Changes in food insecurity indicators and household coping strategies, before and after the food voucher strategy in Medellín, Colombia (2024)
DOI:
https://doi.org/10.15517/3dfx2846Keywords:
food security, food assistance, vulnerable populations, public policyAbstract
Introduction: Food insecurity refers to the difficulty individuals face in accessing safe food in sufficient quantity and quality to meet their nutritional requirements, in accordance with their tastes and preferences, thereby enabling a healthy and active life. In the District of Medellín, food assistance strategies to ensure access to food among vulnerable groups through the distribution of food packages and vouchers. The objective of this study was to evaluate the effect of the periodic delivery of vouchers redeemable for food on households' perceptions of food security and coping strategies using questionnaires administered before and after participation in the project. Methodology: A secondary-source, longitudinal observational study was conducted with a sample of 317 households benefiting from the food voucher program during 2024. The results of the measurements taken before and after the intervention were analyzed using the food insecurity perception and coping strategies questionnaires, comparing the changes observed at both times. Results: The provision of food vouchers had a positive effect on reducing the classification of perceived food insecurity reflected in decreased median score from 12 to 5 points and the changes in RCSI scores from 21 to 10 points, indicating more than half following the intervention. Conclusions: Although the periodic distribution of food vouchers had a positive effect on the perception of food security and on reducing coping strategies among beneficiary households, given the multifactorial nature of food insecurity, this strategy should be complemented by actions aimed at strengthening livelihoods and improving the socioeconomic conditions of households.
Downloads
References
Alcaldía de Medellín. (2018). Política pública de seguridad y soberanía alimentaria y nutricional de Medellín: Plan de seguridad y soberanía alimentaria y nutricional del municipio de Medellín.
Alcaldía de Medellín. (2024a). Plan de desarrollo municipal “Medellín Te Quiere” 2024–2027. https://www.medellin.gov.co/es/wp-content/uploads/2025/05/Plan-de-Desarrollo-Distrital-2024-2027.pdf
Alcaldía de Medellín. (2024b). Resultados encuesta de calidad de vida, 2024. Departamento Administrativo de Planeación. https://www.medellin.gov.co/es/departamento-administrativo-de-planeacion/
Concejo de Medellín. (2005). Acuerdo municipal 38 de 2005 (julio 30): Por el cual se establece la política pública de seguridad y soberanía alimentaria y nutricional en Medellín. https://www.medellin.gov.co/es/wp-content/uploads/2022/08/acuerdo-0038-2005.pdf
Concejo de Medellín. (2013). Acuerdo municipal 100 de 2013 (enero 17): Por medio del cual se complementa el Acuerdo municipal 38 de 2005 que establece la política pública de seguridad y soberanía alimentaria y nutricional en Medellín. https://www.medellin.gov.co/es/wp-content/uploads/2022/08/Acuerdo-100-de-2013.pdf
Dad, F., Dibari, F., Kebede, A., Lefu, E., Ndumiyana, T., & Butaumocho, B. (2023). Digitalisation in the WFP fresh food voucher programme: A pilot study from rural Amhara region, Ethiopia. Frontiers in Nutrition, 10, Article 1217794. https://doi.org/10.3389/fnut.2023.1217794 DOI: https://doi.org/10.3389/fnut.2023.1217794
De Groot, R., Palermo, T., Handa, S., Ragno, L. P., & Peterman, A. (2017). Cash transfers and child nutrition: Pathways and impacts. Development Policy Review, 35(5), 621–643. https://doi.org/10.1111/dpr.12255 DOI: https://doi.org/10.1111/dpr.12255
Departamento Administrativo Nacional de Estadística y Organización de las Naciones Unidas para la Alimentación y la Agricultura. (2022). Nota estadística: Escala de experiencia de inseguridad alimentaria-FIES. https://www.dane.gov.co/files/investigaciones/notas-estadisticas/NotaEstadistica-FIES-DANE-FAO.pdf
Departamento Nacional de Planeación. (2008, marzo 31). Documento Conpes Social 113: Política nacional de seguridad alimentaria y nutricional (PSAN). https://www.minagricultura.gov.co/Normatividad/Conpes/Conpes%20113%20de%202008.pdf
Fang, T., Tran, A., Oranga, B., Kopper, R., & Kang, Y. (2024). Associations between a cash voucher intervention, food consumption, and coping strategies in Somali food-insecure populations. Agriculture & Food Security, 13(1), Article 8. https://doi.org/10.1186/s40066-023-00458-w DOI: https://doi.org/10.1186/s40066-023-00458-w
Garner, J. A., Coombs, C., Savoie-Roskos, M. R., Durward, C., & Seguin-Fowler, R. A. (2020). A qualitative evaluation of Double Up Food Bucks Farmers’ Market incentive program access. Journal of Nutrition Education and Behavior, 52(7), 705–712. https://doi.org/10.1016/j.jneb.2019.11.010 DOI: https://doi.org/10.1016/j.jneb.2019.11.010
Hernández-Vásquez, A., Visconti-Lopez, F. J., & Vargas-Fernández, R. (2022). Factors associated with food insecurity in Latin America and the Caribbean countries: A cross-sectional analysis of 13 countries. Nutrients, 14(15), 3190, Article 3190. https://doi.org/10.3390/nu14153190 DOI: https://doi.org/10.3390/nu14153190
IndiKit. (s. f.). Índice de estrategias de afrontamiento reducido (rCSI). https://es.indikit.net
López, L. P. M., Castaño, L. S. Á., & Isaza, E. J. P. (2017). Las políticas alimentarias y nutricionales en Colombia y América Latina: Historia, contexto y desafíos. Editorial Universidad de Antioquia. https://libros.udea.edu.co/index.php/editorial_udea/catalog/book/25
Melcon, M. O., Alet, M. J., & Ameriso, S. F. (2025). Sesgos en neuroepidemiología: Consecuencias y recomendaciones. Neurología Argentina, 17(2), 112–120. https://doi.org/10.1016/j.neuarg.2025.04.002 DOI: https://doi.org/10.1016/j.neuarg.2025.04.002
Miguel-Berges, M. L., Jimeno-Martínez, A., Larruy-García, A., Moreno, L. A., Rodríguez, G., & Iguacel, I. (2022). The effect of food vouchers and an educational intervention on promoting healthy eating in vulnerable families: A pilot study. Nutrients, 14(23), 4980, Article 4980. https://doi.org/10.3390/nu14234980 DOI: https://doi.org/10.3390/nu14234980
Mohammadi-Nasrabadi, F., Omidvar, N., Vedadhir, A., Khoshfetrat, M.-R., Houshyar-Rad, A., Abdollahi, M., Zerafati-Shoae, N., & Mehrabi, Y. (2023). Cash transfer versus staple food subsidies: An effective factor on food security and expenditure of urban households in Iran. Journal of Nutrition and Food Security. https://doi.org/10.18502/jnfs.v8i2.12596 DOI: https://doi.org/10.18502/jnfs.v8i2.12596
Nchanji, E. B., & Lutomia, C. K. (2021). Regional impact of COVID-19 on the production and food security of common bean smallholder farmers in Sub-Saharan Africa: Implication for SDGs. Global Food Security, 29, 100524, Article 100524. https://doi.org/10.1016/j.gfs.2021.100524 DOI: https://doi.org/10.1016/j.gfs.2021.100524
Nguyen, B., & Drees, B. M. (2022). Food and nutrition security in clinical settings. Missouri Medicine, 119(2), 167–172.
Organización de las Naciones Unidas para la Alimentación y la Agricultura, Fondo Internacional de Desarrollo Agrícola, Organización Panamericana de la Salud, Organización Mundial de la Salud, Fondo Internacional de Emergencia de las Naciones Unidas para la Infancia y Programa Mundial de Alimentos. América Latina y el Caribe: Panorama regional de la seguridad alimentaria y la nutrición 2024. https://doi.org/10.4060/cd3877es DOI: https://doi.org/10.4060/cd3877es
Organización de las Naciones Unidas para la Alimentación y la Agricultura, Fondo Internacional de Desarrollo Agrícola, Fondo Internacional de Emergencia de las Naciones Unidas para la Infancia, Programa Mundial de Alimentos y Organización Mundial de la Salud. (2024). El estado de la seguridad alimentaria y la nutrición en el mundo 2024. https://doi.org/10.4060/cd1254es DOI: https://doi.org/10.4060/cd1254es
Pouwels, K. B., Widyakusuma, N. N., Groenwold, R. H. H., & Hak, E. (2016). Quality of reporting of confounding remained suboptimal after the STROBE guideline. Journal of Clinical Epidemiology, 69, 217–224. https://doi.org/10.1016/j.jclinepi.2015.08.009 DOI: https://doi.org/10.1016/j.jclinepi.2015.08.009
Programa Mundial de Alimentos [PMA]. (2026). Reduced Coping Strategies Index (rCSI). VAM Resource Centre. https://vamresources.manuals.wfp.org/docs/reduced-coping-strategies-index
Rodríguez-Villamil, N., & Arboleda-Montoya, L. M. (2022). Estrategias de afrontamiento para acceder a los alimentos en hogares del departamento de Antioquia, Colombia. Cadernos de Saúde Pública, 38(3), Article e00146521. https://doi.org/10.1590/0102-311x00146521 DOI: https://doi.org/10.1590/0102-311x00146521
Röth Deubel, A. N. (2011). Introducción para el análisis de las políticas públicas. Cuadernos de Administración, 19(30), 113–128. https://doi.org/10.25100/cdea.v19i30.120 DOI: https://doi.org/10.25100/cdea.v19i30.120
Saldivar-Frausto, M., Unar-Munguía, M., Méndez-Gómez-Humarán, I., Rodríguez-Ramírez, S., & Shamah-Levy, T. (2022). Effect of a conditional cash transference program on food insecurity in Mexican households: 2012–2016. Public Health Nutrition, 25(4), 1084–1093. https://doi.org/10.1017/S1368980021003918 DOI: https://doi.org/10.1017/S1368980021003918
Savy, M., Fortin, S., Kameli, Y., Renault, S., Couderc, C., Gamli, A., Amouzou, K., Perenze, M. L., & Martin-Prevel, Y. (2020). Impact of a food voucher program in alleviating household food insecurity in two cities in Senegal during a food price crisis. Food Security, 12(2), 465–478. https://doi.org/10.1007/s12571-019-00996-x DOI: https://doi.org/10.1007/s12571-019-00996-x
Segall Corrêa, A. M., Álvarez Uribe, M. C., Melgar-Quiñónez, H., & Pérez-Escamilla, R. (2012). Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA): Manual de uso y aplicación. Comité Científico de la ELCSA. https://openknowledge.fao.org/server/api/core/bitstreams/a14d12d0-db25-4356-a33d-f89dbeeebb09/content
Shi, A. X., Zivich, P. N., & Chu, H. (2024). A comprehensive review and tutorial on confounding adjustment methods for estimating treatment effects using observational data. Applied Sciences, 14(9), Article 3662. https://doi.org/10.3390/app14093662 DOI: https://doi.org/10.3390/app14093662
Sullivan, G. M., & Feinn, R. (2012). Using effect size—Or why the p value is not enough. Journal of Graduate Medical Education, 4(3), 279–282. https://doi.org/10.4300/JGME-D-12-00156.1 DOI: https://doi.org/10.4300/JGME-D-12-00156.1
Sumsion, R. M., June, H. M., & Cope, M. R. (2023). Measuring food insecurity: The problem with semantics. Foods, 12(9), Article 1816. https://doi.org/10.3390/foods12091816 DOI: https://doi.org/10.3390/foods12091816
Swart, E., Bitzer, E., Gothe, H., Harling, M., Hoffmann, F., Horenkamp-Sonntag, D., Maier, B., March, S., Petzold, T., Röhrig, R., Rommel, A., Schink, T., Wagner, C., Wobbe, S., & Schmitt, J. (2016). STandardisierte BerichtsROutine für Sekundärdaten Analysen (STROSA) – ein konsentierter Berichtsstandard für Deutschland, Version 2. Das Gesundheitswesen, 78(S1), e145–e160. https://doi.org/10.1055/s-0042-108647 DOI: https://doi.org/10.1055/s-0042-108647
Teta, I., Foudjo, B. U. S., Nielsen, J. N., Oben, J., Nguefack-Tsague, G., Ntentie, F. R., Cakir, V., Klemm, R., & Kang, Y. (2023). Outcomes of a food voucher program and factors associated with the recovery rate of children with moderate acute malnutrition in Far North Cameroon. Journal of Health, Population and Nutrition, 42(1), Article 37. https://doi.org/10.1186/s41043-023-00379-1 DOI: https://doi.org/10.1186/s41043-023-00379-1
Vandenbroucke, J. P., Von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., & Egger, M. (2009). Mejorar la comunicación de estudios observacionales en epidemiología (STROBE): Explicación y elaboración. Gaceta Sanitaria, 23(2), 158.e1–158.e28. https://doi.org/10.1016/j.gaceta.2008.12.001 DOI: https://doi.org/10.1016/j.gaceta.2008.12.001
Vasudev, C., Mishra, S., Rathi, A., Fledderjohann, J., & Vellakkal, S. (2026). Diverse coping strategies for food insecurity: A qualitative study of economically precarious households in India in the context of COVID-19. PLOS ONE, 21(6), Article e0350020. https://doi.org/10.1371/journal.pone.0350020 DOI: https://doi.org/10.1371/journal.pone.0350020
Wei, J. C., Kuo, P., & Chang, R. (2025). Strategies to avoid confounders and bias in observational studies. International Journal of Rheumatic Diseases, 28(1), Article e70076. https://doi.org/10.1111/1756-185X.70076 DOI: https://doi.org/10.1111/1756-185X.70076
Wijesinghe, M. S. D., Karawita, U. G., Nissanka, N. A. K. A., Gunawardana, B. M. I., Weerasinghe, W. M. P. C., Supun, Y. A., Peiris, D. R., Bandara, R. D., & Batuwanthudawe, R. (2024). Improving dietary diversity and food security among low-income families during financial crisis using cash transfers and mHealth: Experience from two selected districts in Sri Lanka. BMC Nutrition, 10(1), Article 150. https://doi.org/10.1186/s40795-024-00958-3 DOI: https://doi.org/10.1186/s40795-024-00958-3
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Jenifer Puerta Zapata, Elizabeth Cristina Sánchez Orozco, Catalina Echavarría Osorio, Valeria Yánez Triana, Manuela Arango Ruiz, Santiago Gómez Velásquez (Autor/a)

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Population and Health in Mesoamerica informs its authors and readers that all publications must be submitted with the Letter of Acceptance of Copyright Conditions where the authors are asked for authorization to submit the article to the Journal for consideration so that it may carry out any of the following activities:
- The graphic and style editing of the work or part of it.
The publication and reproduction of the work or part of it, both in print and electronic media, including the Internet and any other known or unknown technology.
The translation of the work or part of it into any language or dialect.
The adaptation of the work to reading, sound, voice and any other available technical representation or mechanism, which makes possible its access for partially or totally blind people, or with any other form of special abilities that prevent their access to the conventional reading of the article.
The distribution and availability of the work to the public, in such a way that the public may have access to them from the time and place that each person chooses, through the physical or electronic mechanisms available to them.
Any other form of use, process or system known or to be known that is related to the activities and editorial purposes to which the Journal is linked.
You can access the Letter by clicking HERE. If you have a question, please write to revista.ccp@ucr.ac.cr
In addition, the content of this site is protected under the Attribution - Noncommercial - Share Alike (by-nc-sa) license which permits commercial use of the original work or derivative works and distribution of which must be made under the same license that governs the original work. The graphic design, images and texts generated by the e-Information Science magazine are property of the Universidad de Costa Rica and are licensed under Creative Commons Attribution - NonCommercial - Attribution-ShareAlike 4.0 International.
Authors who publish in this journal accept the following conditions:
-The authors retain their moral rights over the publication and assign the patrimonial rights mentioned in the Letter of Assignment of Rights with the Creative Commons Attribution - NonCommercial - Compatitr Equal 4.0 International license, which allows third parties to use what is published as long as they mention the authorship of the work and to the first publication in this journal.
-Authors may make other independent and additional contractual arrangements for non-exclusive distribution of the version of the article published in this journal (e.g., inclusion in an institutional repository or publication in a book) as long as they clearly indicate that the work was first published in this journal.
This policy is established in accordance with Law 6638 on Copyright and Related Rights of the Republic of Costa Rica.
