The program of interest is implemented by ACTED, an international NGO. ACTED has been present in Pakistan since 1993 and has become a leading relief and development aid provider in the country. ACTED’s main goals are to deliver integrated, multi-sectorial and good-value relief and immediate recovery to households in the aftermath of an emergency and to strengthen communities’ capacity to manage and reduce risks and increase their resilience for the future. Besides disaster preparedness and emergency response, ACTED is mainly engaged in delivering programs focusing on the reha- bilitation and construction of infrastructure like shelter, sustainable energy development, livelihood support, agricultural development, education and vocational training as well as water, sanitation and hygiene [ACTED, 2016]. ACTED applies an integrated approach involving the comprehensive implementation of interventions such as shelter and Non-Food Items (NFI), Water, Sanitation and Hygiene (WASH) as well as Food Security and Livelihoods Support (FSL). These activities are also part of the program we are evaluating.
The program `Responding to Natural Disasters in Pakistan 2015-2019' under United Kingdom Department
for International Development (DFID) funding is embedded in the context
and needs highlighted in the previous section. The multi-year humanitarian
program focuses on natural disaster preparedness, response and recovery.
It is implemented as part of a consortium of NGOs under the official
name ``Consortium for Natural Disaster Preparedness, Response and Recovery
Basic Humanitarian Package
In what follows we describe the components of what we call the basic humanitarian package, com- posed of several different activities the ACTED team conducted.
Shelter and Non Food Item Assistance. Affected vulnerable households are supported to in- tegrate disaster risk reduction (DRR) practices into shelter construction in a way that strengthens resilience to local hazards. Strong emphasis is placed on beneficiary-driven design and construction, supported by technical trainings and mentoring in the field. Some beneficiary families receive condi- tional cash support or materials to enable construction. In flood-prone areas, DRR techniques such as raising the plinth, reinforcing the base of the wall with a mud ‘toe’, using a mud-lime combination to plaster walls, corner bracing and construction of lighter roofs are encouraged. Households that have suffered from past disasters (2010-2011 floods mostly) and which are still in need of shelter re- habilitation/construction are targeted. These households receive shelter repair kits as well as shelter construction training by technical staff. The most vulnerable households who cannot participate in own shelter construction receive grants to pay for skilled labor to build/rehabilitate their Shelter. In addition, ACTED implements “Cash for Work” activities, which are expected to generate income for recovery while reviving livelihoods. Cash for work services will mostly take place as rehabilitation or construction of irrigation channels, drainage lines, stoves, and nadi (river) filters. The main intention is not to provide cash, but mostly to improve living conditions and livelihoods infrastructure. In particular, work activities shall provide village-wide benefit.
Water, Sanitation and Hygiene. The WASH component of the integrated recovery package is modeled after the Pakistan Approach to Total Sanitation. This Community Led Total Sanitation approach supports community mobilization to construct their own household latrines. The idea is that through creation of demand within communities (Village Sanitation Committees) and support for supply interventions, communities become open defecation free. This approach includes subsidy support for the most vulnerable in the form of demonstration latrines and the distribution of a ‘sanitation kit’ that provides the key materials needed to build a latrine for those also deemed vulnerable. Support for rehabilitation of water supply schemes in these communities is also part of the program and is based on the exact localities’ needs. The PATS intervention also includes support for behavioral change related to improved hygiene practices and options for household treatment of water (distribution of water filters to part of the beneficiaries).
Food Security and Livelihood Support. ACTED FSL activities involve training on agriculture and water management and livestock management and vaccination trainings. Agriculture and water management trainings aim at building the capacity of farmers by organizing them into water user groups. A quick demonstration of improved farm, crop and water management techniques is taught to the beneficiaries. Additionally, livestock trainings aim to provide essential knowledge and skills to communities that own livestock so that they are able to cope with any calamity and minimize livestock losses through proper mitigation and preparedness. The trainings specifically cover the types of livestock emergencies, risks associated with hazards in livestock spectrum, preparedness plan, and distribution of inputs in disaster hit areas of Sindh as well as disease outbreak handling. Additionally, seeds and other agriculture inputs are distributed to a limited amount of households. Others also benefit from kitchen gardening training.
In the second stage of the intervention we introduce two types of additional trainings conducted by ACTED. The additional packages have as a goal to transmit key messages of WASH, FSL, and shelter (a) in-person and (b) via telephones.
A. Additional Training - Face-to-face: ACTED performed additional training in the treat- ment villages. Basically this consisted in having two trainers going to the villages and perform- ing an about two hour class training about 25 people once. In this class the trainers taught the residents on one of the three topics, covering how to have better personal and hygiene habits and the importance of using latrines in the WASH training; good agriculture and water man- agement techniques, and livestock management techniques in the FSL training; and building techniques in the Shelter training. In this sense, this additional training sessions had as a goal to convey compact knowledge of these important messages.
B. Additional Training - Phone Calls: The second type of additional interventions exploits the fact that we have mobile numbers for those assessed at baseline (or their neighbors/ entrusted people) and can thus call them to provide telephonic additional training. The callers had a script with the same key messages as in the personal Additional training but written in an interactive, easy to understand way that could be delivered by phone in approximately 20 minutes. The respondent had the opportunity to ask questions. We make in total 1600 calls, with up to eight attempts per call. One concern prior to implementation was the bad telephone connection. Thus, whether the phone calls could be indeed be delivered was closely monitored.
The topics of the trainings were WASH, shelter or FSL, and all individuals in the same village received the calls on the same topic. Not all people from the cluster-village received a call. In fact, we varied whether all individuals from the baseline were called (100%) or only 50%. The latter variation was introduced in order to test possible spill-overs of information between villagers where 50% of individuals were called on the remaining 50%, i.e. whether information is shared between villagers.