Modalities
- Cash and/or food vouchers (CVA) delivered as part of MCHN programmes.
- Household assistance, including food transfers and/or CVA, as part of an emergency response.
Strengthen the delivery of ongoing national social protection programmes to improve the availability, quality, affordability and consumption of diets for women and children
(see Nutrition sensitive social assistance).
Conditions and considerations
- Household assistance is provided at the household level in the form of in–kind, cash, or vouchers based on average household requirements for food/nutrition and sometimes (but not necessarily) other basic needs. Household in–kind assistance typically includes general food distributions (GFD) and non–food item distributions. Household CVA includes cash transfers or vouchers. Household cash transfers can be based on household food/nutrition requirements alone, or on needs across different sectors, ie, multi–purpose cash (MPC).
- Household assistance for the prevention of undernutrition requires a nutrition lens to the selection of appropriate food assistance modalities (cash, vouchers, or in–kind) in order that assistance is able to meet nutritional requirements of all household members.
- Household food assistance programmes are more likely to improve child, maternal or PBWG’s nutrition outcomes if they specifically take into account the requirements of those women and children, and include improving access to fortified foods/supplements and SBC.
- The minimum expenditure basket (MEB) is a tool increasingly used in operational contexts to design responses using cash and voucher modalities. In most circumstances, CVA is not sufficient to impact nutrition outcomes on its own – especially when in the form of multi–purpose cash. However, when designed to be nutrition sensitive and integrated with nutrition SBC and programmes such as those aiming to improve children’s diets, deliver essential nutrition services and promote positive feeding, dietary and care practices, cash transfers can improve dietary diversity, access to services and uptake of positive practices.
In practice, interventions that complement CVA and other forms of targeted nutrition interventions may be needed. These include the provision of certain nutritious foods for specific groups through in–kind or commodity vouchers or cash transfer top ups and social behavioural change communication (SBCC) to nudge people towards making better food choices; caregiver feeding and health seeking behaviour practices (including preventative and curative health and nutrition services). The use of CVA top ups to meet these additional needs is more and more frequent in operational contexts. The decision on whether to deliver food assistance in kind, through CVA or as a combination of the two will depend on a number of questions outlined in detail elsewhere
(see Relevant technical guidance).
In summary, some key considerations include:
- Appropriateness – Is the modality appropriate given the market conditions? This addresses questions such as whether increasing the purchasing power of and/or demand for nutritious foods on the part of the target population enable them to buy foods that fill the identified food consumption and micro– and macro–nutrient gaps and whether diverse foods for an adequately nutritious diet are available in sufficient quantities in local markets?
- Feasibility – Do the proposed modality and delivery mechanism combinations have a reasonable chance of success and reduce programming risks for participants, the implementing organisation and local market actors? This addresses questions such as whether vulnerable populations able to safely and predictably access markets within a reasonable distance from their home and will it be possible to monitor the supply, price and quality (relative to local or applicable humanitarian standards) and price of key foods on the market?
- Objective – Which modality or modalities are best suited to increase nutrition sensitivity of programming? This addresses questions such as whether the modality complements and integrates with the local diet to improve dietary adequacy for the target groups/individuals? For cash or vouchers, are consumers willing to buy the necessary foods for their own consumption? For in–kind food, do beneficiaries know how to prepare and are they willing, to prepare the foods offered? If applicable, how does your analysis support sequencing plans for using cash, voucher and/ or in–kind approaches for providing a quality diet or for evolving needs?
- Cost – Is the modality cost efficient and/or cost effective relative to others? This addresses questions around the trade–offs that exist between transfer size, duration, eligibility criteria, nutritional value of rations and coverage.