Nutrition Improvement through Cash and Health Education (NICHE)

Nutrition Improvement through Cash and Health Education (NICHE)

The Nutrition Improvement through Cash and Health Education (NICHE) programme is a "cash-plus" intervention within Kenya's national safety net system. It is designed to address child malnutrition by investing in the critical first 1,000 days of a child's life. The programme recognizes that poor nutrition outcomes are driven by both a lack of financial resources and a lack of information. Therefore, NICHE combines direct financial support (cash top-ups) with essential health and nutrition education.

Under the Second Kenya Social and Economic Inclusion Project (KSEIP2), NICHE is being significantly scaled up. It builds on a successful pilot under the predecessor project (KSEIP) that was tested in five (5) counties. Under KSEIP2, NICHE will expand to up to 25 counties with high rates of poverty and childhood malnutrition, often exacerbated by climate vulnerability.

The core model provides a monthly cash top-up to households already receiving government-financed social assistance. This is paired with structured nutrition education delivered by Community Health Promoters (CHPs). The programme targets the first 1,000 days (from conception to a child's second birthday), a period critical for preventing stunting and promoting healthy development.

Beyond the core model, KSEIP2 introduces an enhanced version called NICHE-Plus in up to eight counties. NICHE-Plus includes:

  1. A positive parenting package to encourage responsive caregiving and child safety.
  2. An anticipatory climate shock-responsive element, which provides an additional cash top-up and modified nutrition messages before and during climate events like droughts or floods.

The primary objective of NICHE is to reduce child malnutrition in the first 1,000 days and improve maternal, infant, and young child nutrition (MIYCN) outcomes.
Specific objectives and mechanisms include:

  • Improving dietary diversity and breastfeeding practices.
  • Promoting optimal health and nutrition behaviors for both pregnant/lactating women and young children.
  • Enhancing the human capital of children to equip them for healthy and productive adulthoods.
  • (Under NICHE-Plus) Protecting nutrition and assets from climate-induced food insecurity.

Based on the project document, a household must meet the following criteria to be eligible for NICHE under KSEIP2:

  1. Geographic Location: Reside in one of the up to 25 target counties selected for high poverty, high childhood malnutrition, and high climate vulnerability.
  2. Existing Social Protection Enrollment: Already be a beneficiary of a Government of Kenya-financed National Safety Net Program (NSNP), which entails the following programmes:
    1. Older Persons Cash Transfer (OPCT);
    2. Cash Transfer for Orphans and Vulnerable Children (CT-OVC);
    3. Persons with Severe Disabilities Cash Transfer (PwSD-CT); and
    4. Hunger Safety Net Programme (HSNP).
  3. Demographic Status: The household must contain a pregnant or lactating woman (PLW) OR a child under three years of age (36 months). 
  4. The household must be poor and/or vulnerable as assessed by the Enhanced Single Registry (ESR).

The experience of the NICHE Programme under KSEIP1 has provided remarkable results, namely:

  1. Reduction in Child Undernutrition: Cash transfer programs are associated with a 1.35% reduction in stunting (low height-for-age) and a 1.31% reduction in wasting (low weight-for-height).
  2. Improved Parenting Practices: These programs consistently lead to improved parenting practices, including better feeding and caregiving.
  3. Prevents Maladaptive Coping: By providing an additional KES 2,000 top-up and intensified nutrition messaging before/during a drought or flood, the programme helps families avoid distress sales of assets or reduced food consumption.
  4. Protects Human Capital: It ensures that the nutritional gains made during a child's first 1,000 days are not eroded by a single climate event, safeguarding their long-term development.