The Impact of Cash-Based Assistance on the Nutritional Outcomes in Refugee Children 0-59 Months in West Nile Sub-Region of Uganda

Cash-based transfer and food in-kind assistance are two different modalities used to deliver assistance to conflict-affected populations. The use of cash has become a common modality of assistance in humanitarian response given its benefits. In Uganda, the World Food Programme (WFP) has increased the use of cash-based transfers to refugees and asylum seekers. Despite the assistance, the prevalence of malnutrition remains high among refugee children in West Nile. This study, therefore, this study examined the effect of cash-based assistance on the nutritional outcomes of children (0-59) months in refugee settlements in the West Nile Sub-region of Uganda, while also assessing the influence of various factors such as caregiver education, food storage, and child-feeding practices. Data was collected from 122 respondents using a descriptive study design. Statistical analyses, including ANOVA and Pearson’s chi-square tests, were employed to assess the relationship between cash assistance and nutritional outcomes, with anthropometric measurements {mid-upper arm circumference (MUAC) and Z-score values of weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ)} used to evaluate physical growth.

The study's findings revealed that 31.12% of caregivers of children (0-59) months received cash assistance of between 19,000 to 24,000 Uganda shillings with significant variation in proportions between the districts at a P-value <0.005. Of that, 92.62% of caregivers received cash assistance every two months compared to only 7.38% who received cash monthly at a P-value of 0.130. The study findings showed that there was no significant effect of cash assistance on the nutritional outcomes among children as confirmed by the moderate underweight prevalence of 12.96% (P=0.1714), low stunting level of 15.19% (P=0.0571) below <20% World health organization (WHO) cut off and moderate wasting prevalence of 6.67% at P-value of 0.0634. The underweight and wasting prevalences are above <10% and <5% WHO threshold respectively. Although these discrepancies in the prevalences of underweight, wasting, and stunting are not statistically significant, the results show a low prevalence of underweight, stunting, and wasting. Thus, the null hypothesis is accepted. Thus, there is no adequate evidence that cash assistance has a statistically significant association with nutritional outcomes among children under five years in refugee settlements. Concerning nutritional knowledge, food storage, and child-feeding practices of caregivers of children (0-59) months, 62.24% of caregivers had poor nutrition knowledge, 93.62% of caregivers had basic food storage facilities for keeping food and 69.29% of them had good child-feeding practices.

Conclusively, these findings suggest that while cash-based assistance does not show a statistically significant impact on nutritional outcomes, it may still play a role in improving food security. Humanitarian agencies should consider scaling up cash-based transfers alongside broader food security and livelihood interventions to enhance household food access.”