Food and Nutrition, Innovation, and Participation: How Refugees from Myanmar Adapted Electronic Card Vouchers to Promote Dignity and Improve Nutrition

Source: Wed, 8 Nov 2017 02:41 PM
Padee Go Laa who lives in Mae La camp. Copyright: The Border Consortium
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Author: Maria Bovill and Edel Silan, The Border Consortium, November 2017

Approximately 100,000 refugees live along the Thailand-Myanmar border in nine refugee camps. The camps are under the control of Thailand’s Ministry of Interior and basic humanitarian services are delivered by non-governmental organisations (NGOs) with support from international donors.  The Border Consortium (TBC) is the main agency providing food, nutrition, shelter and camp management support for the past three decades.  TBC has been providing a food basket of rations to refugee households composed mainly of rice, beans, fish or shrimp paste, oil and salt, as well as supplementary food for malnourished children, pregnant women and nursing mothers in all nine refugee camps. Living conditions are very simple in these camps; most have no access to electricity and are blocked off from phone signals.

TBC broke new grounds in mid-2016 when it began to pilot a Food Card System in two of the nine camps. The refugees in these two pilot camps are mainly from the Karen Ethnic nationality from Myanmar who have sought protection from the conflicts in their communities for three decades now. The Food Card System enables refugees to buy their own food and therefore, promotes decision-making and dignity within the communities. Using food cards to support food security and nutrition instead of distributing food rations allows recipients to make their own dietary choices, from a wider range of food products available in the market, and provides an opportunity to promote improved nutritional status.

 

The Innovation: A Food Card System. In Nu Po and Tham Hin camps, the Food Card System was piloted with approximately 40% of families in each camp, all of whom volunteered. The food card offered households the opportunity to buy food from designated shops in camp markets, also run by refugees, giving them more control and ability to expand their food choices. With the food card, the refugees can now opt to buy not just rice, oil, beans, fish or shrimp paste and salt, as in their typical food baskets. They now have the choice to select vegetables, fish, eggs, meat and spices using their food card.   

The Food Card System also introduced refugees to buying goods and services using a more modern electronic system. The food card functions like a debit card and vendors use android phones and printers to record sales, compute balances, print out official receipts of purchases made by the refugees, and record their sales on a daily basis.

 

Participation. The system was conceptualised and developed with full participation of the communities. A Food Card System Working Group, comprised of refugees, managed the system day-to-day, and together with TBC, identified and accredited vendors and set up complaints and response mechanisms to resolve food card-related issues. Based on vulnerability category assigned under Community Managed Targeting (Annex 1), participating households received Thai Baht credits on their food cards, which could be spent at any accredited vendor’s shop.

Many elements went into successfully developing a working market. It was necessary to identify suppliers, train vendors and develop strategies to address issues that might arise for households with special needs. The Nutrition Programme developed nutrition messaging for the Food Card System to promote dietary diversity. TBC worked with the Camp Management Committee to assist them in developing governance structures to manage the system. Positive response by the community to the new system was greater than anticipated. Households were part of decision making about which sections would be the first to try out the system and how the scale up would be organised. All households cooperated in training and trials on the use of their food cards, and continue to actively engage in the continuing monitoring of the system and the market. 

 

Nutrition. The Food Card System was implemented to support food security/nutrition, with the primary objective being one of food security, while providing more food choices and budgeting responsibilities to households to prepare for their future. TBC piloted the use of hand-held Androids for Post Distribution Monitoring (PDM) data collection for the Food Card System. As the use of the food card has the added benefit of expanding dietary diversity over the food ration, the Nutrition Programme developed tools to integrate nutrition messages in the system, as well as to measure changes related to nutrition with the shift from the commodity food basket distribution.  

Food Card System messaging for nutrition pamphlets and posters (Annex 2) were developed to show the importance of using the card to purchase foods from all three food groups to promote good health for families. Pamphlets were provided to each household in the pilot; posters were provided to the accredited vendors to display in their shops so that at the point of purchase, participants would be reminded to select from all three food groups. Materials were translated in Karen and Burmese. Finally, the Nutrition Programme provided a segment of the vendor training accreditation on proper food sanitation and hygiene practices and importance for good health.

The Food Consumption Score Nutritional Quality Analysis (FCS-N)[i] and Household Hunger Scale[ii] were incorporated into the PDM (Annex 3) as the nutrition components to detect differences pre- to post-Food Card System and to determine and understand gains/challenges related to diet diversity and hunger.

The PDM results indicated overall satisfaction among food card holders and vendors with the Food Card System. The food card offered households the dignity of choice and flexibility when shopping from designated vendors, while promoting well-being of families through dietary diversity. The food card provided increased access to milk, eggs, meat, fruits and vegetables – important sources of macro- and micronutrients. Households that received the food card were more food secure with no severe hunger compared to households receiving the food ration. Nutrition education should continue to focus on the importance of dietary diversity.

 

Participation Works. The Grand Bargain[iii] calls for a “participation revolution” in which organisations listen more and include affected communities in decisions that have an impact on them. TBC’s implementation of the Food Card System in the refugee camps along the Thailand-Myanmar border provides an illustration of how such depth of participation can happen. The success of the Food Card System hinges on community participation – a system shaped by the refugees who comprise the Working Group responsible for creating the infrastructure to manage day to day operations, incorporating feedback into the system;  the vendors, suppliers, and auxiliary support services,  who have organised themselves to comprise a functioning community market;  and the food card holders themselves, who fully engaged with the leaders and TBC in training, testing and now in monitoring the system. The refugees are no longer mere recipients of this food aid system, as they have gained a sense of power and the ability to make and influence decisions that directly impact their lives. The results are promising.

 

For further information: Maria Bovill, The Border Consortium, www.theborderconsortium.org

 

Endnotes

[i] Food Consumption Score Nutritional Quality Analysis (FCS-N), Technical Guidance Note, World Food Programme, First Edition, August 2015.

[ii] Ballard, Terri; Coates, Jennifer; Swindale, Anne; and Deitchler, Megan. Household Hunger Scale: Indicator Definition and Measurement Guide. Washington, DC: Food and Nutrition Technical Assistance II Project, FHI 360, August 2011.

[iii] https://interagencystandingcommittee.org/grand-bargain-hosted-iasc.

Download PDF: Annex 1: Community Managed Targeting (English) Download PDF: Annex 1: Community Managed Targeting (English) Download PDF: Annex 2.1: Nutrition pamphlet (English) Download PDF: Annex 2.1: Nutrition pamphlet (English) Download PDF: Annex 2.2: Nutrition poster (English) Download PDF: Annex 2.2: Nutrition poster (English) Download PDF: Annex 3: Post Distribution Monitoring Form (English) Download PDF: Annex 3: Post Distribution Monitoring Form (English)

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