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Clinical and Translational Nutrition

Community and Public Health Nutrition

Global Nutrition

Effects of Hybrid Food Assistance Programs on Child Nutrition: A Systematic Review and Meta-Analysis

Sunday, July 26, 2026
3:15 PM - 3:25 PM ET
Location: Maryland Ballroom A
Emerging Leaders in Nutrition Science Poster Competition

    Presenting Author(s)

  • Yue Zhan, PhD Candidate

    PhD Candidate
    Friedman School of Nutrition Science and Policy, Tufts University
    Boston, Massachusetts, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • NQ

    Naina Qayyum

    Friedman School of Nutrition Science and Policy, Tufts University, United States

  • SC

    Sean B. Cash

    Friedman School of Nutrition Science and Policy, Tufts University, United States

  • HA

    Harold Alderman

    International Food Policy Research Institute, United States

  • MC

    Mei Chung

    Friedman School of Nutrition Science and Policy, Tufts University, United States

Disclosure(s):
Yue Zhan, PhD Candidate: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Hybrid food assistance programs combine household-level cash transfers with targeted food supplements for children to address household resource constraints while prioritizing child nutrition objectives. The aim of study was to systematically review evidence on the effects of these programs on nutrition outcomes for children aged under five in low- and middle-income countries.

Methods: We searched 6 databases for experimental and quasi-experimental studies evaluating programs that combined household cash or food transfers with child-targeted supplements. Eligible studies must report at least one child anthropometric outcomes including height-for-age z score (HAZ), weight-for-height z score (WHZ), stunting, and wasting. Two reviewers independently conducted abstract and full-text screening and assessed study quality using the Cochrane Risk-of-Bias Tool. Meta-analysis was conducted for each outcome using a random-effects model, and heterogeneity was assessed using the I2 statistic.

Results: Thirteen studies describing 12 hybrid programs across 9 countries were included. Study quality was mixed, with 6 studies at low risk of bias, 2 with some concerns, and 5 at high risk of bias. Hybrid programs were associated with statistically significant reductions in both stunting (standardized mean difference [SMD] -0.10; 95% CI: -0.16, -0.04; I2 = 51.7%) and wasting (SMD -0.12; 95% CI: -0.22, -0.01; I2 = 69.8%). We did not observe significant changes in mean HAZ (mean difference [MD]: 0.04; 95% CI: -0.01, 0.09; I2 = 75.1%) or WHZ (MD: 0.13; 95% CI: -0.02, 0.28; I2 = 94.9%) in the meta-analyses. Reductions in stunting and wasting were more evident in programs with larger household transfers, sizeable child-targeted rations, and design features that address intra-household sharing.

Conclusions: Hybrid programs modestly reduce stunting and wasting but do not consistently improve linear or ponderal growth. Future programs and evaluations should better account for intra-household sharing, supplement consumption, and program intensity to clarify pathways of impact and improve effectiveness.

Funding Sources: No external funding