Tenders Are Invited For Evaluating The Impact Of Cash-Based Assistance On Nutrition Outcomes For Children With Severe Acute Malnutrition (Sam) And Their Caregivers Evidence Generation Is Particularly Thin In SomaliaS Humanitarian Context. The Research On Food Assistance For Nutrition Impact (Refani) And Cash For Improved Nutrition In Somalia (Cins) Studies Conducted In Somalia (By Concern And University College London) Examined The Linkages Between Cash Transfers And Nutrition Outcomes. Both Studies Demonstrated A Positive Impact Of Cash Assistance On Household Dietary Diversity. The Refani Study Found No Significant Difference In The Incidence And Prevalence Of Global Acute Malnutrition (Gam) Between Intervention Groups. However, Households Receiving Cash Transfers Showed Increased Total Household Expenditure, Improved Dietary Diversity, And Higher Food Consumption Scores. Women Specifically Experienced Improved Dietary Diversity And A Small But Statistically Significant Increase In Maternal Muac. The Cins Study, Informed By The Findings Of The Refani, Further Revealed That Carefully Designed Conditionalities Can Significantly Improve The Uptake Of Essential Health Services, Namely Timely Vaccination For Children Under Five Years Of Age. While Sbc Interventions (Health Audio Messages) Were Found To Enhance Household Dietary Diversity, They Did Not Result In Measurable Reductions In Child Morbidity, Malnutrition, Or Mortality. These Findings Highlight That While Cash Transfers Can Strengthen Household-Level Food Security And Access To Services, Their Direct Impact On Child Nutrition Outcomes May Be Limited Without Complementary Interventions1 Preliminary Results From Recent Study Conducted In Somalia By Save The Children And John Hopkins University Found That A Cashplus For Nutrition Programme Providing A Cash Transfer And Intensive Social And Behaviour Change In The Form Of Mother-To-Mother Support Groups Reduced Wasting Prevalence And Incidence In The Bay And Hiraan Regions Versus Cash Alone Given In Two Different Amounts (90/70 Usd Vs. 125/105 Usd In The Two Locations, Respectively). See The Resourcing Families For Better Nutrition In Somalia - Evidence Brief (2025, Paper Soon To Be Published). Since 2022, The Somali Cash Consortium (Scc) Has Been Delivering Lifesaving Multipurpose Cash Assistance (Mpca) To Families Of Children With Sam With Complications Admitted To Stabilisation Centres (Scs). The Cash Amounts Disbursed On Rolling Basis To Beneficiaries Are Fully Aligned With The Minimum Expenditure Basket (Meb) And The Transfer Value (Tv) Endorsed By Somalia Cash Working Group. Transfer Amounts Vary Slightly Between Districts To Reflect Local Price Differences. Through A Partnership With The Caafimaad+ Consortium - Specialised In Nutrition And Health-Care Services - More Than 3,000 Households Have Received Targeted Support. Preliminary Monitoring Suggests Notable Reductions In Default And Relapse, As Well As Improvements In Caregiver Wellbeing; However, Robust, Prospective Evidence Is Still Lacking. Since 2024 The Scc Has Been Routinely Collecting Baseline Data On This Cash-For-Nutrition Modality, Generating 1 Evidence And Guidance Note On The Use Of Cash And Voucher Assistance For Nutrition Outcomes In Emergencies | Global Nutrition Cluster 2 A Robust Dataset Ready For Secondary Analysis And Review. In Parallel, Caafimaad+ Partners Have Assembled Extensive Nutrition-Programme Data From 22 Districts Across Somalia. Both Datasets Will Be Made Available To The Consultant Or Research Firm To Inform And Enrich The Planned Analysis. While The Cash Assistance Provided As Part Of The Intervention Is Not Designed To Directly Contribute To The Clinical Recovery Of Children With Sam, This Research Seeks To Unpack The Indirect Yet Critical Role That Cash Support Plays In Improving Treatment Outcomes For Children With Sam. By Addressing Economic Barriers Across Different Stages Of Care, From Admission To Discharge And Follow-Up, Cash Transfers Have The Potential To Strengthen Program Performance And Reduce The Risk Of Relapse. These Insights Are Particularly Relevant For Humanitarian And Fragile Contexts Where Food Insecurity, Poverty, And Limited Access To Health Services Intersect To Undermine The Impact Of Standard Nutrition Interventions. In Line With Dg EchoS 2025 Health Policy Guidelines This Study Aims To Identify Innovative, Evidence-Driven Approaches That Reduce Excess Morbidity While Upholding Humanitarian Principles. Specifically, The Study Responds To The Gaps In Evidence Regarding If And How Targeted Cash Transfers Can Improve Adherence To Sam Treatment Services And Improve Recovery, Relapse And Overall Cost-Effectiveness. Findings Will Inform Dg Echo Partners And Global Clusters On Optimising Cva Design For Nutrition Impact. Common Challenges Children With Sam And Their Caregivers Face When Seeking Treatment. Below Are A Number Of Barriers Identified Via Observation And Key Informant Interviews With Programme Participants In Somalia. 1. Caregiver Willingness To Remain At The Stabilization Centre (Sc): A Common Challenge In Treating Children Admitted To Sc Is That Caregivers, Usually Mothers, Often Do Notstay At The Stabilization Centre (Sc) For The Full Treatment Period. This Is Mainly Because Many Of Them Are The Main Earners In The Family Or Have Other Children And Responsibilities At Home. Staying At The Sc Means They Lose Income And Cannot Take Care Of Other Needs, Which Makes It Hard To Remain Until The Child Fully Recovers. As A Result, Some Leave Early Or Drop Out Of Treatment Altogether. Providing Cash Assistance Can Ease Some Of This Financial Stress, Helping Caregivers Stay Longer And Focus On Their ChildS Recovery Without Worrying As Much About Lost Income Or Unmet Household Needs. 2. Hidden Costs Of Sam Treatment: Although Treatment For Sam With Complications Is Generally Provided Free Of Charge, Families Frequently Incur Additional, Unanticipated Expenses. These May Include Costs Related To Transportation, Food, Diagnostics, Or Medications For Comorbidities Not Covered By The Facility. In Many Cases, Caregivers Are Either Asked Or Expected To Bear These Costs. These Out-Of-Pocket Expenses Can Be A Barrier To Completing Treatment. The Cash Assistance Might Allow Families To Cover These Unexpected Costs, Ensuring That The Child Received Full And Timely Care. 3. Household Resources Overstretched Leading To Poor Recovery After Sc Discharge And Risk Of Relapse: Once The Child Is Stabilised In The Sc, They Are Referred To Otp To Continue Treatment. However, Otp Services May Not Be Available Or Hard To Access In Many Areas. Even When Available, Food Insecurity At Home Often Leads To Sharing Of The Therapeutic Food (Rutf), Which Reduces Its Effectiveness. Cash Assistance Might Help Families Meet Basic Needs, Reducing The Pressure To Share Rutf And Increasing The Likelihood Of Treatment Adherence And Sustained Recovery. Why Cva For Nutrition? Cash Assistance Intrinsically Promotes Dignity And Autonomy. 2Allowing Households To Decide How To Allocate Resources Empowers Them To Prioritise Their Most Pressing Needs - Whether Medical Fees, Transport, Nutritious Foods, Or Other Essentials - Rather Than Being Limited To In-Kind Rations Or Other Items. By Giving Recipients, The Flexibility To Address Multiple Drivers Of Malnutrition, Mpca Strengthens Resilience And Respects Recipient Households Agency, Principles That Are At The Core Of Humanitarian Action. Support To Ensure Health And Nutrition Treatment Service Are Available And Households Make Informed Choices To Promote Their ChildS Recovery Are Also Essential Alongside Cash. Tender Link : Https://Somalijobs.Com/Tenders
