The Nutritional Improvements through Cash and Health Education program aims to improve child health Copyright: UNICEF
In her small Kenyan village, Agnes, mother of five children, found solace and strength in a mother-to-mother support group, one of many set up by the national and county governments. Located in Mutsengo, Kilifi County, where chronic malnutrition among children is high, the close-knit mother’s group became a hub for sharing insights on child development, breastfeeding, nutrition, and positive parenting strategies.
Agnes’s family also faced serious economic challenges as a result of a severe drought in Kenya. Agnes used her cash transfer benefits to invest in chickens to diversify her family's livelihood. Soon the modest investment developed into a thriving household poultry business. In just a few months, Agnes went from two chickens to a flock of 30 birds. The chickens not only provided a sustainable source of income but also supported household consumption.
A staggering 26 percent of Kenyan children suffer from stunting and the under-5 mortality rate stands at 43 per 1,000 births. Limited access to basic sanitation and clean water as well as food insecurity and high incidence of child violence compounds the challenges. However, Agnes's story vividly illustrates the profound impact of a social protection program and underscores that a small financial boost and nutrition counseling can improve child health and unlock the untapped potential of women as economic contributors.
Social protection programs provide an entry point to improve human capital
Led by the Ministry of Labour and Social Protection, Nutritional Improvements through Cash and Health Education (NICHE) aims to improve the nutritional well-being of children in their early years. The program is funded by the World Bank and UK Foreign Commonwealth Development Office, and UNICEF provides technical assistance to the government. The program provides cash top-up of KSh 500 (about US$4) each month, capped at KSh 1,000 (about US$8) per household to existing beneficiaries of National Safety Net program (Inuaa Jamii).
Additionally, the program provides accompanying measures such as nutrition counseling and knowledge sharing among parents on how to best manage childcare during this critical phase of the life cycle. The counseling emphasizes evidence-based practices for child development and better parenting such as exclusive breastfeeding, oral rehydration salts, vitamin A supplements, complementary feeding, and improved water, sanitation and hygiene practices.
Lessons learned from NICHE
1. Integrating social protection and nutrition programming can have a profound impact: The NICHE program started as a pilot, led by UNICEF, implemented from 2017 to 2020 in collaboration with county governments. Evaluated through a randomized controlled trial, the pilot demonstrated significant impacts on child diets, water treatment, and exclusive breastfeeding.
2. Building government capacity is critical for scaling up: NICHE is delivered by trained community health promoters—a cadre of staff hired by the government of Kenya through national and county government partnerships. So far, the program has supported 30,000 households directly, trained more than 1,000 healthcare workers and more than 12,000 community health promoters, and established over 4,500 mother-to-mother support groups reaching over 55,000 mothers.
3. Peer-to-peer learning results in community wide impacts: Mother-to-mother support groups offers guidance on parenting, from pregnancy and childbirth to breastfeeding and early childhood development. These groups create a nurturing environment where mothers can connect, share experiences, learn from each other, and feel empowered in their parenting journey. Remarkably, a significant number of these support groups are providing an opportunity to improve social cohesion and increasingly communities are coming together to start income generating activities at the village level.
4. Child protection interventions are critical to reduce child violence: In Kilifi County, the NICHE package includes a child protection component that offers positive parenting training. This training is helping beneficiaries provide nurturing care for children and manage their behavior positively, avoiding physical or psychological punishment.
A milestone to a brighter future
Investing in the early years has started paving the way to a brighter future for Kenyan citizens living in poverty. NICHE's comprehensive approach is laying the foundation for an enduring change. The government of Kenya is considering a national scale-up of the program by integrating NICHE with other economic inclusion initiatives, creating a pathway to lift people out of poverty and help in realizing the bottom-up economic transformation agenda.
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