Use of cash vouchers in tropical storm emergency response in the Philippines

By Nashrudin Modin and Demosthenes Militante

Nashrudin Modin has worked in the Philippines mission of ACF International since 2005, under the Food Security and Livelihoods (FSL) Programme.  He was ACF’s Head of Project for the FSL in the Tropical Storm Washi emergency response project.  Currently he is the deputy consortium coordinator of ACF in the emergency response to Typhoon Bopha. 

Demosthenes Militante has worked in the Philippine mission of ACF International as FSL Coordinator since 2010.  Prior to ACF, he had worked for six years in the FSL programme of another international NGO in the Philippines.”

ACF is working with three other international NGOs in this consortium - Plan International, Save the Children International and Care Netherlands. The authors gratefully acknowledge the contributions of Dr. Martin Parreno, Nutrition Coordinator, who contributed to the explanation about the therapeutic programme for the SAM children. This project was funded by ECHO, the Spanish Agency for International Cooperation for Development and Ajuntament de Barcelona.

Late afternoon of 16 December 2011, Tropical Storm (TS) Washi hit Mindanao, a major island in the southern part of the Philippines. It was felt in at least 13 provinces in seven regions in the Visayas and Mindanao islands. The most severely affected in terms of loss of lives and damage to properties was Cagayan de Oro City in Misamis Oriental province and Iligan City in Lanao del Norte province, both in Mindanao. The final casualty count almost reached 1,500 while an estimated 641,098 persons (or 92,964 families) were affected, 43,663 of whom were moved to evacuation centres. Some 9,193 households lost their homes while 18,873 other had homes partially damaged. Besides the loss of lives and destruction of thousands of homes, TS Washi also had a disastrous impact on people’s livelihoods. The total cost of damage to agriculture and infrastructure was initially estimated at EUR17.5 million.

A three-month emergency intervention was implemented by Action Contre la Faim (ACF) and consortium partners, Plan International, Save the Children International and Care Netherlands. One of the intended results of the project was to reduce the vulnerability of the most affected households by improving their access to food. This was in response to rapid needs assessment findings that affected families, mostly in the evacuation centres, were highly dependent on food aid. The emergency intervention was implemented in the two cities of Cagayan de Oro and Iligan. The insights shared in this article are extracted from the post-activity analysis and post-distribution monitoring conducted by the ACF team.

Strategy

The initial strategy of ACF’s Food Security and Livelihoods (FSL) team was to provide blanket food assistance to families in evacuation centres. However, the overwhelming response from various sectors (e.g. government agencies, international humanitarian agencies, local non-governmental organisations (NGOs), private groups and individuals, religious organisations, etc.) at the onset of the emergency resulted in a glut of food assistance. The aid provided was mostly dry items and canned goods, often of poor quality and low nutritional value.

As a result, ACF’s FSL team shifted their strategy to targeting pregnant and lactating women (PLWs) and children suffering from severe acute malnutrition (SAM). A cash voucher programme¹ was implemented to allow the target beneficiaries to purchase a variety of nutritious and fresh foods. This was viable as a rapid assessment by ACF showed that shops, public markets, groceries and supermarkets in the two cities were operating normally.

Cash vouchers were distributed to 3,035 beneficiaries, of whom 2,973 were PLWs and 62 were SAM children and their families. To identify the target PLW and SAM beneficiaries, the FSL team worked with ACF’s Nutrition team, who were then implementing care practice support to PLWs and a treatment programme for SAM children among the TS Washi-affected families (UNICEF funded). The cash vouchers were distributed during February and March 2012.

The cash voucher intervention

Each PLW beneficiary received a set of cash vouchers with total value amounting to 30 euros or PhP 1,700². Beneficiaries received the vouchers in two equal instalments of PhP850 each separated by two weeks. Each voucher was expected to provide food to last for two weeks. The cash vouchers were used only in ACF-accredited partner shops, stores and vendors and beneficiaries were allowed to use the vouchers to buy specific items (see Box 1).

Box 1: Allowable food items using cash vouchers

A mother and her baby with her voucher

Rice, flour, corn, oats ad simple bread

Meat (beef, pork, goat meat, and by-products)

Poultry (dressed chicken, by-products and live poultry)

Fish and seafood products (fresh and dried)

Eggs and salted eggs

Beans (monggo, red beans and white beans)

Sugar (brown and white)

Leafy vegetables (pechay, cabbage, camote tops, lettuce, etc.)

Vegetables (carrots, squash, potatoes, chayote, tomatoes, eggplants, string beans, etc.)

Spices (ginger, onion, garlic, etc.)

Iodized salt

Condiments (soy sauce, vinegar, fish sauce, catsup, etc.)

Noodles (fresh miki, fresh canton, etc.)

Fruits (bananas, orange, avocado, papaya, mango, pineapple, etc.)

Oil margarine, butter, etc.

These food items were printed at the back of the cash vouchers and on the leaflets that accompanied the cash vouchers to provide the beneficiaries, the shops and vendors a convenient reference.

The supermarket and market vendors could not give change so purchases needed to amount to the denominations of the cash vouchers. The supermarket and market vendors were not entitled to any commissions or fees from ACF. Their only benefit in participating was the increased transactions coming from the target beneficiaries of ACF. The city governments were partners in the project and monitored the food prices to ensure that nobody took advantage of the high demand for their food items.

The market situations in the two cities were different. In Cagayan de Oro, there were large supermarkets which allowed ACF to find a partner that could accommodate the volume of the food items that the PLW-beneficiaries would purchase. In Iligan, the only large supermarket declined to participate in the cash voucher scheme. As a result, ACF partnered with the federation of vendors in the main city public market. The design of the cash voucher schemes implemented in Cagayan de Oro and Iligan were therefore different as follows:

Cagayan de Oro: Each beneficiary received two vouchers in each installment, one valued at PhP500 and another PhP350. This allowed the beneficiary to shop for food items more than once at the supermarket using one voucher at a time. Figure 1 shows the front and reverse of the cash voucher.

Figure 1: Cash voucher in Cagayan de Oro city

Iligan: The beneficiaries received a set of vouchers in each installment with smaller denominations (PhP100, PhP 50, PhP 20, PhP10, PhP 5) amounting to a total value of PhP850. This allowed the beneficiary to make small purchases from different accredited vendors within the public market. Figure 2 shows a sample design of the cash vouchers used in Iligan City.

Figure 2: Cash voucher in Iligan city

Insights from the cash voucher intervention

Post-distribution monitoring (PDM) activity was conducted by ACF one week after each distribution amongst a random selection of beneficiaries (n=350). This provided insights into how the assistance was received and used by the beneficiaries, and whether the distribution caused any protection issues, risks, or concerns. A Household Survey Questionnaire was the main tool used in data gathering and included sections on the beneficiaries’ Food Consumption Score (FCS) and Individual Dietary Diversity Score (IDDS).

The ACF team visited evacuation centres, as well as the places of origin where former internally displaced persons (IDPs) had returned after their evacuation centres were closed. In total, about 19% of the total beneficiaries participated in this PDM.

A note on food item monitoring

The regular food items included in the FCS and IDDS monitoring tool were used, which include dairy products that were not purchasable using the vouchers. The questionnaire asks specifically for food items they purchased using the cash vouchers. However, respondents included their purchases of milk in monitoring feedback and this is reflected in Figures 1-3. It is possible that the data on the other food items could include purchases using other incomes. But the team still believes the responses on purchases fairly represent how they used the vouchers. This is due to the apparent behaviour of beneficiaries to fully use up the vouchers in one shopping and consume the purchased food items within a week.

Respondent profile

Of the total 350 respondents, 68.6% or 240 respondents came from Cagayan de Oro City, while 31.4% (110 respondents) were from Iligan City. There were 343 respondents from households of PLWs, and seven (7) from households of SAM children (the SAM sample is the same in proportion (2%) to the total SAM beneficiaries out of the total 3,035 beneficiaries). The age of the majority of the respondents were between 18 to 29 years old and the household size of the majority of the respondents (88.2%) was between 4 – 7 members.

Household food access and dietary diversity

Food types consumed and food frequency immediately prior to the voucher distribution (“more than 7 days ago”) were investigated. This found that the majority (85%) of the respondents had received food assistance from government/private organisations/INGOs/ NGOs and 24.6% had used livelihoods income to fund food purchases. Other food sources were cash assistance (1.4%), cash-for-work (2%), food-for-work (2.3%), vouchers (10%) and assistance from relatives/friends (3.7%). The most common pre-voucher foods consumed were cereals (staples) (99.7%, n=349) followed by vegetables (90%, n=315), meat and fish (84.3%, n=295), and condiments (70.3%, n=246). Fruit intake was 34.9 % (n=122) (Figure 1).

To investigate the impact of the voucher on food consumption, food type and frequency since the voucher distribution (“in the last 7 days”), was investigated. Using cash vouchers, the most common foods purchased were cereals (98.3%) followed by meat and fish (92.1%), vegetables (87.5%) and condiments (see Figure 2). Cereals were almost consumed everyday (6.33 days) followed by condiments (5.66 days), sugar (5.43 days) and oils (5.35 days). Vegetables, fruits and meat food groups were eaten on less than 3.67 days. See Figure 3.

With the exceptions of vegetables and cereals purchase and consumption which showed a marginal decrease, intakes of food groups generally increased with cash vouchers, significantly so for fruit consumption (from 122 respondents pre-voucher to 249 using vouchers).

Cereals and vegetables were the most common voucher-sourced foods prepared for SAM children (given daily), while meat and fish were prepared 5 out of 7 days. SAM children received no dairy or dairy products in the previous 7 days (these foods were not allowable in the voucher scheme).

For both PLW and SAM children, the most common food groups consumed in the previous 24 hours were grains, roots or tubers (94%), meat, poultry, fish, seafood (76.3%) and eggs (70.9%).

Overall, 57 % of the respondents had acceptable Food Consumption Score (FCS) results, 18% were borderline and 25% had a poor score.

Effectiveness of the cash voucher intervention

Most of the respondents (92.3%, n=323) indicated that the items lasted for one week and never longer than two weeks. Without voucher support, only 17.1% of respondents would have bought the same foods in the same amount. Reported benefits of the vouchers were reduced food expenses (93.7%, n=328), greater access to food (88.9%, n=311), and improved quality and quantity of food consumed (76.9%, n=26). More than half of the respondents (52.9%, n=185) shared the food purchased. All the respondents were satisfied with the distribution process (well organised, accessible, convenient), the range of food items available in stores and the assistance provided.

Analysis

Close to 25% of the respondents were still able to earn income which they use to buy food. One explanation for this is that Cagayan de Oro and Iligan cities have large areas that were untouched by the flood and where normal economic and business sectors of the cities were still functioning. In addition, the PDM was conducted in March 2012, (two and half months after the disaster) by which time, the general economy and the business sectors of the two cities were starting to normalize.

Our findings show that prior to receiving the cash vouchers, the respondents already had access to fresh food items such as vegetables, meat, fruits and other fresh foods. This is contrary to the findings of the needs assessment done immediately after the disaster which found that respondents were fully dependent on food kits being distributed to them. Respondents were found to have other sources of cash, e.g. cash-for-work and relatives. Many cash-based interventions, specifically cash-for-work, had been implemented before the voucher programme. The ACF team now recognized that another assessment should have been implemented prior to the actual cash intervention to establish the precise situation of the target beneficiaries.

The respondents maintained their preference for five food items when using the cash vouchers: cereals (staples), vegetables, meat, condiments and oils/fats. The cash voucher distribution increased the access of IDPs to more nutritious foods with an increase in purchase of almost all food items, significantly in fruit consumption.

One possible explanation for food items generally lasting only one week is that the beneficiaries did not have adequate storage facilities. Another possible explanation is that the monetary value of the cash voucher was not adequate. The high level of sharing with other household (52.9%) is also likely a factor and in itself, should be examined further in order to inform future cash transfer/voucher schemes and food aid interventions by ACF.

Overall, the PDM results indicate that the respondents were satisfied with the cash voucher intervention but suggested that hygiene items should be included among the items covered in future programmes.

It is interesting to note that although the design of the cash vouchers used and the type of markets (supermarket vs public market) were different between the two cities, there was no difference in the behaviour of beneficiaries in using the cash vouchers. Almost 100% of the beneficiaries made a single visit to the market (supermarket or public market) to purchase their food items despite Iligan city’s design allowing multiple market visits/purchases. A common reason was to save on transportation costs. This has a bearing on future cash voucher interventions, particularly if the objective is to encourage beneficiaries to spread their purchases of fresh food over a longer time period.

Conclusions

The PDM results indicate that the cash voucher intervention of ACF achieved its objective of improving the access of the target beneficiaries to food and made a significant contribution to the objective of improving the nutritional value of the food consumed. As reported by the population, the cash received from cash-for-work and the cash voucher interventions allowed them to buy fresh and nutritious foods such as vegetables, meats and fruits.

The high satisfaction expressed by the respondents indicates that the processes and systems being employed by ACF in its CTP projects are broadly adequate. However, there are insights from the PDM that merits further examination and should be considered in future CTPs, in particular, the monetary value of the vouchers, low FCS and the high level of sharing food.

The time between assessment and intervention can see considerable change in circumstances of the affected population; this remains a challenge in acute emergency response and perhaps especially in urban contexts that are an emerging context under scrutiny.

For more information, contact: Demosthenes Militante, email: dmilitante@ph.acfspain.org

¹The FSL team referred to the voucher as a cash voucher, although it is restricted to food purchases, for the following reasons:

(1) The vouchers carry a cash value

(2) Beneficiaries are free to utilise the vouchers as if it is cash, meaning they can choose how much and how many of each food items to purchase and at what price. FSL team relates food vouchers to commodity vouchers where specific food items and quantities are indicated in the vouchers.

²This 30 euro was based on the budget pegged for a food kit that ACF originally intended to distribute to affected families. A typical ACF food kit contains rice (20kg), noodles (20 packs), canned sardines (20 cans), sugar (2 kg), salt (1 kg), and dried fish (2 kg). This food kit was estimated to provide food for a family of five for four weeks.