Modality preferences: Are uninformed choices leading us down the wrong road?
Photo: KC Nwakalor/GTS
Cash and voucher assistance, or CVA, is a clumsy term. Cash can be spent on anything, while on a scale of choice, dignity and empowerment, community feedback shows that vouchers are far closer to in-kind assistance. Grand Bargain signatories agreed to increase the use of cash and “build an evidence base to assess the costs, benefits, impacts, and risks of cash relative to in-kind assistance and vouchers.” Several donor policy documents show a clear preference for unconditional cash over vouchers or in-kind aid. So why do so many people in crisis regions report preferring vouchers?
Voucher users cite disempowerment, inefficiencies, and exploitation
GTS has been listening to the experiences of voucher recipients for years, and there are common themes. When people are given restricted vouchers for food, they rarely spend them on food items alone but sell them to buy other things they need, losing out on a lot of value in the process. Women are pressured to sell their vouchers far below their true value, as voucher vendors abuse the power imbalance and exploit people’s need for liquid cash. Vouchers often result in wasted resources, benefiting middlemen rather than people in need.
“Often vendors say rude things like ‘If you are unhappy, just go home. You cannot redeem your voucher anywhere but here.’ This kind of mistreatment leads us to sell our voucher at a very low price, sometimes half the actual voucher value. It is better to accept less and move on than to go back to the shops and be disrespected.”
The difficulties voucher recipients face at distribution points are well-documented. People in Nigeria reported that voucher vendors cheat them out of food supplies by using smaller measuring cups. Recipients in the Central African Republic (CAR) say they receive poor-quality goods in exchange for their vouchers.
“Some vendors do not allow us to choose preferred items, others shout at us.”
If vouchers are so problematic, why do people say they prefer them?
When we ask about ‘modality preferences’, as so many partners want us to do, many people still report preferring vouchers over cash. From over five thousand surveys across Nigeria, Somalia and the Central African Republic last year, we have identified three reasons why the stated preferences of affected people may contradict their experiences, and why simply asking people what type of aid they would prefer to receive may not deliver accurate data:
1. Familiarity bias – people prefer what they know
In Nigeria, where some 90% of CVA is delivered through vouchers, 47% of respondents said they preferred to receive vouchers, with a further 34% preferring a mix between vouchers and cash. Only 19% say they prefer cash. In CAR, we also see a clear pattern of people saying they prefer the modality they are currently receiving. Almost half (44%) of voucher recipients say they prefer to stick with vouchers, even though almost all (96%) of cash recipients think cash is king. In fact, 97% of people interviewed in CAR and 92% of people interviewed in Nigeria who said they preferred vouchers are current voucher recipients.
The argument that people are more likely to prefer what they know is not unique to aid, the ‘mere-exposure effect’ is well known in psychology and consumer behaviour alike. Some recipients may be concerned about the confusion or delays that a change in delivery mechanism could cause. Others may simply not be informed about what other options are available, or what the benefits of other modalities might be.
Luckily, familiarity can be built with investment in new technologies and solid communication, as seen in Somalia. After heavy investment in cash, and in particular in mobile money technologies, cash is thriving. As people have become familiar with the system, an overwhelming preference for mobile money emerges time and again – 96% of cash recipients would choose cash again, and even 77% of voucher recipients expressed a preference for cash.
2. The difficulty of comparing hypothetical alternatives
When asking people how they would like to receive aid in a quick survey, we are asking them to imagine a future scenario and compare their hypothetical wellbeing, often without giving any details about what receiving aid in this way would look like in practice. Some might find the idea of in-kind aid more convenient, but they might neglect to consider that the distribution location could be far from where they live, or that they might not receive the quality, quantity, or type of goods that they need. Preferences change seasonally and depending on other types of aid they are receiving, making comparisons even harder.
“[Aid providers] should be mixing food and money for us so that we can buy soap, firewood, water and so many other things with the money. That way the CVA would go further than it currently does.”
Problems with certain modalities or delivery mechanisms are all too easy to confuse with issues with the roll-out of an intervention. There may be cases where negative perceptions of a delivery mechanism are driven by technical issues, or a lack of information about how to use the system. If people request the provision of some in-kind goods, is it because that modality truly fits their circumstances better, or because the roll out of CVA was disorganised and unreliable? Taking quantitative data about modality preferences alone is risky, as it often does not tell you why people have this or that preference. Humanitarians cannot possibly know what they should fix.
3. Courtesy bias – the false friend
The final hurdle in obtaining honest and informed feedback from people is cultural – many people say they simply do not find it appropriate or polite to criticise humanitarians. Others are grateful for the aid they receive and so are cautious in suggesting changes in case doing so has negative consequences for them. Courtesy bias strengthens the power of the status quo.
“I know it will sound improper for someone receiving assistance to criticise it, but since you insisted that we should voice it, the aid is not really covering our most important needs.”
We see evidence that the preferences people express may not correspond with their true needs or wishes. In Nigeria, where only 19% said they would prefer to receive some form of unrestricted cash, 60% reported cash as their biggest unmet need.
Courtesy bias may be the most difficult to overcome, and demonstrates the importance of communicating with people about their right to participate in the aid that affects them. This includes the right to criticise. It also shows the importance of seeking to understand people’s experiences of an intervention, rather than just asking simple questions about satisfaction or preferences. Independent organisations play a vital role in ensuring a more complex picture of the response is used upon which to base decisions.
Choices are not choices if they’re uninformed
Some might question why we are worrying about this issue, or considering preferences for vouchers problematic. Shouldn’t we, as an organisation that exists to amplify the views of affected people, simply advocate for using vouchers if people prefer them?
If a preference for vouchers has been an informed decision, in a context where people are aware of the alternatives and feel empowered to voice their opinions, humanitarians should certainly take this into account. Adapting aid programming to people’s preferences is vital. If, however, this choice is inconsistent with other data, we must think again. Preferences that are coerced, intentionally or not, or given out of a need to be “grateful” cannot truly represent what people want. Likewise, contextual factors make preferences more tangible in some places than others. Some contexts, such as Somalia, are fertile ground for cash, facilitated by the proliferation of financial service providers which stimulate the market. CAR and parts of Nigeria lack the same fruitful landscape, yet this does not mean opportunities for cash have been exhausted. Making policy decisions based on preferences that are uninformed or based on limited services does not respect the dignity of affected people.
The responsibility for ensuring honest opinions drive action lies at multiple levels. Humanitarians must be aware of and strive to recognise and remove bias when gathering feedback. This usually requires qualitative research and long-term engagement and trust-building with communities, rather than just a short assurance before a survey that critique will have no negative impact on people’s aid. Donors and agencies should consider unrestricted aid as the default, aiming for cash where appropriate, and looking at voucher programmes that claim to align with people’s preferences with a critical eye. Only by examining biases and analysing data holistically can we understand preferences in a meaningful way, and adapt programming accordingly.
Ground Truth Solutions has been amplifying the views of cash and voucher assistance (CVA) recipients through its Cash Barometer project since 2019. The Cash Barometer is an independent mechanism for accountability that uses representative face-to-face surveys and qualitative approaches to allow CVA recipients to provide feedback and impact decision-making.
