Edoardo Masset

Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review

Objective To assess the effectiveness of agricultural interventions in improving the nutritional status of children in developing countries. Design Systematic review. Data sources Published and unpublished reports (after 1990) in English identified by searching 10 databases (Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Jolis, PubMed, Web of Science, and World Bank), websites, previous systematic reviews, and reference lists and by contacting experts. Study selection Included studies assessed effects of agricultural interventions aiming at improving the nutritional status of children (bio-fortification, home gardens, small scale fisheries and aquaculture, dairy development, and animal husbandry and poultry development). Only studies that used a valid counterfactual analysis were included. Before/after studies and participants/non-participants comparisons affected by selection bias were excluded. Data analysis Results were analysed for four intermediate outcomes (programme participation, income, dietary diversity, and micronutrient intake) and one final outcome (prevalence of under-nutrition). Analysis was by summary tables of mean effects and by meta-analysis (for vitamin A absorption). Results The review included 23 studies, mostly evaluating home garden interventions. The studies reviewed did not report participation rates or the characteristics of participants in programmes. The interventions had a positive effect on the production of the agricultural goods promoted, but not on households’ total income. The interventions were successful in promoting the consumption of food rich in protein and micronutrients, but the effect on the overall diet of poor people remains unclear. No evidence was found of an effect on the absorption of iron, but some evidence exists of a positive effect on absorption of vitamin A. Very little evidence was found of a positive effect on the prevalence of stunting, wasting, and underweight among children aged under 5. Conclusions The question posed by the review cannot be answered with any level of confidence. The data available show a poor effect of these interventions on nutritional status, but methodological weaknesses of the studies cast serious doubts on the validity of these results. More rigorous and better designed studies are needed, as well as the establishment of agreed quality standards to guide researchers in this important area.

Do Monetary and Non-Monetary Indicators Tell the Same Story About Chronic Poverty? A Study of Vietnam in the 1990s

This paper investigates whether monetary and non-monetary indicators tell the same story about chronic poverty using a unique two-period household panel from Vietnam in the 1990s. Using transition matrices and a simple measure of immobility, we find that monetary poverty is less persistent than malnutrition among adults and stunting among children (although there is some evidence of catch-up among stunted children). Monetary poverty is also found to be less persistent than primary and lower secondary school enrollments. Non-parametric tests on common samples reveal that the distributions of all these poverty indicators are different. Furthermore, defining chronic poverty to occur when an individual is monetarily poor, stunted, malnourished or out of school in both waves of the panel, we find the extent of overlap and correlation between the sub-groups of chronically poor is generally quite low. This implies that expanding the number of dimensions used to identify chronic poverty may not lead to greater clarity about the characteristics of chronic poverty.

Are Chronically Poor People being Left Out of Progress Towards the Millennium Development Goals? A quantitative analysis of older people, disabled people and orphans

The most useful poverty profiles are those based on functional groupings defined in relation to key livelihood features. This paper considers three groups, sometimes called the traditional poor, which are commonly identified as being poor in participatory poverty assessments: orphans, people with disabilities, and older people. Each group may be considered a functional classification because its members share similar livelihood strategies. This paper reports the level and trend in selected Millennium Development Goal-related welfare indicators for these groups, and compares these trends with those in the population as a whole in Bulgaria, Ghana, Nicaragua, Vietnam and Andhra Pradesh. It is generally found that these groups are relatively disadvantaged and in some respects experience less rapid progress than other population groups, suggesting the need for targeted efforts to support these disadvantaged groups to ensure progress toward meeting the Millennium Development Goals. This paper recommends changes in data collection for greater coverage of these groups and identifies some important research questions.

Improving community development by linking agriculture, nutrition and education: design of a randomised trial of “home-grown” school feeding in Mali

BackgroundProviding food through schools has well documented effects in terms of the education, health and nutrition of school children. However, there is limited evidence in terms of the benefits of providing a reliable market for small-holder farmers through “home-grown” school feeding approaches. This study aims to evaluate the impact of school feeding programmes sourced from small-holder farmers on small-holder food security, as well as on school children’s education, health and nutrition in Mali. In addition, this study will examine the links between social accountability and programme performance.DesignThis is a field experiment planned around the scale-up of the national school feeding programme, involving 116 primary schools in 58 communities in food insecure areas of Mali. The randomly assigned interventions are: 1) a school feeding programme group, including schools and villages where the standard government programme is implemented; 2) a “home-grown” school feeding and social accountability group, including schools and villages where the programme is implemented in addition to training of community based organisations and local government; and 3) the control group, including schools and household from villages where the intervention will be delayed by at least two years, preferably without informing schools and households. Primary outcomes include small-holder farmer income, school participation and learning, and community involvement in the programme. Other outcomes include nutritional status and diet-diversity. The evaluation will follow a mixed method approach, including household, school and village level surveys as well as focus group discussions with small-holder farmers, school children, parents and community members. The impact evaluation will be incorporated within the national monitoring and evaluation (M&E) system strengthening activities that are currently underway in Mali. Baselines surveys are planned for 2012. A monthly process monitoring visits, spot checks and quarterly reporting will be undertaken as part of the regular programme monitoring activities. Evaluation surveys are planned for 2014.DiscussionNational governments in sub-Saharan Africa have demonstrated strong leadership in the response to the recent food and financial crises by scaling-up school feeding programmes. “Home-grown” school feeding programmes have the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including small-holder farmers and women’s groups. Alongside assessing the more traditional benefits to school children, this evaluation will be the first to examine the impact of linking school food service provision to small-holder farmer income, as well as the link between community level engagement and programme performance.Trial registrationISRCTN76705891

Land Markets, Risk and Distress Sales in Nicaragua: The Impact of Income Shocks on Rural Differentiation

Farmers in the Nicaragua countryside face substantial risk due to legal uncertainty regarding property rights, price fluctuations and limited access to rural financial markets. Income shocks can lead to obligations to sell land, can fuel differentiation processes, and can drive people into poverty. We review empirical evidence on income shocks and related distress sales by households of different wealth endowments. From panel data of the 1995 and 2000 land market surveys, estimates are made to identify relevant farm household characteristics and the market forces that determine distress sales. Results show that small farms are most affected by idiosyncratic shocks and usually try to adopt a defensive strategy based on reduced consumption to retain their land resources. In the long run, this strategy occasionally succeeds in preserving land ownership and maintaining income at higher levels than those enjoyed by landless peasants. But the pressures towards distress sales can, nevertheless, be powerful, and different responses to income shocks by poor, middle and rich peasants are likely to increase rural differentiation.

What is the impact of a policy brief? Results of an experiment in research dissemination

Despite the popularity of policy briefs as a tool for disseminating research, there is no evidence of their effectiveness in changing peoples beliefs. We conducted an experiment whereby readers of a policy brief were randomly assigned to different versions of the brief and to a control group. We collected data on opinions and knowledge regarding the impact of agricultural interventions before and after reading a brief disseminating the conclusions of a systematic review. We found that the brief helped some readers to form an opinion, but we found no evidence of a change in prior beliefs. We recommend that more trials and laboratory experiments should be conducted to assess the efficacy of policy briefs and attitudes to evidence-based policy-making.

The targeting effectiveness of social transfers

ABSTRACT Many methodologies exist for dividing a population into those who are classified as eligible for social transfers and those who are ineligible. Popular targeting mechanisms include means tests, proxy means tests, categorical, geographic, community-based and self-selection. This paper reviews empirical evidence from a range of social protection programmes on the accuracy of these mechanisms, in terms of minimising four targeting errors: inclusion and exclusion, by eligibility and by poverty. This paper also reviews available evidence on the various costs associated with targeting, not only administrative but also private, social, psycho-social, incentive-based and political costs. Comparisons are difficult, but all mechanisms generate targeting errors and costs. Given the inevitability of trade-offs, there is no ‘best’ mechanism for targeting social transfers. The key determinant of relative accuracy and cost-effectiveness in each case is how well the targeting mechanism is designed and implemented.

An impact evaluation design for the Millennium Villages Project in Northern Ghana

This article details the design of an impact evaluation of the Millennium Villages Project in Northern Ghana. The evaluation is particularly challenging because the intervention cannot be randomised; it is clustered in a group of homogeneous communities and likely to generate spill-over effects. We propose a difference-in-differences design selecting control communities based on a propensity score and collecting five rounds of yearly data. We address a number of evaluation questions in relation to testing the breaking of the poverty trap, assessing project externalities, the role of qualitative research, cost-effectiveness and project synergies, sustainability and scalability in the presence of scale economies.

Systematic reviews of cost-effectiveness in low and middle income countries: a review of reviews

ABSTRACT We investigate whether systematic reviews of cost-effectiveness analyses of interventions in low and middle income countries are feasible and useful. To this aim, we systematically review systematic reviews of cost-effectiveness studies and systematic reviews of effectiveness studies. We find 27 systematic reviews of cost-effectiveness studies, predominantly of health interventions. We look at the methodologies employed by these reviews to summarise the results of the original studies and we look at the policy recommendations they provide. We conclude that systematic reviews of cost-effectiveness studies in developing countries are few and that their ability to provide policy recommendations is very limited. The paucity of cost-effectiveness analyses in developing countries and the difficulty to summarise the results of diverse cost-effectiveness analyses in a meaningful way are major problems. We suggest that the collection of cost data along impact evaluations and methodological development in the summary of cost-effectiveness ratios across studies constitute a more promising approach.

What have we learned after ten years of systematic reviews in international development

ABSTRACT The paper discusses the role of systematic evidence in helping make better decisions to reach global development targets. Coming at the end of the first decade of serious funding and support for systematic evidence generation in development economics and development studies, the paper presents opportunities and challenges for the continued development of systematic review methodologies. It concludes by introducing the papers collected in the issue, which make and demonstrate the case for theory-based approaches to evidence synthesis.