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

Background: 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. The aim of this study was to evaluate the effects of NC and NC combined with unconditional cash transfer (NC+UCT) on children’s growth and food security in Somalia. Methods: : The study was performed with a quasi-experimental design in two districts in the Banadir region of Somalia. The study used two-stage stratified sampling. Caregivers (n=255) of 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 primary outcome variables of the study were indicators of children’s nutrition, i.e., wasting. The secondary outcome variables were indicators of underweight, stunting, and food security, i.e., dietary diversity, household hunger scale and food consumption scores. Data were collected at baseline and 11 months after programme implementation. Difference-in-differences analysis was used to estimate the effect of the interventions. Results: : Our study did not find any significant impact on child wasting (aOR: 0.81, 95% CI: 0.26–2.56, p  = 0.722), underweight (aOR: 1.29, 95% CI: 0.40–3.48, p  = 0.603), or stunting (aOR: 0.84, 95% CI: 0.29–2.46, p  = 0.764) compared to the control group. Similarly, in the NC+UCT group, we did not find any significant reduction in wasting (aOR: 0.79, 95% CI: 0.26–2.36, p  = 0.669), underweight (aOR: 0.88, 95% CI: 0.33–2.35, p  = 0.806), or stunting (aOR: 1.51, 95% CI: 0.55–4.20, p  = 0.426) compared to the control group. No intervention effect was observed on food security outcomes, child dietary diversity scores, minimum child dietary diversity (≥4 food groups) or household expenses (Table 3). Conclusion: NC, alone or in combination with UCT, did not impact children’s growth or household food security. A culturally tailored NC programme over a longer period and larger, regular, and predictable transfers might result in a significant reduction in malnutrition and food insecurity. Trial registration The evaluation was registered on the RIDIE registry (RIDIE-STUDY-ID-5a1264bdb207a) on 11/19/2017.