Implications of Ethiopian Productive Safety Net Programme on household dietary diversity and women's body mass index: a cross-sectional study.

Introduction: Poor nutritional status of women remains a critical problem in Ethiopia. Nutrition for women matters not only for the public health relevance of breaking the intergenerational cycle of malnutrition but for its high return in other sectors such as education and health. The Ethiopian Productive Safety Net Programme (PSNP) is a program that protects chronically food-insecure households against food insecurity through cash or food transfer. However, its effect on food access and women's body mass index (BMI) has remained unexplored.

Objective: This study was intended to assess differences in household dietary diversity (HDD) and women's BMI and associated factors among PSNP and non-PSNP households.

Methods: This community-based cross-sectional study was carried out in the Kombolcha District of Eastern Ethiopia from July 1 to 28, 2015. HDD and women's BMI were compared. Ordinal logistic regression was used to identify factors associated with women's BMI.

Result: The prevalence of undernutrition was 27.3% (95% confidence interval [CI]: 23.8-30.9) and 20.2% (95% CI: 17.1-23.5) for women from PSNP and non-PSNP households, respectively. PSNP membership had a significant effect on HDD and minimal effect on women's BMI. Ordinal logistic regression yielded significant associations for medium wealth status, with an odds ratio (OR) of 0.533 (95% CI: 0.339-0.837), uptake of better health care services compared to previous year with an odds ratio (OR) of 0.647 (95% CI: 0.429-0.974) and reduction in selling assets for the sake of buying food with an OR of 1.575 (95% CI: 1.057-2.349).

Conclusion and recommendation: There was high magnitude of chronic energy deficiency among PSNP and non-PSNP households, at 27.3 and 20.2%, respectively, and it was associated with economic status and health care utilization, suggesting the need to promote profitable income-generating activities and nudging for minimum health care as a condition for transfer.