The Synergetic Effect of Cash Transfers for Families, Child Sensitive Social Protection Programs, and Capacity Building for Effective Social Protection on Children’s Nutritional Status in Nepal

Renzaho, Andre Μ Ν; Chitekwe, Stanley; Chen, Wen; Rijal, Sanjay; Dhakal, Thakur; Dahal, Pradiumna

doi:10.3390/ijerph14121502

Cited by 18 publications

(16 citation statements)

References 29 publications

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“…Studies looking at the impact of seasonality on household food insecurity and nutritional status of children in Bangladesh confirms that the prevalence of food insecurity and growth faltering among children is higher during monsoon season compared to dry season [38, 44]. Initiation and expansion of new social safety net programmes such as cash transfer, food transfer and other income generating programmes can improve the capacity of people to acquire foods and thereby maintain and ensure household food security status during low harvest seasons [45–49].…”

Section: Discussionmentioning

confidence: 99%

“…A working mother may have more control on food choices due to increased accessibility and affordability. They are also likely to have better knowledge about health and nutrition of their children, which may influence better feeding practices[49, 53, 68–72]. On a different note, given the nature of the work the women are involved in, further explorative study would be pertinent to identify the factors facilitating good feeding practices among working mothers in different areas.…”

Section: Discussionmentioning

confidence: 99%

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Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

et al. 2019

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Introduction Dietary diversity score (DDS) is a proxy indicator for measuring nutrient adequacy. In this study, we aimed to identify the nutritional statuses and current patterns of DDS among children between 6–59 months old and their associations with different individual and household level factors in rural Bangladesh. Methods The Nobokoli programme of World Vision Bangladesh was implemented in Mymensingh, Sherpur, Rangpur, Dinajpur, Thakurgaon, Panchagar, and Nilphamari districts of Bangladesh between 2014 and 2017. A cross-sectional community household survey was administered between July and October 2014 to collect baseline data to evaluate the Nobokoli programme. A total of 6,468 children between 6–59 months old were included in the final analysis. Anthropometric data was collected following WHO guidelines on using wooden height and digital weight scales. We collected food intake information for the past 24 hours of the survey. The WHO’s child growth standard medians were used to identify the nutritional indices of stunting, wasting, and underweight. Food items consumed were categorized into nine food groups and the DDS was constructed by counting the consumption of food items across these groups during the preceding 24 hour period. The association of DDS and nutritional status (stunting, wasting and underweight) with sociodemographic factors and household food security status were examined using multivariable models; linear regression and logistics regression respectively. Results The prevalence of stunting, wasting and underweight among children aged 6-59months were 36.8%, 18.2% and 37.7% respectively. Our findings revealed that almost all children ate any form of starch followed by consumption of milk or milk products (76%) and fleshy meat /fish (61%) respectively. The mean DDS among children was 3.93(sd 1.47). Forty percent of the children obtained a DDS score less than 4. Multivariable analysis suggested that children whose mothers had higher educational attainment and are skilled workers had higher DDS (15% and 48% respectively) compared to their counterparts. The DDS showed strong positive association with household wealth status. Children from food secure households had 26% higher DDS compared to children from food insecure households. Similarly, increasing maternal education and household wealth were found to be protective against childhood stunting and undernutrition. Discussion Our findings reiterate the need for improving household socioeconomic factors and household food security status for improving dietary diversity practices and nutritional status of children. Evidence-based solutions are needed to be implemented and expanded at scale to ensure appropriate dietary practices and improve nutritional status of the children in local context.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

et al. 2019

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“…In the short-term, CTs enhance household incomes which can improve the ability to pay for health services. Correspondingly, CTs have been found to have a positive impact on health service utilization and health outcomes (Lagarde et al , 2007; Owusu-Addo and Cross, 2014; Owusu-Addo et al , 2018), nutrition (Martins et al , 2013; Renzaho et al , 2017; Owusu-Addo et al , 2018), HIV (Pettifor et al , 2012; Heise et al , 2013) and mental health (Owusu-Addo et al , 2018). In relation to utilization of health services, the framework indicates that while access to health services is an intermediate determinant of health which can be impacted upon by CTs through the removal of financial barrier (i.e.…”

Section: Resultsmentioning

confidence: 99%

Cash transfers and the social determinants of health: a conceptual framework

Owusu‐Addo

Renzaho

Smith

2018

Health Promotion International

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Cash transfers (CTs) can play a significant role in tackling the social determinants of health (SDoH), but to date there is a lack of conceptual framework for understanding CTs linkages to the SDoH. This article proposes a framework that identifies the linkages between CTs and SDoH, discusses its implications, and argues for active involvement of health promoters in CT design, implementation and evaluation. The development of the framework followed two stages: evidence review and stakeholder involvement. The evidence review entailed a systematic literature search to identify published and unpublished impact evaluation studies of CTs in sub-Saharan Africa. Critical reflection on the evidence synthesized from the literature formed the basis for the development of the framework. Interviews with CT policy makers, managers and development partners were also carried out to help refine the framework. Interviews were audio-recorded and transcripts were analysed using thematic framework analysis. The study finds that there is limited recognition of SDoH in CT policy making and implementation. The evidence reviewed, however, points to strong impacts of CTs on SDoH. The framework thus conceptualizes how CTs work to influence a broad range of SDoH and health inequities. It also highlights how CT architecture and contexts may influence program impacts. The proposed framework can be used by policy makers to guide CT design, adaptation and operations, and by program managers and researchers to inform CTs’ evaluations, respectively. The framework suggests that to optimize CT impact on SDoH and reduce health inequities, health promoters should be actively engaged in terms of the programs design, implementation and evaluation.

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“…Currently in Kalikot, Jumla, Humla, Dolpa, Mugu, Achham, Rautahat, and Bajhang.29 Renzaho et al 2017. …”

mentioning

confidence: 99%

Promoting Holistic Child Development

2019

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Introduction The global development community has recognized holistic investments in early years as a sound foundation to achieve at least seven Sustainable Development Goals (SDGs) on poverty, hunger, health, education, gender, water and sanitation, and inequality. In Nepal, the 2005-2015 Early Childhood Development (ECD) Strategy, a Thematic Working Group on ECD in the National Planning Commission (NPC), and a Parliamentary ECD Caucus-all indicate a strong political will to prioritize the ECD agenda. Recent programming from development partners has also provided a substantive push toward a holistic, integrated approach to ECD in the country. However, ECD is still understood by stakeholders mainly as an 'education' agenda, and programs that comprise the various ECD dimensions, including nutrition, stimulation, and social protection, are not coordinated. A transition to federalism offers unprecedented opportunities for integrating and packaging ECD interventions at the local level. As such, this review aims to (a) build a common definition and framework to guide the integrated approach in investing in early years (b) identify current successes and gaps in current programming, and (c) explore actionable opportunities to integrate services in early childhood to ensure that every child gets a healthy start in life. Methodology The study consisted of four phases, starting with a desk study, followed by national-level discussions and field-level discussions and then evidence synthesis to design a framework for synergizing investments in early years. An analytical framework (AF) was formulated based on the findings of desk reviews to guide the consequent discussions and selection of respondents for national-level consultations from relevant government agencies, donor partners, and nongovernmental organizations (NGOs). The team conducted field visits to further deep dive into specific cases, challenges, and potential opportunities in scoping for work in ECD. Field visit sites were chosen through purposive sampling aimed at iteratively filling the information gaps in the AF and improving the accuracy of data already collected. To this end, about 18 key informant interviews (KIIs) and nine focus group discussions (FGDs) were conducted in Mahottari, Mugu, Lalitpur, and Kathmandu Districts. The consultations at both the national and field level generated critical lessons, considerations, and potential entry points for increasing delivery efficiency of ECD services offered across the three thematic pillars of health and nutrition, learning and stimulation (L&S), and social protection. Key Findings The study offered critical insights into the current policies, priorities, and programming, including a spectrum of interventions in ECD and care. It also provided the necessary background to explore current definitions and scope of 'integration'. For consistency purposes, hereafter, the report defines the concept as a synergy of (a) goals (objectives that can be met only through multisectoral approaches); (b) processes (implementa...

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The Synergetic Effect of Cash Transfers for Families, Child Sensitive Social Protection Programs, and Capacity Building for Effective Social Protection on Children’s Nutritional Status in Nepal

Cited by 18 publications

References 29 publications

Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

Cash transfers and the social determinants of health: a conceptual framework

Promoting Holistic Child Development

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