Cash for Improved Nutrition in Somalia

Primary Investigator

  • Andrew Seal

Study Period

September 2017 - January 2020

Study Description

Background and study aims
Cash transfers have gained popularity as a tool to address humanitarian needs in many countries around the world. However, evidence on their effectiveness at reducing malnutrition, sickness, and mortality is scant and inconclusive. In 2016, we conducted a study (REFANI-S) to look at the impact of unconditional cash transfers, together with free piped water and a non-food item kit, on child malnutrition in Somalia. We found that although household expenditure, food security, and dietary intake all improved, there was no impact on child malnutrition. Somalia continues to be affected by recurrent natural disasters and ongoing conflict. This results in some of the highest malnutrition and child mortality statistics globally. The aim of this study is to assess the impact of a conditional cash transfer together with behaviour change communication on the risk factors for child undernutrition.

Study Arms

  • Unconditional Cash Transfer vs. Conditional Cash Transfer
  • mHealth Intervention messaging vs. no mHealth Intervention

Primary Outcomes

  • Measles vaccination coverage - % of children 9-<59 months of age who received measles vaccine - EPI vaccination coverage - % of children 0-<59 months of age who received all vaccines required by the national vaccination protocols (measured at baseline and
  • Child diet diversity score of children 6--<24 months of age (measured at baseline and endline via Caregiver 24 hour dietary recall)
  • Parental/caretakers knowledge of BCC health and nutrition topics (measured monthly via questionnaire)

Study Interventions

  • Behavior change communication (BCC)
  • Cash transfer

Research Gaps

  • Acceptability

    Which food products do recipients enjoy eating and have the fewest side effects?

  • Effectiveness

    How well do different food compositions and interventions prevent or treat undernutrition, when implemented "on the ground"?

  • Innovation

    What novel food-based products and programming methods effectively prevent and treat undernutrition?

Study Population