Chapter 2
Review of Related Literature
Social protection is a key strategy in the fight against hunger and malnutrition. By
addressing the underlying causes of hunger, social protection to produce food and augment
income. In the absence of social protection, the food-insecure are often forced to cope in
ways that further increase their vulnerability and undermine their future income. The
extension of social protection to these population groups is critical; however, the depth of its
programmes can enhance households’ food consumption along with their ability impacts
depends on how programmes are designed and implemented. This social protection guidance
note supports policy dialogue by considering different programming design options for social
protection to better contribute to food security and nutrition outcomes (Owens,2017).
Domestic food price inflation remains high in most low- and lower-middle-Income
countries. Information from the latest month between February and May 2025 for which food
price inflation data are available shows high inflation in many low- and lower middle-income
countries, with inflation higher than 5% in 76.5% of low-income countries (a decrease of 11.0
percentage points since the last update on May 16, 2025), 54.5% of lower-middle-income
countries (4.5 percentage points higher), 45% of upper-middle-income countries (2.0
percentage points lower), and 14.5% of high-income countries (4.0 percentage points lower).
In real terms, food price inflation exceeded overall inflation in 60% of the 161 countries
where data is available (World Bank, 2025)
The current global evidence base regarding the nutritional impacts of nutrition-sensitive
programs, including popular ones such as social safety nets and agriculture development
programs, is generally limited because of poor targeting, design and implementation of
programs, and equally important, sub-optimal evaluation designs. Although there is a
consensus regarding the need to invest in nutrition-sensitive programs in order to address the
underlying causes of undernutrition and to improve the effectiveness, reach, and scale of both
nutrition-specific interventions and nutrition-sensitive programs, the evidence of what works,
how and at what cost is extremely limited. Thus, building a strong body of evidence from
rigorous, theory-based comprehensive evaluations of different nutrition-sensitive program
models that bring together interventions from a variety of sectors (e.g., health, education,
agriculture, social protection, women’s empowerment, water, and sanitation) is essential to
provide the needed guidance for future investments for improving nutrition. This chapter
provides this type of guidance, focusing on how to design and carry out rigorous process,
cost, and impact evaluations of complex nutrition-sensitive programs; and it aims to
demystify some of the perceived insurmountable challenges that have prevented investments
in rigorous evaluations of such programs in the past. By doing so, we hope that the evidence
gap in nutrition-sensitive programming, which has characterized the past decades of
development, will quickly be filled and that future investments will benefit from a strong
body of evidence on what works to improve nutrition, how it works, and at what cost (Onley,
Leroy, and Ruel, 2017).