Cash transfers, diet quality, and child growth among refugee children: evidence from turkey’s ESSN program

Abstract

This study examines the impact of the world’s largest humanitarian unconditional cash transfer program targeting refugees—the Emergency Social Safety Net (ESSN) program—on child nutrition and growth outcomes. Using the 2018 Turkey Demographic and Health Survey, which includes a representative sample of Syrian refugees, and employing a regression discontinuity design, this paper assesses the program’s effects on child growth—measured by height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ), including their extreme values—and on child-level nutrition, measured across five major food categories. The paper finds that receiving cash transfers increases HAZ by 0.6 to 0.8 standard deviations. Additionally, the transfers reduce the incidence of both underweight and overweight status based on WAZ scores. WHZ scores and the incidence of overweight status based on WHZ also decline. Examining the program’s impact on nutrition, the study finds a significant reduction in children’s energy-dense, nutrient-poor food consumption, consistent with the decrease in overweight incidence. Overall, the ESSN program improves food consumption patterns among refugees, leading to better child growth outcomes.