Factors Associated with the Risk of Acute Malnutrition among Children Aged 6 to 36 Months in Households Targeted by an Emergency Cash Transfer Program

Jessica Bliss, Nathan Jensen, Brian Thiede, Jeremy Shoham, Carmel Dolan, Victoria Sibson, Bridget Fenn

Research output: Contribution to journalArticle

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)387-400
Number of pages14
JournalFood and Nutrition Bulletin
Volume37
Issue number3
DOIs
StatePublished - Sep 1 2016

All Science Journal Classification (ASJC) codes

  • Food Science
  • Geography, Planning and Development
  • Nutrition and Dietetics

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