UNICEF’s Cash Transfer and Nutrition Programme: Addressing Yemen’s Surging Cases of Malnutrition

Approximately 2.2 million Yemeni children under the age of five are acutely malnourished, including more than 500,000 who are fighting to survive.

Prior to the war, the Palestine Hospital’s Department of Nutrition, in Sana’a, extended its services to four districts, which would 10 cases of childhood malnutrition per month. Since 2015, that number has almost tripled, to an average of 28 cases. Babies under six months old arrive malnourished, with watery diarrhea and respiratory infections.

Recently, there has also been an uptick in the number of children suffering from heart problems, brain atrophy, and hypoglycemia, which can be a matter of life and death.

When parents bring their children to outpatient clinics, the medical team assesses their overall condition. If the child is diagnosed with malnutrition, they are quickly referred to a specialized therapeutic feeding center (TFC) and then admitted for treatment. Upon arrival, the hospital’s counsellors educate the parents on proper feeding techniques, portions, and the need for proteins, fruits, vegetables, and complex carbohydrates in their child’s diet.

Admission rates are low, with only 50 percent of the cases ever reaching TFCs – most likely due to transportation and financial barriers, as well as the high costs associated with the stay (since the treatment can take weeks). To help offset these costs and foster proper nutrition at home, parents are given three vouchers from UNICEF’s Cash Transfer and Nutrition Programme.

Yousef Al-Shaibani, 34, supervises and oversees the registration process throughout five governorates.

 “Caregivers receive a voucher to cover their transportation and daily expenses, as well as a “discharge” voucher”, Yousef explains. “This is meant to cover the cost of healthcare, nutrition, and to give parents more dedicated time with their child for at least three months after they leave the hospital, to help prevent relapse.”

Dr. Shrooq Mohammed Abdullah Sinan, 38, is a pediatrician in the hospital. When she receives and screens the children who are referred from across the area, she identifies the causes of malnutrition, any complications, and then determines who is admitted for treatment. Since most of the children she sees suffer from acute malnutrition, they are given medicine, vitamins, and formula immediately. In more complex cases – such as chest infection, fever, or watery diarrhea accompanied with vomiting – the child will be given antibiotics.

In Shrooq’s experience, UNICEF’s Cash Transfer and Nutrition Programme is vital because some families cannot afford to purchase medicine, access transportation, or cover the cost of food for the parent who stays with their child in the hospital. “The programme has provided medicine and financial support, which have encouraged families to bring their children to get nutrition, treatment, and achieve better long-term health outcomes”, Shrooq observes.

When 9-month-old Amat arrived at the center, she suffered from acute malnutrition and brain problems, and required urgent treatment, care, and nutrition. She weighed just 2.3 kilograms, which is what an average 2-month-old should weigh. “Within 5 days, we were able to increase her weight to 2.9 kilograms, and that is a good ratio”, Shrooq says with a smile.

The programme’s immediate objective is to reduce preventable child deaths by increasing the rates of admission to therapeutic feeding centers. Accordingly, the operational design addresses the caretaker’s immediate need for cash to pay for the service and avoid any treatment disruptions.