Revisiting the “Cash versus Food” Debate: New Evidence for an Old Puzzle?

Abstract

The longstanding "cash versus food" debate has received renewed attention in both research and practice. This paper reviews key issues shaping the debate and presents new evidence from randomized and quasi-experimental evaluations that deliberately compare cash and in-kind food transfers in ten developing counties. Findings show that relative effectiveness cannot be generalized: although some differences emerge in terms of food consumption and dietary diversity, average impacts tend to depend on context, specific objectives, their measurement, and program design. Costs for cash transfers and vouchers tend to be significantly lower relative to in-kind food. Yet the consistency and robustness of methods for efficiency analyses varies greatly.

Cash vs. food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania

“…In these studies, although both food and cash transfers increase food expenditure and food consumption, food transfers result in larger increases in caloric intake, they may be preferred by beneficiaries, and they may be more appropriate when food markets are functioning poorly. [24, 50, 51] In contrast, cash transfers allow freedom of choice, are cheaper to implement, and may be more “efficient” (according to microeconomic theory) than food transfers. [24, 50, 51] Until now, there were no equivalent data on the comparative effectiveness of different types of support among HIV-infected populations.…”

“…[24, 50, 51] In contrast, cash transfers allow freedom of choice, are cheaper to implement, and may be more “efficient” (according to microeconomic theory) than food transfers. [24, 50, 51] Until now, there were no equivalent data on the comparative effectiveness of different types of support among HIV-infected populations. The data from this study suggest that, at 6 months, the two strategies were statistically similar at improving most measures of adherence and retention among PLHIV versus the standard of care.…”

“…Furthermore, in addition to the few outcomes where cash was statistically superior to food, the ease of distribution through mobile money providers, lower distribution cost, and participant preference for cash suggests that short-term cash transfers may be a more promising intervention to consider for scale-up in many settings, an assertion suggested in other studies. [24, 50] Furthermore, it may be justified to consider expanding government-run cash transfer programs to HIV-affected households. [23, 36, 52, 53] …”

“…[19–22] Cash transfers are particularly attractive because they give beneficiaries freedom of choice, they may be cheaper to distribute and easier to monitor, and because their increasing adoption by anti-poverty programs across SSA may signal political and logistical readiness for cash transfer programs delivered at scale. [23, 24] …”

Impact of two policy interventions on dietary diversity in Ecuador

“…In the case of developing economies, Gentilini (23) reviewed several studies tackling the issue of cash transfers v. in-kind food transfers, leading to the conclusion that although there was relative effectiveness in these interventions, average impacts depended on the context, measurement and programme design. There is evidence of the positive impact of CCT on nutrition, specifically on stunting, anaemia, weight gain, preventive care visits, chronic malnutrition in infants, dietary diversity and Hb counts in the Latin American context.…”