Cash and vouchers for nutrition in Wajid Somalia

What did the study set out to achieve?

The project aimed to create actionable recommendations to inform future food and nutrition programming in Somalia and other food crises. It focuses on prevention of acute malnutrition among vulnerable populations, including pregnant and lactating women and children under five years of age.

There is limited and sometimes confusing evidence about the impact of combinations of assistance modalities, such as cash transfers and food vouchers, on nutritional status and about the importance of the design and implementation of such programmes. This study intended to compare the effectiveness of food vouchers alone, to the effectiveness of mixed transfers, consisting of food vouchers and unconditional cash transfers.

The research asked if the provision of both cash and vouchers was more effective than vouchers alone for preventing acute malnutrition, and supporting health behaviours and food security, for pregnant and lactating women and children under five years of age. The team assessed changes in diet and acute malnutrition status among pregnant and lactating women receiving similarly sized household transfers, delivered either as food vouchers or as mixed transfers consisting of in-kind food, vouchers, and cash, over a four month period.

What were the key findings?

• Despite decreases in household food security, Pregnant and Lactating Women (PLW) dietary diversity and mean mid-upper arm circumference improved. No PLWs in the mixed transfer group became malnourished by the end of the study period.
• Transfers were not protective for children’s diet diversity. However, child nutrition status improved in both intervention groups in terms of mean MUAC (statistically significant) and acute malnutrition prevalence (not statistically significant). This compares to a large decline in nutrition status in the non-assistance group.
• The findings show that within the context of the 2017/18 Somalia food crisis, the modality of assistance provided to pregnant and lactating women (mixed transfers or food-vouchers) made no difference in preventing acute malnutrition and protecting nutritional status.

Results showed promise but do not indicate a clear benefit for mixed transfers as compared to food vouchers – likely a result of study limitations. More research or programme evaluations are needed to deepen understanding – in particular with larger sample sizes and longer intervention periods.