Houngbe Freddy, Tonguet-Papucci Audrey, Altare Chiara, Ait-Aissa Myriam, Huneau Jean-François, Huybregts Lieven, Kolsteren Patrick
Research and Analyses Unit, Action Against Hunger, Paris, France;
Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium.
J Nutr. 2017 Jul;147(7):1410-1417. doi: 10.3945/jn.117.247858. Epub 2017 May 24.
Limited evidence is available on the impact that unconditional cash transfer (UCT) programs can have on child nutrition, particularly in West Africa, where child undernutrition is still a public health challenge. This study examined the impact of a multiannual, seasonal UCT program to reduce the occurrence of wasting (weight-for-height, midupper arm circumference), stunting (height-for-age), and morbidity among children <36 mo old in Tapoa Province, in the eastern region of Burkina Faso. The study was designed as a 2-arm cluster-randomized controlled trial, with 32 villages randomly assigned to either the intervention or the control group. The study population comprised households that were classified as poor or very poor according to household economy approach criteria and that had ≥1 child <1 y of age at inclusion. The intervention consisted of seasonal UCTs, provided monthly from July to November, over 2 y (2013 and 2014). A monthly allowance of 10,000 West African Financial Community of Africa francs (∼US$17) was given by mobile phone to mothers in participating households. Anthropometric measurements and morbidity were recorded on a quarterly basis. We found no evidence that multiannual, seasonal UCTs reduced the cumulative incidence of wasting in young children [incidence rate ratio: 0.92 (95% CI: 0.64, 1.32); = 0.66]. We observed no significant difference ( > 0.05) in children's anthropometric measurements and stunting between the 2 groups at the end point. However, children in the intervention group had a lower risk [21% (95% CI: 18.6%, 21.3%); < 0.001] of self-reported respiratory tract infections than did children in the control group. We found that seasonal UCTs in the framework of safety nets did not result in a significant decrease in the incidence of acute malnutrition among children in Tapoa Province. Cash transfers combined with complementary interventions targeted to child nutrition and health should be investigated further. This trial was registered at clinicaltrials.gov as NCT01866124.
关于无条件现金转移（UCT）项目对儿童营养状况的影响，现有证据有限，尤其是在西非，儿童营养不良仍是一项公共卫生挑战。本研究考察了一项多年度、季节性UCT项目对布基纳法索东部地区塔波阿省36月龄以下儿童消瘦（身高别体重、上臂中部周长）、发育迟缓（年龄别身高）发生率及发病率的影响。该研究设计为双臂整群随机对照试验，32个村庄被随机分配至干预组或对照组。研究人群包括根据家庭经济方法标准被归类为贫困或极贫困且纳入研究时拥有≥1名1岁以下儿童的家庭。干预措施为季节性UCT，在2年（2013年和2014年）期间从7月至11月每月提供。通过手机向参与家庭的母亲发放每月10,000西非法郎（约合17美元）的津贴。每季度记录人体测量数据和发病率。我们没有发现证据表明多年度、季节性UCT降低了幼儿消瘦的累积发生率[发病率比：0.92（95%CI：0.64, 1.32）；P = 0.66]。在终点时，两组儿童的人体测量数据和发育迟缓情况无显著差异（P>0.05）。然而，干预组儿童自我报告的呼吸道感染风险低于对照组[21%（95%CI：18.6%，21.3%）；P<0.001]。我们发现，安全网框架下的季节性UCT并未导致塔波阿省儿童急性营养不良发病率显著下降。应进一步研究现金转移与针对儿童营养和健康的补充干预措施相结合的情况。该试验已在clinicaltrials.gov注册，注册号为NCT01866124。
