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Interest has grown in leveraging cash transfer programs with nutrition interventions to improve child nutrition at scale. However, little is known about how doing so affects household economic well-being. We study a program providing cash or food transfers, with or without nutrition behavior change communication (BCC), to poor women in rural Bangladesh. We find that adding BCC to cash or food transfers leads to larger impacts on both consumption and assets - an apparent puzzle, given the transfer value is unchanged. Evidence suggests this occurs through the BCC inducing increases in income generation - plausibly by improving households’ social capital and empowerment.
Interest has grown in leveraging cash transfer programs with nutrition interventions to improve child nutrition at scale. However, little is known about how doing so affects household economic well-being. We study a program providing cash or food transfers, with or without nutrition behavior change communication (BCC), to poor women in rural Bangladesh. We find that adding BCC to cash or food transfers leads to larger impacts on both consumption and assets - an apparent puzzle, given the transfer value is unchanged. Evidence suggests this occurs through the BCC inducing increases in income generation - plausibly by improving households' social capital and empowerment.
Social protection programs are primarily focused on influencing household behavior in the short term, increasing consumption to reduce poverty and food insecurity, and promoting investments in human capital. A large body of evidence across numerous settings shows that cash and food transfer programs are highly effective in doing so. However, there is growing interest in understanding the extent to which such programs can help households stay out of poverty in the longer term, specifically after transfers end. We bring new evidence to this question, re-interviewing Bangladeshi households that participated in a well-implemented randomized social protection intervention four years after it ended. We find that combining transfers, either cash or food, with behavior change communication activities sustainably reduced poverty. Cash transfers alone had sustainable effects, but these were context-specific. The beneficial impacts of food transfers did not persist four years after the intervention finished.
Evidence shows that cash and in-kind transfer programs increase food security while interventions are ongoing, including during or immediately after shocks. But less is known about whether receipt of these programs can have protective effects for household food security against shocks that occur several years after interventions end. We study the effects of a transfer program implemented as a cluster-randomized control trial in rural Bangladesh from 2012-2014 – the Transfer Modality Research Initiative (TMRI) – on food security in the context of the COVID-19 pandemic. We assess TMRI’s impacts at three post-program time points: before the shock (2018), amidst the shock (2021), and after the immediate effects of the shock (2022). We find that TMRI showed protective effects on household food security during and after the pandemic, but program design features “mattered”; positive impacts were only seen in the treatment arm that combined cash transfers with nutrition behavior change communication (Cash+BCC). Other treatment arms – cash only, and food only – showed no significant sustained effects on our household food security measures after the intervention ended, nor did they show protective effects during the pandemic. A plausible mechanism is that investments made by Cash+BCC households in productive assets – specifically livestock – increased their pre-shock resilience capacity.
The importance of children’s nutritional status for subsequent human capital formation, the limited evidence of the effectiveness of social protection interventions on child nutrition, and the absence of knowledge on the intra-household impacts of cash and food transfers or how they are shaped by complementary programming motivate this paper. We implemented two, linked randomized control trials in rural Bangladesh, with treatment arms including cash transfers, a food ration, or a mixed food and cash transfer, as well as treatments where cash and nutrition behavior change communication (BCC) or where food and nutrition BCC were provided. Only cash plus nutrition BCC had a significant impact on nutritional status, but its effect on height-forage z scores (HAZ) was large, 0.25SD. We explore the mechanisms underlying this impact. Improved diets – including increased intake of animal source foods – along with reductions in illness in the cash plus BCC treatment arm are consistent with the improvement we observe in children’s HAZ.
More children born today will survive to adulthood than at any time in history. It is now time to emphasize health and development in middle childhood and adolescence--developmental phases that are critical to health in adulthood and the next generation. Child and Adolescent Health and Development explores the benefits that accrue from sustained and targeted interventions across the first two decades of life. The volume outlines the investment case for effective, costed, and scalable interventions for low-resource settings, emphasizing the cross-sectoral role of education. This evidence base can guide policy makers in prioritizing actions to promote survival, health, cognition, and physical growth throughout childhood and adolescence.
Public food transfer program provide a lifeline for the poor in both high- and low-income countries, and many countries stepped these up in response to COVID-19. But little is known about how effective these programs have been in reaching the poor during the crisis. This brief reviews the findings of an evaluation of Bangladesh’s Food Friendly Program, pointing to the difficulties encountered during the pandemic and lessons to help these program perform better in future crises.
Little is known about whether reductions in intimate partner violence (IPV) from cash transfer programs persist over the longer term. Using a randomized controlled trial design, we show that a program providing poor women in rural Bangladesh with cash or food transfers, alongside nutrition behavior change communication (BCC), led to sustained reductions in IPV 4 years after the program ended. Transfers alone showed no sustained impacts on IPV. Evidence suggests cash and BCC led to more sustained impacts on IPV than food and BCC – through persistent increases in women’s bargaining power, men’s costs of perpetrating violence, and poverty-related emotional well-being.