Using Household Grants to Benchmark the Cost Effectiveness of a USAID Workforce Readiness Program

McIntosh, Craig

doi:10.1257/rct.4388-1.0

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…As was the case in the one-year evaluation results from this study (McIntosh and Zeitlin, 2022), we find no evidence of complementarity; the combined arm demonstrates the impacts seen in either arm with no additional benefits arising from them being implemented together. Most of these outcomes represent a 'fade' of about 50% relative to the impacts seen in the midline study, meaning that roughly half of the benefit observed after one year is still present more than three years later.…”

Section: Introductionsupporting

confidence: 56%

“…We find evidence that both interventions have sizeable impacts on primary economic outcomes relative to control, with cash transfers out-performing training, and that these impacts persist in the medium term, though they muted relative to the short term and no longer statistically distinguishable from one another. McIntosh and Zeitlin (2022) reported short-term impacts, finding that HD increased hours worked, monthly income, and productive assets, and that the impacts of cash transfers were significantly larger at cost-equivalent levels on the latter two domains; moreover, only cash transfers significantly moved consumption outcomes. The medium-term evidence presented here shows that HD continues to elevate productive hours per week by 3.3, productive assets are almost twice the control group, and an index of business knowledge is higher by 0.25 standard deviations even three year later.…”

Section: Introductionmentioning

confidence: 99%

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Skills and Liquidity Barriers to Youth Employment: Medium-term Evidence from a Cash Benchmarking Experiment in Rwanda

McIntosh¹,

Zeitlin²

2022

Preprint

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We present results of an experiment benchmarking a workforce training program against cash transfers for underemployed young adults in Rwanda. 3.5 years after treatment, the training program enhances productive time use and asset investment, while the cash transfers drive productive assets, livestock values, savings, and subjective well-being. Both interventions have powerful effects on entrepreneurship. But while labor, sales, and profits all go up, the implied wage rate in these businesses is low. Our results suggest that credit is a major barrier to self-employment, but deeper reforms may be required to enable entrepreneurship to provide a transformative pathway out of poverty.

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Section: Introductionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Skills and Liquidity Barriers to Youth Employment: Medium-term Evidence from a Cash Benchmarking Experiment in Rwanda

McIntosh¹,

Zeitlin²

2022

Preprint

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“…While blinding of participants is impossible for CTs, blinding personnel and outcome assessment was mentioned in only one RCT. In it, blinding was not performed (McIntosh & Zeitlin, 2020). Overall, few studies (8/38) referred to preregistered protocols.…”

Section: Description Of Studies and Qualitymentioning

confidence: 99%

“…Although there is some preliminary evidence that CTs are cost-effective interventions compared to a USAID workforce readiness program (McIntosh & Zeitlin, 2020) and psychotherapy (Haushofer, Shapiro & Mudida, 2020), the work done to compare the cost-effectiveness of interventions in terms of SWB and MH is nascent, especially in LMICs. Our meta-analysis contributes to this literature by providing a comprehensive empirical foundation to compare the cost-effectiveness of cash transfers to interventions aimed at improving MH or SWB.…”

Section: Implications and Suggestions For Future Researchmentioning

confidence: 99%

The impact of cash transfers on subjective well-being and mental health in low- and middle- income countries: A systematic review and meta-analysis

McGuire¹,

Kaiser²,

Bach-Mortensen³

2020

Preprint

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Background: A large body of evidence evaluates the impact of cash transfers (CTs) on physical health and economic indicators. A growing amount of research on CTs contains measures of subjective well- being (SWB) and mental health (MH) but no attempt has been made to systematically synthesize this work.Methods/design: We undertook a systematic review and meta-analysis of RCTs and quasi- experimental studies, including peer-reviewed publications and grey literature (e.g. reports, pre-prints, and working papers), conducted over the period 2000-2020, examining the impact of CTs on self- reported SWB and MH outcomes.Results: Two authors (JM and CK) double-screened 1,147 records of potentially relevant studies, finding 38 studies suitable for inclusion in our meta-analysis, covering 100 outcomes and a total sample of n=114,274 individuals. The average effect size (Cohen’s d) of 38 CT studies on our composite outcome of MH and SWB is 0.10 standard deviations (SDs) (95% CI: 0.8, 0.13) for an average time until follow-up of two years. However, there is a substantial amount of heterogeneity in the estimated effects (I-squared = 64% and 95% Prediction interval: 0.0021, 0.215). CT value, both in absolute terms and relative to previous income, are significant predictors of the effect size. We find only weak evidence that the impact diminishes over time. Four randomized controlled trials in our sample were designed to identify the spillover effects of CTs on the SWB and MH outcomes of non-recipients. Two found negative spillovers but the average effect is not statistically significant and is close to zero.Discussion: Cash transfers significantly increase MH and SWB in low- and middle-income countries. More research on the long run (5+ years) effects is needed, as well as further analysis of the community and household spillover effects of cash transfers on MH and SWB outcomes. We encourage the inclusion of MH and SWB metrics in impact evaluations of interventions to enable the assessment of their relative cost-effectiveness at improving lives compared to cash transfers.

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“…In addition to the evidence synthesis, this review contributes to the growing literature of situating cash transfers as the “control” or standard of care. This is particularly relevant to studies assessing the cost-effectiveness of new interventions and their value compared to if a low-cost cash transfer programme were implemented as opposed to nothing [ 53 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

et al. 2021

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Background To strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention’s complementary (“plus”) components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being. Methods and findings Forty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child’s life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = −0.13 (−0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = −0.06 (−0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings. Conclusions In this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

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Using Household Grants to Benchmark the Cost Effectiveness of a USAID Workforce Readiness Program

Cited by 5 publications

References 30 publications

Skills and Liquidity Barriers to Youth Employment: Medium-term Evidence from a Cash Benchmarking Experiment in Rwanda

Skills and Liquidity Barriers to Youth Employment: Medium-term Evidence from a Cash Benchmarking Experiment in Rwanda

The impact of cash transfers on subjective well-being and mental health in low- and middle- income countries: A systematic review and meta-analysis

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

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