultural output, individual and household demographics, obstetric history and outcomes, mental health, maternal health, child health and development, and social networks.
- Conditions
- Maternal and Child Health Outcomes
- Being tested
- Casual labor subsidy
- Keywords
- Agriculture, Maternal and child health, Social networks
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Casual labor subsidyOther
Eligible participants will be offered a voucher that can be redeemed for a set number of days of agricultural labor from casual laborers hired by local One Acre Fund offices. Casual laborers receive standard training in line with the trainings currently offered by the organization to participating farmers.
| Study group | Role | What they receive |
|---|---|---|
| Treatment arm with casual labor voucher program | Experimental | Eligible members (pregnant and/or mother of at least one child aged 1 years or younger) of 1AF in the randomly selected treatment districts receive vouchers for a set number of days of free work from casual laborers employed by local 1AF offices. This is in addition to standard 1AF programming. Receives: Other: Casual labor subsidy |
| Control arm | No intervention | Eligible members will only receive standard 1AF programming in randomly selected control districts. They will not receive the labor subsidy during the study period. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Agricultural Output
A continuous measure of the value of the participant's agricultural yield, measured in Malawian Kwacha
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Labor inputs
A pair of recall questions repeated for each household member aged 10 years or older (including the respondent) that ask about the average number of days a week and the average number of hours per day the individual works on the respondent's farm, both measured continuously.
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Antenatal care seeking
A continuous variable of number of antenatal care visits for those pregnancies that overlap with the index agricultural season
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Care seeking for child health
Two continuous variables measuring number of routine postnatal care and sick child visits
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Reach of social networks
A social networks module that collects data on the extent and characteristics of the participant's social networks. Measured by the number of people reported in the participant's network, with a higher number indicating a larger network.
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Postnatal care seeking
A continuous variable of number of postnatal care visits for those pregnancies that overlap with the index agricultural season
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Secondary outcomes (8)
Maternal consumption short term recall: number of meals
Two questions regarding the number of meals consumed the day before and the number of meals consumed two days before
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal consumption medium term recall: protein intake
Four questions regarding the number of times the participant consumed fish, meat, eggs, and usipa.
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal mental health
Patient Health Questionnaire-2 (PHQ-2): a 2-item Likert scale questionnaire for assessing depressive symptoms. Score can range between 0 and 6, with higher scores indicating more severe depressive symptoms.
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Child birth weight
A continuous variable measured in grams of the reported birthweight of each child born during most delivery
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Barriers to perinatal care
A set of four Likert style questions asking to respondents to how much they agree with the following statements as reasons to not visit a health facility for ANC and/or PNC: "The health facility is too far away," "I have to work on my farm," "I am too unwell/sick," "and "I do not think the quality of care is worth it"
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal hunger
Question about how often the respondent went to bed hungry in the past month: "Never," "A few times," "Nearly every other night," and "Most nights"
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Child consumption
A set of four questions concerning the frequency of breastfeeding; meat, egg, or fish; fruits or vegetables; and porridge, bread, rice, pap, or pasta consumption in the past month for the youngest child.
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Willingness to hire causal labor
Likert scale question on how likely the participant is to hire a casual worker during the upcoming agricultural season
Measured: Assessed after harvest season (6 - 8 months after intervention initiation)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Oct 2024
- Study start16 Aug 2025
- Primary completion7 Sep 2025
- Study completion7 Sep 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Maternal and Child Health OutcomesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 989 participants (actual)
Sponsor and investigators
- Lead sponsor
- Nicholas Rahim
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Nicholas Rahim, Harvard School of Public Health (HSPH)
- Investigators
- Gabriella Fleischman, Principal investigator, Harvard Kennedy SchoolNicholas Rahim, Principal investigator, Harvard School of Public Health (HSPH)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06631768
- Sponsor's protocol ID
- IRB24-1234
- Status last verified
- Sep 2025
- First submitted
- 1 Oct 2024
- Last updated
- 16 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: After manuscript publication, fully de-identified data may be shared with researchers upon request.
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Gendered Misallocation of Labor: Evidence From Malawian Farmers
- ClinicalTrials.gov ID
- NCT06631768
- Acronym / sponsor ID
- IRB24-1234
- Conditions
- Maternal and Child Health Outcomes
- Keywords
- Agriculture, Maternal and child health, Social networks
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 989 participants (actual)
- Lead sponsor
- Nicholas RahimUniversity, hospital or other
- Study start
- 16 Aug 2025 (actual)
- Primary completion
- 7 Sep 2025 (actual)
- Study completion
- 7 Sep 2025 (actual)
- First posted
- 8 Oct 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators will conduct a cluster randomized controlled trial across districts in Malawi to evaluate the effect of providing free casual labor to pregnant farmers and female farmers on agricultural output, maternal and child health outcomes, child development, and social networks.
Detailed description
This will be a cluster randomized control trial (RCT), where 75 of the districts in which One Acre Fund (1AF) currently operates within in Malawi will be randomly selected for inclusion in this study. Of these 75 districts, 38 will be randomly selected to implement the intervention. The intervention constitutes a voucher offered to all female famers who are currently enrolled in the 1AF program who are pregnant and/or have a child ages 1 years and below that entitles the recipient to a set number of days of labor from casual workers employed by local 1AF offices. The remaining 37 districts will serve as the control group.
Data will be collected at baseline during the planting season and endline at the conclusion of the harvest season. Data collected will pertain to agricultural output, individual and household demographics, obstetric history and outcomes, mental health, maternal health, child health and development, and social networks.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment arm with casual labor voucher program | Experimental | Other: Casual labor subsidyEligible members (pregnant and/or mother of at least one child aged 1 years or younger) of 1AF in the randomly selected treatment districts receive vouchers for a set number of days of free work from casual laborers employed by local 1AF offices. This is in addition to standard 1AF programming. |
| Control arm | No intervention | –Eligible members will only receive standard 1AF programming in randomly selected control districts. They will not receive the labor subsidy during the study period. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Pregnant at time of One Acre Fund program rollout
- Mother to at least one child aged below 1 years of age
Key exclusion criteria (1 listed)
- -None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Casual labor subsidyEligible participants will be offered a voucher that can be redeemed for a set number of days of agricultural labor from casual laborers hired by local One Acre Fund offices. Casual laborers receive standard training in line with the trainings currently offered by the organization to participating farmers. | Other | Treatment arm with casual labor voucher program |
Primary outcome
Agricultural Output
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
A continuous measure of the value of the participant's agricultural yield, measured in Malawian Kwacha
Labor inputs
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
A pair of recall questions repeated for each household member aged 10 years or older (including the respondent) that ask about the average number of days a week and the average number of hours per day the individual works on the respondent's farm, both measured continuously.
Antenatal care seeking
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
A continuous variable of number of antenatal care visits for those pregnancies that overlap with the index agricultural season
Care seeking for child health
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Two continuous variables measuring number of routine postnatal care and sick child visits
Reach of social networks
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
A social networks module that collects data on the extent and characteristics of the participant's social networks. Measured by the number of people reported in the participant's network, with a higher number indicating a larger network.
Postnatal care seeking
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
A continuous variable of number of postnatal care visits for those pregnancies that overlap with the index agricultural season
8 secondary outcomes
Maternal consumption short term recall: number of meals
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal consumption medium term recall: protein intake
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal mental health
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Child birth weight
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Barriers to perinatal care
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Maternal hunger
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Child consumption
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Willingness to hire causal labor
Time frame: Assessed after harvest season (6 - 8 months after intervention initiation)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2025.
- Individual participant dataSharing planned: Yes. After manuscript publication, fully de-identified data may be shared with researchers upon request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gabriella Fleischman principal investigator
Harvard Kennedy School
Nicholas Rahim principal investigator
Harvard School of Public Health (HSPH)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Casual labor subsidy in people with Maternal and Child Health Outcomes, run by Nicholas Rahim at 1 site in Malawi.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Malawi. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Agricultural Output (time frame: Assessed after harvest season (6 - 8 months after intervention initiation)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2025.