The impact of Cash transfer on Children’s Nutrition outcome in Humanitarian context of Somalia, Systematic review.

Background Acute malnutrition is sustained problem in Somalia despite interventions. This is mainly due to many factors including protracted conflicts. The aim of this systemic review was to understand better the effect of cash transfer on child and pregnant and lactating women (PLW) nutrition outcome in Somalia as there wasn’t any pooled study done so far. Methods The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines was used to conduct this systematic review of all studies including qualitative studies conducted on Cash transfer and nutrition outcome among children and PLW in humanitarian settings of Somalia. Wasting was the outcome of interest since humanitarian context was focused. However, stunting and underweight were also considered as primary outcome. In addition to manual searches, key phrases were searched in several databases, including PubMed/Medline, Science Direct, and Google Scholar. Two reviewers worked separately to choose, extract, and analyze data quality. Result Nine papers in total—two qualitative and the remaining randomized/nonrandomized trials—were included in this review; however, because study designs varied, we chose not to do a meta-analysis. According to qualitative research, cash transfers help beneficiaries' families and children nutrition better. Furthermore, two controlled trial studies on pregnant/lactating women and children found that cash with voucher and cash with behavioral change communication significantly (P < 0.05) reduce acute malnutrition in PLW and children, respectively. Many of included studies, however, concluded that, in the humanitarian context of Somalia, cash alone, cash plus cash, cash with voucher or nutrition counseling do not significantly (P > 0.05) reduce acute malnutrition in children. Conclusion This review concludes that although there is limited evidence that cash transfer programs combined with appropriate behavioral change communication, as well as cash or vouchers, can reduce acute undernutrition in Somalia among children and pregnant/lactating women respectively, cash transfers alone do not significantly impact under-five child undernutrition in Somalia. However, the qualitative findings show perceived benefits of cash transfers on children's and household nutrition. To address children's acute undernutrition in the humanitarian setting of Somalia, cash must be combined with other health interventions including effective behavioral change communication. Additionally, scaling up Health and Nutrition co-responsibility cash transfer initiated by Baxnaano program in Somalia is the way forward.