The risk of acute malnutrition among children aged 6‐36 months in households targeted by an emergency cash transfer program in Niger (251.2)

Abstract

Emergency cash transfer programs (CTPs) are promising nutrition‐sensitive interventions in the prevention of acute malnutrition. Identifying how the expenditure of cash transfers relates to child nutrition status is a necessary step for informed program design and targeting. We investigated the relationship between cash transfer expenditures and acute malnutrition in children ages 6‐36 months through a cohort study of 420 households enrolled in a six month unconditional emergency CTP in Niger. A set of Cox proportional hazard models was used to estimate the risk of acute malnutrition while adjusting for relevant child, household, and community characteristics. Expenditure on food was not associated with the risk of acute malnutrition (HR:0·968, p=0·54). Medical expenditures were associated with high risk among both healthy and ill children (HR: 1·379, p=0·008 and HR: 1·919, p=0·20, respectively). Risk was higher among children in the poorest households than those in wealthier households (HR: 2·714, p<0·001), and 66% lower in children with greater baseline weight‐for‐height Z scores (HR: 0·336, p<0·001). Among recipients of this CTP, food expenditures did not have a protective effect against the risk of acute malnutrition. The significance of wealth and health‐related factors suggests that a principal role of emergency CTPs is to enable medical access for ill children. The timing of emergency CTPs is an important factor in reaching at risk children, but even timeliness may not compensate for persistent poverty and undernutrition.Grant Funding Source: Supported by the United States Agency for International Development