Behaviour change communication for child feeding in social assistance: A scoping review and expert consultation.

To increase the effectiveness of social assistance on child nutrition, programmes are increasingly combined with behaviour change communication for improved infant and young child feeding (BCC for IYCF). Unfortunately, there is limited knowledge about which BCC strategies are most effective when combined with social assistance. A systematic scoping review and an expert consultation was conducted to (1) describe the landscape of BCC for IYCF strategies used in social assistance within low- and middle-income countries and (2) to examine the effects of these BCC strategies on IYCF practices and child nutrition. Ten quantitative, three qualitative and four mixed methods studies were reviewed and complemented by 12 expert consultations carried out between August and October 2020. In most of the studies attendance in BCC for IYCF was conditional for receiving social assistance, although experts agreed that this conditionality may be counterproductive. A variety of BCC strategies were used with two being most common-group sessions with pre-determined topics and individual counselling. Context-specific adaptation, interactive delivery and building on existing IYCF knowledge emerged as crucial but was perceived as economically infeasible in social assistance programmes. Given the variety of BCC strategies and inconsistency in outcomes, it is impossible to draw conclusions regarding effectiveness. Nevertheless, tentative evidence suggests that the promotion of existing nutrition services, educational group sessions and individual counselling may be effective in improving IYCF. BCC for IYCF can make social assistance more beneficial, but may increase costs, demands on beneficiaries, and deviate from the original focus of the programmes.

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries.

BACKGROUND: To strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention's complementary ("plus") components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being. METHODS AND FINDINGS: Forty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child's life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = -0.13 (-0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = -0.06 (-0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings. CONCLUSIONS: In this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

Assessing mental health in a context of extreme poverty: Validation of the rosenberg self-esteem scale in rural Haiti.

A widening evidence base across low- and middle-income countries (LMICs) points towards mutually reinforcing linkages between poverty and mental health problems. The use of validated and culturally relevant measures of mental health outcomes is crucial to the expansion of evidence. At present, there is a paucity of measures that have been tested and validated in contexts of extreme poverty. Using data from adult women living in extreme poverty in rural Haiti this study assesses the cross-cultural validity of the widely used Rosenberg Self-Esteem Scale (RSES) and its applicability in assessing linkages between poverty and mental health outcomes. We find no evidence for a one-dimensional 10-factor structure of the RSES within our data and agree with other authors that the standard self-esteem model does not fit well in this cultural context. Comparisons with another widely used measure of mental health-the K6 measure-indicate that the RSES cannot be used as a proxy for mental health outcomes. We conclude that the use of the RSES in different cultural contexts and with samples with different socioeconomic characteristics should be undertaken with caution; and that greater consideration of the validity of psychosocial constructs and their measurement is vital for gaining robust and replicable insights into breaking the cycle between poverty and mental health problems.

The Development Impacts of COVID-19 at Home and Abroad: Politics and Implications of Government Action.

What is COVID-19's impact on development? What lessons can be drawn from development studies regarding the effects of and recovery from COVID-19? The unprecedented scale and scope of government interventions carry implications at all levels: global, national, and local. In this introduction, our team of Editors underline the importance of systematic substantive study to further knowledge acquisition, and rigorous global-, national-, or context-specific evaluation to inform evidence-based policymaking. The 12 articles summarised here capture these values and sense of "high quality". In particular, despite early considerations in the first year of the pandemic, they illuminate the need for diverse responses beyond business-as-usual, attention to the multiplicity of impact of policies formulated, and progressive strategies to counteract the impacts of this disaster around the world. The path of future research is clear: studies need to consider and give voice to marginalised groups to counteract the short- and long-term impacts of the pandemic.

Quel est l'impact de la COVID-19 sur le développement international ? Quelles leçons pouvons-nous tirer des études de développement concernant les effets de la COVID-19, et du redressement après son passage ? L'ampleur et la portée sans precedent des interventions gouvernementales comportent des conséquences à tous niveaux: mondial, national, et local. Dans cette introduction, notre équipe éditoriale souligne l'importance des études à la fois systématiques et substantielles, afin d'élargir l'acquisition de connaissances; ainsi que des évaluations rigoureuses au niveau mondial, national, ou spécifiques au contexte, ayant pour but d'informer une politique des décisions basée sur l'évidence. Les 12 articles résumés ici présentent ces valeurs et ce sentiment de « haute qualité¼. En particulier, malgré des considérations précoces pendant la première année de cette pandémie, les articles soulèvent la nécessité de réponses diversifiées, bien au-delà des démarches jusqu' ici habituelles (en anglais, « business as usual¼), l'importance de prêter attention à la multiplicité d'impacts des politiques formulées, et le besoin de stratégies progressistes, pour faire face aux impacts de cette catastrophe partout dans le monde. Le chemin à prendre pour les recherches futures est clair: les études doivent considérer et donner une voix aux groupes marginalisés, pour faire face aux impacts à court et longue terme de la pandémie.

COVID-19 in LMICs: The Need to Place Stigma Front and Centre to Its Response.

COVID-19 has caused unprecedented health, economic and societal impacts across the world, including many low- and middle-income countries (LMICs). The pandemic and its fallout have laid bare deep-seated social and economic inequalities with marginalised groups being at greater risk of infection and being disproportionately affected by containment measures and their socioeconomic consequences. Stigma is a central element to such inequalities but remains largely overlooked in the debate on the response to COVID-19, including in LMICs. Yet we know from experiences with other infectious diseases such as HIV/AIDS and Ebola that disease-related stigma is detrimental to halting and controlling pandemics and achieving equitable development. Emerging evidence suggests that stigma associated with COVID-19 is already taking hold. This paper assesses potential driving factors of COVID-19-related stigma, and how this intersects with existing stigma fault lines and explores mechanisms through which COVID-19-related stigma may be counteracted, with a focus on LMICs.

La COVID-19 a eu un impact sanitaire, économique et sociétal sans précédent à travers le monde, y compris dans de nombreux pays à revenu faible ou intermédiaire (PRFI). La pandémie et ses retombées ont mis à nu de profondes inégalités sociales et économiques, les groupes marginalisés étant plus exposés au risque d'infection et étant touchés de façon disproportionnée par les mesures de confinement et par leurs conséquences socioéconomiques. La stigmatisation est au centre de ces inégalités mais reste largement négligée dans les débats sur la réponse à la COVID-19, y compris dans les PRFI. Grâce à l'expérience que nous avons sur d'autres maladies infectieuses telles que le VIH/SIDA et la maladie à virus Ebola, nous savons pourtant que la stigmatisation liée à une maladie empêche de contrôler et de stopper les pandémies et ne permet pas un développement équitable. De nouvelles preuves suggèrent que la stigmatisation associée à la COVID-19 gagne déjà du terrain. Cet article évalue les facteurs potentiels de stigmatisation liée à la COVID-19, analyse comment cela se recoupe avec les failles existantes de la stigmatisation et explore les mécanismes par lesquels on peut lutter contre la stigmatisation liée à la COVID-19, en mettant l'accent sur les PRFI.

Child Poverty in Vietnam: Providing Insights Using a Country-Specific and Multidimensional Model.

Despite a wide under-prioritization, the issue of child poverty has received increasing attention worldwide over the last decade. The acknowledgement in Vietnam that child-specific poverty measurement is crucial for poverty efforts directed towards children, and the current lack thereof, instigated the development of a Vietnam child poverty approach. This paper proposes a country-specific, multidimensional and outcome-based approach for the measurement of the incidence, depth and severity of child poverty. It does so at the level of the individual child using household survey data. The development of such an approach at the level of the individual child presents an appropriate alternative for or supplement to the widely used monetary poverty approach, allowing for the use of compatible analytical methods. Findings suggest that 37% of all children in Vietnam live in poverty, with the most pressing areas of deprivation being water, sanitation and leisure. We do not find evidence for a gender bias but do observe a large urban-rural divide, regional disparities and large ethnic inequalities. We argue that this tailor-made approach is a valuable new tool for policy makers and analysts in Vietnam as it enables identification and analysis of poor children, their characteristics and most pressing areas of deprivation within the country's specific social and cultural context.

The Importance of Choice and Definition for the Measurement of Child Poverty-the case of Vietnam.

Increased attention to childrens' special position within poverty measurement resulted in the development of various child poverty approaches in the last decade. Analysis shows that their development processes involve a similar set of steps and decisions, predominantly taken in the same sequence. However, it also becomes apparent that many of these decisions are made implicitly rather than explicitly, resulting in unclear and non-transparent underlying constructs. Consequently, child poverty approaches often lack a solid and robust foundation and are misinterpreted and misunderstood when used for analytical and policy purposes. This paper distills a generic construction process from the analysis of existing child poverty approaches, presenting a tool for clear and transparent development of such approaches. It is then applied to the case of Vietnam, using household survey data, to illustrate its practical use and develop a Vietnam-specific child poverty approach. Findings suggest that 37% of all children are poor, whilst observing a large rural-urban divide but no significant differences between boys and girls.