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Impact evaluation of different cash-based intervention modalities on child and maternal nutritional status in Sindh Province, Pakistan, at 6 mo and at 1 y: A cluster randomised controlled trial

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  • Bridget Fenn
  • Tim Colbourn
  • Carmel Dolan
  • Silke Pietzsch
  • Murtaza Sangrasi
  • Jeremy Shoham

Abstract

Background: Cash-based interventions (CBIs), offer an interesting opportunity to prevent increases in wasting in humanitarian aid settings. However, questions remain as to the impact of CBIs on nutritional status and, therefore, how to incorporate them into emergency programmes to maximise their success in terms of improved nutritional outcomes. This study evaluated the effects of three different CBI modalities on nutritional outcomes in children under 5 y of age at 6 mo and at 1 y. Methods and findings: We conducted a four-arm parallel longitudinal cluster randomised controlled trial in 114 villages in Dadu District, Pakistan. The study included poor and very poor households (n = 2,496) with one or more children aged 6–48 mo (n = 3,584) at baseline. All four arms had equal access to an Action Against Hunger–supported programme. The three intervention arms were as follows: standard cash (SC), a cash transfer of 1,500 Pakistani rupees (PKR) (approximately US$14; 1 PKR = US$0.009543); double cash (DC), a cash transfer of 3,000 PKR; or a fresh food voucher (FFV) of 1,500 PKR; the cash or voucher amount was given every month over six consecutive months. The control group (CG) received no specific cash-related interventions. The median total household income for the study sample was 8,075 PKR (approximately US$77) at baseline. We hypothesized that, compared to the CG in each case, FFVs would be more effective than SC, and that DC would be more effective than SC—both at 6 mo and at 1 y—for reducing the risk of child wasting. Primary outcomes of interest were prevalence of being wasted (weight-for-height z-score [WHZ]

Suggested Citation

  • Bridget Fenn & Tim Colbourn & Carmel Dolan & Silke Pietzsch & Murtaza Sangrasi & Jeremy Shoham, 2017. "Impact evaluation of different cash-based intervention modalities on child and maternal nutritional status in Sindh Province, Pakistan, at 6 mo and at 1 y: A cluster randomised controlled trial," PLOS Medicine, Public Library of Science, vol. 14(5), pages 1-24, May.
  • Handle: RePEc:plo:pmed00:1002305
    DOI: 10.1371/journal.pmed.1002305
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    Cited by:

    1. Andre M. N. Renzaho & Stanley Chitekwe & Wen Chen & Sanjay Rijal & Thakur Dhakal & Pradiumna Dahal, 2017. "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," IJERPH, MDPI, vol. 14(12), pages 1-22, December.
    2. Delaram Ghodsi & Nasrin Omidvar & Bahareh Nikooyeh & Roshanak Roustaee & Elham Shakibazadeh & Ayoub Al-Jawaldeh, 2021. "Effectiveness of Community Nutrition-Specific Interventions on Improving Malnutrition of Children under 5 Years of Age in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(15), pages 1-22, July.
    3. Elisabetta Aurino & Sara Giunti, 2022. "Social Protection for Child Development in Crisis: A Review of Evidence and Knowledge Gaps [School Feeding Reduces Anemia Prevalence in Adolescent Girls and Other Vulnerable Household Members in a ," The World Bank Research Observer, World Bank, vol. 37(2), pages 229-263.

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