Unconditional Seasonal Cash Transfer Increases Intake of High-Nutritional-Value Foods in Young Burkinabe Children: Results of 24-Hour Dietary Recall Surveys within the Moderate Acute Malnutrition Out (MAM’Out) Randomized Controlled Trial

Background: Cash transfer programs have the potential to improve dietary intake by improving accessibility to food. However, quantitative data on the impact of cash transfer programs on children’s energy and nutrient intake is lacking. Objective: The aim of this study was to evaluate the effect of seasonal unconditional cash transfer on children’s energy, micro and macronutrient and food group intake during the lean season in Burkina Faso. Methods: Within the framework of the MAM’Out study, a cluster randomized controlled trial, two 24-h dietary recall surveys were conducted in July and August 2014. Daily energy, macro- and micronutrient intake, breastfeeding practices, as well as food group consumption, were analyzed for 322 children aged 14 to 27 months from the intervention group (benefiting from unconditional cash transfer during the lean season 2013 and 2014) and the control group, using mixed linear/logistic/Poisson regression models or a gamma-generalized linear model with log-link. A dietary diversity score was calculated based on seven food groups. Results: Unconditional cash transfers during the lean season improved the diets of rural children through higher consumption of eggs (11.3 g ± 1.55 vs 3.25 g ± 0.79, p<0.001), fat (20.6 g ± 0.80 vs 16.5 g ± 0.89, p<0.01) and vitamin B12 (0.40 mg ± 0.02 vs 0.34 mg ± 0.02, p<0.001) compared to controls, and higher proportions of children eating dairy products (OR: 4.14 (1.48, 11.6), p<0.05), flesh food (OR: 2.09 (1.18, 3.70), p<0.05), eggs (OR: 3.61 (1.56, 8.37), p<0.05) and iron rich or iron fortified food (OR: 2.23 (1.20, 4.13), p<0.05). No difference was found in energy intake between the two groups. The minimum dietary diversity of two thirds of the children who benefited from cash transfers was adequate compared to that of only one third in the control group (p<0.001). Conclusion: Unconditional seasonal cash transfer increases dietary diversity and intake of high nutritional value foods in Burkinabe children aged 14 to 27 months. As such, their use can be recommended in actions addressing children’s dietary intake during the lean season. Study registered in ClinicalTrials.gov (NCT01866124).