Abstract
BackgroundHousehold food insecurity is a critical concern for ultra-poor families in low- and middle-income countries like Bangladesh, particularly those with members who have disabilities. The COVID-19 pandemic has worsened this situation.ObjectiveThis study aimed to assess the impact of microfinance-based livelihood programs on food insecurity in ultra-poor families with members affected by cerebral palsy in Bangladesh.MethodsData were extracted from the SUPPORT CP trial for 251 children with cerebral palsy. The Household Food Insecurity Access Scale score was the outcome variable. The explanatory variable was the intervention type, dividing the sample into 3 arms: Arm C (care as usual), Arm B (Community-Based Rehabilitation [CBR]), and Arm A (CBR with the integrated microfinance-based livelihood program [IMCBR]). Both linear regression and the Generalized Estimating Equations model were used to determine the association of outcome variable with explanatory variables adjusting for covariates.ResultsWe found a consistent level of household food insecurity across each time point, with a significant increase in the midline during the peak of COVID-19 pandemic in 2020. However, following the end of the COVID-19 pandemic, both Arms A and B, where interventions were provided, reported a significant decline in food insecurity. Notably, Arm A, where IMCBR was provided, exhibited the fastest decrease in food insecurity followed by Arm B, where only CBR was provided, compared to Arm C.ConclusionMicrofinance programs can reduce food insecurity among families of children with cerebral palsy in Bangladesh, especially during crises like COVID-19, underscoring the need to integrate them with tailored disability rehabilitation services.