AND SITUATIONAL FILTERS
Cash transfer programmes focus primarily on influencing demand through consumer-level interventions that address economic, cognitive or aspirational factors that contribute to food acquisition and consumption. However, by working in partnership with food retailers and suppliers, programmes may be able to combine supply-side interventions (that is, at food-market level) with demand-side actions. These supply-side interventions are wide-ranging and can include physical improvements in the way nutritious foods are promoted and stocked in retail environments, as well as improvements in the level of convenience and ease with which beneficiaries are able to use cash transfers.
Food deserts are a key challenge for high-income countries.
These are food environments that are swamped with energy-dense, nutrient-poor food options, but lacking nutritious foods, predominantly in low-income communities. Cash transfer programmes in these contexts need to consider where beneficiaries are likely to shop, based on where they live, work and their daily routines, and the likelihood that these food environments will enable them to make the best (nutritional) use of their transfers. Recipients of cash transfers may also be influenced by the methods of payment that are used by the programme and accepted by stores (e.g. paper-based value vouchers vs. electronic benefit transfer (EBT) cards). These factors, along with other vendor properties, may influence any stigma felt by beneficiaries.
Cash transfer design option 7: Partnering with retailers to improve in-store promotion and stocking of nutritious foods In the United States of America, SNAP has used store eligibility requirements to enhance the retail food environment where SNAP beneficiaries shop, recognizing that a large percentage of SNAP benefit usage takes place in convenience stores.
In 2016, regulations were amended to increase minimum stock requirements from three to seven varieties within each food category, including meat, poultry and fish, bread or cereals, vegetables or fruits, and dairy products. The B’more Healthy Corner Stores for Moms and Kids project tested several different store-level interventions for improving urban food environments to encourage WIC redemption rates in Baltimore, Maryland. These included in-person training of storeowners, point-of-purchase promotion of WIC-eligible foods, product placement (such as arranging for eligible foods to be closer to the front of the store or at eye level), and grouping WIC-eligible foods together in displays. Only the storeowner training led to increased stocking and sales of WIC-eligible foods, however, the intervention period was short and the sample size small (10 corner stores) (Wensel et al., 2019).
Cash transfer design option 8: Partnering with retailers to improve ease of use of cash transfer benefits for nutritious food In rural areas of the United States of America, lack of access to supermarkets and grocery stores among SNAP beneficiaries has highlighted the potential for farmers markets as a strategy to increase the consumption of fruits and vegetables. However, farmers markets are not always present in low-income communities and, while SNAP as a whole has tried to move from paper vouchers to EBT systems, farmers markets, particularly in rural
areas, may not always accept EBT payment methods. In response, the USDA Food and Nutrition Service has issued guidance for farmers markets on how to expand access for SNAP recipients and also provides grants to farmers markets to put in place wireless EBT payment systems (USDA FNS, 2018).
CONCLUSION
This article has attempted to link some of the newly-emerging thinking and frameworks on food environments with ongoing discussions on how to make cash transfer programmes more nutrition-sensitive. While social protection and nutrition policymakers and practitioners have been called on to adopt a nutrition-sensitive lens, taking into consideration the malnutrition burden and dietary needs of vulnerable groups, this may not be enough to operationalize nutrition-sensitive cash transfer programmes where critical information about the food environment is lacking. Without information to characterize external food-environment factors, as well as individual filters, the food environment may be a “black box”
that limits the ability of policymakers to select programme design options that have the best chance of being effective.
Similarly, in the evaluation of these programmes, lacking food environment information may limit our understanding of why programmes have had or not had their desired effect.
ACKNOWLEDGEMENTS
This work was supported by the Center for a Livable Future (CLF)-Lerner Fellowship Program. The views expressed herein do not necessarily represent those of CLF.
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