Academic journal article Bulletin of the World Health Organization

Impact of a Cash-for-Work Programme on Food Consumption and Nutrition among Women and Children Facing Food Insecurity in Rural Bangladesh/Impact D'un Programme De Remuneration En Especes Du Travail Sur la Nutrition et la Consommation De Nourriture Chez Les Femmes et Les Enfants Soumis a L'insecurite Alimentaire Dans Les Zones Rurales Du Bangladesh/ Influencia del Programa Dinero

Academic journal article Bulletin of the World Health Organization

Impact of a Cash-for-Work Programme on Food Consumption and Nutrition among Women and Children Facing Food Insecurity in Rural Bangladesh/Impact D'un Programme De Remuneration En Especes Du Travail Sur la Nutrition et la Consommation De Nourriture Chez Les Femmes et Les Enfants Soumis a L'insecurite Alimentaire Dans Les Zones Rurales Du Bangladesh/ Influencia del Programa Dinero

Article excerpt

Introduction

Cash-for-work programmes are usually associated with disasters and emergencies and have been implemented in Afghanistan, Bangladesh, Haiti, Indonesia, Pakistan and Uganda. (1) Many organisations employed cash interventions after the Asian tsunami of 2004 and cash-for-work programmes were widespread in Aceh, Indonesia, and in Sri Lanka. (2) However, when implemented incorrectly, these programmes can disrupt the local economy, artificially inflate wages and result in unsustainable shifts in the labour force. (3)

In north-western Bangladesh there is an annual period of food insecurity (the monga) that generally occurs between mid-September and mid-November and is primarily caused by unemployment and a lack of income before the large aman rice harvest. (4) People who live on chars, which are large flat islands in the main river channels, are particularly affected by the monga as flooding occurs during the preceding months almost every year. When flooding is severe, there can be household damage, a loss of assets, disruption of agricultural activities and obstacles to rearing livestock. Chars dwellers may be confronted with river bank erosion, which can take away their homestead and any land they possess. The scarcity of work also has severe repercussions for the income of poor chars households and many are obliged to reduce their food intake during this period. (5)

The Chars Livelihood Programme (http://www.clp-bangladesh.org), funded by the United Kingdom Department for International Development, aims to lift over 55 000 extremely poor households out of poverty by providing income-generating assets. Households are provided with a raised earthen plinth on which their homes are reconstructed and homestead gardens can be established. In part, these plinths are created by a labour-intensive earthmoving process that involves members of poor chars households. (6)

In August and September 2007, widespread severe flooding across northern Bangladesh intensified and prolonged the impact of the monga for chars dwellers. (6) In some households participating in the Chars Livelihood Programme, the cash-for-work intervention was implemented between September and December 2007 to coincide with the monga. The programme provided approximately 2.6 million person--days of paid work during which both men and women received 36 taka (about US$ 0.50) for each cubic metre of soil moved in the construction of the earthen plinths.

No previous research has been conducted into the impact of cash-for-work programmes on nutritional status. In Bangladesh there was concern among some nongovernmental organisations that the physical labour required by the local cash-for-work programme would cause women to lose weight and to neglect their children because the mothers needed to work quite long hours. If this occurred, the programme would be counterproductive and would probably be detrimental to the health of the people it was intended to help. The present panel study was designed to determine whether women and children aged less than 5 years from landless households who were living on chars and who participated in a monga season cash-for-work programme were able to maintain a better nutritional status than similar women and children living in the same geographical area who belonged to households not taking part in the programme.

Methods

Study design

Over 100 000 households were enrolled in the Chars Livelihood Programme and the subsidiary cash-for-work programme was open to all members of the community. The wage rate was specified in advance. The panel study involved 1009 households containing a child aged less than 5 years and an adult female (usually the mother) which were randomly selected from more than 50 000 taking part in the cash-for-work programme and 1051 similarly selected control households that were not taking part in the programme. The two groups were comparable in household size, the adults' occupations and the age of the adult female family member. …

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