Essential elements of an integrated social protection system that works for children

Khurshid, Atif; Stewart, David; Delamónica, Enrique

doi:10.1177/1468018120903923

Cited by 3 publications

(2 citation statements)

References 1 publication

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“…However, the goal of this review was to assess whether cash-plus programmes are more effective than cash alone rather than compared to no intervention. In addition to the cash-plus programmes included in this review, there are other combination interventions that may have an impact on children; examples include productivity and livelihood interventions that are targeted to households or adults, but have a benefit to improving child outcomes [ 60 ], or broader environmental health interventions such as water and sanitation management [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

et al. 2021

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Background To strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention’s complementary (“plus”) components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being. Methods and findings Forty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child’s life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = −0.13 (−0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = −0.06 (−0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings. Conclusions In this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

et al. 2021

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“…In addressing these issues, the collaboration of all these stakeholders is important because child poverty and food insecurity is intertwined with multiple social, cultural and economic determinants. Addressing it in a decisive manner requires complex solutions and the commitment of multiple stakeholders to child-sensitive social protection strategies (Khurshid et al, 2020;Nébié et al, 2019;Roelen et al, 2019). The collaborative action of national governments, international bodies and CSOs, especially, is also essential to address child poverty and vulnerability in a way that can break the cycle of disadvantage across generations and build intergenerational solidarity that facilitates overcoming adversities such as food insecurity within families and communities.…”

Section: Multidimensional Perspectivementioning

confidence: 99%

Addressing food insecurity in Africa: Strategies for ensuring child-sensitive social protection

Zelenev

2022

International Social Work

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Recognized as a multifaceted challenge, food security is high on the political and socio-economic agendas of many countries. Gaining a better understanding of the multidimensional nature of the challenge of food insecurity in Africa, especially its complex impact on children, can facilitate concerted actions and better targeting of interventions by national governments, international agencies and civil society organizations aimed at child-sensitive social protection.

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Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs

Carducci,

Dominguez,

Kidd

et al. 2024

Nutrition Reviews

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Context The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. Objective Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. Data Sources A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. Data Extraction Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5–19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. Data Analysis A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. Conclusions This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. Systematic Review Registration PROSPERO registration no. CRD42022303255.

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Essential elements of an integrated social protection system that works for children

Cited by 3 publications

References 1 publication

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

Addressing food insecurity in Africa: Strategies for ensuring child-sensitive social protection

Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs

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