00:00 Thank you.
00:01 Um,
00:01 so welcome everyone,
00:02 um,
00:03 to this seminar on a,
00:05 on an evaluation
00:07 on testing the impacts of adding
00:09 a parenting program to a cash transfer program in Burkina Faso.
00:14 Um,
00:14 as many of my name is Ela Kahola.
00:16 I'm the manager of the,
00:18 the Strategic Impact Evaluation Fund,
00:20 which gave support to this evaluation.
00:23 Um,
00:23 as many of you might know,
00:25 um,
00:25 the,
00:26 the safe portfolio has a focus
00:29 on early childhood development and parenting programs in particular,
00:34 and,
00:34 um,
00:35 as you'll see today in this,
00:37 um,
00:37 in this evaluation,
00:38 there are at least
00:39 3 things to like about this particular evaluation in the portfolio.
00:44 Um,
00:44 so first,
00:45 it's,
00:46 you know,
00:46 as,
00:46 as you know,
00:47 parenting programs
00:49 in which people are going door to
00:50 door or go intensively interacting with the household
00:54 are,
00:55 are very expensive and scale has been,
00:57 has been a challenge.
00:59 And so one way to scale these programs has been
01:01 to add it to existing programs that involve outreach,
01:05 um,
01:05 and so you'll see today kind of this is a bit of a test of,
01:08 um,
01:08 can you add
01:10 a parenting program to an existing program and get impact.
01:13 Um,
01:14 but another thing to like about this is that it there,
01:17 the,
01:17 the researchers have really tried
01:19 to test mechanisms,
01:21 right?
01:21 Um,
01:21 is this
01:23 are resources enough
01:24 to kind of get people
01:26 to invest more in kids and to foster child development,
01:29 or do you need something that something
01:31 extra that comes with the parenting program?
01:34 And they've gone one step further to kind of to ask,
01:37 you know,
01:37 what,
01:38 what is it about parenting programs that matter?
01:40 Is it just the information they provide,
01:42 or is,
01:43 you know,
01:43 do you really need that intense,
01:46 um,
01:46 follow up to get results?
01:48 And then the third thing
01:50 um to like about this evaluation is that it was implemented,
01:53 um,
01:54 both the,
01:54 the program itself,
01:56 but also the evaluation
01:58 in a very challenging context for,
02:01 for both of these activities.
02:03 Um,
02:03 and so like other.
02:05 that we do,
02:06 we want to open
02:08 the seminar with
02:10 some context provided by the operational task team leaders to tell us
02:14 what was going on in Burkina Faso at this time,
02:17 why was this evaluation relevant for the dialogue they were having.
02:22 Um,
02:22 there with the client,
02:24 um,
02:24 and what did they learn,
02:25 um,
02:26 um,
02:26 in the process of doing this evaluation.
02:29 So we'll first hear from
02:30 Diane,
02:31 Yuko,
02:31 and Julian on,
02:33 on the operational context,
02:35 um,
02:35 and then we will,
02:36 uh,
02:37 switch to Damien who can tell you about the evaluation design,
02:41 um,
02:41 and what they found,
02:42 and hopefully,
02:43 um,
02:43 at the end,
02:44 we'll have a little bit of time for,
02:46 for comments,
02:47 I mean,
02:47 sort of for questions and,
02:48 and comments.
02:50 So,
02:51 shall I pass it over to you,
02:53 Diane,
02:53 first?
02:55 Yes,
02:56 uh,
02:57 thank you,
02:57 Alaka.
02:58 So,
02:59 I will take the floor,
03:01 uh,
03:01 in the name of the team.
03:03 And I'm pleased to quickly share with you,
03:05 um,
03:06 some elements of context in our Burkina Faso.
03:10 So,
03:10 uh,
03:11 according to UNDP 20.
03:16 34 report,
03:19 Burkina Faso Human Development Index was
03:24 0.38 in
03:28 2013.
03:30 Systematically,
03:31 uh,
03:32 placing the country in the category of nation with,
03:36 um,
03:37 uh,
03:37 low human uh development.
03:40 And
03:41 according to the 2014 National Nutrition Survey,
03:47 the prevalence of chronic
03:49 malnutrition was
03:51 29.1%.
03:55 Its results considered severe by the World Health Organization,
04:00 while the infant and child mortality rate
04:04 was around 89
04:06 deaths
04:07 per 1000 live births.
04:10 So,
04:11 um,
04:12 phase to this situation,
04:13 the implementation of a multi-dimensional response
04:17 combining direct nutrition,
04:19 uh,
04:20 interventions
04:21 with actions aimed at improving access to drinking water,
04:27 sanitation,
04:28 basic healthcare,
04:29 and social safety nets
04:31 in general
04:32 was necessary um.
04:34 To overcome the obstacles
04:37 related to poverty and access to essential
04:41 services.
04:44 It is in this context that the social safety net project was implementing
04:50 in,
04:50 uh,
04:51 was implemented for,
04:53 from
04:54 2014 to 2024
04:59 over a period of
05:01 10 years.
05:03 And this project with
05:06 $196 million in funding
05:10 aimed to increase access to social safety net
05:13 for poor
05:15 and vulnerable households
05:17 while laying the groundwork
05:21 for an adaptive social safety net
05:23 system in Burkina Faso.
05:27 It should be noted that this project was
05:30 not limited to redistribution of cash transfers.
05:34 The latter were
05:35 a component of an integrated package of social safety nets along
05:42 with accompanying measures to strengthen human capital
05:47 and economic inclusion initiative
05:49 that empowered poor households through the implementation of income
05:54 generating activities.
05:57 The evaluation,
05:58 the result of which
06:01 will be presented here by
06:04 our researcher
06:05 was conducted from uh 2018
06:11 to 2020,
06:12 a period
06:14 marked
06:15 in Burkina Faso by the beginning and uh
06:18 worsening of the security crisis in Burkina Faso.
06:22 It was also during this period that the first internal displacements
06:27 were recorded.
06:29 To which was added to the outbreak of the COVID-19 pandemic.
06:36 Lockdown restrictions and security crises have made it
06:40 difficult to collect data on the ground.
06:44 Despite
06:46 these challenges,
06:47 and although cash transfer has been suspended by the new
06:52 Burkinabe authorities,
06:54 this evaluation,
06:55 which
06:56 aimed to assess the impact of
06:59 cash transfer
07:00 as part of the integrated package of social safety nets
07:05 on human capital,
07:07 provided
07:08 evidence.
07:09 Uh,
07:10 that could be used
07:11 beyond Burkina Faso,
07:13 uh,
07:13 and also,
07:14 uh,
07:15 in,
07:15 in,
07:16 uh,
07:16 in the future,
07:17 uh,
07:18 in the design of future projects
07:21 aimed at improving human
07:24 capital.
07:26 So,
07:26 uh,
07:27 let's stop here and,
07:28 uh,
07:29 I don't know if my colleague here want to compliment.
07:33 Uh,
07:33 if not,
07:34 uh,
07:34 I will give the floor to,
07:36 uh,
07:36 the researcher team to share the evaluation result,
07:39 uh,
07:40 with you.
07:41 Over to you,
07:42 uh,
07:42 Aleka.
07:43 Thanks.
07:47 Thanks so much,
07:48 Diane for that context.
07:49 Um,
07:50 I think we can go to you,
07:51 Damien,
07:52 for the,
07:52 for the presentation of the evaluation.
07:55 Thank you very much,
07:55 Diane,
07:56 for,
07:56 for the,
07:57 uh,
07:57 context.
07:58 So let me,
07:59 uh,
08:00 share my
08:01 screen.
08:04 Let me know if you can see it.
08:09 OK,
08:10 great.
08:10 So I,
08:10 I'll,
08:11 I'll
08:12 Get started.
08:13 So
08:14 we know already a little bit the contact,
08:15 but basically we are,
08:17 we are going to look at the medium
08:19 term impacts of an integrated social safety net program
08:22 that was run by the
08:24 government of Burkina Faso.
08:26 And that included cash transfers.
08:29 Information meetings
08:31 and home visits and we'll look at,
08:33 at the impact on the child development.
08:35 We are very grateful for funding from the strategic Impact Evaluation Fund.
08:41 And this is work um
08:43 we've done with uh Richard Akresh,
08:45 Arun and Kazaa,
08:47 and uh
08:48 Abigail uh Stoker.
08:51 Uh,
08:52 oh,
08:52 no,
08:52 I'm.
08:54 I have a little bit of a problem to move the slide.
08:58 Da da da.
09:00 I solved that last time.
09:04 Mm,
09:05 let me
09:06 try again.
09:16 Uh
09:20 Sorry about that.
09:23 Here we go.
09:24 No.
09:29 I
09:31 I'll stop sharing.
09:34 Try again
09:40 I don't know.
09:55 Um I'm sorry about that.
10:05 I think I have just to be patient but.
10:21 What about this?
10:25 And then
10:31 This is not optimal.
10:35 Um
10:40 I don't know why.
10:58 I'm gonna try clicking on the slide
11:01 and then trying to advance it.
11:04 You mean on this.
11:06 Yeah,
11:06 so click on the slide.
11:08 Yeah.
11:10 And,
11:10 sorry,
11:11 yeah,
11:11 that was a trick.
11:12 Sorry about that.
11:13 OK.
11:14 Um,
11:15 so,
11:16 um,
11:17 the motivation for this work
11:19 is that we know that social safety nets for poor families,
11:24 include cash transfer most of the time,
11:25 and it's a
11:26 critical component,
11:28 and we have a lot of evidence
11:31 from randomized controlled trials that
11:33 Giving cash works as an impact,
11:36 but still over 240 million children in poor countries
11:40 are not reaching their potential
11:42 in terms of health,
11:44 education,
11:44 early childhood development.
11:46 And governments have been searching for alternative complementary approaches.
11:52 Thinking that families might lack information on best practices
11:58 and that quality of parenting behavior matters.
12:02 Many governments or non-government
12:04 non-governmental,
12:06 non-governmental
12:08 organizations are trying to
12:09 adding accompanying measures,
12:11 and in this project we
12:13 try to understand whether adding components to create
12:16 an integrated social safety net is effective
12:19 and which of these
12:20 components matter.
12:22 So
12:23 what we are going to have as a research question
12:26 is whether combining cash transfers,
12:30 information at the village of the level,
12:32 information meetings at the village
12:33 at the level of the village,
12:35 and home visits
12:36 into one integrated social safety net can remove
12:40 household barriers to change
12:42 and improve the development of the children.
12:45 And more specifically we'll be adding
12:47 whether village level information meetings,
12:51 adding village level information meetings to a cash
12:54 transfer program,
12:55 improve
12:56 the effectiveness of the program,
12:58 and on top of that,
12:59 whether adding home visits
13:01 on top of the information meetings further improve
13:04 child outcomes.
13:06 And we are also asking ourselves
13:08 whether these beneficial effects last once the intervention ends.
13:13 So
13:14 in this study,
13:16 We look at a randomized program evaluation
13:18 of an integrated social safety net program
13:21 in rural Burkina Faso
13:23 that was
13:24 administered by the government,
13:25 so it's not some sort of,
13:27 you know,
13:27 small pilot run by NGO.
13:29 It's really
13:31 something run by the government
13:33 and into that program we selected for the um.
13:38 evaluation 225 villages
13:42 that were randomly allocated into 5 groups.
13:45 On the right you see the control group
13:48 where nothing happens during the time of the study.
13:51 And then
13:51 that's 45 villages.
13:53 And then with
13:54 4 intervention groups with 45 villages,
13:57 one
13:58 that received
14:00 only the cash transfers,
14:01 the unconditional cash transfer.
14:02 We'll call that the cash only
14:04 group.
14:06 One group of 45 villagers that receives.
14:10 Uh,
14:11 the cash transfer plus the information meetings
14:14 at the village
14:16 of the
14:18 At the level of the village,
14:19 sorry,
14:20 and then finally
14:21 we have 2 groups,
14:23 2
14:24 treatment groups where we have 45 villages that receive the cash transfer,
14:29 the information at the village level,
14:31 and then home visits.
14:33 Initially we planned to try to separate two types of home visits.
14:38 Some home visits would have been just for health,
14:41 and some others for
14:42 health and parenting.
14:44 But
14:45 we realized it was difficult to make that distinction,
14:48 so in the end we are going to pull this.
14:51 2 times 45 5 villages into 90 villages and
14:55 there was only one type of home visits,
14:58 but that was the initial design.
15:02 So what we think are the main contributions of this study,
15:05 we are one of the first studies to
15:07 evaluate rigorously
15:10 with an LCT and integrated social safety net intervention
15:14 focused on providing
15:15 cash transfers,
15:17 information meetings,
15:18 and home visits.
15:19 And our design allows us to separate out,
15:22 separate out the role of the cash
15:24 versus the information meetings versus the home visits
15:28 to understand which component each plays
15:31 in improving child
15:32 development.
15:34 And also,
15:34 and I'll explain that
15:37 because of the insecurity on the part of Burkina Faso
15:39 and COVID that also happened at the same time.
15:42 Our inline survey was delayed 15 months after treatment intervention
15:47 ended.
15:47 That was not our plan.
15:49 We,
15:49 we had planned to come with an
15:51 online survey immediately after the end of the intervention.
15:55 We couldn't do that,
15:56 so we don't know if the immediate effects,
15:58 but we are able to say something about medium,
16:01 medium term effects,
16:03 15 months after the end of the cash after the end of the intervention.
16:09 So let me give you a quick overview of the results.
16:13 So we find that the combined intervention of the cash
16:15 transfer plus the information meetings plus the home visits,
16:19 they have the following impacts in the medium term.
16:22 In terms of fertility and pregnancy,
16:25 we see fewer,
16:26 fewer pregnancies,
16:28 older age for the mother at each pregnancy,
16:31 and more medically assisted childbirth.
16:34 In terms of the health behavior.
16:36 We see improved child nutrition.
16:39 Increased use of bed nets,
16:42 increased
16:42 number of prenatal visits,
16:44 increased hand washing by the mother.
16:47 In terms of education outcomes,
16:49 we see increased school enrollment,
16:51 increased years of schooling,
16:53 and improved grade progression for the children.
16:57 In terms of early childhood development.
17:00 So
17:01 on the one assessment which is called strength and difficulties,
17:05 we see.
17:06 Uh,
17:07 improvement,
17:08 improvement,
17:08 but only for
17:09 the prosocial behaviors
17:11 that we use another assessment of child
17:16 early childhood development called the Denver assessment
17:19 that includes language,
17:20 cross fine motor skills,
17:22 and personal social skills.
17:24 On that assessment we see
17:25 no impact.
17:27 That was for
17:28 the impact of the combined intervention,
17:30 cash plus information and home visits.
17:33 If we looked
17:34 at the
17:36 Impact of cash transfer only the impacts are more limited.
17:40 We see the impacts on education.
17:43 We see the impacts on early childhood development,
17:46 prosocial behaviors,
17:48 but not the other ones.
17:49 And we see very few impacts on
17:51 adding just information meetings to the cash transfers.
17:56 So let me give you more details
17:59 about
18:00 the project itself.
18:01 So it was the what was called in French the Project
18:04 Philesocio
18:06 and in More Binae.
18:09 So the cash transfer component was paid quarterly.
18:13 It was unconditional
18:15 and the transfer amounts
18:16 were of 30,000 CFA francs,
18:18 so about $60 US dollars
18:20 for household receipt
18:22 with up to 4 children.
18:24 And the amount was 40,000 CFA francs,
18:27 or $80 US dollars
18:29 per households with five or more children.
18:32 The information sessions.
18:38 We had quarterly village sessions.
18:41 Plus monthly meetings for groups
18:43 of 25
18:44 to 30 mothers
18:46 and then the home visit components that was
18:49 2 home visits per month
18:51 done by a social,
18:52 a trained social worker.
18:54 OK.
18:55 So
18:56 it was a randomized controlled trial.
18:58 We had a good
19:00 balance at baseline
19:02 with our 225 villages.
19:05 We show that in the paper.
19:07 We had,
19:07 however,
19:08 a big issue with attrition,
19:10 but our attrition was entirely at the village because of the insecurity.
19:16 This was done in the east and southeast of Burkina Faso,
19:19 and
19:20 we
19:21 couldn't go to all villages actually at some point we were thinking,
19:25 I discussed with the TTS,
19:27 are we going to do an online survey or not?
19:29 And in the end we made the decision
19:31 that it was safe to go to 74 villages but not the other one.
19:36 OK.
19:37 So we lost a lot of sample,
19:39 but we keep the balance,
19:41 and there is no differential attrition across the treatment arms,
19:44 so we are able to do.
19:46 To
19:47 finish the study on a smaller sample.
19:51 In the 74 village where it was safe to return to,
19:55 there we have very little household attrition.
19:57 We were
19:58 only 2.7% of the household in those 74 villages.
20:03 That we surveyed
20:05 at baseline
20:06 were lost
20:08 at endline and all the other ones,
20:10 more than 97%
20:13 we were able to go.
20:15 So it was
20:16 challenging
20:18 context,
20:18 but still
20:20 we were able to go,
20:21 as I said,
20:22 later than what we had planned and only to a sub sample of the village.
20:25 But still
20:26 we find interesting results and so that's why we,
20:29 we continued this,
20:31 this study,
20:31 and wrote this
20:33 paper.
20:34 So
20:35 in terms of the project timeline,
20:37 our baseline survey was in the spring of 2018.
20:41 The cash transfer started pretty soon after that in June of the same year.
20:46 The information meetings and the home visits started one year later.
20:49 It took time for
20:50 the government and the project to train the people to recruit the social workers,
20:54 etc.
20:55 So it started in June 2019.
20:59 The intervention ended.
21:00 The cash,
21:01 the information meeting,
21:02 and the home visit
21:03 that all ended
21:05 in December 2020.
21:07 And as I said,
21:08 we were planning to come with the headline survey just after that,
21:11 but that's not what happened because
21:13 of COVID,
21:13 because of
21:14 the insecurity.
21:15 We only
21:17 were able to do the online survey in the spring of 2022,
21:23 15 months later.
21:25 I'm not going to spend too much about the techniques and the econometrics
21:28 just to remind you that we pooled what we call T3 and T4,
21:33 the two groups with the cash plus the information and the two times
21:37 of home visits,
21:39 and otherwise we use standard techniques to
21:41 account for the large number of outcomes.
21:44 We are creating an index for families of outcome,
21:47 and you'll see in the tables
21:48 we
21:49 Present what we call,
21:51 what is called randomization inference p value to account for
21:55 uh multiple hypo hypothesis testing.
21:58 Let me give you another summary
22:00 of the results using these indices
22:03 for 6 families of outcomes.
22:07 We created indices.
22:09 You live in
22:10 ah.
22:12 Red the pregnant pregnancy index in
22:15 green,
22:15 the health behavior index.
22:17 In dark blue,
22:19 the anthropometric index,
22:20 in orange,
22:21 the education index.
22:23 In
22:23 purple,
22:24 the Denver index,
22:25 and Denver is one of the assessment,
22:27 assessments for
22:28 early childhood development.
22:30 And the other one is the
22:31 strength and difficulties index.
22:33 It's in blue gray.
22:35 Let's start by looking
22:36 at the right of the picture.
22:38 We have 6 indices,
22:40 and we see
22:41 that for 4 out of these 6 indices.
22:45 With
22:46 an improvement.
22:47 So this is the impact of the combination of cash transfer
22:52 information meetings at the village level
22:54 and home visits.
22:55 And in 4 out of 6 indices
22:57 we see an improvement,
22:59 improvement that is statistically significant.
23:02 You see that the confidence interval
23:04 goes above this red line for 0,
23:07 so it's above 0,
23:08 and it's,
23:09 we,
23:10 we can
23:10 be confident that it's statistically significant.
23:13 So we see that for the pregnancy index,
23:16 the health behavior index,
23:18 the education index,
23:19 and the strength and difficulties index.
23:22 If we go to the left of the picture,
23:24 we are looking at the impact on the 6 indices
23:27 of the
23:28 cash only.
23:30 We still there we see only 2 of the 6 indices
23:33 that are positive and statistically significant.
23:36 That's education.
23:40 And the strength and difficulties index.
23:44 Is there a question or should I
23:47 continue?
23:52 OK,
23:52 I think I'll continue and you'll tell me the
23:55 question.
23:55 I cannot read the question
23:56 on the chat,
23:57 but I guess I'll address those after that.
24:00 And then in the middle we have cash plus information
24:02 and here we have only one of the six indexes
24:05 where we see a
24:07 stat statistically significant improvement.
24:10 OK?
24:11 That's for the education index.
24:12 So just from this picture we see
24:15 that the
24:16 With
24:17 more
24:17 positive and statistically significant impact
24:20 when we have the combination of the cash transfer
24:23 with the information meetings and the home visits.
24:25 No,
24:26 I'll basically go over
24:28 the detail of these results one by one.
24:32 We start with the fertility or pregnancy index
24:35 and what we see here,
24:36 so you see the impacts
24:38 of the three intervention,
24:39 the cash only
24:41 cash plus information and cash plus information
24:43 with home visits.
24:45 And we see here on the bottom line that
24:48 the combination of cache information and home visits.
24:51 Increase the age at pregnancy starting from the 2nd pregnancy
24:55 of the mother.
24:57 OK,
24:57 so mothers are older
24:58 for their 2nd,
24:59 3rd pregnancy,
25:00 etc.
25:02 That
25:04 also means that they are in total they've
25:08 they've been
25:09 pregnant less often.
25:11 And also we see an improvement that
25:14 on whether or not
25:15 that birth was medically assisted
25:18 and overall we see
25:20 an improvement statistically significant
25:23 for the
25:24 pregnancy index where we put all these
25:27 fertility index,
25:28 fertility measures.
25:30 And pregnancy measure together,
25:32 but only for the intervention that combined cash information and
25:37 home visits.
25:39 So let me summarize our integrated social safety nets,
25:42 including cash information and home visits.
25:46 Led to a reduction in the number of pregnancy,
25:48 an increase in the likelihood of medically assisted births for the last pregnancy,
25:52 an increased age at each pregnancy,
25:54 and overall improvements
25:56 in our pregnancy related outcomes index,
25:59 but there was no impact for cash only
26:02 or cash plus information.
26:05 Now let's move to the
26:07 health behaviors.
26:09 So I have here the list of all the health topics
26:12 that were covered both in the information and home visits.
26:15 And I should stress the content
26:18 of the topics that were covered was the same for the
26:22 group information meetings at the village level and the home visits.
26:26 The curriculum was the same.
26:27 It's the mode of delivery that was different.
26:30 I'm not going to read everything,
26:31 but you see.
26:34 They were supposed to discuss breastfeeding,
26:36 prenatal visits,
26:36 how to feed the child,
26:38 the food groups,
26:38 dietary
26:39 of the
26:40 pregnant woman,
26:41 prevention of anemia,
26:42 malaria,
26:44 etc.
26:45 as well as family planning,
26:47 personal hygiene,
26:49 management of diarrhea,
26:50 etc.
26:51 OK,
26:52 so let's look at the impact
26:54 on
26:54 then in the survey we asked
26:56 the mother
26:57 what they did.
26:58 So we are in this table,
27:00 we have a first set of outcomes.
27:03 Where we see
27:04 few impacts only for whether the child gets vitamin A,
27:07 we see a positive impact
27:09 of
27:10 combining cash plus information and home visits.
27:13 The rest is we don't see
27:15 very much,
27:16 but those are all
27:17 getting vitamin A,
27:19 getting iron supplementation,
27:20 supplementation,
27:22 and the vaccines,
27:22 those are all.
27:24 Outcomes,
27:25 health outcomes where you need an interaction with the
27:28 supply side,
27:29 with the health facility.
27:31 OK.
27:31 So here,
27:32 there,
27:33 we see very little.
27:34 But when we look at other
27:36 health behavior
27:38 where you don't necessarily need an interaction with the
27:41 health,
27:42 uh health clinic,
27:43 then we see,
27:45 especially for the group.
27:47 The treatment group that combines cash information and home visits,
27:50 we see.
27:52 A lot more improvement.
27:53 We see it for using mosquito nets,
27:56 the food group diversity index,
27:58 whether the mother washed her hands after using
28:00 the toilets or before feeding the child,
28:02 whether the child had no
28:04 diarrhea in the last month,
28:06 the number of prenatal visits and the index.
28:09 So for these
28:10 outcomes we see.
28:13 Um,
28:14 several positive impacts.
28:16 So,
28:17 To summarize,
28:18 we see no impacts on vaccination,
28:20 vitamin A,
28:21 iron A for mother children,
28:23 but this might be related to supply side health clinic-related constraints.
28:28 Um,
28:29 Then for the integrated social safety net
28:32 combining cash information and home visits,
28:34 we see
28:35 increased use of mosquito bed nets.
28:37 We see
28:38 improved
28:40 food diversity for young children,
28:41 an increase in
28:43 washing hands for the by the mother,
28:46 reduction in diarrhea for the children,
28:48 increased prenatal visits,
28:50 no impact on breastfeeding,
28:51 but that was already very high,
28:53 and overall improvement in this health behavior index.
28:56 Whereas for we see
28:58 less consistent impacts for the cash only and the cash plus information
29:03 uh
29:04 intervention.
29:07 Let me move to
29:08 child anthropometrics.
29:09 So we measure the children
29:11 from age 0 to 5,
29:13 and we look at age for age,
29:15 arm circumference,
29:16 and weight for age.
29:17 Here we see mainly impacts
29:19 on the cash only.
29:21 Uh,
29:21 intervention and the combined intervention cash cash plus plus information,
29:28 meetings and home visits,
29:29 we see improvement,
29:31 but only for the
29:32 arm circumference
29:33 for age
29:34 the score
29:35 and overall we don't see impact on the anthropometrics
29:39 index.
29:41 So that's basically what I,
29:42 I,
29:43 uh,
29:43 just said,
29:44 uh,
29:44 arm circumference for age is improved by the
29:48 cash transfer and the cash plus information and home visits.
29:52 Now I'm moving to the education outcomes,
29:55 and I should stress
29:56 that this was not designed.
29:58 As an intervention focusing on
30:01 the education of
30:03 school-age children,
30:04 as
30:05 like I said,
30:06 it was mainly
30:07 early childhood development.
30:09 But still,
30:10 you know,
30:11 bringing cash to,
30:12 to,
30:12 to the households
30:14 can
30:15 of course improve the education of the children.
30:18 That's,
30:18 that's what we are looking at in this um.
30:22 Uh,
30:23 slides and we see
30:25 again for the groups for the treatment that combined cash and information,
30:30 uh,
30:31 meetings,
30:32 uh,
30:32 and home visits,
30:33 we see,
30:34 um.
30:35 Improvement in enrollment
30:37 in school,
30:38 whether the child is enrolled in school,
30:39 the years of schooling completed,
30:41 whether any school is completed,
30:43 and
30:43 grade progression,
30:44 which is the
30:46 number of years completed over the number of years expected for the age.
30:50 And we see also a
30:53 fairly good impacts of cash only.
30:56 And the indication index is actually positive
30:58 and statistically significant in the last column
31:01 for all three information.
31:03 Remember that was the only
31:04 index that was
31:06 significant for cash plus information
31:09 without
31:10 the home visits.
31:11 So,
31:12 um,
31:13 Positive impacts on education.
31:15 No,
31:15 we are.
31:16 And that's basically what I just already
31:19 described.
31:19 No,
31:19 we are moving.
31:21 On
31:21 our two measures of early childhood development,
31:25 the first one is what is called the strength and difficulties questionnaire.
31:29 So it's 25 items
31:31 across 5 different scales,
31:33 and each statement is scored as not true,
31:35 somewhat true,
31:36 certainly true.
31:37 The 1st 4 items
31:39 are about
31:40 problems,
31:41 emotional problems,
31:42 conduct problems,
31:43 hyperactivity scale,
31:44 peer problem scale.
31:46 And the,
31:47 the last
31:49 item is prosocial.
31:51 So,
31:52 uh,
31:52 we,
31:53 we add the
31:55 total difficulty score 1 to 4 from the first program scale,
31:59 and then we look separately at the prosocial scale.
32:03 And the other
32:04 uh
32:06 Uh,
32:06 early childhood,
32:08 um,
32:09 questionnaire was the Denver pre-screening development.
32:12 Looks at language skills,
32:13 fine motor skills,
32:14 gross motor skills,
32:15 personal social skills.
32:17 And in each of the four sections,
32:19 there is a set of questions for each child according to
32:23 their age,
32:24 and there's yes or no answer for whether the child can do the task activity.
32:28 So here are the results
32:30 first for the strength and difficulties,
32:33 and then we find
32:34 no impact on the
32:36 difficulties,
32:37 the first
32:39 two columns,
32:40 then in the.
32:42 Column 3 and 4,
32:43 we are looking at the prosocial behaviors and we see positive impacts
32:47 for
32:48 the combination of cash plus information and home visits
32:51 and
32:52 at least for the what the score is in the average
32:56 for the cash arm and we see then when we do our index.
33:00 We see an improvement for both cash only
33:03 and cash plus information and home visits.
33:07 On the Denver we see
33:10 very
33:10 few positive and statistically significant impacts
33:14 for
33:18 Any of the three interventions.
33:22 So the summary for early childhood development
33:25 on the strength and difficulties assessment assessment.
33:29 The integrated social safety net of
33:32 combining cash information and home visits
33:34 in the immediate terms has no impact in the total difficulties measure,
33:38 but improves the prosocial scale
33:41 and the overall index.
33:42 The cash-only intervention improves
33:45 the prosocial scale and the
33:47 SDQ index,
33:48 but there are no,
33:49 there is no impact of cash plus information.
33:52 For the Denver assessment,
33:53 overall we find no statistically significant effects of the treatment.
33:59 So
34:00 I'm,
34:01 I'm wrapping up with a summary of the results
34:03 and then I'll have a quick discussion on,
34:04 on the potential mechanisms.
34:06 So
34:07 I've shown all
34:08 to you the uh to
34:10 the,
34:10 the detailed results,
34:12 but let me wrap up.
34:13 The combination of cash plus information and home visits
34:16 in the medium term has the following impact.
34:19 In fertility and pregnancy,
34:21 it leads to fewer pregnancy.
34:23 Older age at each pregnancy for the mother and more medically assisted childbirth.
34:28 In terms of
34:29 health behavior,
34:30 it leads to
34:31 uh
34:32 improved child nutrition,
34:34 more use of bed nets.
34:36 And uh uh
34:38 uh more prenatal visits
34:44 and increased annual.
34:46 Uh,
34:47 for education,
34:48 it leads to increase school enrollment,
34:50 years of schooling
34:52 completed and improved grade progression.
34:55 Then,
34:55 uh,
34:56 in terms of early childhood development,
34:58 um.
35:00 There was an improvement in the
35:02 strength and difficulty psychological psychological assessment,
35:05 but only for the prosocial behaviors.
35:08 And no impacts on the Denver assessment.
35:12 We see limited medium term impacts of the cash transfer only.
35:15 They are mainly
35:17 there on education outcomes and
35:19 the prosocial behaviors in terms of early childhood development.
35:23 And we see very little impacts of the information,
35:28 adding the information to the cash transfer.
35:30 We see them
35:31 they're mainly for
35:33 Uh,
35:34 the education outcome.
35:36 So now let's quickly discuss the possible mechanisms.
35:40 So first question is why
35:42 is the combination
35:43 of cash plus information
35:46 and home visits so effective
35:47 compared to the other intervention and in general?
35:50 And we think it has a lot to do with the salience
35:54 with the home visits.
35:55 The parents feel like the government cares about them and their children.
35:59 And
36:00 we think it's,
36:01 and we see that also by the fact that
36:03 we see,
36:04 we didn't see any difference between the two types of
36:07 home visits we were planning to do.
36:08 Remember,
36:09 we're trying
36:10 to look at different types of home visits.
36:11 So,
36:13 And we think the parent might not understand the group meeting information
36:17 or think they will do the change later.
36:19 They might be confused,
36:21 don't believe it,
36:22 but a home visit could change and impact all of that.
36:25 So basically
36:26 the fact that it's followed by a home visits,
36:29 and we also think there is an accountability effect.
36:32 Very often it's the same health or social worker that revisits again and again
36:37 twice a month,
36:38 and that can create a 1 to 1 relationship that is absent.
36:42 With the,
36:42 the larger
36:43 group meetings.
36:45 And we think these combative
36:46 accountability effect might play an important role.
36:50 Why do we find limited impact
36:51 in terms of early childhood development?
36:54 The cash might have played a role,
36:56 maybe because the,
36:57 the
36:58 household receive more money,
36:59 they are more busy with,
37:02 with their business and they might have less time,
37:04 but we also need to recognize that.
37:07 As I said earlier,
37:08 we came 15 months after the
37:11 The intervention ended,
37:13 so some programs,
37:15 uh,
37:15 effects might have been there but fade out.
37:18 We will not be able to know,
37:19 but that's,
37:20 that's a possibility.
37:22 So
37:22 one thing that was somewhat
37:24 puzzling is that the combination of cash plus the information meetings at the
37:28 village level,
37:29 we find very little impact
37:32 and sometimes it's,
37:32 it's actually
37:33 the impact of cash plus information meetings is less than cash only.
37:38 It's also less than cash.
37:40 Uh,
37:41 present information at home with it.
37:42 So what's going on with these information meetings and why,
37:45 what,
37:46 what might be the problem?
37:48 So
37:49 Maybe the information
37:50 is misunderstood and crossed out things that the parents are already doing.
37:55 Maybe the group meetings give the information,
37:57 but it's a little bit of a dump of information
37:59 and it's not giving the tools to act on it.
38:02 People might
38:03 feel overwhelmed.
38:04 They might feel,
38:05 oh,
38:05 I should do all of that
38:07 with my children and I'm not doing,
38:09 and they might end up being discouraged.
38:12 And maybe the home visitor is,
38:14 is a solution to that.
38:16 Also,
38:17 but
38:18 So this larger information meeting comes with government vehicles,
38:22 big room meetings.
38:23 They're quite visible,
38:25 and we are in an environment where there is insecurity,
38:28 terrorism,
38:29 and the home visit with their much smaller footprint.
38:33 Um,
38:34 Were better.
38:35 But this is still quite exploratory exploratory at this stage,
38:40 and we are,
38:40 we are happy to discuss and have suggestions.
38:44 If I have 1 or
38:45 2 minutes more,
38:47 I could,
38:47 I will just,
38:49 because I know SIF likes,
38:51 likes this,
38:51 I'll say something about treatment fidelity.
38:54 So our survey firm,
38:56 so the treatment fidelity is what what was planned
39:00 to happen.
39:01 Actually happened and you,
39:02 you know,
39:02 we were in a difficult context with COVID during
39:06 some time of the intervention and in the um
39:10 Uh,
39:11 insecurity.
39:12 So
39:12 it's an important question in this study.
39:15 So are,
39:15 um,
39:17 Survey firm IPA conducted monitoring checks
39:21 in January,
39:21 March,
39:22 June,
39:22 September,
39:22 and November of 2020.
39:26 In each monitoring check.
39:28 The survey firm contacted 63 households in 9 villages.
39:33 Selected randomly across the four treatment arms.
39:36 And asked each household whether the different
39:39 treatment components were relevant for their village.
39:42 Given the randomization took place.
39:45 So
39:46 this is the results.
39:47 So first thing to note is that
39:50 The cash
39:52 Um,
39:55 Um,
39:56 so sorry,
39:57 first thing to note is that the monitoring checks were done in person
40:00 in January and March
40:01 of 2020
40:03 and then by phone because both of COVID and indeed insecurity.
40:07 So the cash
40:09 receipt was fairly high and consistent
40:12 except one period in September 2020 where it was
40:15 lower.
40:17 The quarterly village meetings were also fairly high,
40:20 at least in the beginning.
40:21 It went down after.
40:23 And
40:24 I think at least one mother group meeting.
40:26 Remember there was the
40:27 village all village
40:30 meetings and also the
40:31 smaller group meetings for groups of 25 to 30 mothers.
40:36 This was also fairly high with a drop a little bit
40:39 at the end of 2020.
40:41 Then the home visit also fairly high.
40:44 So,
40:44 so it's fairly high
40:46 at the beginning with somewhat of a,
40:48 a decline towards the end of the year.
40:51 So,
40:52 I think I'll stop there and um thanks a lot for
40:56 uh your attention and,
40:58 and
40:58 I'm looking forward to your questions or comments.
41:03 Thanks so much,
41:03 Damien.
41:04 Um,
41:05 we,
41:05 we already have a few questions in the chat.
41:07 Um,
41:07 I'll just read them out to you,
41:09 and then,
41:09 but others
41:10 feel free to,
41:11 um,
41:12 stick your questions in the chat.
41:14 So the first is just a clarification on the cash transfer itself.
41:18 Um,
41:19 this person is asking
41:20 if those transfers were a one-off,
41:22 or if not,
41:24 how long kind of did the the transfers last.
41:28 Then,
41:28 um,
41:29 Sharon Wolf has a question.
41:31 On whether the SDQ,
41:32 the constraints and difficulties,
41:34 was that validated for the context and the population,
41:38 and I have that same question about the Denver,
41:40 um,
41:41 and I just want to add
41:42 one more hypothesis to your list about why you might not see.
41:46 Uh,
41:47 effects on the Denver,
41:48 it could be
41:49 that the,
41:50 you know,
41:50 even the thresholds,
41:51 you know,
41:52 for,
41:52 for setting,
41:53 for measuring
41:55 the Denver
41:56 might be on a different population and from a different era,
41:59 um,
42:00 and so you,
42:01 the,
42:01 the Denver may not be
42:03 functioning
42:04 as it does in other contexts in this context.
42:07 So you,
42:07 you may.
42:08 Just want to do a little bit of exploration on,
42:10 on some of the psychometric properties of the Denver
42:13 before
42:13 thinking about,
42:14 you know,
42:15 why,
42:15 why don't we see real effects on early childhood development,
42:19 um,
42:19 measures that could be a,
42:21 a measure,
42:21 an artifact of the,
42:23 of the measurement,
42:24 um,
42:24 but,
42:24 but the kind of the question is kind of maybe you can
42:27 talk about,
42:28 um,
42:29 what was done for the SDQ and the Denver
42:32 to adapt it,
42:34 um,
42:34 for context.
42:36 OK,
42:37 so the first question,
42:38 uh,
42:39 the transfer and the amount I showed on
42:42 one of the,
42:43 they were quarterly.
42:45 Uh,
42:46 and,
42:47 um,
42:48 it was basically,
42:50 let me see.
42:52 Go back here,
42:53 the amounts are quarterly for the cash.
42:57 Here
42:58 And they're basically taking place for the cash from June 2019
43:03 to December 2020,
43:05 so that's one year and a half.
43:08 And
43:09 the rest of the intervention.
43:11 Uh sorry,
43:12 sorry,
43:12 my mistake.
43:13 Uh,
43:14 from June 2018 to December 2020 for the cash.
43:18 So,
43:19 uh,
43:20 that's
43:21 two years and a half,
43:22 um,
43:23 and,
43:24 uh,
43:25 the information meetings and the home visit,
43:27 that was
43:28 during one year and a half.
43:30 So yes,
43:30 the SDQ and uh uh Denver,
43:34 I mean that's a,
43:34 that's a good point.
43:35 We,
43:36 um,
43:37 I don't know that it is.
43:40 Like,
43:41 fully,
43:41 uh,
43:44 Uh,
43:44 validated in a separate study or so,
43:47 but we,
43:48 we've
43:49 worked with,
43:50 uh,
43:51 Um,
43:53 Local colleagues to adapt the SDQ and
43:57 And the Denver with uh.
44:01 Uh,
44:02 changed some of the questions,
44:03 some of the,
44:04 the toys,
44:05 etc.
44:05 so we've
44:06 tried to
44:07 adapt it.
44:08 We have used in
44:09 other studies in Burkina Faso,
44:11 uh,
44:12 before,
44:12 at least I think the Denver,
44:14 and so,
44:15 um,
44:16 but it's a good point.
44:17 We should,
44:17 we should check we've.
44:21 I tried to make it,
44:22 to make it uh.
44:24 Culturally irrelevant,
44:25 but,
44:26 but I guess I like how you are suggesting maybe it's
44:30 The level are too,
44:31 too low or
44:33 that the
44:35 The anchoring is,
44:36 is not correct,
44:37 or?
44:39 Yeah,
44:39 like,
44:40 so I think you can,
44:41 there's a,
44:41 you know,
44:42 different types of validation,
44:43 and then Sharon,
44:44 feel free to kind of come in
44:46 on this because you are,
44:47 she's kind of validated many,
44:50 many tools in many different contexts,
44:52 um,
44:53 but you,
44:54 of course,
44:55 you want to linguistically adapt it and make things,
44:57 you know,
44:57 the prompts culturally relevant,
44:59 but
44:59 you also want to check.
45:01 Um,
45:02 you know,
45:02 in the data,
45:02 is it functioning in the same way,
45:05 um,
45:05 as it should,
45:06 right?
45:07 Um,
45:07 you know,
45:08 are,
45:08 are the items working in the same way?
45:11 Do you see kind of ceiling and or floor effects,
45:13 you know,
45:14 that,
45:14 that may be,
45:15 uh,
45:16 kind of driving down
45:18 some variation in the context,
45:20 like,
45:20 is it?
45:21 You know,
45:21 in some contexts,
45:22 a tool may work
45:23 to give you a full
45:24 nice full distribution,
45:25 um,
45:26 um,
45:26 whereas in another context,
45:29 it may be,
45:29 even though it wasn't intended to be,
45:31 it may be,
45:32 uh,
45:32 functioning like a more like a screening tool.
45:36 But maybe Sharon,
45:37 if you want to come in,
45:38 um,
45:38 and kind of
45:39 just uh
45:41 maybe give some pointers on what other things,
45:43 quick things Damien might want to,
45:45 to check for to see if
45:47 some of the lack of impact is coming from,
45:50 from measurement.
46:08 Uh,
46:08 she says she's,
46:11 yeah,
46:11 Faye,
46:11 can you,
46:12 Faye,
46:12 can you unmute,
46:14 um,
46:14 Sharon,
46:15 please.
46:33 Let's see.
46:40 Oh,
46:40 OK.
46:40 Well,
46:41 uh,
46:41 so,
46:41 so,
46:42 um,
46:43 OK,
46:44 so we'll,
46:44 we'll wait for Sharon to type in the chat,
46:46 but maybe we can move on
46:48 to,
46:48 in the meantime,
46:49 to another question that comes from
46:52 Marcus.
46:52 Marcus,
46:53 it's a long question,
46:54 so why don't you just unmute and ask
46:56 Damian.
46:58 If you can.
47:00 Yes,
47:01 sure.
47:01 Thank you so much.
47:02 Um,
47:04 so,
47:04 I mean,
47:04 it looks like for some of the tables that you were showing,
47:08 um,
47:09 basically the treatment is almost closing the kind of behavior gap,
47:12 you're getting to 100%,
47:15 um,
47:15 unless I misread,
47:17 um.
47:18 So
47:18 just
47:19 I'm,
47:20 I'm curious,
47:21 you know,
47:21 beyond kind of the statistical significance of the results,
47:25 um,
47:25 could you say a little bit more about the
47:27 kind of the absolute and the relative effect sizes,
47:30 and I,
47:30 I appreciate that you had a limited sample size,
47:33 but
47:34 whether there's,
47:35 um,
47:36 any indication that there are certain types of households that may have benefited
47:39 relatively more
47:41 um
47:42 from the intervention.
47:44 Thank you.
47:47 OK.
47:47 Uh,
47:48 yes,
47:48 you're right on,
47:49 on some of the,
47:50 especially the health outcomes and,
47:52 uh,
47:53 am I still,
47:53 uh,
47:54 sharing the
47:56 Yes,
47:57 you are.
47:57 Yeah,
47:58 so I,
47:58 I think here we see for example,
48:00 some,
48:00 some of the
48:01 For example,
48:02 um,
48:05 Or maybe in this table,
48:06 but it,
48:07 uh,
48:07 but for,
48:08 for breastfeeding or prenatal visit,
48:10 it's,
48:10 it's quite high.
48:11 So I see that the
48:13 Table doesn't include the,
48:14 the mean.
48:15 Oh,
48:15 yes,
48:15 it does.
48:16 Sorry.
48:17 You see,
48:17 uh,
48:18 4.67 prenatal visits and
48:21 99% uh.
48:25 Breastfeeding,
48:26 that's very high.
48:27 So we,
48:27 sorry,
48:27 we,
48:28 in the paper,
48:29 we do two types of um
48:32 Heterogeneity analysis,
48:34 uh,
48:34 one by,
48:35 I mean,
48:36 maybe I,
48:36 I should,
48:37 I,
48:38 I did not mention that.
48:39 I,
48:39 I'm afraid,
48:40 but
48:41 This is already uh um
48:43 a sample that is targeted on poverty.
48:46 There was uh uh
48:48 Uh,
48:48 PMT uh targeting.
48:50 So those are already
48:52 poor households which are eligible
48:54 for the cash transfer.
48:57 But
48:58 we did a heterogeneity analysis by
49:01 Poverty among the poor,
49:03 and we see,
49:05 at least for some outcomes that the poorest benefit more.
49:08 And we did also another heterogeneity analysis on
49:12 This tends to conflict.
49:14 I mean,
49:14 knowing that we lost the ones that are closest to conflict,
49:17 so it's,
49:19 but,
49:19 and we also find,
49:20 uh,
49:21 for some outcome strongest,
49:22 um,
49:23 effect for people who are closest
49:26 households or villages who are also uh
49:28 closest to conflict.
49:30 Um,
49:31 but you're right.
49:31 I mean,
49:32 we,
49:32 we,
49:33 we lost a lot of power with,
49:34 um.
49:36 Dropping from 225 villages to 74,
49:39 so basically we,
49:41 we lost quite a lot of power to do our heterogeneity analysis.
49:47 Uh,
49:48 I,
49:49 I think there was,
49:50 uh,
49:50 no,
49:50 I need to find in the chat.
49:52 Um,
49:54 the question by Sharon.
49:58 Sharon,
49:59 um,
49:59 give you some suggestions on what to look for.
50:02 You can do some
50:03 just to even one simple thing just to see if you know the structure.
50:08 Of the,
50:10 you know,
50:10 the intended structure of the instrument,
50:12 say like the five factors,
50:13 does that hold
50:14 in your data?
50:15 Can you see it in your data?
50:17 You could do the similar,
50:18 similar thing,
50:19 um,
50:19 to for the Denver.
50:21 So for example,
50:22 you know,
50:22 do the literacy items
50:25 versus the,
50:26 I forget what other categories are there in the,
50:28 in the Denver,
50:29 say like numeracy or something else or like do they
50:32 appear to.
50:33 All together you could look for
50:35 kind of,
50:36 you know,
50:37 just very basic things about item rest correlation and
50:40 and chromeback
50:41 just to see does it function well
50:44 um you just want to see that before
50:46 you,
50:47 you say,
50:47 oh well,
50:48 it didn't have effects on child development,
50:50 no,
50:50 I see.
50:50 So,
50:50 OK,
50:51 uh,
50:52 I,
50:52 I think we should do that with,
50:53 uh,
50:54 some sort of a diagnosis
50:56 of
50:57 before,
50:57 yeah.
51:00 And there's,
51:00 and then I guess if the diagnosis is good,
51:02 we,
51:03 we are more confident about our conclusion.
51:05 There was no effect.
51:06 And if the diagnosis is not good,
51:09 we'll say,
51:09 well,
51:10 sorry,
51:10 we cannot say much about.
51:11 Yes,
51:12 yeah,
51:12 you can say that and,
51:13 and you can say it's really hard to adapt things
51:17 to very different context.
51:19 A great suggestion,
51:20 uh,
51:20 Sharon,
51:20 I
51:21 copy pasted your,
51:23 your chat so that I.
51:24 Another,
51:25 another quick thing you can do,
51:26 I'm saying this from like bad
51:28 experience on my own part,
51:30 um,
51:30 a very quick thing is to see whether
51:33 the index moves with things you think it should move with.
51:36 Say,
51:36 like.
51:37 Asset household asset quint you know,
51:39 the quintiles
51:40 or maternal education
51:42 if the,
51:43 if it's not,
51:43 if it's moving very little with these things,
51:46 that would also kind of suggest like maybe you aim too high
51:50 um with the with the with the question question.
51:54 OK,
51:54 no,
51:55 that makes perfect sense.
51:59 Thank you.
52:02 Do we have any other questions for Damien or
52:05 for any for the operational team even about kind of
52:08 doing this,
52:09 um,
52:10 both the kind of the,
52:12 the actual interventions themselves or the evaluation
52:15 in Burkina?
52:36 Alika,
52:36 if I can,
52:37 I mean,
52:37 again,
52:38 I guess one thing that would be really
52:39 interesting to hear from the operational colleagues is
52:42 the adaptations that were made
52:44 um
52:45 during the process of,
52:46 of implementation to account for both insecurity and,
52:49 and COVID.
52:50 Um,
52:51 if anyone could comment on that,
52:52 I'd be really interested to hear.
52:55 Thank you.
53:01 OK.
53:02 Uh,
53:02 maybe I can come in.
53:04 Alaka.
53:06 Oh,
53:06 please,
53:06 yes,
53:07 yes.
53:09 Thanks,
53:10 thank you for,
53:11 for the question.
53:12 Um.
53:13 Uh,
53:15 about,
53:15 uh,
53:16 this aspect,
53:17 what we can share,
53:18 uh,
53:19 is that we try to have a pilot of um,
53:25 Uh
53:27 Like,
53:27 uh,
53:28 creating,
53:29 uh,
53:29 opportunities for beneficiaries
53:32 to have,
53:33 uh,
53:33 some
53:34 sensitization message
53:38 by uh,
53:38 uh,
53:39 their phone.
53:41 So we,
53:42 uh,
53:43 did a pilot,
53:44 um.
53:47 like vocal messages
53:49 that can be spread through the population
53:54 because as you mentioned,
53:56 the security.
54:00 The access to the different villages was very
54:05 difficult.
54:06 So on
54:07 the place where the access was
54:11 possible.
54:13 Uh,
54:13 the local actors
54:17 were going there physically,
54:20 but for those
54:23 who,
54:24 uh,
54:26 wasn't,
54:26 for which it wasn't possible to go on theground,
54:31 we
54:32 try a pilot phase
54:35 to spread local vocal
54:38 messages to the beneficiaries.
54:41 And,
54:41 uh,
54:43 going through these uh tools to
54:46 spread,
54:46 uh,
54:47 all the
54:49 Message on nutrition or climate change or,
54:53 or something like that.
54:55 So it's this kind of adaptation that,
54:58 uh,
54:58 we find on the operation.
55:01 Um,
55:02 for the new
55:03 operation,
55:04 we are also,
55:04 uh,
55:05 we are preparing,
55:06 uh,
55:06 now,
55:06 we want to,
55:07 uh,
55:08 roll out,
55:09 uh,
55:09 this,
55:10 uh,
55:11 way to,
55:11 uh,
55:12 to proceed on the field because
55:14 Even
55:17 now,
55:18 we also continue in Burkina Faso to face insecurity,
55:22 and
55:23 there's some population that it's difficult for,
55:26 for which,
55:27 for which it's difficult
55:30 to access,
55:30 so.
55:33 For accompanying measure,
55:35 uh,
55:36 we plan to use,
55:37 uh,
55:37 this process,
55:38 uh,
55:39 because we did a quick evaluation on,
55:41 uh,
55:41 this way to,
55:42 uh,
55:43 sensitize,
55:44 uh,
55:44 people on the field,
55:45 and,
55:45 uh,
55:46 it's worked,
55:46 uh,
55:47 very well.
55:47 So
55:48 we hope that,
55:49 uh,
55:49 with this new operation,
55:51 we will be able to,
55:52 uh,
55:53 use the same,
55:54 uh,
55:54 tools to,
55:55 uh,
55:56 implement the accompanying,
55:58 uh,
55:58 measure,
55:59 uh,
56:00 uh,
56:00 in benefit to the population.
56:08 Thanks so much,
56:09 Dan.
56:09 Um,
56:10 so why don't we,
56:12 we are at time or very near time.
56:14 Why don't we all give the,
56:16 both the operational team and the evaluation team a
56:19 virtual round of applause,
56:21 um,
56:21 for,
56:21 for this great work and for sharing the findings,
56:24 um,
56:24 and their insights with us today.
56:29 Thank you everyone.
56:31 Thanks a lot for the opportunity.
56:33 Thank you.
56:34 Thanks a lot.
56:36 Thank you.
56:37 Goodbye.
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Impacts of Integrated Social Safety Nets in Burkina Faso
February 25, 2026 10:00 AM | (UTC-05:00) Eastern Time
Abstract
Cash transfers are a cornerstone of social protection. This seminar presents the evaluation of an integrated program in Burkina Faso that combines cash transfers with parenting interventions delivered through group meetings or home visits. In a randomized experiment across 225 villages, households received cash alone; cash plus information on child health and development; or cash, information, and home visits reinforcing the information. Fifteen months after treatment ended, households receiving all three components had fewer pregnancies, more medically assisted births, improved health behaviors, and better educational outcomes. Adding home visits is essential for enhancing child development. Cash alone or with information produces no lasting effects.
Download: Paper; Presentation
Speakers
Damien de Walque (presenter)
Lead Economist, World Bank
Julian Koschorke
Senior Social Protection Specialist, World Bank
Yuko Okamura
Senior Economist, World Bank
Diane Kiemde Traore
Senior Social Protection Specialist, World Bank
Alaka Holla (Chair)
Lead Economist
Program Manager, Strategic Impact Evaluation Fund World Bank