Abstract: We study the relationship between mental health and economic productivity in Ghana using a randomized controlled trial of 7,800 households. Households either received cognitive behavioral therapy (CBT), a graduation program, CBT followed by a graduation program, or nothing. The CBT program led to short-term reductions in depression, and improved socioemotional skills. We find some evidence that both the CBT program and graduation program improved economic outcomes, but do not find evidence of complementarities. The CBT program led to individuals increasing their per capita consumption, and the graduation programs to increased wealth, concentrated in increased livestock ownership. We find some evidence suggesting that program gains were larger for individuals with larger baseline wealth. 

Abstract: The graduation approach has shown promise in sustainably increasing target recipients' consumption and income in a number of countries. We test the approach in a refugee population in Uganda and contrast results with those from a parallel implementation in surrounding host communities. Relative to eligible households in control villages, program participants, who receive one year of consumption support, increase economic activity and see strong improvements in well-being as measured in the beginning of year two, shortly after a $300 cash asset transfer, and after the end of the two-year program. Effects are notably larger in host communities, who are on average better-off even in the absence of the program. The difference in effects can be explained in part by results from subgroup analysis that shows that effects are stronger among better-off households. However, taking into account differences across a large set of baseline characteristics does not eliminate the host-refugee gap, suggesting that potentially the more limited opportunities for economic expansion (land availability for farming and livestock rearing, market access) restrict the program’s effectiveness among refugees.

Abstract: Multifaceted social protection programs, in particular "Graduation"-style programs with asset transfers and coaching, generate sizable welfare improvements, but their scale is often limited. Two key barriers to scaling are costs and the complexity of implementation. Individualized coaching—a hallmark of many Graduation programs—is one of the largest cost components and is challenging to organize effectively. We examine results from two programs, one in Uganda and one in the Philippines, in which we randomized the coaching component to be delivered during individual household visits or group meetings. While group coaching could benefit from increased information sharing among group members and improved social connections, it might reduce individualized coaching attention and accountability or inhibit some participants' willingness to discuss their problems. We find that both program structures increase economic activity and economic and subjective well-being relative to a control group. Importantly, we find no differences in impact between the individual and group coaching approaches on average or within machine-learning-generated subgroups based on baseline characteristics. Our results demonstrate that group coaching is more cost-effective and easier to organize relative to individual coaching and that it does not jeopardize program impacts. 

Abstract: We employ an at-scale randomized experiment to evaluate how one of the world's largest citizen-led monitoring efforts, India's ``social audits'' initiative, impacted corruption and access to social protection in one of India's poorest states. Combining administrative data on program expenditures with survey data, we document that both elected and appointed village leaders engage in corruption and corruption is gendered, with a higher burden of corruption for women. Further, the nature of corruption varies across two distinct schemes linked to India's workfare program. Submitting names of villagers who did not work was the main form of leakage in the public works scheme, whereas kickbacks dominated in the national housing scheme, which provides a conditional cash transfer for home construction. Audits reduced corruption in both programs, with differing implications for participants by program. Reduced corruption in public works was accompanied by lower levels of implementation and therefore less access -- survey data show the share of citizens participating reduced by more than 50% in audited communities. Conditional on participating, amounts received by citizens did not change. In contrast, audits reduced kickbacks paid to local leaders under the national housing program by 28% and as a result income retained by participants increased by 7%.

Abstract: We examine the role of gender targeting, and couples training on economic cooperation, within the context of a Multifaceted Anti-poverty Program for the Ultra Poor in Malawi. We randomized at both the village and household levels, and within the treatment group, we randomized into three treatments: female spouse recipient, male spouse recipient and female spouse recipient plus couples training. After 17 months, the gender of the recipient does not affect overall household or spousal consumption or the total, or spouse specific, ownership of assets, suggesting the presence of income pooling and complete risk sharing. Female targeting, compared with male targeting, did not lead to improvements in children’s outcomes, nor female spouse’s mental well-being, and while female targeting led to empowerment gains in the short run, these were short lived. Male targeting shifted the economic focus of the household towards agricultural activities. Finally, participation in training on spousal economic cooperation and gender empowerment for female targeted households affected the nature of investments made by the household (towards agriculture, suggesting a drift towards male domains/preferences), but nonetheless, led to a Pareto improvement with improved household income and business income, driven by higher female business income, increased female spouse’s likelihood of owning livestock and improved male livestock ownership value. At 17 months gender training improved female economic agency, male mental health and couples are more likely to stay together.

Abstract: This study presents new evidence on the gendered effects of social safety net programs, in the context of the National Social Safety Nets Project (NASSP), a flagship program of the Nigerian government. The program has three components: 1) a basic unconditional cash transfer, 2) a top-up conditional cash transfer with behavioral change training, and 3) a livelihood support component comprising life skills and business skills training complemented by a lump sum productive grant. This study evaluates the impact of receiving Package 2 (components 1 and 2), or Package 3 (components 1, 2, and 3) relative to receiving Package 1 (component 1 alone). This evaluation provides new evidence on scalable strategies to implement targeted government-led cash transfers and sustainable support for graduation out of poverty. It especially furthers our understanding of the impacts of livelihoods interventions on intrahousehold gender dynamics and women’s economic empowerment and wellbeing.

Within the subset of NASSP livelihood households (receiving Package 3), the following additional interventions are tested: 1) default selection of an eligible female household member to receive the livelihood support component compared to allowing households to select an eligible beneficiary by themselves; and 2) providing a household gender sensitization that encourages gender equality and household collaboration and cohesion compared to no sensitization. The gender sensitization includes a 2.5 hour visit to the household led by a trained facilitator where adult members of the household come together to discuss gender roles, watch a video of positive examples of intra-household collaboration and economic empowerment of women in their community, and discuss the skills and strengths of each household member aged 18-45 years.

The study draws on data from a random sample of almost 8,000 NASSP participant households from 460 communities in six states from each geopolitical zone in the country.

Abstract: Low utilization of primary and preventive healthcare during pregnancy and early childhood is a significant determinant of suboptimal maternal and child health outcomes, particularly in low- and middle-income countries (LMICs). To address this issue, Conditional Cash Transfer (CCT) programs have been implemented, which provide cash to low-income households upon fulfilling specific conditions. One such program, the Pradhan Mantri Matru Vandana Yojana (PMMVY), was introduced nationally in India in 2017, targeting pregnant and lactating women.

Data and Methods: This study used data from three rounds of India’s National Family Health Surveys (NFHS) conducted in 2005–06, 2015–16, and 2019–21. The analysis focused on children under five years, comparing pre- and post-intervention periods to assess the impact of PMMVY. Addressing the non-randomized nature of PMMVY receipt, the study uses the Triple Difference (TD) estimation strategy, considering firstborn children as the primary beneficiaries of the program.

Results: The study found that PMMVY coverage has increased over time, reaching 63% of eligible beneficiaries in 2019–20. Among firstborn children, exposure to PMMVY was associated with improvements in weight-for-age and height-for-age z-scores. Program's conditionalities, including pregnancy registration, antenatal care, and immunizations, were positively associated with PMMVY beneficiaries. Additionally, higher program expenditure was linked to improvements in child anthropometric outcomes. Program benefit-cost ratio shows a $1.38 return on every dollar spent in the short run.

Interpretation: The findings suggest PMMVY could strengthen child nutrition in India. PMMVY conditions promoted prenatal and postnatal healthcare. The economic analysis showed that PMMVY was cost-effective and provided significant health benefits.  These findings can help LMIC policymakers implement similar perinatal CCT program.