To address ongoing food insecurity and acute malnutrition in Somalia, a broad range of assistance modalities are used, including in-kind food, food vouchers, and cash transfers. Evidence of the impact of cash and voucher assistance (CVA) on prevention of acute malnutrition is limited in humanitarian and development settings. This study examined the impact of CVA on prevention of child acute malnutrition in 2017/2018 in the context of the Somalia food crisis. Changes in diet and acute malnutrition were measured over a 4-month period among children age 6-59 months from households receiving household transfers of approximately US$450 delivered either as food vouchers or a mix of in-kind food, vouchers, and cash. Baseline to endline change in children's dietary diversity, meal frequency, minimum acceptable diet (MAD), mid-upper arm circumference (MUAC), and acute malnutrition (MUAC < 12.5 cm) were compared using difference-in-difference analysis with inverse probability weighting. There were no statistically significant changes in dietary diversity, meal frequency, or the proportion of children with MAD for either intervention group. Adjusted change in mean MUAC showed increases of 0.5 cm (confidence interval [CI; 0.0, 0.7 cm]) in the food voucher group and 0.1 cm (CI [-0.1, 0.4]) in the mixed transfer group. In adjusted analysis, prevalence of acute malnutrition among children under 5 years increased by 0.7% (CI [-13.4, 14.4%]) among food voucher recipients and decreased by 4.8% (CI [-9.9, 8.1%]) in mixed transfer recipients. The change over time in both mean MUAC and acute malnutrition prevalence was similar for both interventions, suggesting that cash and vouchers had similar effects on child nutrition status.

中文翻译：

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现金和代金券援助以及索马里儿童的营养状况。

为了解决索马里持续的粮食不安全和严重营养不良，使用了广泛的援助方式，包括实物粮食，粮食券和现金转移。在人道主义和发展环境中，现金和代金券援助（CVA）对预防急性营养不良的影响的证据有限。这项研究在索马里粮食危机的背景下研究了CVA在2017/2018年预防儿童急性营养不良的影响。在6到59个月大的孩子中，以接受食品调价或实物食品，餐券和现金的方式交付的大约450美元的家庭补助金的家庭，在4个月内测量了饮食和急性营养不良的变化。儿童饮食多样性，进餐频率，最低可接受饮食（MAD）的基线到最终变化，使用差异概率分析和逆概率加权法比较了上臂中段（MUAC）和急性营养不良（MUAC <12.5 cm）。两个干预组的饮食多样性，进餐频率或MAD患儿比例均无统计学意义的变化。调整后的平均MUAC变化在食品券组中增加了0.5 cm（置信区间[CI; 0.0，0.7 cm]），在混合转移组中增加了0.1 cm（CI [-0.1，0.4]）。在调整后的分析中，食品券接收者中5岁以下儿童的急性营养不良患病率上升了0.7％（CI [-13.4，14.4％]），混合转移接受者中则下降了4.8％（CI [-9.9，8.1％]） 。两种干预措施的平均MUAC和急性营养不良发生率随时间的变化相似，