Putting Children First: Identifying solutions and taking action to tackle poverty and inequality in Africa. Addis Ababa, Ethiopia, 23-25 October 2017 This three-day international conference aimed to engage policy makers, practitioners and researchers in identifying solutions for fighting child poverty and inequality in Africa, and in inspiring action towards change. The conference offered a platform for bridging divides across sectors, disciplines and policy, practice and research.

2. Tackling Undernutrition in the First 1,000 days with a Cash-
Plus approach
Presented by:
Kerina Zvogbo (Senior Social Protection Advisor, Save the Children Nigeria): kerina.zvogbo@savethechildren.org
Akomolafe Oluwatosin (Knowledge Management Advisor): oluwatosin.akomolafe@savethechildren.org
Luke Harman (Senior Social Protection Advisor, Save the Children UK): l.harman@savethechildren.org.uk

3. OUTLINE

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8. Payment
mechanism
Target
group
Targeting
approach
Transfer
size
Frequency
Duration

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11. T1 T2

12. Drivers of maternal and
child undernutrition
Key results
Men andWomen’s
Knowledge Attitude and
Perception
• Over 60% recalled messages on EBF, compared to 20% in non-CDGP areas,
• 70% recalled messages on nutritious foods compared to 20% in non-CDGP areas
Women’s control over
income
• 76% control how the cash transfer is spent & it is predominantly spent on food
• Approximately 65% of women reported using their last payment on food for the
household
Household income • 25% increase in household income over the baseline and total household
expenditure increased over and above the value of the transfer.
Maternal and child care
practices
• 36% attend ANC in CDGP compared to 20% in non-CDGP communities
• Exclusive Breastfeeding (first six months) was 70% of mothers in CDGP
communities compared to 20% in non-CDGP communities
Household food security &
Dietary diversity
• Improved food security especially during the lean seasons
• 52% of 6-23 month-olds were eating from four or more food groups compared
to 40% in non-CDGP communities
Child nutrition • Stunting in CDGP communities is at 65% while in non-CDGP communities,
stunting is at 71%

13. Programme Design Key results
Tat Lan
Maternal and
Child Grant
(Myanmar)
Experimental
(CT+ BCC vs. BCC
alone)
• 42.6% of mothers made 4+ ANC visits
while pregnant (vs. 24.6% in non-
programme villages)
• Exclusive breastfeeding 89% (vs. 69% in
non-programme villages)
Women &
Children/Infants
Nutrition in
Sindh,WINS
(Pakistan)
Non-experimental
CT + CMAM + IYCF
+ SBCC
Between 2013 and 2016:
• Stunting reduced by 10.2%
• Wasting reduced by 6.6 percentage points
Child grant
(Nepal)
Non-experimental
(CT + health facility
strengthening +
growth monitoring +
parental classes +
nutrition)
• Underweight incidence decreased from
27.2% to 3.9% (2014 to 2016)
• Qualitative studies show mothers gained
increased knowledge on nutrition &
showed better care for children.

14. Programme Design Key results
Transfer Modality
Research Initiative
(Bangladesh)
Experimental
(CT + Nutrition BCC vs.
Food + Nutrition BCC vs.
Food Alone vs. Cash
Alone)
• CT + led to 7.3% decline after 24 months
(which is 3 times national decline).
• Cash alone did not lead to a statistically
significant reduction.
Cash Plus can also be effective in humanitarian settings!
Prospective Cash
Plus nutrition
supplement study
(Niger)
Experimental
(multiple combinations of
just supplements vs. cash
only vs. Cash +
supplements)
After 4 months:
• MAM 2x lower for Cash + (vs. cash alone)
• SAM 3x lower for Cash + (vs. supplements
alone)
Six month CT
programme (DRC)
Experimental
(CT + Treatment of SAM
vs. SAM Treatment alone)
• CT + SAM treatment increased recovery
from SAM vs. SAM treatment alone (35%
hazard ratio for CT + group)
• CT + SAM treatment decreased relapse
• After 6m, 80% of children regained MUAC
and weight-for-height/length (vs.<40% in
control with many deteriorating after)

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