Cash-based assistance and the nutrition status of pregnant and lactating women in the Somalia food crisis: A comparison of two transfer modalities

Abstract

Background Large-scale emergency assistance programmes in Somalia use a variety of transfer modalities including in-kind food provision, food vouchers, and cash transfers. Evidence is needed to better understand whether and how such modalities differ in reducing the risk of acute malnutrition in vulnerable groups, such as the 800,000 pregnant and lactating women affected by the 2017/18 food crisis. Methods Changes in diet and acute malnutrition status were assessed among pregnant and lactating women receiving similarly sized household transfers over a four-month period (total value of~US$450 per household) delivered either as food vouchers or as mixed transfers consisting of in-kind food, vouchers, and cash. Baseline and endline comparisons were conducted for 514 women in Wajid, Somalia. Primary study outcomes were Minimum Dietary Diversity for Women, meal frequency, and mid-upper arm circumference (MUAC), with MUAC<21.0 cm classified as acute malnutrition. Adjusted analyses consisted of difference-indifference analysis using linear and logistic regression models with inverse probability weighting based on propensity scores to account for the non-randomized design. Findings No significant difference in change in dietary quality was observed between food voucher and mixed transfer recipients; a significant difference in change in mean meal frequency was observed (0.3 meals/day, CI: 0.1-0.5, p = 0.001) and the mixed transfer group had significantly greater meal frequency at endline (p<0.001). Mean MUAC increased significantly

Impact of conditional and unconditional cash transfers on health outcomes and use of health services in humanitarian settings: a mixed-methods systematic review

“…Two studies in Somalia assessed the impact of different emergency assistance modalities on acute malnutrition including in-kind food provision, food vouchers and UCTs (US$450 over 4 months). 33 34 Adjusted change in mean MUAC increased 0.1 cm (95% CI −0.1 to 0.4) in the mixed transfer (food, vouchers and unrestricted cash) recipients and 0.5 cm (95% CI 0.0 to 0.7) in the food voucher recipients. Adjusted prevalence of acute malnutrition in children under 5 decreased by 4.8% (95% CI −9.9 to 8.1) in mixed transfer recipients and increased by 0.7% (95% CI −13.4 to 14.4) compared with food voucher recipients.…”

“… 51 Two studies reported on a combination of human conflict and drought in Somalia. 33 34 The internal displacement camps were in Somalia 39 and Ecuador, 42 while refugee settlements based in Kenya hosted refugees escaping civil conflicts in Southern Sudan and Somalia. 44 Both Jordan and Lebanon supported Syrian refugees escaping civil conflicts.…”

“… 34 Likewise, a UCT programme targeting pregnant and lactating women found no significant difference in preventing acute malnutrition compared with a control group with no cash-related intervention. 33 When 6 monthly cash transfers (US$40 per month) were compared with food vouchers and food transfers in Northern Ecuador, all three arms significantly improved the quality and quantity of consumed food (measured by HDDS, Dietary Diversity Index (DDI), FCS, caloric intake, per capita food consumption). However, while the cash modality resulted in the most satisfaction among recipients (and food vouchers in the least), the increase in calories and dietary diversity were most cost-effectively accomplished by equal-valued food vouchers.…”

Cash and voucher assistance and children's nutrition status in Somalia

“…PLW and CU5 in eligible households were enrolled as study participants. This paper focuses on CU5 results; PLW findings are reported elsewhere (Doocy et al, n.d.).…”

Perfil epidemiológico das famílias segundo a inserção no programa de transferência de renda residentes em cidades litorâneas do Nordeste do Brasil

“…However, the increase in purchasing power is not enough to generate health benefits, programs from different countries show that families benefiting from CTP have a higher consumption of foods rich in sugars and processed foods (Doocy et al, 2020;Grummon & Taillie, 2018;Menezes et al, 2008), thus requiring nutrition education. Research, Society and Development, v. 10, n. 11, e179101119570, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.…”