Can prior receipt of social protection build resilience during future shocks?

In many low- and middle-income countries, it has become common for people living in poverty or being vulnerable to poverty to receive direct social transfers, either in the form of direct cash payments (cash transfer programmes), vouchers, or in-kind (including food), to help them attain a minimal standard of living, and to build their resilience to cope with crises and shocks.

Research evidence shows that cash and food transfers can increase household food consumption and food security while the support is ongoing – including during or immediately after adverse shocks. What is less clear is if they can better prepare households for shocks that occur several years after interventions have ended.

Understanding whether the support can go beyond temporary relief to enable longer-term resilience and nutritional wellbeing is important for designing social protection programmes, particularly in the context of frequent, compound shocks. Low- and middle-income countries are facing the prospect of devastating events (such as extreme weather, economic crises, and pandemics) occurring simultaneously or in rapid sequence. Yet, while some promising research exists, relatively little evidence is available to inform policy decisions and shape interventions.

A recent study, part-funded by DEEP, aimed to address some of the knowledge gaps. It examined the impact that Bangladesh’s Transfer Modality Research Initiative (TMRI), a unique social protection pilot implemented prior to COVID-19, had on food security during the pandemic – when three major nationwide lockdowns had profound implications for the economy, food availability, and daily living.

The TMRI social protection programme was delivered several years before COVID-19, from May 2012 to April 2014. It was implemented as a randomised control trial (RCT) in two rural areas, the northwest region and the coastal southern region. There were multiple intervention groups (or ‘treatment arms’) involving cash and food transfers along with complementary nutrition training focused on education and behaviour change across households and communities.

According to research on the effects of the pandemic on household food security in Bangladesh, the onset of COVID-19 saw moderate-to-severe food insecurity in rural households triple to 45.1% (pre-pandemic, 14.9% of rural households were either moderately or severely food insecure). Disruptions in access to food (shortages in food supply, shops being closed, travel restrictions, and social distancing) were reported by 17.3% of rural households at the start of the pandemic (but became less important over time).

Our study used a TMRI sample comprising 2,000 households living in 200 villages, evenly divided among a control group and three treatment groups: cash only, food only, and cash combined with nutrition behaviour change communication (‘cash plus’ programming). We focused on the northwest region (the North), which had a higher prevalence of poverty when the TMRI began; 76% of households in the control group were considered extremely poor.

Participants in the cash group had previously received a monthly payment of Bangladeshi Taka (BDT) 1,500 (approximately US$ 19) per household. Meanwhile, the food group participants had received a monthly food ration equal to the value of the cash transfer, comprising 30 kilograms of rice, two kilograms of mosoor pulse (a type of lentil), and two litres of micronutrient-fortified cooking oil.

The nutrition behaviour change communication activities were intensive. They included weekly group training led by community nutrition workers; twice-a-month home visits by community nutrition workers; and monthly group meetings between programme staff and influential community leaders. The training covered basic nutrition; control and prevention of micronutrient deficiencies; infant and young child feeding practices; health care; maternal nutrition; and hygiene. Discussions included the importance of fruit, vegetables, and animal source foods, and how home gardens or livestock or poultry rearing could facilitate access to them.

We collected data at three post-programme time points: before COVID-19 (2018), during COVID-19 (2021), and after the pandemic’s immediate effects (2022). We used two measures of household food security: the Food Insecurity Experience Scale (FIES), a metric used to track global progress towards achieving Sustainable Development Goal 2 (zero hunger); and the Food Consumption Score (FCS), which defines a threshold for an ‘acceptable’ level of food consumption.

We found that prior receipt of the TMRI had positive effects during and after the pandemic – but the type of transfer ‘mattered’. Only the households that received cash transfers combined with nutrition behaviour change communication were more resilient to the detrimental effects the pandemic had on household food security.

For example, in the aftermath of the third COVID-19 lockdown, households in this group were more likely to eat healthier food, including animal source foods, pulses/legumes, fruit, and vegetables. These households were also less likely to experience challenges in accessing food compared to those in the control group – for example, during the third lockdown, the likelihood of encountering moderate or severe difficulties in accessing food was 11.1% lower. Households were more likely to be food secure across all three rounds of data collection, including post-shock.

In contrast, prior receipt of cash only or food only transfers had no sustained effects on household food security after the TMRI intervention ended, nor did they have any protective effects during COVID-19.

We believe the most plausible explanation for these findings is that households that received the combined cash and nutrition behaviour change communication intervention had built up their resilience to shocks prior to COVID-19. In the post-intervention, pre-pandemic period, they had made larger investments in productive assets, specifically livestock (the North is agroecologically suited to livestock-rearing). In 2018, four years post-programme, the households had higher levels of asset holdings compared to those in the control group. With higher income-generating resources, they were better placed to weather the economic consequences of the lockdowns.

Additionally, when COVID-19 struck, these households were more likely to have a second income earner (often a woman) engaged in productive activities like livestock or poultry rearing – bolstering income during lockdowns as well as increasing the physical availability of a wider range of nutrient-rich foods.

Our findings contribute to the evidence on the medium- to long-term impacts of cash and in-kind transfer programmes on food security, and the importance of programme design in determining sustained success, including during shocks. The research suggests that a ‘cash plus’ intervention delivered several years before COVID-19 helped to bolster food security during and after the pandemic – but cash only and food only interventions did not – indicating that in such contexts, programme design really does matter.