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Effects of multiannual, seasonal unconditional cash transfers on food security and dietary diversity in rural Burkina Faso: the Moderate Acute Malnutrition Out (MAM’Out) cluster-randomized controlled trial

  • Freddy Houngbe (a1), Audrey Tonguet-Papucci (a2), Eunice Nago (a3), Josselin Gauny (a2), Myriam Ait-Aïssa (a2), Jean-François Huneau (a4), Patrick Kolsteren (a1) and Lieven Huybregts (a5)...

Abstract

Objective

To evaluate the impact of multiannual, seasonal unconditional cash transfers (UCT) provided within the Moderate Acute Malnutrition Out (MAM’Out) research project on households’ food security and children’s and caregivers’ dietary diversity.

Design

A two-arm cluster-randomized controlled trial with sixteen villages in the intervention group and sixteen others in the control group. A monthly allowance of 10 000 XOF was transferred to caregivers of eligible children via a personal mobile phone account from July to November 2013 and 2014.

Setting

Tapoa province in the eastern region of Burkina Faso.

Participants

Data on household food access (monthly adequate household food provisioning (MAHFP); household food insecurity access scale (HFIAS)) and maternal and child dietary diversity were analysed for 1143 households, 1219 caregivers of reproductive age (15–49 years) and 1247 under-5 children from both intervention and control groups.

Results

The mean women dietary diversity score in intervention caregivers and the mean dietary diversity score (DDS) in intervention children with inadequate minimum DDS at baseline were respectively 7 % (95 % CI 2, 11 %; P = 0·002) and 17 % (95 % CI 11, 23 %; P <0·001) higher compared with the control group. However, no difference was found in the intervention effect on household food security measured with HFIAS (relative risk = 1·03; 95 % CI 0·92, 1·15; P = 0·565) and MAHFP (relative risk = 0·98; 95 % CI 0·96, 1·01; P = 0·426).

Conclusions

Multiannual, seasonalUCT increased dietary diversity in children and their caregivers. They can be recommended in actions aiming to improve maternal and child diet diversity.

Copyright

Corresponding author

*Corresponding author: Email houngbef@gmail.com

References

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1. Overseas Development Institute (2015) Doing Cash Differently: How Cash Transfers Can Transform Humanitarian Aid. Report of the High Level Panel on Humanitarian Cash Transfers. London:Overseas Development Institute.
2. Garcia, M & Moore, CMT (2012) The Cash Dividend: The Rise of Cash Transfer Programs in Sub-Saharan Africa. Washington, DC: The World Bank.
3. Bastagli, F, Hangen-Zanker, J, Harman, L et al. (2016) Cash Transfers: What Does the Evidence Say? A Rigorous Review of Programme Impact and of the Role of Design and Implementation Features. London: Overseas Development Institute in collaboration with Oxford Policy Management.
4. Alviar, C, Davis, B, Handa, S et al. (2012) The impact of the Kenya cash transfer program for orphans and vulnerable children on household spending. J Dev Effect 4, 937.
5. American Institutes for Research (2013) Zambia’s Child Grant Program: 24-Month Impact Report. Washington, DC: American Institutes for Research.
6. Attanasio, O, Gomez, LC, Heredia, P et al. (2005) The Short-Term Impact of a Conditional Cash Subsidy on Child Health and Nutrition in Colombia. Report Summary: Familias 03. London: The Institute for Fiscal Studies.
7. Ferré, C & Sharif, I (2014) Can Conditional Cash Transfers Improve Education and Nutrition Outcomes for Poor Children in Bangladesh? Evidence from a Pilot Project. Policy Research Working Paper no. 7077. Washington, DC: The World Bank.
8. Haushofer, J & Shapiro, J (2013) Policy Brief: Impacts of Unconditional Cash Transfers. https://www.princeton.edu/~joha/publications/Haushofer_Shapiro_Policy_Brief_2013.pdf (accessed November 2018).
9. Miller, CM, Tsoka, M & Reichert, K (2011) The impact of the Social Cash Transfer Scheme on food security in Malawi. Food Policy 36, 230238.
10. Gilligan, D, Margolies, A, Quinones, E et al. (2013) Impact Evaluation of Cash and Food Transfers at Early Childhood Development Centers in Karamoja, Uganda: Final Impact Report. Washington, DC: International Food Policy Research Institute.
11. Hidrobo, M, Hoddinott, J, Peterman, A et al. (2014) Cash, food, or vouchers? Evidence from a randomized experiment in northern Ecuador. J Dev Econ 107, 144156.
12. Leroy, JL, Gadsden, P, Rodriguez-Ramirez, S et al. (2010) Cash and in-kind transfers in poor rural communities in Mexico increase household fruit, vegetable, and micronutrient consumption but also lead to excess energy consumption. J Nutr 140, 612617.
13. Tiwari, S, Daidone, S, Ruvalcaba, MA et al. (2016) Impact of cash transfer programs on food security and nutrition in sub-Saharan Africa: a cross-country analysis. Glob Food Sec 11, 7283.
14. Ministry of Community Development, Mother and Child Health, Republic of Zambia (2014) Social Cash Transfer Programme, Impact Evaluation (Randomized Controlled Trial): 24-Month Report for the Multiple Category Targeting Grant. Washington, DC: American Institutes for Research.
15. Bailey, S & Hedlund, K (2012) The Impact of Cash Transfers on Nutrition in Emergency and Transitional Contexts: A Review of Evidence. HPG Synthesis Paper. London: Overseas Development Institute.
16. Ruel, MT, Alderman, H & Maternal and Child Nutrition Study Group (2013) Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382, 536551.
17. Akresh, R, de Walque, D & Kazianga, H (2016) Evidence from a Randomized Evaluation of the Household Welfare Impacts of Conditional and Unconditional Cash Transfers Given to Mothers or Fathers. Policy Research Working Paper no. 7730. Washington, DC: The World Bank.
18. Seidenfeld, D, Handa, S, Tembo, G et al. (2014) The Impact of an Unconditional Cash Transfer on Food Security and Nutrition: The Zambia Child Grant Programme. IDS Special Collection. Brighton: Institute of Development Studies.
19. UNICEF, World Health Organization & International Bank for Reconstruction and Development/The World Bank (2017) Levels and Trends in Child Malnutrition – Key Findings of the 2017 Edition of the Joint Child Malnutrition Estimates. Geneva: WHO.
20. Tonguet-Papucci, A, Huybregts, L, Aissa, MA et al. (2015) The MAM’Out project: a randomized controlled trial to assess multiannual and seasonal cash transfers for the prevention of acute malnutrition in children under 36 months in Burkina Faso. BMC Public Health 15, 762.
21. Houngbe, F, Tonguet-Papucci, A, Altare, C et al. (2017) Unconditional cash transfers do not prevent children’s undernutrition in the Moderate Acute Malnutrition Out (MAM’Out) cluster-randomized controlled trial in rural Burkina Faso. J Nutr 147, 14101417.
22. Tonguet-Papucci, A, Houngbe, F, Lompo, P et al. (2017) Beneficiaries’ perceptions and reported use of unconditional cash transfers intended to prevent acute malnutrition in children in poor rural communities in Burkina Faso: qualitative results from the MAM’Out randomized controlled trial. BMC Public Health 17, 527.
23. Tonguet-Papucci, A, Houngbe, F, Huybregts, L et al. (2017) Unconditional seasonal cash transfer increases intake of high-nutritional-value foods in young Burkinabe children: results of 24-hour dietary recall surveys within the Moderate Acute Malnutrition Out (MAM’Out) randomized controlled trial. J Nutr 147, 14181425.
24. Black, RE, Allen, LH, Bhutta, ZA et al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371, 243260.
25. Cartry, M (1966) Attitudes familiales chez les Gourmantché. L’homme 6, 4167.
26. MAFAP, (2013) Revue des politiques agricoles et alimentaires au Burkina Faso. Série rapport pays SPAAA. Rome: FAO.
27. Institut National de la Statistique et de la Démographie & ICF International (2012) Enquête Démographique et de Santé et à Indicateurs Multiples (EDSBF-MICS IV) 2010. Calverton, MD: INSD and ICF International.
28. Action Contre la Faim (2012) Enquête CAP – Connaissances Attitudes et Pratiques (Santé, Hygiène et Nutrition) – District Sanitaire de Diapaga, Burkina Faso. Paris: Action Contre la Faim.
29. Action Contre la Faim, (2013) Programme ‘Wash-in-Nut’: intégration d’un paquet minimum EAH dans les programmes de traitement de la sous-nutrition, Burkina Faso. Paris: Action Contre la Faim.
30. Boucher-Castel, L & Chalimbaud, J (2013) Rapport de synthèse NCA-Tapoa, Burkina Faso. Paris: Action Contre la Faim.
31. Boudreau, T, Lawrence, M, Holzmann, P et al. (2008) The Practitioners’ Guide to the Household Economy Approach. Johannesburg: Food Economy Group.
32. Leroy, JL, Ruel, M, Frongillo, EA et al. (2015) Measuring the food access dimension of food security: a critical review and mapping of indicators. Food Nutr Bull 36, 167195.
33. Clay, E (2013) Food security: concepts and measurement. In Trade Reforms and Food Security: Conceptualizing the Linkages, pp. 2534. Rome: FAO.
34. Bilinsky, P & Swindale, A (2010) Months of Adequate Household Food Provisioning (MAHFP) for Measurement of Household Food Access: Indicator Guide (v.4). Washington, DC: FHI 360/Food and Nutrition Technical Assistance III Project.
35. Coates, J, Swindale, A & Bilinsky, P (2007) Household Food Insecurity Access Scale (HFIAS) for Measurement of Household Food Access: Indicator Guide (v.3). Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.
36. Becquey, E, Martin-Prevel, Y, Traissac, P et al. (2010) The household food insecurity access scale and an index-member dietary diversity score contribute valid and complementary information on household food insecurity in an urban West-African setting. J Nutr 140, 22332240.
37. Knueppel, D, Demment, M & Kaiser, L (2010) Validation of the Household Food Insecurity Access Scale in rural Tanzania. Public Health Nutr 13, 360367.
38. Krebs-Smith, SM, Smiciklas-Wright, H, Guthrie, HA et al. (1987) The effects of variety in food choices on dietary quality. J Am Diet Assoc 87, 897903.
39. Lowik, MRH, Hulshof, KFAM & Brussaard, JH (1999) Food-based dietary guidelines: some assumptions tested for the Netherlands. Br J Nutr 81, Suppl. 2, S143S149.
40. Working Group on Infant and Young Child Feeding Indicators (2006) Developing and Validating Simple Indicators of Dietary Quality and Energy Intake of Infants and Young Children in Developing Countries: Summary of Findings from Analysis of 10 Data Sets. Washington, DC: Food and Nutrition Technical Assistance Project, FHI 360.
41. Kennedy, G, Ballard, T & Dop, M (2013) Guidelines for Measuring Household and Individual Dietary Diversity. Rome: Nutrition and Consumer Protection Division, FAO.
42. World Health Organization (2008) Indicators for Assessing Infant and Young Child Feeding Practices. Part 1: Definitions. Geneva: WHO.
43. Vyas, S & Kumaranayake, L (2006) Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21, 459468.
44. Greenland, S (1987) Interpretation and choice of effect measures in epidemiologic analyses. Am J Epidemiol 125, 761768.
45. Nurminen, M (1995) To use or not to use the odds ratio in epidemiologic analyses? Eur J Epidemiol 11, 365371.
46. Cummings, P (2009) Methods for estimating adjusted risk ratios. Stata J 9, 175196.
47. Grellety, E, Babakazo, P, Bangana, A et al. (2017) Effects of unconditional cash transfers on the outcome of treatment for severe acute malnutrition (SAM): a cluster-randomised trial in the Democratic Republic of the Congo. BMC Med 15, 87.
48. Popkin, BM (1999) Urbanization, lifestyle changes and the nutrition transition. World Dev 27, 19051916.
49. Bosu, WK (2015) An overview of the nutrition transition in West Africa: implications for non-communicable diseases. Proc Nutr Soc 74, 466477.
50. Thow, AM, Fanzo, J & Negin, J (2016) A systematic review of the effect of remittances on diet and nutrition. Food Nutr Bull 37, 4264.
51. United Nations High Commissioner for Refugees, UNICEF, World Food Programme et al. (2004) Food and Nutrition Needs in Emergencies. Geneva: WHO.
52. United Nations High Commissioner for Refugees, The Cash Learning Partnership, Danish Refugee Council et al. (2015) Operational Guidance and Toolkit for Multipurpose Cash Grants. Geneva: UNHCR.
53. De Cock, N, D’Haese, M, Vink, N et al. (2013) Food security in rural areas of Limpopo province, South Africa. Food Secur 5, 269282.
54. Mohammadi, F, Omidvar, N, Houshiar-Rad, A et al. (2012) Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran. Public Health Nutr 15, 149157.

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