Learn how the World Bank Group is helping countries with COVID-19 (coronavirus). Find Out

BRIEF

Evaluation of a Behavioral Approach to Improve Outcomes in Early Childhood

April 18, 2017

Improving early childhood development parenting practices and nutrition is a critical first step in preparing children for school and productive working lives. With nearly 80 percent of Madagascar’s population of 22 million living below $1.25 per day, around half of Malagasy children are chronically malnourished. As part of the roll out of a World Bank supported social safety net project that gives cash transfers to the poorest households, SIEF researchers will test the impact of adding in community meetings on healthy development with behavioral “nudges” to boost mothers’ self-esteem and help them take positive steps for their children’s future. The results will help inform future roll out of the safety net program, and provide researchers with valuable information on the applicability of behavioral science to improve early childhood development.

Research Area: Early Childhood Nutrition, Development, and Health
Country: Madagascar
Evaluation Sample: Six districts
Timeline: 2016-2019
Intervention:  
Researchers: Damien De Walque, World Bank; Lia Fernald, University of California (Berkeley); Patricia Kariger, Research Consultant; Josh Martin, ideas42; Dana Guichon, ideas42; Jiyoung Han, ideas42; Tina Razafinimanana, ideas42
Partners: Pierre Lazamanana, Director, Ministry of Population, Social Protection, and Gender; Rasendra Rastima, Director General, Madagascar’s FID - Fonds d'Intervention pour le Développement; Haga Allivenja, Evaluation Director, FID - Fonds d'Intervention pour le Développement; Achille Razakatoanina, Director CCT, FID - Fonds d'Intervention pour le Développement; Mirana Noroniaiana Ranarivelo, Private Sector Partnership Specialist, UNICEF; Noroiaina Rakoto, Independent Consultant (Early Childhood Development Specialist); 


Problem

With nearly 80 percent of Madagascar’s population of 22 million living below $1.25 per day, around half of Malagasy children are chronically malnourished. In 2016, the Government of Madagascar, with World Bank support, implemented a social safety net project to provide cash transfers to the poorest households. The program was rolled out in seven districts, covering some 39,000 households. The program included a cash transfer conditioned on children over the age of six attending school, and an unconditional cash transfer for families with children under the age of six. 

Intervention

As part of the roll out of a social safety net, SIEF researchers are testing the impact of community meetings on healthy development and using behavioral “nudges” to boost mothers’ self-esteem and help them take positive steps for their children’s future. The “Mother Leaders” are beneficiaries elected by their peers and who received training to support the monthly community meetings. They also worked with local non-governmental organizations to deliver the behavioral “nudges These “nudges” included creative exercises to help women develop plans for spending or to boost positive thinking and aspirations, empowering recipients to make better decisions. The exercises were held every two months while women waited for their payments. 

Evaluation

Rural areas in Madagascar are organized by commune administrative units, each of which contain several villages. Fifty-one communes in six rural districts were randomized in four treatment and control groups, covering about 51,000 households: in 77 villages, mothers received the cash transfer only; in 77 villages they received the cash with community meetings; in 77 they received both and also meetings to help them plan; and in 78 they received the cash, community meetings and meetings to help with self-affirmation; and 70 were the control group and didn’t receive anything. The behavioral change activities were led by local non-governmental organizations trained by ideas42. Apart from the baseline, data was collected at midline after program had been going on for about 20 months. Researchers surveyed households on, among other things, parenting practices, economic activities, and diet diversity, and also child development progress using the Malawi Development Assessment Test. Endline results will be collected in October 2019. 

Eligibility

Households who qualified for the social safety net transfer program, which covered poor households with children under the age of 12 in some of the poorest regions of Madagascar. 

Results

On its own, cash improved food consumption and long-term food security over 12 months, and also children’s language development. In the group that also had the “Mother Leaders” and community meetings, along with cash, there were gains in children’s social skills development and language, while short-term food security rose and people had a more diverse diet. Twinning cash transfers with the activities designed to improve planning led mothers to spend more time with their children; the self-affirmation activities with cash led to gains in children’s social skills development and there were also gain in household spending on education.

Policy Impacts

The Government of Madagascar, with support from the World Bank, is now planning to scale up the social safety net program and will mainstream behavioral “nudges” into program as it is expanded to other parts of the country.

Global Impacts

Drawing on the Madagascar experience, the introduction of behavioral interventions in cash transfer programs is being developed in Kenya, Tanzania, and Ghana in partnership with the World Bank and ideas42.