Jessica Bliss1, Nathan Jensen2, Brian Thiede3,4, Jeremy Shoham5, Carmel Dolan5, Victoria Sibson6, Bridget Fenn7. 1. 1 Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA. 2. 2 Department of Applied Economics and Management, Cornell University, Ithaca, NY, USA. 3. 3 Department of Development Sociology, Cornell University, Ithaca, NY, USA. 4. 4 Department of Agricultural Economics, Sociology, and Education, Pennsylvania State University, State College, PA, USA. 5. 5 Emergency Nutrition Network, London, United Kingdom. 6. 6 Save the Children, London, United Kingdom. 7. 7 Independent consultant, Paris, France.
Abstract
BACKGROUND: Assessing whether and how the expenditure of emergency cash transfer programs (CTPs) relates to child nutritional status is a necessary step for informed program design and targeting. OBJECTIVE: We hypothesized that greater child food expenditures would have a protective effect against the risk of acute malnutrition in the context of a food crisis in Niger. METHODS: We investigated the relationship between food and medical expenditures and acute malnutrition in children aged 6 to 36 months through an observational cohort study of 420 households enrolled in an emergency CTP in Niger. A Cox proportional hazards model was used to estimate the risk of acute malnutrition while adjusting for relevant child and household characteristics. RESULTS: Seventy-four (18% of the cohort) children developed acute malnutrition. The risk was 1.79 times higher among ill children than healthy children (hazard ratio [HR]: 1.79; 95% confidence interval [CI]: 1.10-2.92; P < .05), nearly 3 times higher among children in the poorest households than those in wealthier households (HR: 2.98; 95% CI: 1.86-4.78; P < .001), and 2.85 times lower with each unit increase in baseline weight-for-height Z score (HR: 0.35; 95% CI: 0.23-0.53; P < .001). Food expenditures were not associated with risk (HR: 0.97; 95% CI: 0.87-1.07; P > .05). CONCLUSION: Our findings highlight the importance of the health-related determinants of child undernutrition and suggest that a potential role of emergency CTPs may be to enable and promote health service access where services exist. They also indicate a need for more sustained poverty reduction and undernutrition prevention activities in concert with well-timed and strategic use of emergency interventions.
BACKGROUND: Assessing whether and how the expenditure of emergency cash transfer programs (CTPs) relates to child nutritional status is a necessary step for informed program design and targeting. OBJECTIVE: We hypothesized that greater child food expenditures would have a protective effect against the risk of acute malnutrition in the context of a food crisis in Niger. METHODS: We investigated the relationship between food and medical expenditures and acute malnutrition in children aged 6 to 36 months through an observational cohort study of 420 households enrolled in an emergency CTP in Niger. A Cox proportional hazards model was used to estimate the risk of acute malnutrition while adjusting for relevant child and household characteristics. RESULTS: Seventy-four (18% of the cohort) children developed acute malnutrition. The risk was 1.79 times higher among ill children than healthy children (hazard ratio [HR]: 1.79; 95% confidence interval [CI]: 1.10-2.92; P < .05), nearly 3 times higher among children in the poorest households than those in wealthier households (HR: 2.98; 95% CI: 1.86-4.78; P < .001), and 2.85 times lower with each unit increase in baseline weight-for-height Z score (HR: 0.35; 95% CI: 0.23-0.53; P < .001). Food expenditures were not associated with risk (HR: 0.97; 95% CI: 0.87-1.07; P > .05). CONCLUSION: Our findings highlight the importance of the health-related determinants of child undernutrition and suggest that a potential role of emergency CTPs may be to enable and promote health service access where services exist. They also indicate a need for more sustained poverty reduction and undernutrition prevention activities in concert with well-timed and strategic use of emergency interventions.
Authors: Odell W Kumeh; Mosoka P Fallah; Ishaan K Desai; Hannah N Gilbert; Jason B Silverstein; Sara Beste; Jason Beste; Joia S Mukherjee; Eugene T Richardson Journal: BMJ Nutr Prev Health Date: 2020-12-01
Authors: Kim Robin van Daalen; Sara Dada; Rosemary James; Henry Charles Ashworth; Parnian Khorsand; Jiewon Lim; Ciaran Mooney; Yasmeen Khankan; Mohammad Yasir Essar; Isla Kuhn; Helene Juillard; Karl Blanchet Journal: BMJ Glob Health Date: 2022-01
Authors: Victoria L Sibson; Carlos S Grijalva-Eternod; Garba Noura; Julia Lewis; Kwanli Kladstrup; Hassan Haghparast-Bidgoli; Jolene Skordis-Worrall; Tim Colbourn; Joanna Morrison; Andrew J Seal Journal: Matern Child Nutr Date: 2018-05-08 Impact factor: 3.092