Background: In an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6-59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers' hygiene and feeding practices. Methods: In a study of 1655 households, 1655 caregivers for 2370 children aged 6 to 59 months enrolled in a nutrition programme provided by Save the Children answered an adapted questionnaire on hygiene and feeding practices. At the same time, based on standard criteria in the questionnaire, naturalistic observations of caregivers' hygiene practices were conducted. Every child in the study was measured with anthropometric Mid-Upper-Arm Circumference measurements for the classification of Moderate Acute Malnutrition, Severe Acute Malnutrition and Global Acute Malnutrition. Descriptive statistics were used for analysis. Results: 1) There was Severe (12.1%) and Global Acute (19.9%) Malnutrition among children included in the nutrition programme, more frequently in the 6-24 month age group compared to the 25-59 month age group (p < 0.01). 2). The practices in the households were below what could generally be considered hygienic. 3) There was poor caregivers' knowledge of breastfeeding benefits and complementary foods. Conclusion: Child malnutrition might derive from gaps in the caregiver's knowledge, attitudes, and practices regarding hygiene and infant feeding. An awareness of these gaps can be helpful in designing future educational programmes that target caregivers, particularly in at-risk population groups.

No abstract

The effects of nutrition counselling (NC) and unconditional cash transfer (UCT) in improving growth in children under five and household food security are poorly understood in humanitarian settings. Therefore, this study aimed to evaluate the effects of NC and NC combined with unconditional cash transfer (NC + UCT) on children’s growth and food security in Somalia. The study was performed with a quasi-experimental design in two districts in the Banadir region of Somalia. Caregivers (n = 255) with mildly to moderately malnourished children aged 6 to 59 months old (n = 184) were randomized to the NC, NC + UCT and control groups. The interventions consisted of weekly NC for three months alone or in combination with UCT. The outcome variables were wasting, underweight, stunting, and food security. Difference-indifferences analysis was used to estimate the effect of the interventions. Our study did not find any significant impacts of NC or NC + UCT on child wasting, underweight, stunting, food security or household expenses. In conclusion, NC, alone or in combination with UCT, did not impact children’s growth or household food security. Thus, a culturally tailored NC programme over a longer period, supplemented with cash transfer, could be beneficial to consider when designing interventions to reduce malnutrition and food insecurity.

Background:The effects of nutrition counselling (NC) and unconditional cash transfer (UCT) in improving growth in children under five and household food security are poorly understood in humanitarian settings. The aim of this study was to evaluate the effects of NC and NC combined with unconditional cash transfer (NC+UCT) on children’s growth and food security in Somalia.Methods:The study was performed with a quasi-experimental design in two districts in the Banadir region of Somalia. The study used two-stage stratified sampling. Caregivers (n=255) of mildly to moderately malnourished children aged 6 to 59 months old (n= 184) were randomized to the NC, NC+UCT and control groups. The interventions consisted of weekly NC for three months alone or in combination with UCT. The primary outcome variables of the study were indicators of children’s nutrition, i.e., wasting. The secondary outcome variables were indicators of underweight, stunting, and food security, i.e., dietary diversity, household hunger scale and food consumption scores. Data were collected at baseline and 11 months after programme implementation. Difference-in-differences analysis was used to estimate the effect of the interventions.Results:Our study did not find any significant impact on child wasting (aOR: 0.81, 95% CI: 0.26–2.56, p = 0.722), underweight (aOR: 1.29, 95% CI: 0.40–3.48, p = 0.603), or stunting (aOR: 0.84, 95% CI: 0.29–2.46, p = 0.764) compared to the control group. Similarly, in the NC+UCT group, we did not find any significant reduction in wasting (aOR: 0.79, 95% CI: 0.26–2.36, p = 0.669), underweight (aOR: 0.88, 95% CI: 0.33–2.35, p = 0.806), or stunting (aOR: 1.51, 95% CI: 0.55–4.20, p = 0.426) compared to the control group. No intervention effect was observed on food security outcomes, child dietary diversity scores, minimum child dietary diversity (≥4 food groups) or household expenses (Table 3).Conclusion:NC, alone or in combination with UCT, did not impact children’s growth or household food security. A culturally tailored NC programme over a longer period and larger, regular, and predictable transfers might result in a significant reduction in malnutrition and food insecurity.Trial registrationThe evaluation was registered on the RIDIE registry (RIDIE-STUDY-ID-5a1264bdb207a) on 11/19/2017.