Evidence and guidance notes on the use of cash and voucher assistance for nutrition outcomes in emergencies

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The use of Cash and Voucher Assistance (CVA) as a modality of humanitarian assistance has increased rapidly over recent years across all humanitarian sectors. There is growing recognition that CVA modalities can contribute to nutrition outcomes. However, the use of CVA for this purpose has been restricted likely due to the limited evidence base and lack of familiarity of nutrition practitioners with CVA modalities and approaches. There has also been no guidance on why, when and how to integrate cash and voucher modalities in nutrition interventions, what information and analysis is required to make these decisions and how a CVA component should be designed to maximise effectiveness and minimise risks. CashCap and the Global Nutrition Cluster have attempted to address this gap through the development of an evidence note and guidance note to support nutrition sector partners to more routinely consider and, if appropriate, use CVA modalities in emergency nutrition responses.¹

The Evidence note provides an overview of the evidence of the use of CVA for nutrition outcomes in emergencies and identifies the most common approaches and best practice to integrate CVA in nutrition response. It starts by linking CVA with the conceptual framework for adequate maternal and child nutrition, introducing demand and supply side barriers to achieving adequate nutrition and how cash and voucher modalities can address them. The note also provides an overview of the impact of cash and vouchers on the nutrition status of children and the determinants of adequate nutrition, concluding that CVA alone is unlikely to be enough to achieve nutrition outcomes. Lastly, based on reviewed studies and programme documents, the note identifies and assesses the main CVA approaches for nutrition.

The Guidance note provides step-by-step guidance throughout the humanitarian programme cycle on the incorporation of CVA into a nutrition response. Links are provided to additional resources and guidance to support operationalisation. Measures are also identified to help apply a nutrition lens to household cash transfer, including entry points for improving the potential of household cash transfers, including multi-purpose cash, to contribute to nutrition outcomes. The note concludes with recommendations to the nutrition sector and other humanitarian actors on key actions that are required to more routinely consider and, if appropriate, use cash and voucher modalities in nutrition in emergencies.

Due to the general lack of experience within the nutrition sector to systematically consider and use CVA modalities, the guidance note is based on expert opinion and extensive consultation with nutrition practitioners. As such, it should be regularly updated to reflect emerging learning and experiences in considering and using CVA modalities for nutrition outcomes.

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