A Randomized Impact Evaluation of the Graduation Program Strengthen Productive Safety Net Program Phase 4 (PSNP4) Institutions and Resilience (SPIR) in Ethiopia

Last registered on November 02, 2023

Pre-Trial

Trial Information

General Information

Title
A Randomized Impact Evaluation of the Graduation Program Strengthen Productive Safety Net Program Phase 4 (PSNP4) Institutions and Resilience (SPIR) in Ethiopia
RCT ID
AEARCTR-0008281
Initial registration date
September 22, 2021

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 28, 2021, 3:10 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
November 02, 2023, 9:31 AM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Region

Primary Investigator

Affiliation
International Food Policy Research Institute

Other Primary Investigator(s)

PI Affiliation
International Food Policy Research Institute
PI Affiliation
International Food Policy Research Institute
PI Affiliation
International Food Policy Research Institute
PI Affiliation
World Vision International
PI Affiliation
International Food Policy Research Institute

Additional Trial Information

Status
Completed
Start date
2018-02-08
End date
2021-09-30
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
The SPIR project supports delivery of the Fourth Phase of the Productive Safety Net Program (PSNP4) in Ethiopia’s Amhara and Oromia Regions while also delivering multisectoral programming to enhance livelihoods, increase resilience to shocks, improve food security and nutrition and strengthen gender equality for PSNP4 beneficiaries. The impact evaluation uses a clustered randomized controlled trial (RCT) design with four intervention arms (three treatments and a control group) to compare alternative graduation model program strategies to improve livelihoods, food security and nutrition of PSNP4 beneficiaries.
External Link(s)

Registration Citation

Citation
Alderman, Harold et al. 2023. "A Randomized Impact Evaluation of the Graduation Program Strengthen Productive Safety Net Program Phase 4 (PSNP4) Institutions and Resilience (SPIR) in Ethiopia." AEA RCT Registry. November 02. https://doi.org/10.1257/rct.8281-2.1
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Experimental Details

Interventions

Intervention(s)
The impact evaluation evaluates combinations of four SPIR interventions described below; L and N correspond to the primary SPIR interventions around livelihoods and nutrition, respectively, while L* and N* represent enhanced versions of these interventions.

Intervention L: SPIR livelihood activities: starting Village Economic and Social Associations (VESAs), financial literacy training, agriculture and livestock value chain development, home gardening and forage production
Intervention L*: SPIR livelihoods activities plus: (i) Social Analysis and Action (SAA) to improve women’s access to markets, (ii) aspirations promotion activities in randomly selected kebeles (subdistricts), and (iii) targeted poultry or cash livelihood transfers
Intervention N: SPIR nutrition activities: Nutrition Behavior Change Communication (BCC); WASH activities
Intervention N*: SPIR nutrition activities plus: (i) Timed and Targeted Counseling (TTC) (more intensive nutrition BCC), (ii) Community-based Participatory Nutrition Promotion (CPNP), (iii) male engagement in BCC, and (iv) Interpersonal Therapy in Groups (IPT-G) interventions for women and men screened for depression (provided after the midline survey)
Intervention Start Date
2018-03-01
Intervention End Date
2021-09-30

Primary Outcomes

Primary Outcomes (end points)
Child stunting (height-for-age Z-scores (HAZ)<-2) for children under 24 months; Minimally acceptable diet for children under 24 months; food security as measured by the household food gap in months; depression severity score (PHQ-9); gender norms and female empowerment (attitudes toward female mobility; attitudes toward IPV; input into productive decisions, mobility, group membership, respect, self-efficacy; prevalence of intimate partner violence; gender norms); Assets (Total Index, Productive, Livestock); Access to savings (primary male/female membership in Rusacco/VSLA/MFI/Bank Account); Access to credit total value of productive/consumption loan primary male/female took out); Income from livestock and poultry; Aspirations (Current level of education of the oldest child, level of education primary male/female would like the oldest child to receive, level of education primary male/female would like the oldest child to receive in 10 years)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Other anthropometry measures (HAZ, WHZ, WAZ, wasting, SAM, MAM) for children under 24 months; Infant and young child feeding practices; Infant and young child feeding knowledge; Household dietary diversity score; Minimum dietary diversity-Women; Food Security Index; Food Insecurity Experience Scale; Value of household food consumption per adult equivalent; Child health history - ANC during last pregnancy, IFA during last pregnancy, receiving nutrition information or counseling during last pregnancy, receiving breastfeeding information during last pregnancy, birth in a medical facility (last born); Childcare activities (adult male and female); change in depression scale; Net income from farming; Assets (Consumer, Land Index separate); All other access to savings - primary male/female membership to Rusacco/VSLA/MFI/Bank Account, primary male/female deposited money in a Rusacco/VSLA/MFI/Bank Account with a specific frequency in the past 12 months, primary male/female membership with Eqqub, primary male/female membership with Iddir; All other access to credit - primary male/female took out productive/consumption loan in past 12 months, took out loan from primary source (i.e. Rusacco), took out loan from other secondary sources, primary reason for taking out loan (i.e. to buy livestock), other reasons for taking out loans, total value of productive/consumption loan primary male/female took out, total value of loan the primary male/female still owes, primary reason for difficulty in loan repayment, other reasons for difficulty in loan repayment
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
All households in the study are PSNP4 beneficiaries. The quantitative impact evaluation design compares the impact of combinations of these L, L*, N and N* activity packages by randomly assigning kebeles to one of the following intervention arms:
• Treatment 1: L* + N*
• Treatment 2: L* + N
• Treatment 3: L + N*
• Control: PSNP only
T1, T2 and T3 are each multifaceted graduation programs delivering different combinations of livelihoods and nutrition interventions. For L* activities, SAA was implemented in all L* kebeles, while the aspiration intervention was implemented in a randomly-selected half of the L* kebeles. Poultry or cash was randomly assigned to L* kebeles and provided to the poorest 10 out of 18 of sample households in those kebeles.
Experimental Design Details
Randomization Method
Of the 196 study kebeles that were randomized, 49 were assigned to each of the four treatment arms: T1: L*+N*; T2: L*+N; T3: L+N*; and C: PSNP only. Randomization was stratified at the woreda level to provide balance of treatment assignment geographically and because the woreda is the main administrative structure for local government which shapes local public expenditure and public service delivery. Randomization was conducted by computer at IFPRI offices in Washington DC.
Randomization Unit
Randomization was done at the kebele (subdistrict) level.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
After the initial randomization of 196 kebeles across the four treatment arms, two kebeles were dropped because they had no PSNP beneficiaries and one was dropped for security reasons. The randomization across the 193 remaining kebeles is shown in Table 3.3.2.
Table 3.3.2: Number of kebeles in each treatment arm, by region
Amhara Oromia Total
T1: L*+N* 27 19 46
T2: L*+N 28 21 49
T3: L+N* 29 20 49
C: L+N 29 20 49
Total 113 80 193
Sample size: planned number of observations
In each of 193 kebele, we randomly sampled 18 households, leading to a planned baseline sample of 3,474 households.
Sample size (or number of clusters) by treatment arms
The randomization across the 193 kebeles is shown in Table 3.3.2.
Table 3.3.2: Number of kebeles in each treatment arm, by region
Amhara Oromia Total
T1: L*+N* 27 19 46
T2: L*+N 28 21 49
T3: L+N* 29 20 49
C: L+N 29 20 49
Total 113 80 193
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Power calculations were conducted using data from the PSNP4 impact evaluation midline survey to estimate the necessary sample size required to measure a detectable effect of the program on the following three primary outcomes: child height-for-age Z-scores (HAZ) for children under 24 months, mother’s nutrition knowledge, and food security as measured by the household food gap in months. The sample size estimation was based on the kebele-level randomization leading to comparisons of each treatment group with the control group. We conducted the power calculations for ANCOVA models, adjusting for autocorrelation from baseline to endline. For HAZ, we assumed an autocorrelation of 0.7. For nutrition knowledge and a household’s food gap we assumed no autocorrelation. We used conventional levels and set the power at 80 percent and the significance level at 0.05. The calculations suggested that a sample of 196 kebele clusters was needed, with 18 households per cluster, for an intended sample of 3,528 households. In this sample, for HAZ, the minimum detectable effect (MDE) size is 0.34 SD; for mother’s nutrition knowledge it is roughly 1.0 point on a mean score of 7.51; and for the food gap, it is 0.89 months from a mean of 2.35 months. Details about the power calculations are also available in the baseline report.
IRB

Institutional Review Boards (IRBs)

IRB Name
International Food Policy Research Institute
IRB Approval Date
2018-01-18
IRB Approval Number
PHND-18-0103
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
September 30, 2021, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
April 30, 2021, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
192 kebeles
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
3,812 households
Final Sample Size (or Number of Clusters) by Treatment Arms
Data Publication

Data Publication

Is public data available?
Yes

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Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
There is evidence that cash transfers reduce intimate partner violence (IPV), but less is known about the impacts of public works and complementary programmes on IPV. Using mixed-methods we examined whether and how the Ethiopian government's public works programme (that includes cash and/or food for work) alongside complementary activities that engage women and men affected IPV. We analysed midline data collected in July–October 2019 from a randomised controlled trial (RCT) designed to measure the added impacts of the complementary programming in the Amhara and Oromia regions. Eligible households for this analysis had at least one child aged 0–35 months and a primary female caregiver who was married, and under 50 years-old (n = 2604). A nested qualitative study was conducted with a sub-sample of RCT participants from February–March 2020; data included seven focus group discussions and 58 in-depth interviews. Male partners of women who reported experiencing IPV were purposively sampled. Ordinary Least Squares regression analyses were used to estimate the average treatment effect of the complementary programming, and sub-analyses were conducted on the poorest ten households from each village who received additional livelihood transfers. Qualitative data were analysed using thematic content analysis. We found no impacts of the complementary programming on IPV in the full sample, but some impacts among the poorest sample. Evidence on pathways found that both the public works and complementary programming decreased poverty-related stress and arguments within relationships and increased emotional wellbeing. There were some impacts on women's empowerment from the complementary programming. However, men's reactions to women's empowerment were mixed. There was strong evidence that engaging men in nutrition behaviour change communication contributed to improving gender relations. Our findings indicate that social protection and complementary programmes have the potential to be gender transformative and prevent the drivers of IPV.
Citation
Ranganathan, Meghna; Pichon, Marjorie; Hidrobo, Melissa; Tambet, Heleene; Sintayehu, Wastina; Tadesse, Seifu; and Buller, Ana Maria. 2022. Government of Ethiopia's public works and complementary programmes: A mixed-methods study on pathways to reduce intimate partner violence. Social Science and Medicine 294(February 2022): 114708. https://doi.org/10.1016/j.socscimed.2022.114708
Abstract
Poultry has gained renewed attention as a promising value chain for women because it is an asset that is widely accessible to women, has low start-up costs, and provides a good source of nutritious animal-sourced foods for children in chicken meat and, especially, eggs. The current study presents evidence from an experimental intervention that randomly provided women either a poultry package transfer of vaccinated, improved-breed chickens and related inputs, or a cash grant of equivalent value within a sample of households participating in a social safety net program. These transfers were embedded in a set of intensive livelihood and enhanced nutrition interventions as part of a broader experiment in rural Ethiopia. We assess the impact of the poultry package transfer as well as the enhanced nutrition intervention on the consumption of eggs by both children and adult women. We find that the poultry transfer increased the frequency of egg consumption as well as the sale of eggs, falling between the extreme of an autarkic household and one in which production decisions are fully separable from consumption choices.
Citation
Alderman, Harold; Gilligan, Daniel O.; Leight, Jessica; Mulford, Michael; and Tambet, Heleene. 2022. The role of poultry transfers in diet diversity: A cluster randomized intent to treat analysis. Food Policy 107(February 2022): 102212. https://doi.org/10.1016/j.foodpol.2021.102212

Reports & Other Materials

Description
Endline report
Citation
Alderman, Harold; Billings, Lucy; Gilligan, Daniel O.; Hidrobo, Melissa; Leight, Jessica; Taffesse, Alemayehu Seyoum; and Tambet, Heleene. 2021. Impact evaluation of the strengthen PSNP4 institutions and resilience (SPIR) development food security activity (DFSA): Endline report. https://ebrary.ifpri.org/digital/collection/p15738coll5/id/8084