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Large-scale emergency assistance programmes in Somalia use a variety of transfer modalities including in-kind food provision, food vouchers, and cash transfers. Evidence is needed to better understand whether and how such modalities differ in reducing the risk of acute malnutrition in vulnerable groups, such as the 800,000 pregnant and lactating women affected by the 2017/18 food crisis.

The research team assessed changes in diet and acute malnutrition status among pregnant and lactating women receiving similarly sized household transfers over a four-month period delivered either as food vouchers or as mixed transfers consisting of in-kind food, vouchers, and cash over a four month period.


  • 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.
  • Results show 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 program evaluations needed to deepen understanding – in particular with larger sample sizes and longer intervention periods.


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