We assess whether layering an ultra-poor graduation program on Ethiopia’s Productive Safety Net Programme (PSNP) protects women and their households from localized weather shocks. Using panel data from a large cluster-randomized trial matched with detailed weather records, we identify community-level exposure to dryness shocks. Women who are exposed to dryness shocks experience deteriorating nutritional status (in conjunction with declining household food security and assets) and a significant increase in the risk of intimate partner violence. However, access to the graduation program fully buffers women from any increase in intimate partner violence, and partially buffers women and their households against other adverse effects. Further analysis suggests that improved household savings likely drives the program’s protective impact.

This systematic review examines the effectiveness of social assistance programs in protecting households in Africa - a region highly vulnerable to climate change, conflict, and other shocks - during periods of crisis. We focus on quantitative studies using microdata to assess their impact on household income, poverty, assets, and food security. The evidence consistently shows that social assistance programs provide meaningful protection. Beyond immediate consumption support, they often help households establish savings groups and accumulate assets that can be drawn upon during shocks. However, their effectiveness depends on transfers being sufficiently large, predictable, and regular. Cash-plus programs, which combine consumption support with livelihood interventions, show promise in helping households accumulate buffer stocks. Yet evidence for widespread livelihood diversification remains limited. Moreover, the type of shock matters; while some strategies are effective against weather-related shocks, they may offer less protection against pandemics or conflict, where livelihood losses and displacements are common.

Recently developed cost and affordability of healthy diet (CoAHD) metrics have quickly become mainstream food security indicators. However, published research on the sensitivity of estimation methods is limited. This paper focuses on two important innovations in CoAHD measurement at the global level. First, we develop a demographic scaling factor to adjust healthy diet costs for cross-country differences in age structures, since younger populations generally require fewer calories than older populations. Second, we improve the way in which household expenditure available for purchasing food (“food budgets”) are derived. In addition, we explore sensitivity of global CoAHD estimates to potential problems with the representativeness and food product coverage of global food price data and vary assumptions for activity levels that shape energy expenditure requirements. We apply these explorations to the EAT-Lancet reference diet in 137 countries using price data from 2017. Relative to the conventional methods, we find that demographic scaling and improved food budget derivation substantially reduces the estimated population who cannot afford a healthy diet, from 3.02 to 2.13 billion. Adjustments for low product coverage can lead to modest reductions for specific regions and food groups, while higher physical activity assumptions increase the share of people who cannot afford a healthy diet, though perhaps implausibly so. Methods clearly matter in CoAHD estimation, and more accurate and timelier CoAHD estimates have substantial scope to improve policy analysis, design and targeting.

Introduction In Sidama, Ethiopia, animal-source foods can be difficult to access. Milk has important nutrients for child growth, but carries the risk of aflatoxin M1 (AFM1) contamination. AFM1 is a metabolite of the mycotoxin aflatoxin B1 (AFB1) in dairy feed; cows secrete AFM1 in milk when their feed contains AFB1 produced by Aspergillus fungi in maize, nuts and oilseeds. It is unknown whether AFM1 compromises child growth and health.Methods and analysis This protocol paper describes our study in Sidama to determine the impact of milk consumption and AFM1 on child growth in the first 18 months of life. We will collect baseline and end-line data on dairy production, socioeconomic and nutritional factors of 1000 dairy-owning households with children ages 6–18 months at baseline; and gather samples of milk and dairy feed and child anthropometrics. We will conduct phone interviews every 6 months to ascertain changes in practices or child health. Dairy feed will be tested for AFB1; milk for AFM1, pathogens and nutrients. Controlling for herd size, socioeconomic, nutritional and behavioural factors, we will determine the association between child anthropometrics and milk consumption, as well as AFM1 exposure. We will examine whether AFM1 exposure affects child growth in the first 18 months of life, and weigh the benefits and risks of milk consumption.Ethics and dissemination The protocol is approved by the Institutional Review Boards of the Ethiopian Public Health Institute (EPHI-IRB-481–2022), Michigan State University (STUDY00007996) and International Food Policy Research Institute (DSGD-23–0102). Written informed consent will be obtained from all participants, who may withdraw from the study at any time. Confidentiality of collected data will be given high priority during each stage of data handling. The study’s findings will be disseminated through stakeholder workshops, local and international conferences, journal articles and technical reports.

Consumption of milk is linked to improved nutrient intake and reduced risk of child malnutrition in low and middle-income countries. However, these benefits are contingent on the safety and quality of the milk. Milk consumption may alleviate the widespread risk of malnutrition in rural Ethiopia, but milk-borne contaminants may also compromise child health. We aimed to: i) identify the types of dairy feeds used, their storage conditions, and potential risk of aflatoxin contamination; ii) assess stakeholders' knowledge about aflatoxin contamination along the value chain; and iii) assess parental practices on feeding milk to infants and young children.This qualitative study was conducted in the Sidama region, southern Ethiopia. In-depth interviews (n = 12) and key-informant interviews (n = 18) were conducted with actors along the dairy value chain. Focus-group discussions were conducted with farmers (9FGD/n = 129) and child caregivers (9FGD/n = 122). Study participants were selected to represent a rural-urban gradient, as well as low- and high- dairy cow holdings.We found that while animal-feed processors and their distribution agents had relatively good knowledge about aflatoxin, farmers and retailers did not. Feed storage conditions were poor. Many respondents linked moldy feeds to animal health but not to human health. Farmers' feed choice was influenced by cost, seasonality, and herd size. Small-holding farmers had limited access to commercial feed. Children's consumption of milk was limited to skim milk, as butter was extracted and sold for income. The high cost of dairy products also led some parents to dilute skim milk with water before feeding children, compromising the nutritional value and safety of the milk.Our findings underscore the need to address the gaps in aflatoxin and food safety knowledge, improve storage conditions, and ensure the availability of quality feed to increase the sector's productivity, but most importantly to protect consumers' health and well-being, especially infants and young children.

Over the last 20 years, a burgeoning scholarly literature has analyzed the effects of cash transfer and cash plus interventions in a wide range of contexts and using a range of empirical designs. We conduct a systematic review and meta-analysis to estimate the pooled effect of any cash or cash plus intervention on livelihoods-related outcomes (consumption, income and labor supply), ultimately compiling 305 different treatment estimates from 155 treatment arms in 104 studies (and in 43 countries). Using random effects and multilevel models, our findings suggest that cash transfer programming is associated with an increase of between $1 and $2 in monthly household consumption and income per $100 in cumulative transfers, an effect that persists for a period of roughly three years (inclusive of the period of program implementation); this effect is meaningfully larger (as much as $4 larger) for cash transfer programs that also include a cash plus livelihoods intervention. There are no significant effects observed on labor force participation. We also present a range of estimates capturing the longer-term (cumulative) effects of cash transfers on consumption under alternate assumptions.

Poor diet quality has been identified as a primary driver of malnutrition and increasing burden of noncommunicable diseases in low- and middle-income countries. Low fruit and vegetable consumption contributes to poor diet quality. We experimentally assess whether videos embedded messages about increasing fruit and vegetable consumption affect consumption. Four months after viewing either a basic video or a video that explains why fruits and vegetables can improve health and nutrition outcomes, average household consumption of fruits and vegetables increased by about 9% in both treatment groups relative to the control group, both in kilocalorie and consumption expenditure terms.

The paucity of reliable, timely household consumption data in many low- and middle-income countries have made it difficult to assess how global poverty has evolved during the COVID-19 pandemic. Standard poverty measurement requires collecting household consumption data, which is rarely collected by phone. To test the feasibility of collecting consumption data over the phone, we conducted a survey experiment in urban Ethiopia, randomly assigning households to either phone or in-person interviews. In the phone survey, average per capita consumption is 23 percent lower and the estimated poverty headcount is twice as high than in the in-person survey. We observe evidence of survey fatigue occurring early in phone interviews but not in in-person interviews; the bias is correlated with household characteristics. While the phone survey mode provides comparable estimates when measuring diet-based food security, it is not amenable to measuring consumption using the 'best practice' approach originally devised for in-person surveys.

Food prices spiked sharply in 2007-2008, in 2010-2011 and again in 2021-2022. However, the impacts of these spikes on poverty remain controversial; while food is a large expense for the poor, many poor people also earn income from producing or marketing food, and higher prices should incentivize greater food production. Short-run simulation models assume away production and wage adjustments, and probably underestimate food production by the poor. Here we analyse annual data on poverty rates, real food price changes and food production growth for 33 middle-income countries from 2000 to 2019 based on World Bank poverty measures. Panel regressions show that year-on-year increases in the real price of food predict reductions in the US$3.20-per-day poverty headcount, except in more urban or non-agrarian countries. A plausible explanation is that rising food prices stimulate short-run agricultural supply responses that induce increased demand for unskilled labour and increases in wages.

Telescoping errors occur if survey respondents misdate events from outside the reference period and include them in their recall. Concern about telescoping influenced the design of early Living Standards Measurement Study (LSMS) surveys, which used a two-visit interview format to bound food consumption recall. This design fell out of favor although not for evidence-based reasons. To measure the extent of telescoping bias on food consumption measures, a survey experiment was conducted in Addis Ababa, Ethiopia, randomly assigning households to either a two-visit bounded recall or a single visit unbounded recall. The average value of reported food consumption is 16 percent higher (95 percent CI: 7.4-25.9) in the unbounded single visit recall relative to the two-visit bounded recall. Most of the error is explained by difference in reported spending on less frequently consumed, protein-rich foods, so apparent food security indicators based on household diet diversity are likely overstated with unbounded recall.

Abstract While social protection programmes have multiplied over the last two decades across sub-Saharan Africa, these coexist alongside humanitarian assistance in many places, calling for better integration of assistance delivered through the two channels. Progress on this front is hampered by limited evidence of whether and how these historically siloed sectors can work together. Using quantitative and qualitative data from districts covered by Ethiopia’s Productive Safety Net Programme (PSNP) and where humanitarian food assistance (HFA) was delivered, we assess differences in targeting and transfer values. We find that the PSNP and HFA were targeted to households with different characteristics. PSNP transfers did, on average, reach those households that were chronically food insecure. HFA, while delivered through the PSNP systems, was targeted to households that were acutely vulnerable. These are promising findings as they suggest that social protection systems are able to effectively deliver a continuum of support in response to different types of vulnerability and risk. On transfer values, we find that the value of PSNP transfers is greater than those for HFA. One reason for this may be due to the social pressure on local officials to distribute support more widely across a drought-affected population when faced with acute needs.