Child wasting remains a critical public health challenge in the drought-prone Karamoja region of Uganda. Multi-sectoral, nutrition-sensitive social protection programmes are increasingly implemented to address such complex issues, but evidence of their effectiveness in fragile, arid contexts is limited. This study evaluated the effect of a multi-sectoral, nutrition-sensitive social protection programme on the prevalence of child wasting in selected drought-affected districts of Karamoja. It sought to quantify changes in wasting rates and understand community and implementer perspectives on the programme's mechanisms and challenges. A concurrent mixed methods design was employed. A longitudinal quasi-experimental study compared wasting prevalence (weight-for-height z-score < -2) among children under five in intervention and comparison communities, using repeated cross-sectional surveys. This was complemented by qualitative data from focus group discussions with caregivers and key informant interviews with programme staff and local leaders. Quantitative data indicated a relative reduction in the prevalence of child wasting in intervention communities compared to control areas. Qualitative analysis revealed key themes: the perceived importance of integrating cash transfers with nutrition behaviour change communication, challenges from climatic shocks affecting food security, and logistical barriers in remote service delivery. The multi-sectoral programme was associated with a reduction in child wasting in this drought-affected context. The integration of social protection with nutrition-specific components appears promising, but its effectiveness is moderated by environmental and systemic constraints. Programme design should strengthen climate adaptation components and invest in last-mile delivery systems. Future policy should prioritise sustained funding for integrated approaches and further operational research to optimise delivery models in arid and fragile settings. Child wasting, social protection, multi-sectoral, nutrition-sensitive, drought, Karamoja, Uganda, mixed methods This study provides empirical evidence on the implementation and outcomes of an integrated social protection programme in a fragile, arid context, highlighting the interplay between programme components and contextual barriers.
Okello Ochen (Sun,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: