Impact of two policy interventions on dietary diversity in Ecuador

Objective: To differentiate the effects of food vouchers and training in health and nutrition on consumption and dietary diversity in Ecuador by using an experimental design. Design: Interventions involved enrolling three groups of approximately 200 randomly selected households per group in three provinces in Ecuador. Power estimates and sample size were computed using the Optimal Design software, with a power of 80%, at 5% of significance and with a minimum detectable effect of 0.25 (SD). The first group was assigned to receive a monthly food voucher of $US 40. The second group was assigned to receive the same $US 40 voucher, plus training on health and nutrition issues. The third group served as the control. Weekly household values of food consumption were converted into energy intake per person per day. A simple proxy indicator was constructed for dietary diversity, based on the Food Consumption Score. Finally, an econometric model with three specifications was used for analysing the differential effect of the interventions. Setting: Three provinces in Ecuador, two from the Sierra region (Carchi and Chimborazo) and one from the Coastal region (Santa Elena). Subjects: Members of 773 households randomly selected (n 4343). Results: No significant impact on consumption for any of the interventions was found. However, there was evidence that voucher systems had a positive impact on dietary diversity. No differentiated effects were found for the training intervention. Conclusions: The most cost-effective intervention to improve dietary diversity in Ecuador is the use of vouchers to support family choice in food options.