This study aims to evaluate whether revised food voucher programs, combined with nutrition education sessions, can improve food security, dietary quality, nutrition knowledge, and nutritional outcomes among low-income households in the Philippines. Researchers will compare different monthly voucher amounts-Philippine Peso (PhP) 3,000, PhP 5,000, and PhP 8,000-with a no-voucher control group to determine which approach is most effective. The main questions the study aims to answer are: * Do food vouchers improve household food security, reduce hunger, and improve dietary quality and nutrient intake? * Do larger voucher amounts lead to greater improvements in nutrition and health outcomes? * Does enhanced nutrition education improve nutrition knowledge and healthy eating practices? Participants will: * Receive either a monthly food voucher or no voucher, depending on study group assignment * Attend nutrition education and Social and Behavior Change Communication (SBCC) sessions if assigned to a voucher group * Complete household interviews on food consumption, household expenditures, food security, and nutrition knowledge * Participate in dietary assessments and anthropometric measurements for women and children under 5 years of age
The REVIVE study is a cluster-randomized controlled trial designed to evaluate the effectiveness of revised food voucher interventions combined with nutrition-focused Social and Behavior Change Communication (SBCC) among low-income households in the Philippines. The study will compare three monthly voucher amounts (PhP 3,000, PhP 5,000, and PhP 8,000) with a control group receiving no voucher to assess whether larger voucher values lead to greater improvements in food security, dietary quality, and nutrition-related outcomes. The intervention includes structured food vouchers with revised allocations emphasizing protein-rich foods, fruits, and vegetables, together with nutrition education sessions delivered by trained local government staff. The study will be implemented across selected urban and rural areas in the Philippines. Researchers will collect household- and individual-level data through surveys, dietary assessments, and anthropometric measurements to examine the effects of the intervention on household food consumption, nutrition knowledge, food insecurity, dietary quality, and nutritional status among women of reproductive age and children under five years of age. The study will also assess potential spillover effects within participating communities.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
5,320
Households receive a monthly food voucher valued at PhP 3,000 with a structured allocation of 10% for carbohydrates and oils, 45% for protein-rich foods, and 45% for fruits and vegetables. Vouchers are redeemable continuously throughout the month. The intervention is combined with six structured social and behavior change communication (SBCC) sessions focused on nutrition knowledge, healthy dietary practices, maternal and child nutrition, and WASH behaviors, delivered by trained local government staff.
Households receive a monthly food voucher valued at PhP 5,000 with the same allocation structure (10% carbohydrates and oils, 45% protein, 45% fruits and vegetables) and continuous redemption design. The voucher is paired with six SBCC sessions covering nutrition education and behavior change topics related to diet quality and household nutrition.
Households receive a monthly food voucher valued at PhP 8,000 with the same structured food group allocation and continuous redemption system. The intervention includes six SBCC sessions aimed at improving nutrition knowledge and dietary practices for maternal and child health.
International Food Policy Research Institute
Washington D.C., District of Columbia, United States
RECRUITINGNutrition Knowledge
Composite measure of nutrition knowledge assessed using a structured questionnaire administered to the primary household meal planner. The instrument includes items on food groups, dietary diversity, micronutrient-rich foods, maternal and child feeding practices, and understanding of voucher allocation rules. A total score will be constructed by summing correct responses and standardizing across respondents. Subdomain scores (e.g., dietary diversity knowledge, micronutrient knowledge, child feeding knowledge) will also be analyzed.
Time frame: Baseline and End of intervention (approximately 24 months)
Individual Nutrient Adequacy
Summary measure of dietary nutrient adequacy among women of reproductive age and children under five years, derived from 24-hour dietary recall data. Probability of adequacy will be estimated for energy, macronutrients, and selected micronutrients (vitamin A, B-complex vitamins, vitamin C, calcium, iron, and zinc). The mean probability of adequacy will be calculated by averaging across 11 micronutrients.
Time frame: End of intervention (approximately 24 months)
Minimum Dietary Diversity for Women (MDD-W)
Minimum Dietary Diversity for Women (MDD-W), defined as the proportion of women of reproductive age who consume foods from at least 5 of 10 food groups during the previous 24 hours, based on a 24-hour dietary recall.
Time frame: End of intervention (approximately 24 months)
Global Dietary Quality Score (GDQS)
Global Dietary Quality Score (GDQS), a food-based metric derived from 24-hour dietary recall data that assesses overall dietary quality by accounting for consumption of both healthy and unhealthy food groups. GDQS ranges from 0 to 49, with higher scores indicating better dietary quality and lower risk of nutrient inadequacy and diet-related non-communicable diseases.
Time frame: End of intervention (approximately 24 months)
Hunger and Food Insecurity Experience Scale
Household food insecurity and hunger will be assessed using the Food Insecurity Experience Scale (FIES), an experience-based measure consisting of eight questions about access to adequate food during the previous 4 weeks. The scale captures a range of food insecurity experiences, including worry about obtaining food, reduced dietary quality, reduced food quantity, skipping meals, and going without food. The raw FIES score ranges from 0 to 8, with higher scores indicating greater severity of food insecurity and hunger. Responses will be used to calculate both continuous FIES scores and categorical classifications of food insecurity severity.
Time frame: Baseline and End of intervention (approximately 24 months)
Household Food Consumption Score (FCS)
The Food Consumption Score (FCS) is a composite measure of household dietary diversity, food frequency, and relative nutritional importance of foods consumed. The FCS is calculated using a 7-day recall of household food consumption across standardized food groups. Consumption frequencies are weighted according to the nutritional value of each food group and summed to generate the total score. The FCS ranges from 0 to 112, with higher scores indicating better household food consumption, greater dietary diversity, and improved food access. Lower scores indicate poorer food consumption patterns and greater vulnerability to food insecurity.
Time frame: Baseline and endline (approximately 24 months after baseline survey)
Height-for-Age Z-score (HAZ) in Children Under Five Years of Age
Height-for-age z-score (HAZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. HAZ is a standardized measure of linear growth relative to age and sex. HAZ values typically range from approximately -6 to +6, with higher values indicating better growth status. Children with HAZ \< -2 standard deviations are classified as stunted.
Time frame: End of intervention (approximately 24 months)
Weight-for-Age Z-score (WAZ) in Children Under Five Years of Age
Weight-for-age z-score (WAZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. WAZ is a standardized measure of body weight relative to age and sex. WAZ values typically range from approximately -6 to +6, with higher values indicating better nutritional status. Children with WAZ \< -2 standard deviations are classified as underweight.
Time frame: End of intervention (approximately 24 months)
Weight-for-Height Z-score (WHZ) in Children Under Five Years of Age
Weight-for-height z-score (WHZ) among children under five years of age, calculated using the World Health Organization (WHO) Child Growth Standards. WHZ is a standardized measure of body weight relative to height. WHZ values typically range from approximately -5 to +5, with higher values indicating better nutritional status. Children with WHZ \< -2 standard deviations are classified as wasted.
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Time frame: End of intervention (approximately 24 months)
Body Mass Index (BMI) Among Women of Reproductive Age
Body mass index (BMI) among women of reproductive age, calculated as weight in kilograms divided by height in meters squared (kg/m²). BMI is a continuous measure of nutritional status. Higher BMI values indicate greater body mass relative to height. Nutritional status categories (underweight, normal weight, overweight, and obesity) will be classified according to World Health Organization (WHO) standard cut-offs and Asian-specific cut-offs
Time frame: End of intervention (approximately 24 months)
Household Food and Non-food Expenditure
Total household food expenditure over a 4-week recall period, including food purchased, produced, received as transfers, and redeemed through food vouchers. Monthly-equivalent household expenditures on non-food categories including health, education, housing, utilities, transport, communication, clothing, durable goods, debt repayment, and other miscellaneous expenditures
Time frame: Baseline and End of intervention (approximately 24 months)