DECEMBER 13, 2013
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About the Author:
Harold Alderman, with a Master’s degree in Nutrition (Cornell) and a PhD in Economics (Harvard), where Per Pinstrup-Andersen served as an outside member on his thesis committee. Alderman has naturally gravitated to research on the economics of nutrition and food policy. He spent 10 years at the International Food Policy Research Institute (IFPRI) prior to joining the World Bank in 1991. He rejoined IFPRI in 2012. While at the World Bank, he divided his time between the Development Research Group and the Africa region, where he advised on social protection policy. His current research has focused on the linkages between nutrition and early child development and the means by which nutrition and social protection programs contribute to long-term economic growth.
Can Transfer Programs Be Made More Nutrition Sensitive?
As is commonly presented, nutritional status reflects the interplay of food consumption, access to health and sanitation, and nutrition knowledge and care practices. Social protection programs typically increase income as well as influence the timing and, to a degree, the control of this income. Additionally, social protection programs may achieve further impact on nutrition by fostering linkages with health services or with sanitation programs, and specifically through activities that are related to nutrition education or micronutrient supplementation. This chapter discussed what might be expected from such programs as well as reviews some of the evidence from specific transfer programs.
Transfer programs reach a billion individuals in low income countries, often providing support that increases purchasing by twenty percent or more. Whether the mode of support is conditional or unconditional transfers most programs increase health care utilization as well as food consumption. There is, however, only modest evidence that such programs lead to measurable reductions in stunting or anemia with more encouraging results for very young children whose families receive assistance over much of the most vulnerable period in the child’s growth. The review discusses possible reasons for this relative under performance.
The chapter also reviews recent evidence on the impact of cash transfers relative to in-kind support. While the differences in these modes of delivery is nuanced and context specific, in virtually every study reviewed it cost less to deliver cash, although in some situations, cash programs proved vulnerable to inflation.
The potential of transfer programs to be nutrition sensitive remains largely untapped. Better access to quality health services as well as more explicit nutrition objectives may close the gap between the potential and results.
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