@article{fdi:010080449,
  title = {{E}valuation of an unconditional cash transfer program targeting children's first-1,000-days linear growth in rural {T}ogo : a cluster-randomized controlled trial},
  author = {{B}riaux, {J}ustine and {M}artin-{P}r{\'e}vel, {Y}ves and {C}arles, {S}ophie and {F}ortin, {S}onia and {K}ameli, {Y}ves and {A}dubra, {L}. and {R}enk, {A}. and {A}gboka, {Y}. and {R}omedenne, {M}. and {M}ukantambara, {F}. and {V}an {D}yck, {J}. and {B}oko, {J}. and {B}ecquet, {R}. and {S}avy, {M}athilde},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}n 2014, the government of {T}ogo implemented a pilot unconditional cash transfer ({UCT}) program in rural villages that aimed at improving children's nutrition, health, and protection. {I}t combined monthly {UCT}s (approximately {US}$8.40 /month) with a package of community activities (including behavior change communication [{BCC}] sessions, home visits, and integrated community case management of childhood illnesses and acute malnutrition [{ICCM}-{N}ut]) delivered to mother-child pairs during the first "1,000 days" of life. {W}e primarily investigated program impact at population level on children's height-for-age z-scores ({HAZ}s) and secondarily on stunting ({HAZ} < -2) and intermediary outcomes including household's food insecurity, mother-child pairs' diet and health, delivery in a health facility and low birth weight ({LBW}), women's knowledge, and physical intimate partner violence ({IPV}). {M}ethods and findings {W}e implemented a parallel-cluster-randomized controlled trial, in which 162 villages were randomized into either an intervention arm ({UCT}s + package of community activities, n = 82) or a control arm (package of community activities only, n = 80). {T}wo different representative samples of children aged 6-29 months and their mothers were surveyed in each arm, one before the intervention in 2014 (control: n = 1,301, intervention: n = 1,357), the other 2 years afterwards in 2016 (control: n = 996, intervention: n = 1,035). {D}ifference-in-differences ({DD}) estimates of impact were calculated, adjusting for clustering. {C}hildren's average age was 17.4 (+/- 0.24 {SE}) months in the control arm and 17.6 (+/- 0.19 {SE}) months in the intervention arm at baseline. {UCT}s had a protective effect on {HAZ} ({DD} = +0.25 z-scores, 95% confidence interval [{CI}]: 0.01-0.50, p = 0.039), which deteriorated in the control arm while remaining stable in the intervention arm, but had no impact on stunting ({DD} = -6.2 percentage points [pp], relative odds ratio [{ROR}]: 0.74, 95% {CI}: 0.51-1.06, p = 0.097). {UCT}s positively impacted both mothers' and children's (18-23 months) consumption of animal source foods ({ASF}s) (respectively, {DD} = +4.5 pp, {ROR}: 2.24, 95% {CI}: 1.09-4.61, p = 0.029 and {DD} = +9.1 pp, {ROR}: 2.65, 95% {CI}: 1.01-6.98, p = 0.048) and household food insecurity ({DD} = -10.7 pp, {ROR}: 0.63, 95% {CI}: 0.43-0.91, p = 0.016). {UCT}s did not impact on reported child morbidity 2 week's prior to report ({DD} = -3.5 pp, {ROR}: 0.80, 95% {CI}: 0.56-1.14, p = 0.214) but reduced the financial barrier to seeking healthcare for sick children ({DD} = -26.4 pp, {ROR}: 0.23, 95% {CI}: 0.08-0.66, p = 0.006). {W}omen who received cash had higher odds of delivering in a health facility ({DD} = +10.6 pp, {ROR}: 1.53, 95% {CI}: 1.10-2.13, p = 0.012) and lower odds of giving birth to babies with birth weights ({BW}s) <2,500 g ({DD} = -11.8, {ROR}: 0.29, 95% {CI}: 0.10-0.82, p = 0.020). {P}ositive effects were also found on women's knowledge ({DD} = +14.8, {ROR}: 1.86, 95% {CI}: 1.32-2.62, p < 0.001) and physical {IPV} ({DD} = -7.9 pp, {ROR}: 0.60, 95% {CI}: 0.36-0.99, p = 0.048). {S}tudy limitations included the short evaluation period (24 months) and the low coverage of {UCT}s, which might have reduced the program's impact. {C}onclusions {UCT}s targeting the first "1,000 days" had a protective effect on child's linear growth in rural areas of {T}ogo. {T}heir simultaneous positive effects on various immediate, underlying, and basic causes of malnutrition certainly contributed to this ultimate impact. {T}he positive impacts observed on pregnancy- and birth-related outcomes call for further attention to the conception period in nutrition-sensitive programs.},
  keywords = {{TOGO}},
  booktitle = {},
  journal = {{PL}o{S} {M}edicine},
  volume = {17},
  numero = {11},
  pages = {e1003388 [29 ]},
  ISSN = {1549-1277},
  year = {2020},
  URL = {https://www.documentation.ird.fr/hor/fdi:010080449},
}