Speaker
Description
Despite Thailand’s remarkable progress in overall development, the double burden of malnutrition remains a challenge for the nation’s children. An analysis of the Multiple Indicator Cluster Survey (MICS) 5 shows the coexistence in children under 5 of overweight (8.2%) and wasting (5.4%), with many still experiencing stunting (10.5%).(1) The double burden is also found in the same child with 11.8% of stunted children in the MICS also overweight.
In 2015 the Government of Thailand (RTG) adopted the Child Support Grant for young children from poor and near-poor families to strengthen child nutrition outcomes, improve access to social services and empower women. In 2017, an estimated 23% of all children under the age of 36 months received the CSG in Thailand. To evaluate the impact of the grant, the RTG launched a national impact evaluation study that adopted a mixed-method quasi-experimental design, following principles of the rights-based approach that precludes randomization. The evaluation included infants who received the CSG and matched comparison infants who did not receive the CSG.
The initial analysis of the end-line data found evidence that both new-born infants and younger children in households receiving the Child Support Grant (CSG) achieved better nutritional outcomes than children in matched comparison households. Of those extremely poor children in the households receiving the CSG, 8% were wasted, significantly lower than the 17% in the matched comparison group.(2) For all stunted children receiving CSG, 18% were overweight compared to 34% in the matched comparison group. This result, directly supporting the impact of the CSG in specifically reducing the double burden, is also statistically significant.
The results also demonstrate, in the entire sample, significant impacts in terms of improving access to post-natal care and increasing the proportion of mothers who exclusively breastfeed their infants for the first six months—behaviors that lead to improved nutritional outcomes. For very poor children in the sample, the rate of exclusive breast-feeding increased from 78% to 85% with receipt of the CSG, and nearly doubled the rate of access to recommended post-natal care. For non-poor children, the rate of exclusive breast-feeding increased from 64% to 73%.
The powerful evidence of developmental impact demonstrates the potential role of the Child Support Grant in achieving core nutrition impacts, as well as strengthening access to vital health services and empowering women. A transition to a universal grant, starting from pregnancy, may provide a valuable initiative further strengthening inclusive social development and equitable economic growth.
1.MICS 5
2.The sample is into three groups: (1) “extreme poor”: households with reported per capita income less than Thb 1500 p/m (30.0% of the sample); (1) “less poor”: with income between Thb 1500 and Thb 3000 (35.4% of the sample); (3) “non-poor”: with reported p/c income greater than Thb 3000 (34.6% of the sample, of which 74.0% reported per capita income less than Thb 6000.)
| Institution | UNICEF/TDRI/EPRI |
|---|---|
| Country | Thailand |
