TABLE 1.

LIFT Referral Models in Malawi, by District

District	Referral Model Features	Referral Model Goals
Balaka	Linked clients to all community services that chose to be members of the referral network. LIFT conducted a thorough mapping of services and invited all interested organizations (government, CSO, NGO, etc.) to participate. Clients were expected to complete referrals themselves. Used CommCare, an mHealth app, for data collection and management. Providers made referrals for one service at a time to promote completion of the referral. There was no limit on the number of referrals a client could be given over time, although few (<1%) clients chose more than 1 referral. Full range of ES/L/FS services were included, based on what already existed in the community. LIFT did not create new services. Most popular services were microfinance, health, and government-supported services for agriculture and social welfare.	This first referral model was designed for local ownership and sustainability and featured a systems-level approach to referral network membership. This model also sought to accommodate clients across the vulnerability spectrum, offering referrals to existing economic strengthening services targeting less vulnerable households (such as microfinance), somewhat vulnerable households (such as savings groups or land rights education), and very vulnerable households (such as asset transfer).
Kasungu and Lilongwe	Linked clients directly from NCST sites to VSLA (clinic to community referral). When food aid was available at NCST sites, clients were also referred to food aid (within health facility referral). Clients were guided to VSLA by a referral volunteer to ensure completion. Used paper referral tools for data collection and management. Each client received one referral only. The options for referral were from the NCST site to VSLA, or vice versa, with referrals given to food aid on a limited basis. LIFT created VSLAs if none existed.	This second referral model was designed to be simpler to implement, in that it connected NCST clients directly to VSLA (and food aid, when available). In addition, this model took advantage of existing VSLAs to accelerate start-up time and reduce management costs.

Abbreviations: CSO, civil society organization; ES, economic strengthening; FS, food security; L, livelihood; LIFT, Livelihoods and Food Security Technical Assistance II project; NCST, Nutrition Counseling, Support, and Treatment; VSLA, village savings and loan association.