Please select the eligibility criteria that correspond to the clinical trial below.
Title: Testing the Effect of Mobile Conditional Cash Transfers (mCCTs) of Different Schedules and Amounts on Routine Childhood Immunization Coverage and Timeliness in Pakistan: A Randomized Control Trial.
Brief Summary: Like many developing countries, Pakistan faces a public health challenge of low and incomplete immunization rates of children, only 54% of children aged 12 to 24 months are fully immunized, which leaves children susceptible to vaccine-preventable diseases. The Expanded Program on Immunization (EPI) is a low-cost and effective health intervention, but the uptake is low, delayed, and completion rates are poor.

Door-to-door campaigns can increase coverage, but are extremely expensive. Incentive-based approaches have been rigorously demonstrated to effectively increase take-up and completion rates of immunization, and there is substantial evidence that small incentives can have a large impact on the take up of preventative health behavior in general. There are two major constraints to scaling these findings, however.

This study will attempt to find the most effective incentive design that helps increase the coverage of full immunization rates among children between the ages of 0 - 24 months in the city of Karachi, Pakistan. The study proposes to conduct a randomized control trial involving small conditional cash transfers (mCCTs) to determine the optimal CCT amount (high versus low), schedule (flat versus increasing) and design (lottery versus sure payment) that would lead to the highest increase in immunization rates. Interactive Research and Development's digital immunization registry will be used to enrol and randomize the study participants and generate CCTs disbursed through a mobile money transfer platform and mobile top - ups . The three year study will be conducted in Karachi, Pakistan enrolling a sample of 11,200 children, 0-2 years of age.

The study aims to provide evidence regarding the most cost-effective way to structure incentives in terms of size, schedule, and design; and address the challenge of delivering small incentives in a way that is inexpensive, logistically simple, and not subject to leakage.


Options:
A: Inclusion Criteria:

* Are pregnant.
* Are between 18 and 40 years old.
* Have a BMI (a number calculated from your height and weight) equal to or above 25kg/m2.
* Establish prenatal care before 12 weeks of your pregnancy.
* Can read, speak and understand English.

Exclusion Criteria:

* Do not plan to deliver your baby at Woman's Hospital, Baton Rouge, LA
* Are pregnant with more than one infant.
* Have habitually smoked during the last 6 months.
* Currently abuse or have abused illegal or prescription drugs in the last 6 months.
* Consume more than 2 alcoholic drinks per week.
* Are unwilling to avoid pregnancy for 12 months following delivery.
* Are unwilling to enroll your baby in the 12 month follow-up testing planned in this study.
* Are planning to move out of the area within the next 2 years or plan to be out of the study area for more than 1 month in the next year.
* Are unwilling to be assigned at random to any of the intervention groups.
* Are planning to terminate your pregnancy.
* Are planning to give your baby up for adoption.
* Are pregnant with a baby who has a known fetal anomaly.
* Have a reason that exercising is unsafe (determined by your physician or study staff).
* Have had or plan to have bariatric surgery within 1 year of your expected delivery.
* Currently have or have a history of the following:
* 3 or more first trimester miscarriages
* High blood pressure
* Type 1 diabetes
* Diagnosis of pregnancy related diabetes during screening
* HIV or AIDS
* Psychotic disorder, major depressive episode, bipolar disorder or eating disorder
* Any other pregnancy, blood, heart, lung, hormone, or digestive problem that your doctor considers unsafe for participation in this study
B: Inclusion Criteria:

15-45 years 5-7 months pregnant Resident of study area Consents to participation Access to a mobile phone during morning and afternoon

Exclusion Criteria:

\<15 years of age Not female Not a resident of study area \<5 months and \>8 months pregnant Not a Hindi speaker Access to a mobile phone only during the night
C: Inclusion Criteria:

* Children between 0 - 23 months of age visiting the EPI center for BCG/OPV-0 or Pentavalent-1/Polio-1/PCV-1 or Pentavalent-2/Polio-2/PCV-2 vaccination.
* Children permanently residing within Korangi Town, Karachi and planto remain there for the next three years.
* Caregiver accompanying the child can provide a valid mobile phone number at the time of enrolment

Exclusion Criteria:

* Children visiting the EPI center for Pentavalent-2 or Measles-1 or Measles 2
* Children born out of multiple births i.e twins or triplets
* Children not residing or planning to move out of Korangi in the next three years
* Children accompanied by caregivers unable to provide a phone number
D: Inclusion Criteria:

* Confirmed HIV diagnosis as per the clinic standard
* Female \>= 18 years old at enrollment
* Currently active or recently returned into care or newly enrolled
* With two or more previously scheduled visits (12 months prior to study enrollment
* in the 12 months prior to enrollment:
* missed one or more visits or
* viral load detectable (\>20 mL) or
* not taking prescribed HIV anti-retroviral medications

Exclusion Criteria:

* men
* women who are cognitively impaired or are not able to consent for themselves
* non-working cell phone
* adolescents \< 18 years old at enrollment

Answer: C