Ethiopia’s PSNP and Child Nutrition
Ethiopia’s Productive Safety Net Programme (PSNP), which combines a public works program with unconditional cash and food transfers, is one of the largest safety net programs for household food security in Africa. But does it actually improve childhood nutrition in the country? A recent project paper from IFPRI’s Ethiopia Strategy Support Program (ESSP) explores this question and finds no evidence that the PSNP reduces chronic undernutrition in preschool-aged children; this finding could be the result of confounding environment, social, or economic factors that need to be addressed.
Unlike the annual emergency appeals to reduce mass starvation, the PSNP was conceived as a multi-year program to provide recipients with predictable and reliable benefits, including employment in public works projects for those who are capable of working. Initially, households that had received past emergency food aid were selected into the program. Later, eligibility began to take into consideration households’ assets and income from non-agricultural activities and employment. Eligible households are assigned to either public works programs or direct support programs (in the case of the elderly or disabled).
This ESSP study, which uses inverse-probability-weighted regression-adjustment estimators (IPWRA), examines survey data collected in four rounds from 2006-2012. The survey assessed PSNP beneficiaries and non-beneficiaries and collected information on household demographics, assets, income-generating activities, consumption, and other information that directly impacts access to food. In the 2008, 2010, and 2012 rounds, anthropometric measures were taken for all children aged six months to five years living in beneficiary households. These measures were then converted to z-scores using the WHO growth standards, which allow for comparison to well-nourished children of the same age and sex. These measurements were used to assess undernutrition and its impact on children’s weight and height. The results showed no evidence that PSNP participation has any effect on chronic undernutrition; 48 percent of children surveyed remained stunted (low height-for-age) in 2012.
While the study authors could not definitively identify the reason for these results, they note several important factors that could explain their findings. First, children’s diets remain poor despite receiving PSNP benefits. Specifically, they found no evidence that involvement in the PSNP results in higher consumption of pulses, oils, fruits, vegetables, dairy products, or animal proteins. Second, water and sanitation practices in Ethiopia remain poor, which impacts children’s health and nutrition. Third, most mothers involved in the program do not have contact with health extension workers, nor have they received information regarding good child feeding practices.
The authors also posit that participation in the public works component of the PSNP impacts households’ income constraints and time constraints in different ways. While the increased income stemming from the program may be used to improve and increase food consumption, participation in public works employment also creates a new demand on parents’ time. If this increased workload reduces the time devoted to childcare (specifically child feeding), then this aspect of program participation may also help explain the PSNP’s low impact on children’s nutritional status.
By: Jenn Campus