The Effect of a Cash Transfer Program and Preventive Nutrition Packages on Household Welfare and Child Nutritional Status in Mali
Condition: Poverty; Child Malnutrition
MeSH terms: Malnutrition; Child Nutrition Disorders
Study type: Interventional
Phase: Phase 4

Summary: 
      In the last two decades, cash transfer (CT) programs have emerged as a popular approach to
      long-term poverty alleviation. While the main goal of cash transfer programs is to reduce
      poverty, they also have the potential to improve many development outcomes, such as health
      and education.

      While many studies, mainly in Latin America and Asia, have investigated the impacts of CTs on
      poverty and food security and have, for the most part, found positive impacts, less is known
      about the impacts of CTs in Africa south of the Sahara, and, in particular, West Africa.
      Moreover, despite the fact that cash transfers have been shown to lead to decreases in
      poverty, improvements in household food security, and increases in health service
      utilization, impacts on children's nutritional status (including anthropometric measures) are
      generally small (Manley, Gitter, and Slavchevska 2013). Consequently, policymakers and
      governments are left with the question of how to design social safety nets, such as cash
      transfers, to achieve greater impact on diet quality, health, and nutrition.

      The overall goal of this research is to generate evidence and knowledge on an integrated
      program implemented by the Government of Mali that includes a combination of cash transfers
      and targeted nutrition interventions. The information generated will inform program
      implementers and policymakers about best options to improve food security and nutrition among
      vulnerable groups and individuals in West Africa. Specifically, the main objectives of the
      research are

        1. To provide evidence on the contribution of integrated social transfer programs to
           enhancing household welfare, food security, dietary diversity, and maternal and child
           nutrition in West Africa.

        2. To test different features and combinations of cash transfers and targeted nutrition
           interventions, and assess their impact on food security and maternal and child nutrition
           and health outcomes in Mali.

        3. To generate knowledge regarding the pathways of impact of these different program
           packages, identify the most effective and efficient modalities in the context of Mali,
           and derive lessons learned for other countries in the region.
    

Detailed description: 
      The research entails two study designs: i) a repeated cross-sectional survey (baseline,
      midline and endline) in a sample of 1,440 children between 6 and 24 months of age, mainly to
      asses the program's impact on child nutrition and health outcomes; ii) a panel study
      following a cohort of 2,880 children over 3 years mainly focusing on the evaluation of
      household welfare outcomes. The study will be conducted in the 96 communes where the
      Jigisemejiri program is being implemented, situated in 5 regions of Mali: Sikasso, Koulikoro,
      Segou, Mopti and Kayes. Data will be collected at baseline (2014, T=0), midline (2016, T=~24
      months) and endline (2018, T=~48 months).

      The program is implemented for 48 months. The experimental group receives the cash transfer
      and group counselling intervention for 36 months. During the last 12 months the experimental
      group does not receive any intervention. The control group receives no intervention during
      the first 36 months, but receives the cash transfer and group counselling during the last 12
      months. In a subsample of communes from the experimental group, villages were randomized to
      either receive Preventive Nutrition Packages (PNP) or nothing. The impact of PNP is analyzed
      by comparing villages that received PNP and villages that did not receive PNP during the last
      12 months of the program.
    

Intervention name(s): Cash distribution during first 36 months; Accompanying information sessions on health, child nutrition, household economics and education during first 36 months; Preventive Nutrition Packages during last 12 months; Cash distribution during the last 12 months; Accompanying information sessions on health, child nutrition, household economics and education during the last 12 months
Intervention type(s): Other; Behavioral; Dietary Supplement; Other; Behavioral
Intervention description(s): Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.; Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.; Fortified flour supplements for children (Supercereal Plus)and pregnant/lactating mothers (super Cereal); Three-monthly distribution of Cash (30,000 FCFA/trimester) to households that are beneficiary of the Jigisemejiri program.; Large group gatherings of cash beneficiaries are organized in parallel to the cash distributions. During these meetings, local NGOs present and discuss a topic related to health, child nutrition, household economics or education.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: behavior change communication; cash transfer; household welfare; child nutrition status