Traditional and distance training programs to develop female community animal health workers in Nepal

We randomly offer training to women in rural Nepal leading to government certification as a community animal health worker (CAHW), that is, a local provider of health services to poultry and livestock. The training is intense, traditionally requiring 35 consecutive days away from home at a training center. We randomly assign women from a pool of candidates to receive CAHW training. The type of training is also randomized, so that half of selected trainees undergo a traditional training (TT) course and half undergo a novel distance learning (DL) course with a tablet-based curriculum that requires less time away from home.

2019-05-01

2019-06-30

The outcomes below are organized by theme, e.g., below the heading "Income" we list primary outcomes related to income.
Income
1. Total household annual income
2. Woman's total annual earned income (including agriculture and CAHW work) [HHR12,
3. Woman's annual non-farm enterprise income (including CAHW work)
4. Woman's annual solely controlled income
5. Woman's annual jointly controlled income
Saving
1. Personal savings deposits in past month
2. Household savings deposits in past month
3. Household total savings
4. Personal total savings
Empowerment
1. Woman has control over some non-zero amount of income
2. Mobility
(a) Number of visits to urban centers, markets, family and friends, public gatherings
or meetings
(b) Number of these places she can go to without permission
(c) Degree of accompaniment required to visit these places
(d) Mobility index (ICW index of a-c above with c entering negatively)
3. Community/group leadership
(a) Hold a leadership position in any groups or in the community?
(b) Are you comfortable speaking in front of a group of 10 or more people?
(c) Number of women in the community who would ask respondent for advice?
(d) Number of men in the community who would ask respondent for advice?
(e) Leadership index (ICW index of a-d above)
4. Household chore sharing
(a) Candidate's chore participation
(b) Male relative's chore participation
(c) Female relative's chore participation
(d) Chore sharing index (ICW of a-c above with a entering negatively)
5. Empowerment index (ICW index of 1, 2d, 3d, and 4 above)
Gender attitudes
1. Working outside home index
2. Female mobility index
3. Decision-making power index
4. Chore-sharing index
5. Son preference index
6. Intimate partner violence acceptance index
7. Acceptance of female CAHW
8. Candidate gender attitudes index (ICW index of 1-8 above with 5 and 6
entering negatively)
Aspirations
1. Self
(a) Income aspirations
(b) Status aspirations
2. Boy child aspirations (analysis done at child level)
(a) What grade do you hope for your son to complete?
(b) At what age do you hope for your son to marry?
(c) Desired son's occupation is tier 1 or 2
(d) Desired son's occupation is tier 1
(e) Son aspiration index (ICW of a-d above)
3. Girl child aspirations (analysis done at child level)
(a) What grade do you hope for your daughter to complete?
(b) At what age do you hope for your daughter to marry?
(c) Desired daughter's occupation is tier 1 or 2
(d) Desired daughter's occupation is tier 1
(e) Daughter aspirations index (ICW of a-d above)
(f) Candidate aspirations index (1a, 1b, 2e, 3e)

Male relative gender attitudes
1. Working outside home index
2. Female mobility index
3. Decision-making power index
4. Chore-sharing index
5. Son preference index
6. Intimate partner violence acceptance index
7. Acceptance of female CAHW
8. Male relative gender attitudes index (ICW index of 1-7 above with 5 and
6 entering negatively)
4.2.2 Female relative gender attitudes
1. Working outside home index
2. Female mobility index
3. Decision-making power index
4. Chore-sharing index
5. Son preference index
6. Intimate partner violence acceptance index
7. Acceptance of female CAHW
8. Female relative gender attitudes index ( ICW index of 1-7 above with 5 and 6 entering negatively)
Male relative's aspirations
1. Aspirations for candidate
(a) Income aspirations
(b) Status aspirations
2. Boy child aspirations (analysis done at child level)
(a) What grade do you hope for boy to complete?
(b) At what age do you hope for boy to marry?
(c) Desired boy's occupation is tier 1 or 2
(d) Desired boy's occupation is tier 1
(e) Boy aspiration index (ICW of a-d above)
3. Girl child aspirations (analysis done at child level)
(a) What grade do you hope for girl to complete?
(b) At what age do you hope for girl to marry?
(c) Desired girl's occupation is tier 1 or 2
(d) Desired girl's occupation is tier 1
(e) Girl aspiration index (ICW of a-d above)
4. Male relative aspirations index (ICW of 1a, 1b, 2e, and 3e)
Female relative's aspirations
1. Aspirations for candidate
(a) Income aspirations
(b) Status aspirations
2. Boy child aspirations (analysis done at child level)
(a) What grade do you hope for boy to complete?
(b) At what age do you hope for boy to marry?
(c) Desired boy's occupation is tier 1 or 2
(d) Desired boy's occupation is tier 1
(e) Boy aspiration index (ICW of a-d above)
3. Girl child aspirations (analysis done at child level)
(a) What grade do you hope for girl to complete?
(b) At what age do you hope for girl to marry?
(c) Desired girl's occupation is tier 1 or 2
(d) Desired girl's occupation is tier 1
(e) Girl aspiration index (ICW of a-d above)
4. Female relative aspirations index (ICW of 1a, 1b, 2e, and 3e)

4.3.1 Basic livestock knowledgeability
1. Percent of correct answers on easy livestock medical questions
2. Percent of correct answers on intermediate livestock medical questions
3. Percent of correct answers on difficult livestock medical questions
4. Overall knowledge score (percent correct answers on all questions)
Livestock management (of household's own animals)
1. Total number of easy animal health practices candidate performed (or helped perform)
on own household's animals
2. Total number of hard animal health practices candidate performed (or helped perform) on own household's animals
Recruitment and Completion of CAHW training
1. Enrolled in and completed CAHW training
2. Training center test score
Breadth and depth of service provision
1. Client base
(a) Number of different clients served since beginning as CAHW
(b) Number of different clients served as CAHW in last month
(c) Number of different wards you have done CAHW work in since beginning
(d) Number of different wards you have done CAHW work in in the last month
2. Services provided as a CAHW (not on own household's livestock)
(a) Count of distinct easy CAHW services performed at least once in past year
(b) Count of distinct hard CAHW services performed at least once in past year
Independence and competence
1. Success rates
(a) Percent of easy services successfully provided
(b) Percent of hard services successfully provided
2. Frequency of needing assistance or consultation
(a) Percent of times did not need to consult with another professional when providing easy services
(b) Percent of times did not need to consult with another professional when providing hard services
CAHW income and investment
1. CAHW gross income
2. CAHW operating costs
3. CAHW net income
4. How was CAHW seed money used
5. Investment in CAHW business

Individuals participating in the study were members of livestock cooperatives. Treatment was assigned using a two-stage randomization over 104 cooperatives and 300 candidates. First, we randomly assigned each cooperative to CAHW training by distance learning (DL, 52 cooperatives) or traditional classroom-based training (TT, 52 cooperatives). Cooperatives were stratifed using bins determined by
cooperative-level variables (geographic zone, median household income, and median dependency ratio). Second, we randomly assigned which candidates within a cooperative would receive training of the type assigned to their cooperative, stratifying by cooperative and individual income. The remaining candidates in each cooperative would serve as controls.

Randomization done in office using Stata

Livestock cooperatives (DL versus TT training) and individuals (invitation to training or no invitation).
For all primary outcomes, the treatment is CAHW training, which was assigned individually. It was only the type of training system that was assigned by cooperative.

No

104

300

Our experimental design consists of four different types of individuals:
1. TT trainees (n = 73)
2. TT controls (n = 73)
3. DL trainees (n = 77)
4. DL controls (n = 77)

Note that we only present MDEs for outcomes where baseline data are available. Columns below are as follows: Outcome, sample mean (baseline), LATE MDE in original units, LATE MDE in standard deviations, ITT MDE in original units, ITT MDE in standard deviations Total household income (NPR) 333471 163603 0.5982 83843 0.3066 Total respondent income (NPR) 13820 27051 0.5783 13680 0.2925 Respondent non-farm income (NPR) 4350 16705 0.6343 8554 0.3248 Respondent sole control over income (NPR) 25865 58477 0.6461 30030 0.3318 Respondent joint control over income (NPR) 108182 99543 0.6003 51160 0.3085 Respondent control some income (0/1) 0.593 0.286 0.5817 0.147 0.2980 Mobility Index 12.98 1.827 0.5091 0.923 0.2573 Number of women that would seek your advice 8.08 4.849 0.5735 2.478 0.2930 Empowerment Index (ICW) 1.12E-09 0.530 0.5300 0.268 0.2680 Aspired Income (NPR) 255257 166193 0.6087 84592 0.3098 Aspired number of women seeking help 37.457 73.835 0.6307 37.759 0.3226 Percent of easy correct 0.847 0.153 0.5421 0.079 0.2780 Percent of intermediate correct 0.218 0.138 0.5287 0.071 0.2717 Percent of dicult correct 0.843 0.219 0.6007 0.112 0.3085 Knowledge Score (percentage) 0.595 0.111 0.5146 0.057 0.2642

Pre-analysis plan: Traditional and distance training programs to develop female community animal health workers in Nepal