May 20, 2019
Sikandra Kurdi and Olivier Ecker - IFPRI
Children are often most affected by civil conflict. The ongoing civil war in Yemen, now entering its fifth year, is the most severe example of a man-made humanitarian crisis with devastating child suffering in recent history. Even before the civil war, child malnutrition was widespread in Yemen, but the situation has become dramatically worse. In 2013, 16.3% of children under five years of age suffered from acute malnutrition . Today aid agencies estimate that approximately 50% of children under 5—2 million total—are acutely malnourished.
A challenge for humanitarian aid in this type of long-term crisis is to ensure that aid recipients receive not only enough calories from staple foods, but also adequate dietary quality to provide crucial micronutrients. This is particularly important for young children as there are life-long developmental consequences of childhood malnutrition. Cash transfers are considered a promising approach in part because of studies suggesting that giving people cash leads to greater dietary diversity than the traditional relief strategy of distributing baskets of staple food items.
Two recent related but separate studies we respectively led provide evidence that cash transfers can reduce conflict-driven malnutrition in Yemen. One study provided an impact evaluation of the current Cash-for-Nutrition program of the Yemen Social Fund for Development (SFD), conducted during the civil war, and the other presents a retrospective analysis of the Social Welfare Fund’s (SWF) unconditional cash transfer program during a conflict period preceding the outbreak of the ongoing civil war. Both studies found transfers created substantial benefits on child nutrition outcomes.
The SWF program identified and provided quarterly cash transfers to vulnerable households in Yemen prior to the conflict. Currently, the same targeting is being used in the Yemen Emergency Crisis Response Program for a national cash transfer program implemented through UNICEF.
Using data from the National Social Protection Monitoring Survey, Ecker and co-authors showed that receiving SWF cash transfers decreased the size of the negative impact of conflict on acute malnutrition by at least half, from 2012 to 2013.
The SFD’s Cash-for-Nutrition program (also funded through the Yemen Emergency Crisis Response Program) provides SWF households with young children with additional monthly cash transfers equivalent to about 25% of their food budget and encourages attendance at monthly child and maternal nutrition education trainings led by locally recruited community health educators.
Using data from a randomized control trial designed during the pilot phase of the Cash-for-Nutrition program, Kurdi and co-authors report the program had significant impacts on offsetting negative trends in nutrition outcomes during the conflict years 2015-2017. Receiving the SFD cash transfers increased household food purchases by at least 17 percent.
Importantly, rather than increasing consumption of staples, households used most of the cash transfers to buy more nutrient-rich vegetables, fruits, and animal-source foods such as milk and eggs. As a result, the transfers helped preserve children’s dietary diversity in critical early developmental stages 6-23 months. The program also led to improved breastfeeding and water treatment practices, which further enhanced the nutritional environment.
The benefits of this combination of relatively better household access to nutritious food and better child feeding practices resulted in improved child nutrition outcomes relative to households that did not receive the transfers. The Cash-for-Nutrition program decreased the rate at which children were diagnosed with acute malnutrition by 10 percentage points, compared to households not receiving transfers, and prevented decreases in height and weight among children in the poorest third of treated households.
Together, these studies provide evidence supporting the use of cash transfers as an effective aid approach for mitigating the harm to child nutrition conflict generates.
Sikandra Kurdi is an Associate Research Fellow with IFPRI’s Egypt Office in Cairo. Olivier Ecker is a Senior Research Fellow with IFPRI’s Development Strategy and Governance Division based in Washington. This post first appeared on the Thomson Reuters Foundation News site.
This research was supported by the Nordic Trust Fund; the Yemen Emergency Crisis Response Project funded by the International Development Association (IDA) of the World Bank Group; the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ); and the CGIAR Research Program on Policies, Institutions, and Markets (PIM), led by IFPRI.
