Associations between a cash voucher intervention, food consumption, and coping strategies in Somali food-insecure populations

Background: This cross-sectional study aimed to explore the association between cash voucher assistance on building community resiliency and improving food security among 1371 households (HH) living in northern and southern regions of Somalia. The secondary data analysis used endline data from participants in World Vision’s Emergency Food Security Program from May 2018 to May 2019. The participants received unconditional cash vouchers, conditional cash for work vouchers, and nutrition and livelihood trainings. Logistic regression analysis was conducted to explore the association between program interventions and food consumption score (FCS, borderline/poor: 0–35, acceptable: > 35) and reduced coping strategy index (rCSI, acceptable: 0–3, emergency/crisis: 4–56). Results: A total of 41.5% of all HH that received cash vouchers reported borderline/poor FCS and 71.1% had emergency/crisis rCSI. Utilization of vouchers for food purchase (0.34; 0.23, 0.51) and purchase of more types of food for greater dietary diversity (0.70; 0.55, 0.89) were negatively associated with acceptable FCS. Participants who redeemed cash vouchers were less likely to have an emergency/crisis rCSI (0.68; 0.61, 0.76). Utilization of cash vouchers had a positive association with increased conflict within the HH (2.90; 1.29, 6.48). Participants reporting benefits from improved community rehabilitation through increased check dams were more likely to have acceptable rCSI (2.37; 1.45, 3.89). Conclusions: Our findings suggest that interventions utilizing cash vouchers have to consider contextual factors in calculations of voucher entitlements, increase investment in water management and livelihood skills training, and expand nutrition and livelihood trainings to men and boys to foster women empowerment and improve food security outcomes.