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Impact Evaluation of
Cash for Nutrition
Sikandra Kurdi
Development Strategy and Governance Division
International Food Pol...
 Conflict is now a major driver of food insecurity globally
 Cash transfers are becoming increasingly popular mode of ai...
 Cluster Randomized Control Trial at village level designed for evaluation of the pilot program
o 2,000 households in 190...
 Increased household purchases in cash by 1000
riyals per week (63% of the transfer value)
 Significant impacts of the c...
 Large and significant impact on young child dietary diversity (6-23 months)
o Increase of 0.8 food groups per day (4 is ...
 Significant impact on self-reported practices:
oRate of early initiation of breastfeeding up by 15 percentage
points com...
 Decreased rate of children under 5 reported as having been diagnosed with
malnutrition at health center in past 2 years ...
Other Coping Strategies
29.3%
48.2%
74.3%
14.4%
30.2%
17.3%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Repaying ...
 High attendance at the nutritional training sessions even by non-recipients
of the cash transfers
o 13% of control house...
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Impact Evaluation of Cash for Nutrition

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Sikandra Kurdi
POLICY SEMINAR
Impacts of Cash Transfers on Preventing Malnutrition in Yemen
Co-Organized by IFPRI and the CGIAR Research Program on Policies, Institutions, and Markets (PIM)
SEP 5, 2019 - 12:15 PM TO 01:45 PM EDT

Published in: Government & Nonprofit
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Impact Evaluation of Cash for Nutrition

  1. 1. Impact Evaluation of Cash for Nutrition Sikandra Kurdi Development Strategy and Governance Division International Food Policy Research Institute Washington, DC | September 5, 2019
  2. 2.  Conflict is now a major driver of food insecurity globally  Cash transfers are becoming increasingly popular mode of aid delivery in humanitarian contexts where markets are functional such as in situations of protracted conflict oLess expensive and usually preferred by beneficiaries oMay be more beneficial for nutrition than in-kind food aid  Lack of rigorous evidence on impacts on nutrition because of the difficulty of conducting research in humanitarian settings Motivation
  3. 3.  Cluster Randomized Control Trial at village level designed for evaluation of the pilot program o 2,000 households in 190 towns and villages in 3 districts in Al Hodeidah o Randomization mostly maintained by inertia during program resumption in the ECRP o 93% of households assigned to treatment and 24% of households assigned to control self-report being treated at expost o Impact estimates based on self-reported treatment status with assignment as instrumental variable Methodology Baseline 2015 Jan . Apr Jul Oct 2016 Jan Apr Jul Oct 2017 Jan Apr Jul Follow-up Conflict Pilot intervention ECRP expanded intervention
  4. 4.  Increased household purchases in cash by 1000 riyals per week (63% of the transfer value)  Significant impacts of the cash transfers on increasing consumption on non-staple food items o Including milk, fruits and vegetables, and eggs o Strongest impact on poorest tercile of households o 48% of the transfer value spent on 33 listed non-staples in survey  No impacts on staple calorie consumption (increased for all households between baseline and expost)  No impacts on prices or availability of foods at market Consumption
  5. 5.  Large and significant impact on young child dietary diversity (6-23 months) o Increase of 0.8 food groups per day (4 is minimally acceptable diet)  Significant but smaller in magnitude impact on women’s dietary diversity Dietary Diversity 0 0.5 1 1.5 2 2.5 3 3.5 Baseline (Pre-Conflict, January 2015) Follow-up (Ongoing conflict, August 2017) Child dietary diversity scores Food groups (out of 7) consumed in past 24 hours for children ages 6-23 months Control Treatment
  6. 6.  Significant impact on self-reported practices: oRate of early initiation of breastfeeding up by 15 percentage points compared to 74% in control group at follow-up oRate of exclusive breastfeeding up by 15 percentage points compared to 14% in control group at follow-up oRate of treating water for drinking (mostly by boiling or filtering) up by 17 percentage points for adults and 10 percentage points for children under 2 Sanitation and Breastfeeding Practices
  7. 7.  Decreased rate of children under 5 reported as having been diagnosed with malnutrition at health center in past 2 years by 10 percentage points o Relative to increase between baseline and follow-up of 13 percentage points o Also decreased rate of children diagnosed with severe acute malnutrition by 5 percentage points  Significant increases on anthropometrics for poorest tercile of households o 0.43 in weight-for-age z-scores (WHZ) (measure of short-term nutritional deficiency o 0.35 in height-for-age z-scores (HAZ) (measure of long-term nutritional deficiency) o For children between 7 and 30 months of age at the time of the baseline survey who were measured again at follow-up Child Nutrition Outcomes
  8. 8. Other Coping Strategies 29.3% 48.2% 74.3% 14.4% 30.2% 17.3% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% Repaying debt to neighbors/ relatives Repaying debt to shopkeeper Buying more food Buying better quality food Paying for healthcare Other How Households Used Transfers (multiple responses allowed) Cash transfers allowed households able to make non-food purchases without drawing down their assets, increasing their future resilience Significant decrease in share of households reporting coping with shocks by: • Selling gold • Borrowing from neighbors
  9. 9.  High attendance at the nutritional training sessions even by non-recipients of the cash transfers o 13% of control households in our sample who did not self-report as part of the CCT program still attended nutritional training sessions o 26% of control households who did not self-report as part of the CCT program still reported learning something new from the community health educator o Significant increases between baseline and expost among non-CCT participants in water treatment; knowledge about health center location; knowledge about iron-rich foods for preventing anemia; and knowledge about exclusive breastfeeding Effectiveness of Soft Conditionality

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