Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways
Background: 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 systemati...
| Autores principales: | , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
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American Society for Nutrition
2021
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| Acceso en línea: | https://hdl.handle.net/10568/142739 |
| _version_ | 1855522459258716160 |
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| author | Leroy, Jef L. Koch, Bastien Roy, Shalini Gilligan, Daniel O. Ruel, Marie T. |
| author_browse | Gilligan, Daniel O. Koch, Bastien Leroy, Jef L. Roy, Shalini Ruel, Marie T. |
| author_facet | Leroy, Jef L. Koch, Bastien Roy, Shalini Gilligan, Daniel O. Ruel, Marie T. |
| author_sort | Leroy, Jef L. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: 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. |
| format | Journal Article |
| id | CGSpace142739 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | American Society for Nutrition |
| publisherStr | American Society for Nutrition |
| record_format | dspace |
| spelling | CGSpace1427392025-02-24T06:46:18Z Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways Leroy, Jef L. Koch, Bastien Roy, Shalini Gilligan, Daniel O. Ruel, Marie T. birth weight small-for-gestational age child nutrition pregnancy health social assistance nutrition children birth outcomes maternal nutrition public health Background: 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. 2021-12-06 2024-05-22T12:10:58Z 2024-05-22T12:10:58Z Journal Article https://hdl.handle.net/10568/142739 en https://doi.org/10.1093/ajcn/nqab276 https://doi.org/10.1093/ajcn/nqab278 Open Access American Society for Nutrition Leroy, 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/nxab292 |
| spellingShingle | birth weight small-for-gestational age child nutrition pregnancy health social assistance nutrition children birth outcomes maternal nutrition public health Leroy, Jef L. Koch, Bastien Roy, Shalini Gilligan, Daniel O. Ruel, Marie T. Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title | Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title_full | Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title_fullStr | Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title_full_unstemmed | Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title_short | Social assistance programs and birth outcomes: A systematic review and assessment of nutrition and health pathways |
| title_sort | social assistance programs and birth outcomes a systematic review and assessment of nutrition and health pathways |
| topic | birth weight small-for-gestational age child nutrition pregnancy health social assistance nutrition children birth outcomes maternal nutrition public health |
| url | https://hdl.handle.net/10568/142739 |
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