displaced people around the world are facing a

nutrition crisis

Page summary

"90% of (medical) problems that we see are related to poor nutrition caused by diet." 

- Doctor working in Vial Camp, Greece (2022)


This quote came from an interview I conducted while trying to understand the nutrition situation in the camp.  The doctor went on to explain that the food people received was lacking in protein and vitamins. As a direct result, her team would frequently come across refugees in Vial suffering from various digestive health issues. 


Sadly, Vial Camp was not an exception...

Vial Camp, Greece (2021)

... undernutrition in refugee camps is a common challenge

Many camps have high rates of chronic and acute malnutrition


Relevant details

There are four types of undernutrition:

Refugees living in camps have been found to be living in severe food-insecure situations



Food insecurity has been linked to low diet diversity, which increases micronutrient and macronutrient deficiencies

Common deficiencies amongst refugees include: Iron, Vitamin D, Vitamin A, Zinc, B12, Niacin, Iodine, Thiamine, Vitamin C.

There are four dimensions to food security:

Field hospital in Cox's Bazar, Bangladesh (2021)

Photo: Anadolu Agency

The health impacts are severe

Also worrying are the coping methods of food insecure populations

Photo: ACW

Türkiye, 2024

84% of refugee households adopted a negative coping mechanism to manage the food insecurity. Some examples were:

Photo: SAFA

Ethiopia, 2023

98.2% of refugee households employed at least one negative coping strategy to cater for food needs. Strategies included:

Key points

A hypothesis on what is going wrong

Key points (hypothesis)

Mavrovouni Camp, Greece (2022)

Za'atari Camp, Jordan (2014)

Photo: ABC News

Why are camps causing reliance on humanitarian food systems?

Of the 43.7 million refugees worldwide, more than 6.6 million people reside in camps, with 70% residing in planned camps, and 30% in self-settled camps.

Refugee camps are designed to be temporary solutions, but if historical trends hold, most of these 6.6 million people will spend between 10 to 15 years of their lives in a camp. 

Camps are largely aid dependent, and this is driven by a few factors.

Key point

Photo: WFP

What methods of delivery do humanitarian food systems employ?

WFP is UNHCR's main partner in ensuring refugee food needs are met, and it is involved in food provision to refugees at sites where the population exceed 5000. Up to 5000 people, the UNHCR is responsible for meeting the food needs of the population.

These organisations tend to distribute provisions through in-kind food transfers, Cash-Based Transfers (CBTs), or a combination of the two. CBTs might include cash or food vouchers.

Since the early 2000s, the WFP has been moving away from in-kind food transfers and implementing more CBT programs. A large rationale for this is to encourage greater dietary diversity amongst beneficiaries and to give them more autonomy over their diet.

Nonetheless, in 2023, the WFP still reached twice as many beneficiaries via in-kind food transfers (100.6m) as they did through CBTs (51.6m). In-kind food transfers still form the bulk of the WFP's distribution. 

The organisation is committed to assessing and choosing the modality of distribution (or the combination of modalities) that best suits each specific context.

In-kind transfers: the harsh reality

Zimbabwe, 2014

Monthly rations (1 person):

Maize meal 10kg

Rice 2kg

Sugar beans 2kg

Corn soya blend 2kg

Vegetable oil 750ml

Sugar 500g

Salt 125g

Sources: UNHCR & WFP Joint Assessment of Tongogara Refugee Camp (2014)

*note: it is possible that this camp has shifted entirely to CBTs since

Bangladesh, 2020

Monthly rations (1-3 people):

Rice 30kg

Lentils 9kg

Cooking oil 3l


Sources: Hoddinott J, Dorosh P, Filipski M, Rosenbach G, Tiburcio E. (2020) Food transfers, electronic food vouchers and child nutritional status among Rohingya children living in Bangladesh. PLoS One.;
The Telegraph; The New Humanitarian

*note: some groups in Bangladesh receive CBTs instead

Iran, 2024

Monthly rations (1 person):

Fortified wheat flour 12kg

Vegetable oil 810ml

Cash (male HH) $5.50

Cash (female HH) $6.60


Source: WFP Iran Country Brief (Dec 2024) 

Reading the monthly rations distributed by the WFP in different countries, it becomes clear that a common feature is the staple-heavy diet and lack of fresh foods. In fact, the WFP frequently acknowledges that their rations often fail to meet micronutrient intake standards. 

For instance, a report on their food provision in Liberia stated:

In its 2023 Annual Performance Report (left), the WFP conceded that only 1.4% of their in-kind transfers were 'nutritionally adequate' in 2023.



One study suggests that because of the long distances that food needs to travel to reach refugees, it is not logistically feasible to distribute perishable foods, and thus it is inevitable that displaced populations are deficient in micronutrients such as iron, riboflavin, and Vitamin C.


Key points

Are cash transfers the answer?

The general view in the literature on this topic appears to be that beneficiaries receiving cash transfers generally appear to have increased dietary diversity outcomes, while those receiving in-kind food transfers have larger increases in calories consumed. Thus, depending on what the goal of the program is, both approaches could be appropriate. 

As Bailey points out, the pertinent question as to whether cash transfers are an appropriate tool is whether undernutrition is an issue of availability or access. If the issue is access, then cash transfers can help people to overcome that access gap. If the problem is availability, for instance in an isolated market, then cash may simply drive up the price of goods. 

Photo: UNICEF

Key point

However, funding gaps and budget cuts means dependence all forms of humanitarian food assistance is risky

In the last few years, global shocks such as COVID and the war in Ukraine have diverted funds away from other ongoing humanitarian situations. In turn, humanitarian organisations have had to cut back on their provisions to displaced populations, leaving many in precarious situations.


Aside from global shocks, humanitarian organisations often report large funding gaps that prevent them from meeting the needs of the populations they serve.

Food aid meant for displaced populations are cut with alarming frequency. 


Refugees have limited voice, and in moments of budget cuts they often bear the brunt of the cuts directly. These populations live with the uncertainty of not knowing if they will be provided food support in the coming months.


As we have seen, the impacts are brutal - malnutrition and mortality spikes when too little food is available for populations in need.

Closing thoughts


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