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Effects of Nutrition Counselling and Unconditional Cash Transfer on Child Growth and Family Food Security in Internally Displaced Person Camps in Somalia: A Quasi-Experimental Study
Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0002-0119-5394
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0002-4013-1553
Dalarna University, School of Health and Welfare, Caring Science/Nursing.ORCID iD: 0000-0002-0038-9402
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 20, article id 13441Article in journal (Refereed) Published
Abstract [en]

The effects of nutrition counselling (NC) and unconditional cash transfer (UCT) in improving growth in children under five and household food security are poorly understood in humanitarian settings. Therefore, this study aimed to evaluate the effects of NC and NC combined with unconditional cash transfer (NC + UCT) on children’s growth and food security in Somalia. The study was performed with a quasi-experimental design in two districts in the Banadir region of Somalia. Caregivers (n = 255) with mildly to moderately malnourished children aged 6 to 59 months old (n = 184) were randomized to the NC, NC + UCT and control groups. The interventions consisted of weekly NC for three months alone or in combination with UCT. The outcome variables were wasting, underweight, stunting, and food security. Difference-indifferences analysis was used to estimate the effect of the interventions. Our study did not find any significant impacts of NC or NC + UCT on child wasting, underweight, stunting, food security or household expenses. In conclusion, NC, alone or in combination with UCT, did not impact children’s growth or household food security. Thus, a culturally tailored NC programme over a longer period, supplemented with cash transfer, could be beneficial to consider when designing interventions to reduce malnutrition and food insecurity.

Place, publisher, year, edition, pages
MDPI, 2022. Vol. 19, no 20, article id 13441
Keywords [en]
counselling; cash transfer; humanitarian setting; IDP; nutrition; underweight; wasting
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:du-42919DOI: 10.3390/ijerph192013441ISI: 000873306400001PubMedID: 36294019Scopus ID: 2-s2.0-85140909057OAI: oai:DiVA.org:du-42919DiVA, id: diva2:1705916
Available from: 2022-10-24 Created: 2022-10-24 Last updated: 2025-10-09Bibliographically approved
In thesis
1. Undernutrition and food security in children in internally displaced person camps: Prevalence, risk factors, and the impact of a cash transfer and nutrition counseling intervention
Open this publication in new window or tab >>Undernutrition and food security in children in internally displaced person camps: Prevalence, risk factors, and the impact of a cash transfer and nutrition counseling intervention
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Undernutrition in children under five years old is a critical issue, particularly in internally displaced person (IDP) camps, where families face many challenges, including food insecurity, inadequate healthcare, poor hygiene, and suboptimal feeding practices. Interventions such as cash transfers and nutrition education have been implemented in various humanitarian settings to improve food security and caregiver knowledge, but their impact on child growth in IDP camps remains underexplored. Aim: The primary aim of this thesis was to assess the prevalence, risk, and protective factors associated with undernutrition in children under five living in IDP camps. This thesis also sought to evaluate household and child dietary diversity, infant and child feeding practices, and hygiene, as well as the impact of nutrition counselling (NC) and unconditional cash transfer (UCT) interventions on children’s undernutrition and household food security. Methods: The studies were conducted in three IDP camps in Somalia. Data were collected from 1,655 caregivers and 2,370 children aged 6–59 months using structured questionnaires based on the UNICEF/WHO guidelines on infant and young child feeding. Anthropometric measurements were taken to assess child nutritional status, and dietary diversity was evaluated using the Household Dietary Diversity Score and Child Dietary Diversity Score. Logistic regression analysis was utilized to identify the determinants of undernutrition. A quasi-experimental design was employed to assess the effects of NC and NC+UCT interventions. Results: The studies revealed high rates of underweight (24.5%), wasting (10.9%), stunting (38.3%), and concurrent wasting and stunting (WaSt, 4.14%). The vast majority of households (95.6%) achieved adequate dietary diversity, whereas less than half of the children (43.3%) achieved adequate diversity. The risk factors for undernutrition included poor maternal health, lack of antenatal care, household food insecurity, and poor hygiene practices. Protective factors included timely complementary feeding, maternal decision-making autonomy, and adequate household food security. The NC and NC+UCT interventions did not significantly affect child growth or food security. Conclusion: This thesis underscores the importance of addressing the multiple factors contributing to undernutrition in IDP camps, including feeding practices, hygiene, and dietary diversity. Sustainable interventions focused on maternal education, improved hygiene, and better child dietary diversity are critical for reducing undernutrition and improving child health in IDP settings.

Place, publisher, year, edition, pages
Falun: Dalarna University, 2025
Series
Dalarna Doctoral Dissertations ; 44
Keywords
Malnutrition, IDP camps, Nutrition counselling, Cash transfers, Food security, Somalia
National Category
Nursing
Identifiers
urn:nbn:se:du-50423 (URN)978-91-88679-95-6 (ISBN)
Public defence
2025-08-25, at the Embassy of Sweden in Nairobi, Kenya and online, 13:00 (English)
Opponent
Supervisors
Available from: 2025-06-16 Created: 2025-04-03 Last updated: 2025-10-09Bibliographically approved

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Ali, Mohamed KalidFlacking, RenéeOsman, Fatumo

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