Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways

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cg.authorship.typesCGIAR single centre
cg.contributor.affiliationInternational Food Policy Research Institute
cg.contributor.crpAgriculture for Nutrition and Health
cg.contributor.donorBill & Melinda Gates Foundation
cg.creator.identifierJef L Leroy: 0000-0001-9371-3832
cg.creator.identifierBastien Kolt (Koch): 0000-0003-1392-7190
cg.creator.identifierShalini Roy: 0000-0001-8053-1650
cg.creator.identifierDaniel Gilligan: 0000-0002-3530-0148
cg.creator.identifierMarie Ruel: 0000-0002-9506-348X
cg.identifier.doihttps://doi.org/10.1093/jn/nxab292
cg.identifier.projectIFPRI - Poverty, Health, and Nutrition Division
cg.identifier.publicationRankA plus
cg.isijournalISI Journal
cg.issn0022-3166
cg.issue12
cg.journalJournal of Nutrition
cg.reviewStatusPeer Review
cg.volume151
dc.contributor.authorLeroy, Jef L.
dc.contributor.authorKoch, Bastien
dc.contributor.authorRoy, Shalini
dc.contributor.authorGilligan, Daniel O.
dc.contributor.authorRuel, Marie T.
dc.date.accessioned2024-05-22T12:10:58Zen
dc.date.available2024-05-22T12:10:58Zen
dc.identifier.urihttps://hdl.handle.net/10568/142739
dc.titleSocial assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathwaysen
dcterms.abstractBackground: Poor birth outcomes are an important global public health problem. Social assistance programs that provide cash or in-kind transfers, such as food or vouchers, hold potential to improve birth outcomes but the evidence on their effectiveness has not been reviewed. Objectives: We systematically reviewed studies that used experimental or quasi-experimental methods to evaluate the impacts of social assistance programs on outcomes in low- and middle-income countries. Methods: The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to assess the certainty of the evidence for birth weight and neonatal mortality (most common outcomes reported). We summarized the evidence on hypothesized nutrition and health pathways of impact. Results: We included 6 evaluations of 4 different cash transfer programs and 1 evaluation of a community-based participatory learning and action program that provided food and cash transfers. The 4 studies that assessed birth weight impacts found significant (P < 0.05) effects ranging from 31 to 578 g. Out of 3 studies that assessed neonatal mortality impacts, 2 found significant effects ranging from 0.6 to 3.1 deaths/1000 live births. The certainty of the evidence for both outcomes was rated as very low due to several methodological limitations. In terms of potential pathways, some studies documented positive effects on maternal diet, antenatal care (ANC) utilization, and delivery in a health facility. Conclusions: Better-designed evaluations are needed to strengthen the evidence base on these programs. Evaluation studies should elucidate underlying mechanisms of impact by including outcomes related to maternal diet, ANC seeking, use of skilled delivery, and women's empowerment in nutrition and health domains. Studies should also assess potential unintended negative consequences of social assistance, such as reduced birth spacing and excess pregnancy weight gain.en
dcterms.accessRightsOpen Access
dcterms.bibliographicCitationLeroy, Jef L.; Koch, Bastien; Roy, Shalini; Gilligan, Daniel; and Ruel, Marie. 2021. Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways. Journal of Nutrition 151(12): 3841–3855. https://doi.org/10.1093/jn/nxab292en
dcterms.extentpp. 3841-3855
dcterms.issued2021-12-06
dcterms.languageen
dcterms.licenseCC-BY-4.0
dcterms.publisherAmerican Society for Nutrition
dcterms.relationhttps://doi.org/10.1093/ajcn/nqab276en
dcterms.relationhttps://doi.org/10.1093/ajcn/nqab278en
dcterms.replaceshttps://ebrary.ifpri.org/digital/collection/p15738coll5/id/7949
dcterms.subjectbirth weighten
dcterms.subjectsmall-for-gestational ageen
dcterms.subjectchild nutritionen
dcterms.subjectpregnancyen
dcterms.subjecthealthen
dcterms.subjectsocial assistanceen
dcterms.subjectnutritionen
dcterms.subjectchildrenen
dcterms.subjectbirth outcomesen
dcterms.subjectmaternal nutritionen
dcterms.subjectpublic healthen
dcterms.typeJournal Article

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