Chronic undernutrition is characterized by long-term exposure to food of insufficient quality and inadequate quantity, including restricted intake of energy, protein, fat, micronutrients, essential amino acids, vitamins and minerals. Physiologically, in a state of chronic food insufficiency, the human body conserves energy by prioritizing essential metabolic processes resulting in impaired linear growth and delayed reproductive maturation. Consequently, height can theoretically be considered a measure of an individual’s cumulative health and nutrition. Therefore, a deviation from the ‘normal’ height relative to one’s age represents a deviation from one’s optimal growth and, potentially, the presence of other issues. Similarly, the delayed onset of puberty is another common physiological response to food insufficiency, often accompanying impaired linear growth. Chronic undernutrition can arise from chronic disease, congenital abnormalities and insufficient food intake. In this review, we will explore the hypothesis of CUG during adolescence, given the relationship between impaired linear growth and the delayed onset of puberty in children suffering from chronic undernutrition due to a lack of sufficient quality and quantity of food.
Susan Campisi; Bianca Carducci; Olle Söder; Zulfiqar Bhutta
The productive impacts of transfer programmes have received increased attention. However, little is known about such effects in emergency and crisis settings. Even less is known about whether transfer type – a food basket or a cash grant – influences the productive potential of such transfers. Theory suggests that, while cash transfers can relieve liquidity constraints associated with investments, subsidized food provision, by acting as a form of insurance, may prevent households from retreating to conservative income-generating strategies during volatile periods. Using a randomized field experiment in Yemen, we contrast the effects of transfer modality. The results demonstrate a modest productive impact of both modalities and suggest a role for both liquidity and price risk channels. Cash transfer recipients invested relatively more in activities with higher liquidity requirements (livestock), while food recipients incorporated higher-return crops into their agricultural portfolios.
The methods used to identify beneficiaries of programmes aiming to address persistent poverty and shocks are subject to frequent policy debates. Relying on panel data from Niger, this paper analyses the performance of different targeting methods that are widely used by development and humanitarian actors and explores how they can be applied as part of an adaptive social protection (ASP) system. The methods include proxy-means testing (PMT), household economy analysis (HEA), geographical targeting, and combined methods. Results show that PMT performs better in identifying persistently poor households, while HEA performs better in identifying transiently food insecure households. Geographical targeting is particularly efficient in responding to food crises, which tend to be largely covariate in nature. Combinations of geographical, PMT, and HEA approaches may be used as part of an efficient and scalable ASP system. Results motivate the consolidation of data across programmes, which can support the application of alternative targeting methods tailored to programme-specific objectives.
This paper documents the impact of a cash transfer programme – an initiative of the Government of Lebanon, the United Nations Children’s Fund (UNICEF) and the World Food Programme (WFP), widely known as the No Lost Generation Programme (NLG) and, locally, as Min Ila (‘from to’) – on the school participation of displaced Syrian children in Lebanon. The programme provides cash to children who are enrolled in the afternoon shift of a public primary school. It was designed to cover the cost of commuting to school and to compensate households for income forgone if children attend school instead of working, two critical barriers to child school participation. We rely on a geographical regression discontinuity design comparing children living in two pilot governorates with children in two neighbouring governorates to identify the impact of the programme halfway in the first year of operation (the 2016/17 school year). We find limited programme effects on school enrolment, but substantive impacts on school attendance among enrolled children, which increased by 0.5 days to 0.7 days per week, an improvement of about 20 per cent over the control group. School enrolment among Syrian children rose rapidly across all of Lebanon’s governorates during the period of the evaluation, resulting in supply side capacity constraints that appear to have dampened positive impacts on enrolment.
The rise of social protection into the limelight of social policy has opened up space for understanding how it can act as a key interface between states and citizens. This paper rethinks social protection through the lens of citizenship. It considers how the design and implementation of social protection can be shifted away from discretionary and technocratic forms, to forms which stimulate vulnerable citizens to make justice-based claims for their rights and demand accountability for the realization of those rights. It puts forward a conceptual framework for social protection with three modalities through which citizens can be engaged: as shapers and makers; as users and choosers; and as passive consumers.
Rachel Sabates-Wheeler; Abdul-Gafaru Abdulai; Nikhil Wilmink; Richard de Groot; Tayllor Spadafora
The annual workshop of the Transfer Project, “The State of Evidence on Social Cash Transfers in Africa” focused on new challenges arising from moving from fragmented programmes to integrated social protection systems, combining cash transfers with complementary (also referred to as ‘plus’) interventions, as well as the assessment of social protection in emergency contexts.
This brief summarizes the key insights and conclusions from a discussion paper on gender socialization during adolescence, with a focus on low- and middle-income settings. By reviewing theories from psychology, sociology and biology, significant societal changes and effective programme interventions, the paper sets out to provide a more holistic picture of the influences and outcomes of gender socialization for adolescent programming and policy.
John A. Neetu; Kirsten Stoebenau; Samantha Ritter; Jeffrey Edmeades; Nikola Balvin
Childhood malnutrition remains a significant global health concern. In order to implement
effective policies to address the issue, it is crucial to first understand the mechanisms underlying
malnutrition. This paper uses a unique dataset from Northern Ghana to explain the underlying causes of
childhood malnutrition. It adopts an empirical framework to model inputs in the production of health and
nutrition, as a function of child, household and community characteristics. The findings suggest that child
characteristics are important in explaining inputs and nutritional outcomes, and that maternal agency and
health contribute to improved health status. Household resources in the form of consumption are
positively associated with food intake and nutritional outcomes. Simulations show that income growth,
improving maternal care and avoiding sudden price shocks have a positive but rather limited effect on the
reduction of malnutrition. Effects are greater in children under two. Hence, policies that address underlying
determinants simultaneously, and target the youngest population of children, could have the largest effect
on reducing malnutrition in this population.
This brief introduces the methodological series Conducting Research with Adolescents from low- and middle-income countries (LMICs), outlining key research themes, intervention types, and their associated methodological implications. It highlights adolescence as a critical phase within the life course and a period of biological and social transition that is itself undergoing change. It makes the case that new understandings from neuroscience have important implications for programming; addressing social and structural determinants is crucial to improving adolescent well-being; inter-sectoral and comprehensive multi-component action is required, as is matching action to need; and gender and equity should always be considered in research, programmes and policy.
Written primarily for UNICEF staff, funders of research, policy-makers, ethics committee members and researchers, this brief intends to provide principles and approaches to the common challenges in conducting research with adolescents. It emphasizes the value of research with adolescents and discusses at length the importance of balancing inclusion and protection, concluding with a set of ethical ground rules and recommendations for research with adolescents and examples on how to apply them.