Food Security Clinical Trial
This evaluation is part of a five country project to evaluate the benefits and costs of the
use of two alternatives to food transfers: vouchers and cash (hereafter referred to as
"alternative modalities"). The project will generate information on how outcomes such as
household food expenditure and dietary diversity, relevant to both beneficiaries and WFP,
change following the introduction of these alternative modalities; how benefits and costs of
these are, relative to food transfers, distributed across and within households; and what
are the critical operational issues that need to be addressed for these alternatives to be
successfully implemented. More specifically, the project will answer seven questions:
1. Do households benefit from receipt of the alternative modalities?
2. Are these benefits greater, or less, when transfers are made using alternative
modalities compared to food transfers. How does this vary across outcomes (such as
nutrition, livelihoods, gender dynamics and intra-household resource allocation) that
are of especial interest to WFP?
3. How does the distribution of benefits differ across households when transfers are made
using alternative modalities compared to food transfers?
4. How does the distribution of benefits differ within households when transfers are made
using alternative modalities compared to food transfers? Do certain household members
(women, young children) benefit more from one type of modality? How do these modalities
affect decision-making processes within the household?
5. Why are these differences observed? How do the reasons for these differences affect the
study's ability to generalize from these evaluations?
6. Does the delivery of alternative modalities cost less than food transfers? What
accounts for these cost differences? Are some costs (such as transport) really lower or
are they transferred to beneficiaries? Within the household, who bears these additional
costs?
7. What is the benefit: cost ratios associated with these different modalities from the
perspective of WFP? Is there a conflict between the modality "preferred" by WFP and the
modality "preferred" by beneficiaries?
These objectives will be accomplished through household survey data collection among a panel
of households before and after transfer of alternative modalities. In addition, select
countries will involve the collection of anthropometric, biomarker and cognitive testing.
In Ecuador, the intervention consists of food, food vouchers or cash transfers to Colombian
refugees and poor Ecuadorian households in four urban and peri-urban areas of Carchi and
Sucumbios in northern Ecuador. The transfer is given monthly for 6 months. The program is
conditional on attendance at nutrition and community trainings occurring once a month. In
most cases the transfer recipient is the female head of household or spouse, however in some
cases men may also receive the transfer.
The study is a 2 stage randomized control trial where, first, 80 neighborhoods were
randomized to either treatment or control group; second, treatment clusters (geographical
units within neighborhoods) were randomized to either: cash, food voucher or food
assistance. Approximately 20 - 28 participants from each of the 145 clusters were randomly
selected for interviews. In addition to the household socio-economic survey, hemoglobin
measures were taken from children between 6 months and 5 years of age and adolescent girls
from age 10 to 16 years in each household. The baseline survey occurred in April 2011 and
the endline in November 2011.
Interviews were conducted with female heads of households or spouses where possible, or with
adult male head of households. In addition, hemoglobin was collected for all children ages 6
months to 5 years and for adolescent girls residing in surveyed households.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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