Summary of findings 3. Income‐generation interventions compared to no intervention for food security.
| Income‐generation interventions compared to no intervention for food security | ||||
| Patient or population: children, adults, households Setting: poor rural communities in LMICs Intervention: income‐generation interventions (e.g. livestock transfers, community development programmes) Comparison: no intervention | ||||
| Outcomes | Impact | № of participants (studies) | Certainty of the evidence (GRADE) | Comments |
| Prevalence of undernourishment | — | — | — | 0 included studies reported this outcome. |
| Proportion of household expenditure on food follow‐up: range 1–2 years | 2 studies reported this outcome but did not provide relevant numerical data or indicated clearly the direction of effect. | 434 households (2 prospective controlled studies) | — | — |
| Food security assessed with: proportion experiencing food security; Household food security score follow‐up: 3–4 months | 1 trial reported no effect measure and 1 trial showed an unclear effect potentially favouring the control. | 2193 households (1 trial) | ⊕⊕⊝⊝ Lowa,b | Income‐generation interventions may result in little to no difference in food security. |
| Dietary diversity assessed with: DDS, HDDS, MDD follow‐up: 2 years | 2 trials showed a clear effect favouring income‐generation interventions, 1 trial showed an unclear effect favouring the intervention and 1 trial showed an unclear effect favouring control. A meta‐analysis of 3 of these studies showed that the intervention improved the proportion of children achieving MDD (OR 1.28, 95% CI 1.11 to 1.47) |
3677 households and 3790 children (4 RCTs) | ⊕⊕⊝⊝ Lowa,c | Income‐generation interventions may improve dietary diversity in children and may result in little or no difference to household dietary diversity. |
| Stunting assessed with: HAZ follow‐up: 12 months | Meta‐analysis of 2 studies showed no difference to stunting (OR 1.00, 95% CI 0.84 to 1.19) | 3466 children (2 RCTs) | ⊕⊕⊕⊝ Moderated | Income‐generation interventions probably make little or no difference to stunting. |
| Wasting assessed with: WHZ follow‐up: 2 years | Meta‐analysis of 2 studies showed unclear effect favouring the intervention (OR 1.13, 95% CI 0.92 to 1.40) | 3500 children (2 trials) | ⊕⊕⊕⊝ Moderated | Income‐generation interventions probably make little or no difference to wasting. |
| Cognitive function and development | — | — | — | 0 included studies reported this outcome. |
| CI: confidence interval; DDS: Dietary Diversity Score; HAZ: height‐for‐age z‐score; HDDS: Household Dietary Diversity Score; MDD: minimum dietary diversity; OR: odds ratio; RCT: randomised controlled trial; WHZ: weight‐for‐height z‐score. | ||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||
aDowngraded one level for risk of bias: at least one study was at high overall risk of bias due to selection or attrition bias, or both. bDowngraded one level for indirectness: results are from a single study which assessed a public works programme and the effects may be different from other types of income generation interventions. Additionally public works programmes are often implemented in different ways in different settings. cDowngraded one level for inconsistency: wide variation in point estimates. dDowngraded one level for imprecision: wide confidence intervals.