Evaluating the Impact of Cash Aid on Child Health in Niger, West Africa

Purpose: To assess the effectiveness of cash distribution on overall health status of children under 5 years of age in Niger, West Africa, which is arguably one of the poorest places in the world. The 2004 famine left the country of Niger ravaged by drought directly impacting malnutrition rates. As a result, a cash relief project was implemented in the hardest-hit regions of Niger, representing an innovative approach to humanitarian aid not commonly utilized. Data: Repeated anthropometric measurements of children less than 5 years in 19 different villages were collected and analyzed. Methods: Epi Info was used to calculate weight-for-age z-scores based on the 2000 World Health Organization Standards. A two-sided t-test, with Welch's unequal variance, was utilized to test continuous variables for differences between cash intervention and no cash intervention. Pearson's chi-square test of association was used to test categorical variables. Due to the correlation within households, villages, and cantons (county-like boundaries), the random effects model was employed to determine the effect of cash intervention. Results: Cash distribution had a non-statistically significant increase in weight-for-age z-scores, after adjusting for participation in other food-aid programs, current breastfeeding status, and current diarrhea status. Recommendations: Cash distribution is a cost-effective, appropriate, and sustainable approach to humanitarian aid relief efforts, yet more studies are needed to determine its true effectiveness. Famine relief efforts are an important global public health concern and the model of cash aid in this study can encourage change in humanitarian relief policy and strengthen international relations.