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General

Study Overview

Title:

Sustainability of food security Impacts from Cash Transfers, Food Transfers, and Complementary Programming in the time of COVID-19: Experimental Evidence from Bangladesh

Study is 3ie funded:

No

Study ID:

RIDIE-STUDY-ID-62732de5ab2ea

Initial Registration Date:

05/04/2022

Last Update Date:

12/18/2023

Study Status:

Ongoing

Location(s):

Bangladesh

Abstract:

Between 2012 and 2014, we collaborated with the UN World Food Programme on the implementation of the Transfer Modality Research Initiative (TMRI) project in Bangladesh. TMRI was a multi-arm randomized control trial (RCT) with treatment arms that provided cash transfers and/or food transfers, with or without nutrition behavior change communication (BCC). Payments were made to women living in poor households in two rural areas of Bangladesh - Rangpur and Kurigram Districts in the north, and Patuakhali, Pirojpur, Bhola, Khulna, and Bagerhat Districts in the south. These districts, like much of rural Bangladesh were affected by lockdowns associated with the COVID-19 pandemic. In 2021, we re-surveyed (by phone) a sub-sample of the original TMRI participants, specifically the Cash, Food, and Cash+BCC treatment groups and the control group in the north. We seek to (1) assess whether past participation in the various TMRI treatment arms affected household food security during the second year of the COVID-19 pandemic; and (2) explore potential mechanisms for such effects.

Registration Citation:

Categories:

Health, Nutrition, and Population
Social Protection

Additional Keywords:

Social protection, food security, COVID-19, resilience, Bangladesh

Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:

Shalini Roy

Affiliation:

International Food Policy Research Institute

Name of Second PI:

Mehrab Bakhtiar

Affiliation:

International Food Policy Research Institute

Study Sponsor

Name:

CGIAR Research Program on Policies, Institutions, and Markets (PIM) led by the International Food Policy Research Institute (IFPRI)

Study Sponsor Location:

United States

Research Partner

Name of Partner Institution:

None

Type of Organization:

Location:

Bangladesh

Intervention

Intervention Overview

Intervention:

TMRI sought to assess the relative impacts of different transfer modalities, with and without nutrition behavior change communication on household food consumption, food security and the nutritional status of pre-school children. The primary beneficiaries were women with children ages 0-2 years at baseline, living in poor households in two rural areas of Bangladesh, Rangpur and Kurigram Districts in the north, and Patuakhali, Pirojpur, Bhola, Khulna, and Bagerhat Districts in the south. Beneficiaries in the “Cash” arms received a monthly payment of 1,500 Taka. Beneficiaries in the “Food” arms received a monthly food ration of 30 kilograms (kg) of rice, 2 kg of lentils, and 2 liters of micronutrient-fortified cooking oil. The initial value of the food rations was equal to the value of the cash transfers. Beneficiaries in the “Cash+Food” treatment arms received half of each of the two types of transfers. The beneficiaries of the “Cash+BCC” arm in the North and the “Food+BCC” arm in the South received the same transfers as in the “Cash” only and “Food” only treatment groups, respectively, as well as a suite of intensive nutrition BCC interventions: (1) weekly group BCC trainings (2) twice-a-month visits to the beneficiaries’ homes, and (3) monthly group meetings between program staff and influential community leaders. About 9-15 beneficiaries were part of each BCC group. In both the north and the south, TMRI was implemented as a clustered randomized controlled trial with the following arms: Cash; Food; and ½ cash and ½ food. Cash+BCC was included as an additional treatment arm in the north and Food+BCC was included as an additional treatment arm in the south. Control arms were included in both the north and south. In this study, we are only surveying, by telephone, households in the Cash, Food, Cash+BCC and control arms in the north.

Theory of Change:

The premise behind TMRI’s original design was that improvements in household food security and child nutritional status require higher levels of income. To improve child nutritional status, it might also be necessary to increase caregivers’ understanding of optimal infant and young child feeding practices. Mindful of these considerations, the following theory of change guided the comparative design of the TMRI treatment arms. Food transfers and cash transfers directly increases resources available to the household for food consumption. However, different transfer modalities may lead to different uses of the resources, with implications for what foods are consumed. Adding nutrition BCC to transfers provides caregivers with knowledge on how to improve child diets alongside the resources to do so. Post-program follow-up of the TMRI sample in 2018 indicated that Cash households in the North experienced sustained increases in savings and Cash+BCC households in the North experienced sustained increases in livestock and poultry holdings. This latter finding may have reflected the fact that the BCC included discussions about how improving diets could be facilitated through growing nutritious food or raising animals (either for own consumption or for sale in local markets). These findings from 2018 suggest potential for greater resilience (in terms of higher food security and less income loss) to the COVID-19 pandemic among the Cash and Cash+BCC households in the North relative to the Control group and to the Food treatment arm. If Cash+BCC households were able to continue to produce nutritious foods or animal products during COVID-19, we would expect them to have better food security and more diverse diets, then both the Food and the Control arms as well as the Cash arm.

 

Multiple Treatment Arms Evaluated?

Yes

Implementing Agency

Name of Organization:

World Food Programme

Type of Organization:

Foreign or Multilateral Aid Agency

Program Funder

Name of Organization:

World Food Programme

Type of Organization:

Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?

Yes

Start Date:

05/01/2012

End Date:

04/30/2014

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Randomized control trial

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

This is a follow-up study to assess the sustainability of the original TMRI intervention and its role in promoting resilience to the consequences of the COVID-19 pandemic. We are tracing and re-interviewing households that participated in three of the original treatment arms (Cash, Food, Cash+BCC) in the north as well as households in the control group. We will first assess attrition and balance in these newly collected data using standard methods. Using baseline and post-endline data, we will estimate impact using single difference estimators. Basic estimates will control for treatment status; extended estimates will control for a common set of characteristics. Standard errors will adjust for clustering.

 

Outcomes (Endpoints):

Primary outcomes:

Moderate or severe food insecurity as measured by the FAO Food Insecurity Experience Scale (FIES)

Food Consumption Score (FCS)

 

Secondary outcomes:

Any food insecurity as measured by the FAO Food Insecurity Experience Scale (FIES)

Food Insecurity Experience Scale, raw score

Responses to the eight individual questions that are used to construct the FIES

Low FCS (defined as FCS <42)

Likelihood and frequency of household consumption of specific food groups: Staples; vegetables; fruit; pulses; dairy; meat/fish/eggs; oils/fats; sugar/sweets

 

Intermediate outcomes:

Employment status in week prior to interview for main and second earner

Self-reported perceptions of changes in income levels of household, main income earner, and second income earner

Type of income generating activity  

 

 

Unit of Analysis:

Households; individuals

Hypotheses:

(1) Households in the Cash+BCC treatment arm will have, post-program, lower prevalence of moderate or severe food insecurity and a higher Food Consumption Score relative to households in the Food only treatment group and relative to households in the control group. (2) Households in the Cash treatment arm will have, post-program, lower prevalence of moderate or severe food insecurity and a higher Food Consumption Score relative to households in the Food only treatment group and relative to households in the control group. (3) Households in the Cash+BCC treatment arm will have, post-program, lower prevalence of moderate or severe food insecurity and a higher Food Consumption Score relative to households in the Cash treatment group.

Unit of Intervention or Assignment:

Village

Number of Clusters in Sample:

200

Number of Individuals in Sample:

2,000 at baseline. 1,731 in follow-up sample

Size of Treatment, Control, or Comparison Subsamples:

There are 150 treatment clusters (divided equally between cash, food, and cash+bcc) and 50 control clusters

Supplementary Files

Analysis Plan:

rct_impacts_v11_20231218.pdf

Other Documents:

Data

Outcomes Data

Description:

In-person household surveys collected at baseline (2012) Telephone survey administered in Fall 2021

Data Already Collected?

Yes

Data Previously Used?

Yes

Data Access:

Not restricted - access with no requirements or minimal requirements (e.g. web registration)

Data Obtained by the Study Researchers?

Yes

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

Yes

Description:

Data Obtained by the Study Researchers?

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Yes

Study Materials

Upload Study Materials:

Registration Category

Registration Category:

Non-Prospective, Category 4: Data for measuring impacts have been obtained/collected by the research team and analysis for this evaluation has started

Completion

Completion Overview

Intervention Completion Date:

Data Collection Completion Date:

Unit of Analysis:

Clusters in Final Sample:

Total Observations in Final Sample:

Size of Treatment, Control, or Comparison Subsamples:

Findings

Preliminary Report:

Preliminary Report URL:

Summary of Findings:

Paper:

Paper Summary:

Paper Citation:

Data Availability

Data Availability (Primary Data):

Date of Data Availability:

Data URL or Contact:

Access procedure:

Other Materials

Survey:

Survey Instrument Links or Contact:

Program Files:

Program Files Links or Contact:

External Link:

External Link Description:

Description of Changes:

Study Stopped

Date:

Reason: