Can Digital Cash Transfers Serve those in Active Conflict? Randomized Intervention in Sudan

2025-01-27

2025-04-30

Primary outcomes
1. Household Dietary Diversity Score (HDDS)
2. Food Consumption Score
3. Proportion of households reporting moderate or severe food insecurity
4. Availability of food stock or saving to satisfy food needs
5. Perceived stress level
6. Anxiety
7. Subjective well-being (life satisfaction)

Primary outcomes explanation
1. Household Dietary Diversity Score (HDDS), which will be constructed based on 7-day recall following the guidelines by Food and Agriculture Organization (FAO). The HDDS is a qualitative measure of household-level food security and hence reflects the economic ability of the household to access a variety of foods (FAO, 2023). Previous studies have shown that an increase in dietary diversity is strongly associated with household food security (e.g., Hoddinott and Yohannes, 2002; Hatloy et al., 2000). Respondents are first asked if any of the household members have consumed one or more of the food groups over the preceding week inside or outside of the home. Then, the items are re-categorized into 8 groups to arrive at a score which consists of a simple count of food groups consumed, ranging from 0 (no consumption of any group) to 8 (consumption of all groups) in the previous 7 days.
2. Food Consumption Score (FCS) is constructed based on a 7-day recall period. The FCS is a composite measure used to assess household food security and dietary diversity, which was constructed by the World Food Programme (WFP). It reflects the quantity of consumed over the previous week by most of the household members (50+%) and helps to identify the nutritional adequacy of a household's diet. The score is constructed through points or weights given to each of the 8 food groups.
3. Food Insecurity Experience Scale (FIES), which will be conducted to measure the proportion of households reporting moderate or severe food insecurity. FIES is an experience-based food insecurity metric developed by the FAO of the United Nations and is widely applied to measure the perception and prevalence of food insecurity (FAO, 2014; FAO, 2020). The food security scale categorizes households into food secure, moderately food insecure, and severely food insecure households. FIES builds on an eight-question module related to respondents’ experiences and associated difficulties to access sufficient and nutritious food in the last 30 days. The aggregate FIES is constructed by summing the responses to the eight questions. Its value ranges from zero to eight, with zero standing for those households reporting no experience of food insecurity across all eight dimensions of food insecurity. Based on the various indicators and questions used to measure Food Insecurity Experience Scale (FIES), we also aim to generate an indicator variable for measuring the level of food insecurity.
4. Availability of food stock or saving to satisfy food needs: this is elicited by asking households whether they have food stocks and savings that can satisfy their food needs for some time. We specifically ask how long their household can meet its food needs from food stocks and using cash savings. We then generate a binary indicator for those without food stocks or saving.
5. Subjective Well-being: this is measured using an ordered indicator of overall life satisfaction. This scale ranges from 1 (“completely dissatisfied”) to 10 (“completely satisfied”).
6. Perceived stress level. We use two measures of perceived stress level. One that captures the overall perceived stress of respondents related to everything in their life, like work, family, health, and so on. This is a scale ranging from 1 (not stressed at all) to 10 (extremely stressed). A second and more comprehensive stress measure is constructed from 10 questions in the standard stress assessment instrument Perceived Stress Scale (PSS). Respondents are asked 10 questions on their feelings and thoughts over the last month.
7. Anxiety. We measure anxiety level using the General Anxiety Disorder -7 (GAD-7) instrument. The GAD-7 module includes 7 questions to elicit symptoms of anxiety. The GAD-7 consists of 7 questions that ask respondents how often they have been bothered by specific symptoms of anxiety in the past two weeks. Each item response is scored as 0 – not at all, 1 – several days, 2 – more than half days, and 3 – nearly every day. These scores are then summed to generate an anxiety score as well as binary indicators of moderate or severe anxiety.

1. Preference for digital vs cash vs in-kind
2. Willingness to pay for digital transfers over cash transfers
3. Generalized trust, social cohesion, and trust in institutions, including trust in NGO

The intervention follows individual-level randomization in which 2586 households are randomly assigned into a control group or one of two treatment arms. The treatment assignment is based on (i) whether a household receives any transfer or not; and (ii) the size of the transfer assigned to each household. We assign about 38 percent of the households to the control group and the remaining 62 percent to the treatment group. We further split the treatment group households into one of two treatment arms: those assigned to receive 50 USD (equivalent to the monthly WFP transfer for an average family) and those assigned to receive 75 USD. Figure 1 shows the random assignment and associated control and treatment groups.

Not available

The randomization was done at the household level based on data coming from a pre-transfer survey.

Household level

No

2586 household

2586 household

C (Control): 990 households
T1 (small digital transfer): 795 households
T2 (large digital transfer): 801 households

We compute the minimum number of households needed for each arm considering the primary outcomes described above. Although our total sample is fixed, computing the number of households needed for each treatment arm to detect meaningful impact can inform us about the relative size of our sample compared to an ideal setting. We assume an attrition rate of 10 percent and hence we expect to revisit about 2300 households in our endline survey. Our power calculations aim to achieve 80 percent power at a significance level of 5 percent. We compute these power calculations considering only the primary outcomes described above. We focus on quantifying the impact of the two variants of digital transfers on short-term welfare outcomes of households. As described above, our outcomes of interest include: households’ dietary diversity score (HDDS), experience of food insecurity, subjective well-being, perceived stress level, and anxiety. We compiled mean and standard deviation of these primary outcomes as well as minimum detectable effects (MDEs) for each outcome using the baseline sample as well as other external data and evidence from previous studies. The mean HDDS in our baseline stands at about 7 food groups. Previous studies that evaluated comparable cash transfers programs report average impacts ranging from 6-12 percent increase (Hidrobo et al., 2014; Savy et al., 2020; Leight et al., 2023; Abay et al., 2023). In our study, we assumed 9 percent increase for the continuous outcomes described above. For the binary outcomes, we assumed a 6-7 percentage point reduction. Table 1 summarizes our power calculations involving several primary outcomes meant to test alternative hypotheses. We miss baseline data for anxiety and life satisfaction and hence, the mean and standard deviations reported in Table 1 come from external data. Following these assumptions and features, the results in Table 1 show that the number of respondents in our sample are much larger than the number needed for meaningful impacts for most outcomes, except for detecting impacts on anxiety score. Thus, effectively, the sample sizes reported in Table 1 suggest that our sample enables us to detect even slightly smaller impacts.