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

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

Study Overview

• Status: Completed
• Conditions: Malnutrition; Diet; Deficiency
• Intervention / Treatment: Behavioral: BCC-Only; Other: Small-voucher; Other: Large-voucher

Detailed Description

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).

• Study Type: Interventional
• Enrollment (Actual): 574
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Ethiopia
  • Addis Ababa, Ethiopia, 00000
    • Kalle Hirvonen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 1 year (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Households with young children aged 6-17 months age at the baseline in December 2017.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: BCC-Only; Intervention: Households in the 'BCC-only' arm receive SBCC but do not receive vouchers.	Behavioral: BCC-Only; Households in the 'BCC-only' arm receive SBCC but do not receive vouchers.
Experimental: Small-voucher; 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; 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.
Experimental: Large-voucher; 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; 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.

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: International Food Policy Research Institute
• Collaborators: United Nations World Food Programme (WFP); Addis Ababa University
• Investigators: Principal Investigator: Kalle Hirvonen, PhD, International Food Policy Research Institute, Ethiopia; Principal Investigator: Kaleab Baye, PhD, Center for Food Science and Nutrition, Addis Ababa University, Ethiopia

Study record dates

Study Major Dates

• Study Start (Actual): June 27, 2018
• Primary Completion (Actual): December 31, 2018
• Study Completion (Actual): December 31, 2018

Study Registration Dates

• First Submitted: July 6, 2018
• First Submitted That Met QC Criteria: July 6, 2018
• First Posted (Actual): July 18, 2018

Study Record Updates

• Last Update Posted (Actual): February 26, 2019
• Last Update Submitted That Met QC Criteria: February 25, 2019
• Last Verified: February 1, 2019

More Information

Terms related to this study

• Keywords: fruits; vegetables; dietary diversity; minimum acceptable diet; animal sourced foods
• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition
• Other Study ID Numbers: 699013

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No