Randomized Evaluation of Voucher Interventions for Value and Effectiveness (REVIVE) in Philippines (REVIVE)

无干预：Control: No Voucher

Households in this arm do not receive food vouchers during the study period

实验性的：Monthly Food Voucher - PhP 3,000

Households receive a monthly food voucher valued at PhP 3,000, structured with a 10% allocation for carbohydrates and oils, 45% for protein-rich foods, and 45% for fruits and vegetables. Vouchers can be redeemed continuously and are accompanied by six structured nutrition-focused social and behavior change communication (SBCC) sessions delivered by trained local government staff.

行为的：Food Voucher + SBCC (PhP 3,000)

Households receive a monthly food voucher valued at PhP 3,000 with a structured allocation of 10% for carbohydrates and oils, 45% for protein-rich foods, and 45% for fruits and vegetables. Vouchers are redeemable continuously throughout the month. The intervention is combined with six structured social and behavior change communication (SBCC) sessions focused on nutrition knowledge, healthy dietary practices, maternal and child nutrition, and WASH behaviors, delivered by trained local government staff.

实验性的：Monthly Food Voucher - PhP 5,000

Households receive a monthly food voucher valued at PhP 5,000, with the same food group allocation (10% carbohydrates and oils, 45% protein, 45% fruits and vegetables) and continuous redemption design. Voucher receipt is combined with six SBCC sessions aimed at improving nutrition knowledge and dietary practices.

行为的：Food Voucher + SBCC (PhP 5,000)

Households receive a monthly food voucher valued at PhP 5,000 with the same allocation structure (10% carbohydrates and oils, 45% protein, 45% fruits and vegetables) and continuous redemption design. The voucher is paired with six SBCC sessions covering nutrition education and behavior change topics related to diet quality and household nutrition.

实验性的：Monthly Food Voucher - PhP 8,000

Households receive a monthly food voucher valued at PhP 8,000, structured with 10% allocation for carbohydrates and oils, 45% for protein, and 45% for fruits and vegetables, and redeemed continuously. The intervention is paired with six nutrition-focused SBCC sessions delivered by trained local government personnel to improve dietary behaviors and nutrition knowledge.

行为的：Food Voucher + SBCC (PhP 8,000)

Households receive a monthly food voucher valued at PhP 8,000 with the same structured food group allocation and continuous redemption system. The intervention includes six SBCC sessions aimed at improving nutrition knowledge and dietary practices for maternal and child health.

Nutrition Knowledge

Composite measure of nutrition knowledge assessed using a structured questionnaire administered to the primary household meal planner. The instrument includes items on food groups, dietary diversity, micronutrient-rich foods, maternal and child feeding practices, and understanding of voucher allocation rules. A total score will be constructed by summing correct responses and standardizing across respondents. Subdomain scores (e.g., dietary diversity knowledge, micronutrient knowledge, child feeding knowledge) will also be analyzed.

Individual Nutrient Adequacy

Summary measure of dietary nutrient adequacy among women of reproductive age and children under five years, derived from 24-hour dietary recall data. Probability of adequacy will be estimated for energy, macronutrients, and selected micronutrients (vitamin A, B-complex vitamins, vitamin C, calcium, iron, and zinc). The mean probability of adequacy will be calculated by averaging across 11 micronutrients.

Minimum Dietary Diversity for Women (MDD-W)

Minimum Dietary Diversity for Women (MDD-W), defined as the proportion of women of reproductive age who consume foods from at least 5 of 10 food groups during the previous 24 hours, based on a 24-hour dietary recall.

Global Dietary Quality Score (GDQS)

Global Dietary Quality Score (GDQS), a food-based metric derived from 24-hour dietary recall data that assesses overall dietary quality by accounting for consumption of both healthy and unhealthy food groups. GDQS ranges from 0 to 49, with higher scores indicating better dietary quality and lower risk of nutrient inadequacy and diet-related non-communicable diseases.

Hunger and Food Insecurity Experience Scale

Household food insecurity and hunger will be assessed using the Food Insecurity Experience Scale (FIES), an experience-based measure consisting of eight questions about access to adequate food during the previous 4 weeks. The scale captures a range of food insecurity experiences, including worry about obtaining food, reduced dietary quality, reduced food quantity, skipping meals, and going without food.

The raw FIES score ranges from 0 to 8, with higher scores indicating greater severity of food insecurity and hunger. Responses will be used to calculate both continuous FIES scores and categorical classifications of food insecurity severity.

Household Food Consumption Score (FCS)

The Food Consumption Score (FCS) is a composite measure of household dietary diversity, food frequency, and relative nutritional importance of foods consumed. The FCS is calculated using a 7-day recall of household food consumption across standardized food groups. Consumption frequencies are weighted according to the nutritional value of each food group and summed to generate the total score.

The FCS ranges from 0 to 112, with higher scores indicating better household food consumption, greater dietary diversity, and improved food access. Lower scores indicate poorer food consumption patterns and greater vulnerability to food insecurity.

Height-for-Age Z-score (HAZ) in Children Under Five Years of Age

Height-for-age z-score (HAZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. HAZ is a standardized measure of linear growth relative to age and sex. HAZ values typically range from approximately -6 to +6, with higher values indicating better growth status. Children with HAZ < -2 standard deviations are classified as stunted.

Weight-for-Age Z-score (WAZ) in Children Under Five Years of Age

Weight-for-age z-score (WAZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. WAZ is a standardized measure of body weight relative to age and sex. WAZ values typically range from approximately -6 to +6, with higher values indicating better nutritional status. Children with WAZ < -2 standard deviations are classified as underweight.

Weight-for-Height Z-score (WHZ) in Children Under Five Years of Age

Weight-for-height z-score (WHZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. WHZ is a standardized measure of body weight relative to height. WHZ values typically range from approximately -5 to +5, with higher values indicating better nutritional status. Children with WHZ < -2 standard deviations are classified as wasted.

Body Mass Index (BMI) Among Women of Reproductive Age

Body mass index (BMI) among women of reproductive age, calculated as weight in kilograms divided by height in meters squared (kg/m²). BMI is a continuous measure of nutritional status. Higher BMI values indicate greater body mass relative to height. Nutritional status categories (underweight, normal weight, overweight, and obesity) will be classified according to World Health Organization (WHO) standard cut-offs and Asian-specific cut-offs

Household Food and Non-food Expenditure

Total household food expenditure over a 4-week recall period, including food purchased, produced, received as transfers, and redeemed through food vouchers. Monthly-equivalent household expenditures on non-food categories including health, education, housing, utilities, transport, communication, clothing, durable goods, debt repayment, and other miscellaneous expenditures