Impact Evaluation of WFP's Fresh Food Voucher Pilot Programme in Ethiopia

Study Overview
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Brief Summary
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To assess the impact of WFP's Fresh Food Voucher Pilot Programme in Ethiopia on children's and mother's diets

Detailed Description
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Rationale: Infants, young children and adult women in rural Ethiopia consume one of the least diversified diets in the world. The World Food Programme's Fresh Food Voucher (FFV) Pilot Programme aims to improve dietary diversity among infants and young children and their mothers. The focus on these demographic groups is based on the now well-established theory on the importance of the 'first 1,000 days'. This period, spanning the pregnancy and the first 2 years of child's life, is considered critical for child's physical growth and cognitive development. The beneficiary households receive a voucher that can be used to purchase fresh foods (fruits, vegetables and certain animal source foods). Objective: The main objectives of the evaluation are to assess and report on the performance and results of the FFV programme to help WFP present high-quality and credible evidence of actual impact to its donors. In addition, the evaluation will determine the reasons why certain results occurred (or not) to draw lessons, derive good practices and pointers for learning. Study design: This is a mixed methods evaluation that combines a Randomized Controlled Trial (RCT) with Focus Group Discussions (FGDs) with caregivers and food traders. The RCT contains three arms. The first treatment arm receives a smaller voucher (roughly $12-17) and social behavioural change communication (SBCC). The second treatment arm receives a larger voucher (roughly $21-23) and SBCC. Households in the third study arm (control) receive SBCC but do not receive vouchers. A cluster in this impact evaluation is defined as a village (got in Amharic) and these clusters of are randomly allocated to the different arms of the trial. Within a cluster, all eligible households will receive the same treatment. Study population: All households with a child between 6-17 months at the baseline in December 2017 were eligible to be included in the quantitative sample. Main study parameters/endpoints: The main outcomes of interest are minimum acceptable diet score for children 6- 23 months (World Health Organization, 2008) and minimum diet diversity for women of reproductive age (FAO & FHI-360, 2016).

Official Title
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Impact Evaluation of WFP's Fresh Food Voucher Pilot Programme in Ethiopia

Conditions
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Diet; Deficiency, Malnutrition

Intervention / Treatment
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* Behavioral: BCC-Only
* Other: Small-voucher
* Other: Large-voucher


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Households with young children aged 6-17 months age at the baseline in December 2017.

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 17 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Cluster randomized controlled trial clustered at the village level, 2 treatment arms and one control group.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: BCC-Only<br>Intervention: Households in the 'BCC-only' arm receive SBCC but do not receive vouchers. | Behavioral: BCC-Only<br>* Households in the 'BCC-only' arm receive SBCC but do not receive vouchers.<br>|
| Experimental: Small-voucher<br>Intervention: Households in the 'Small-voucher' arm receive a voucher ( $12-17) every month that entitles them to purchase fresh foods (fruits, vegetables and animal sourced foods). The households in this arm also receive the same social behavioural change communication (SBCC) messages as the 'BCC-only' arm. | Other: Small-voucher<br>* Households in the 'Small-voucher' arm receive a voucher ( $12-17) every month that entitles them to purchase fresh foods (fruits, vegetables and animal sourced foods). The households in this arm also receive the same social behavioural change communication (SBCC) messages as the 'BCC-only' arm.<br>|
| Experimental: Large-voucher<br>Intervention: Households in the 'Large-voucher' arm receive a larger voucher ( $21-23) every month that entitles them to purchase fresh foods (fruits, vegetables and animal sourced foods). The households in this arm also receive the same social behavioural change communication (SBCC) messages as the 'BCC-only' arm. | Other: Large-voucher<br>* Households in the 'Large-voucher' arm receive a larger voucher ( $21-23) every month that entitles them to purchase fresh foods (fruits, vegetables and animal sourced foods). The households in this arm also receive the same social behavioural change communication (SBCC) messages as the 'BCC-only' arm.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Minimum Acceptable Diet Scores (MAD) of children 6-23 months of age | Change in the proportion of children achieving MAD | 12 months | 
| Minimum diet diversity (MDD-W) for women of reproductive age | Change in the proportion of women achieving MDD-W | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Minimum Diet Diversity (MDD) of children 6-23 months of age | Change in the proportion of children achieving MDD | 12 months | 
| Minimum Meal Frequency (MFF) of children 6-23 months of age | Change in the proportion of children achieving MFF | 12 months | 
| Household Diet Diversity Score (HDDS) | Mean difference in HDDS | 12 months | 
| WFP Food Consumption Score- Nutrition | Mean difference in WFP Food Consumption Score- Nutrition | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dietary diversity, minimum acceptable diet, fruits, vegetables, animal sourced foods