Summary of findings 4. Food vouchers compared to no intervention for food security.

Food vouchers compared to no intervention for food security
Patient or population: poor households Setting: urban and agrarian communities in LMICs Intervention: food vouchers Comparison: no intervention
Outcomes	Impact	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
Prevalence of undernourishment	—	—	—	0 included studies reported this outcome.
Proportion of household expenditure on food	—	—	—	0 included studies reported this outcome.
Food security	—	—	—	0 included studies reported this outcome.
Dietary diversity assessed with: FCS follow‐up: 7 months to 1 year	2 studies reported improved dietary diversity (not pooled).	2459 households (2 RCT)	⊕⊕⊝⊝ Lowa,b	Food vouchers may improved dietary diversity slightly.
Stunting (HAZ < –2SD) follow‐up: 12 months	1 study reported reduced stunting (OR 0.48, 95% CI 0.31 to 0.73)	1633 children (1 RCT)	⊕⊕⊕⊝ Moderatec	Food vouchers probably reduce stunting.
Wasting (WHZ < –2SD) follow‐up: 12 months	1 study reports an unclear effect potentially favouring the control (OR 1.17, 95% CI 0.75, 1.82)	1633 children (1 RCT)	⊕⊕⊝⊝ Lowc,d	Food vouchers may result in little to no difference in wasting
Cognitive function and development	—	—	—	0 included studies reported this outcome.
CI: confidence interval; FCS: Food Consumption Score; HAZ: height‐for‐age z‐score; OR: odds ratio; RCT: randomised controlled trial; SD: standard deviation; WHZ: weight‐for‐height z‐score.
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded one level for overall risk of bias: two studies at high risk of selection and attrition bias.
^bDowngraded one level for inconsistency: confidence intervals had minimal overlap.
^cDowngraded one level for indirectness: findings are from one single study that assessed a programme of fresh food vouchers redeemed at designated vendors. Food vouchers may be implemented in different ways across different settings, e.g. for staple foods alone, or with, no vendor‐ restrictions.
^dDowngraded one level for imprecision: findings ranged from an important harm to important benefit.