Comparing effectiveness and cost-effectiveness of cash plus interventions in preventing acute malnutrition in Somalia
Save the Children and Johns Hopkins University (JHU) are researching what combinations and durations of assistance are most effective and cost-effective to prevent severe and moderate acute malnutrition. To increase access to food and prevent wasting, Save the Children, funded by USAID’s Bureau for Humanitarian Assistance (BHA), is implementing the Cash ‘plus’ Nutrition project in Somalia to alleviate hunger of the most affected families and children. This project includes Unconditional Cash Transfers (UCT) for food assistance and social and behavior change communication (SBCC). In the Hiiraan and Bay regions of Somalia, the Save the Children and JHU teams, along with national partners from the Ministry of Health and Somali National Bureau of Statistics, will conduct an impact evaluation to assess: What combinations of assistance are most effective and cost-effective in preventing wasting for children under five and pregnant and lactating women?
Save the Children and JHU will conduct a three-arm cluster, randomized controlled trial with randomization at the village level. The team will conduct a mixed methods approach for data collection and analysis and conduct cost-effectiveness analyses. The three arms being studied are:
1. Cash Transfers: Targeted families will receive one transfer per month, for eight months, based on the Minimum Expenditure Basket reference for food need.
2. Cash Transfers + SBCC: Targeted families will receive cash transfers combined with awareness raising and SBCC interventions, including one-on-one consultations and bi-monthly group sessions to discuss health-related topics.
3. Cash Transfer + Top-Ups: Targeted families will receive cash transfers and individuals at risk, such as pregnant and lactating women, will receive additional cash ‘top-ups’ on a monthly basis, based on the Cost of the Diet methodology.