Child Malnutrition Clinical Trial
Official title:
The Effect of a Cash Transfer Program and Preventive Nutrition Packages on Household Welfare and Child Nutritional Status in Mali
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.
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.
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