Can village savings and loan groups be a potential tool in the malnutrition fight? Mixed method findings from Mozambique

Child malnutrition is a pervasive problem in sub-Saharan Africa that affects individual and national development. This article examines the impact of participation in village savings and loan (VSL) groups, alone and in combination with a rotating labor scheme called Ajuda Mutua (AM), on household and child nutritional outcomes in Nampula Province in Mozambique. It combines findings from an impact evaluation and a qualitative exploration of the dynamics underlying nutritional outcomes. Three pairs of districts were randomly allocated to two interventions (VSL or VSL + AM) or control. The impact evaluation utilized a prospective, longitudinal design. In total, 1276 households were surveyed at baseline in 2009 and three years later. Difference-in-difference propensity score matching models estimated program impacts on months of food sufficiency and household dietary diversity scores (HDDS) at the household level, and on individual dietary diversity scores (IDDS) and weight-for-age at the child level. In the qualitative study, in-depth interviews (IDIs) were completed with a subset of 36 VSL and 36 VSL + AM participants from two districts who had taken part in the two surveys. Transcripts were analyzed using thematic analysis. Survey data indicate that both interventions had a statistically significant, positive effect on months of food sufficiency. The HDDS increased for VSL + AM households and their matched controls; however, the increase was smaller for the VSL + AM group. The difference in increase between the two groups was statistically significant. At the child level, participation in VSL only was found to increase the IDDS. There was no significant effect for weight-for-age. Mean values for both the HDDS and the IDDS remained low. IDIs confirmed that there were improvements in seasonal and transitory food insecurity, which occur when recurring periods of extreme scarcity or sporadic crises are experienced. Due to the timing of the cycle, VSLs provided participants with an infusion of cash to purchase food during the hunger season. VSLs and AMs also offered mechanisms to cope with unexpected events through loans and social support. However, IDIs highlighted lack of money as a persistent challenge in accessing foods to supplement home-grown staples for a diversified nutritional intake. Though parents tended to be aware of the nutritional needs of children, they faced financial constraints in meeting them. There were also indications of a sex gap between control over resources by men and the role played by women in child nutrition. Findings underscore the potential of economic-strengthening activities such as VSLs for improving seasonal and transitory food security, but highlight the need for additional supporting interventions in order to overcome chronic nutritional challenges. (c) 2014 The Authors. Published by Elsevier Ltd.