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Falb K.,Human Development and Health | Kpebo D.,Innovations for Poverty Action | Annan J.,International Rescue Committee
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2012

Objective To document the lifetime prevalence of abuse from in-laws (both nonphysical maltreatment and physical violence), the forms of in-law abuse and reproductive control, and the relationship between experiences of in-law abuse and reproductive control among partnered women in rural Côte d'Ivoire. Design Cross-sectional study using baseline data (October 2010) from a randomised controlled trial examining socio-economic interventions on reduction of violence against Ivorian women. Setting Rural Côte d'Ivoire. Population A total of 981 Ivorian women aged 18 years and older who reported having a male partner and a current source of stable income. Methods Bivariate and multivariable logistic regression. Main outcome measures Lifetime, in-law-perpetrated reproductive control. Results More than one in four (27.0%) women reported experiencing lifetime in-law abuse. In adjusted logistic regression analysis, in-law abuse was significantly associated with in-law-perpetrated reproductive control (adjusted odds ratio 6.9; 95% confidence interval 3.9-12.2; P < 0.0001). Religion and having fewer pregnancies were also associated with reporting in-law-perpetrated reproductive control. Conclusions Increased efforts are needed to involve in-laws in programmes that seek to reduce gender-based violence against women and improve women's reproductive health. © 2012 RCOG.

New Haven, CT, Dec. 8 - A new study today shows that the expansion of mobile money helped bring hundreds of thousands of Kenyans out poverty, especially those in female-headed households. The study, published in Science, examined how M-PESA, Kenya's text message-based payments system, spread across the country over six years. The researchers tracked the economic progress of thousands of households and estimate that the expansion of M-PESA lifted 194,000 households, or two percent of households in the country, above the poverty line, and that these effects were partly driven by women's access to the new way of sending and receiving money. M-PESA, introduced in Kenya in 2007, now reaches 96 percent of the country's households. Because it uses simple SMS messages (not requiring a smartphone) to send money, and cash can be deposited or withdrawn from local agents (for example, at a nearby shop), the service does not require an extensive bank infrastructure and reaches even remote rural areas. Economists Tavneet Suri, Associate Professor of Applied Economics at MIT's Sloan School of Business and Billy Jack, Professor of Economics at Georgetown University, worked with the research and policy non-profit Innovations for Poverty Action to study households across much of the country as the network of agents expanded into new localities. The study was funded by the Bill & Melinda Gates Foundation and the organization Financial Sector Deepening Kenya. "What we saw over six years was impressive -- as people were given access to this low-cost means of sending and receiving cash, poverty, particularly extreme poverty, decreased, and especially for households headed by women," according to Suri. "We saw that when M-PESA came to an area, women shifted their occupations and their savings went up. We estimate that about 185,000 women shifted occupations from subsistence farming to business or retail sales. Previous studies of programs thought to reduce poverty have had mixed results; for example, multiple studies have shown that microloans, while helpful business tools for a few, do not on average bring borrowers out of poverty. "Our earlier work on M-PESA showed that it improved financial resilience in Kenya - while households typically suffered falls in consumption of about 7 percent when hit by misfortune, M-PESA users were able to maintain normal consumption levels in the event of such unexpected setbacks," according to Jack, of Georgetown, "With this longer term data, we're confident that the proliferation of mobile money has also resulted in a reduction in poverty, especially in households headed by women." The findings also add to a growing body of research on gender dynamics surrounding money in low-income countries. "Sometimes the poor, and poor women in particular, just need access to the right set of simple tools to help themselves, but we haven't always known what that the right set was," according to Annie Duflo, Executive Director of Innovations for Poverty Action. "Hopefully these results will inform and encourage the targeted scaling of mobile money services in other countries. While many other countries have a system, too few have the kind of nationwide infrastructure that now exists in Kenya." Innovations for Poverty Action (IPA) discovers and promotes effective solutions to global poverty problems. IPA designs, rigorously evaluates, and refines these solutions and their applications together with decision-makers to ensure that the evidence created is used to improve opportunities for the world's poor. In the 10 years since its founding IPA has worked with over 250 leading academics to conduct over 600 evaluations in 51 countries.

News Article | October 23, 2015
Site: www.reuters.com

Children walk down an alleyway where sewage runs freely in Pikine, Senegal, October 16, 2015. The chaotic expansion of the city of 3 million people in recent years has meant many homes in its sprawling suburbs are unconnected to sewage pipes, leaving residents prey to diseases such as cholera, typhoid and hepatitis, particularly during the three-month rainy season. Many homes have no toilet and those that do pipe waste into septic tanks outside, which often flood during the rains. Aging sanitation trucks are too unwieldy to access many narrow alleys, meaning households must clean out tanks by hand or pay someone else to do so. For many residents, mechanized removal of waste, which costs more than double the price of manual emptying, is too expensive in a country where most people scrape by on less than $3 a day. In one of the first projects of its kind in Africa, Senegal's government and charitable organizations are installing new toilets that turn waste into compost or break down matter with worms in a bid to lower health risks. For the existing septic tanks, they are providing small portable pumps to allow sanitation teams access to the cramped backstreets to remove waste safely. “If we want to have a healthy and productive society, we need better sanitation for everyone,” said Sarah Nehrling, research manager for Innovations for Poverty Action, a partner on the program. Eventually, the project aims to use waste material collected in this way to power an electrical plant -- using new technology to find a renewable means of tackling the problem of frequent blackouts in the port city. Nehrling said they hoped residents would one day be paid for waste to fuel the plant. Hadjiratou Ane, a mother of six from Keur Massar on the very edge of Dakar, said the new toilet in her family compound -- installed by a local organization working with Oxfam, one of the project partners -- had changed her life. Her family previously relied on a hole in the ground and the forest across the street. "The children...no longer need to go to the forests for their needs," said Ane. "The family's health has improved. I am proud to have a toilet." Under the initiative, residents can dial into a call center that gives trucking companies an hour to submit bids to empty tanks, before selecting a winner based on price and proximity. Senegal's national sanitation bureau hopes the project can reduce the households that manually empty their pits and lower sanitation expenses by 45 percent. The goal is to feed households' sludge to a small power plant for conversion into drinking water and grid electricity. A Gates Foundation representative said they hoped the plant would be fully operational in a few months. Initially, it will produce 1,000 megawatt hours of electricity a year -- enough for about 5,000 people -- but project partners believe it can be scaled up as Dakar grows. The city's population is forecast to rise by half by 2025. Some residents, however, turn up their nose at the idea: "I don't think I could drink water made in that way," said Ane. The effort is one of myriad renewables initiatives intended to tackle Senegal's power deficit. Like most African countries, Senegal suffers from high electricity prices and frequent blackouts. Senegal's power costs are up to five times higher than in other developing areas: $0.22 per kilowatt-hour compared to $0.04 in South Asia, according to the International Renewable Energy Agency (IRENA). Poor energy access has hampered Africa's economic growth and poverty reduction. The International Energy Agency (IEA) says an injection of $450 billion is needed to power every urban area by 2040. While Senegal relies on fossil fuel imports, it hopes to harness renewable energies like solar and wind to produce 15 percent of its energy needs by 2025. Djiby Ndiaye, director of Senegal’s national renewable energy agency, said recent low oil prices would not derail the plan: “We have no control over the price. Tomorrow it could rise again.”

Akter T.,Senior Research Assoct | Ali A.R.,Innovations for Poverty Action | Dey N.C.,Research Fellow and Coordinator Environment Research Unit
BMC Public Health | Year: 2014

Background: In a low-income country like Bangladesh, where the poverty rate is higher in rural compared to urban areas, the consistent use of sanitary latrines over time is a challenge. To address this issue, the Water, Sanitation, and Hygiene (WASH) program of the Bangladesh Rural Advancement Committee (BRAC) was devised to improve health of the rural poor through enhanced sanitation services, such as by providing loans or education. Sanitary latrine use in households and changes over time were assessed in this study. Methods. This was a longitudinal cohort study of the baseline, midline, and end line status of the WASH project. Households assessed in all three rounds of surveys (26,404 in each survey) were included in the analysis. Thirty thousand households from 50 upazilas (sub-districts) were selected in two stages: i) thirty villages were selected from each of the 50 upazilas by cluster sampling, and ii) twenty households were chosen systematically from each selected village. A female member capable of providing household-level information was interviewed from each house using the pre-tested questionnaire. Spot observations of some components were made to assess the quality of sanitary latrine use. The adjusted log-binomial regression was performed and risk ratios with 95% confidence intervals were estimated for sanitary latrine use. Data were analyzed using Statistical Package for the Social Sciences (SPSS) and Stata software. Results: The use of sanitary latrines by households increased significantly from the baseline (31.7%) to midline (41.5%) and end line (57.4%) assessment points. The proportion of physically verified clean latrines increased significantly from 33.4% at baseline to 50.8% at the midline and 53.3% at the end line. Analysis of changes in latrine-use showed that 73.3% of the baseline latrine-using households continued to do so at the end line, while the rest switched to unsanitary practices. Households with better socioeconomic status were more likely to use sanitary latrines. Conclusion: There are improvements in ownership and use of sanitary latrines by households over the years in WASH intervention areas. However, switching of some households from sanitary to unsanitary latrines remains a matter of concern regarding sustainability. © 2014 Akter et al.; licensee BioMed Central Ltd.

Saran I.,Public-i | Kasozi H.,Innovations for Poverty Action | Cohen J.,Public-i
American Journal of Tropical Medicine and Hygiene | Year: 2016

Most patients with suspected malaria do not receive diagnostic confirmation before beginning antimalarial treatment. We investigated the extent to which uncertainty about malaria diagnosis contributes to patient nonadherence to artemether-lumefantrine (AL) treatment through a randomized controlled trial in central Uganda. Among 1,525 patients purchasing a course of AL at private drug shops, we randomly offered 37.6% a free malaria rapid diagnostic test (RDT) and then assessed adherence through home visits 3 days later. Of these subjects, 68.4% tested positive for malaria and 65.8% adhered overall. Patients who tested positive did not have significantly higher odds of adherence than those who were not offered the test (adjusted odds ratio [OR]: 1.07, 95% confidence interval [CI]: 0.734-1.57, P = 0.719). Patients who received a positive malaria test had 0.488 fewer pills remaining than those not offered the test (95% CI:-1.02 to 0.043, P = 0.072). We found that patients who felt relatively healthy by the second day of treatment had lower odds of completing treatment (adjusted OR: 0.532, 95% CI: 0.394-0.719, P < 0.001). Our results suggest that diagnostic testing may not improve artemisinin-based combination therapy adherence unless efforts are made to persuade patients to continue taking the full course of drugs even if symptoms have resolved. © Copyright 2016 by The American Society of Tropical Medicine and Hygiene.

Reed E.,George Washington University | Silverman J.G.,University of California at San Diego | Stein B.,George Washington University | Erausquin J.T.,Duke University | And 3 more authors.
AIDS and Behavior | Year: 2013

This study examines whether the challenges of motherhood among female sex workers (FSW) are linked with vulnerability to sexual risk factors for HIV. FSW at least 18 years of age (n = 850) were recruited through respondent driven sampling for a survey on HIV risk in the Rajahmundry area of Andhra Pradesh, India. Logistic regression models adjusted for demographic characteristics were used to assess the relation between reported caretaking challenges and sexual risk indicators for HIV. In adjusted logistic regression models, FSW who reported three or more children in their household or current child health concerns were significantly less likely to report consistent condom use (adjusted odds ratios (AORs) range: 0.5-0.6) and more likely to take more money for sex without a condom (both AORs: 2.5). Women who reported current child health concerns were also more likely to report an STI symptom in the past 6 months (AOR = 1.6; 95 % confidence interval: 1.1-2.3). Findings suggest that challenging responsibilities related to caretaking of children are associated with heightened vulnerability to HIV risk among FSW. Such findings add to the cumulating evidence urging for the implementation of HIV prevention interventions that consider the multiple challenges across various domains of women's lives. © 2012 Springer Science+Business Media, LLC.

Agency: GTR | Branch: ESRC | Program: | Phase: Research Grant | Award Amount: 378.51K | Year: 2014

Manufacturing sectors in developing countries show a far greater dispersion in firm productivity and management practices than counterparts in high-income countries. Sustained increases in wages and employment creation depend on increases in productivity. This project aims to deepen our understanding of the process of productivity improvement in manufacturing firms in low-income countries (LICs) and to gain insights as to why productivity and innovation lag. We focus on the Bangladeshi RMG sector, the largest source of urban employment in Bangladesh. We study the effects of a training program developed and offered by Solutions for Management International (S4Mi), a not-for-profit consulting firm established as a part of DFIDs Responsible and Accountable Garment Sector (RAGS) program. The S4Mi program has elements of training and consulting, with both classroom and in-factory components. S4Mi and the participating factories select a single pilot production line on which to focus. During the first year of the program, there are seven one-week classroom training sessions, four focused on production / planning and three on HR. Each classroom session is followed by in-factory activations, which focus on providing tools and developing a culture suitable for problem solving. Following the initial activation phase, the program is rolled out to other lines in the factory. Further dimensions of particular interest, therefore, are the determinants of the diffusion of practices across the lines. We incorporate a random selection of pilot lines to provide a valid comparison group prior to the factory-wide rollout. We combine extremely detailed productivity analysis with innovative survey and interview data. The productivity analysis provides an impact assessment of training provided as part of the project. Through the lens of the evaluation, the intense training offers an opportunity to observe a set of factories transitioning - or attempting to transition - internal processes and procedures. The survey and interview data will provide a unique window onto the internal processes of change that accompany the transition. A sample of the key questions we address is: a. Does the training program increase productivity, and, if so, do gains in productivity translate into better working conditions? b. Which share of taught practices are managers aware of at baseline? Are managers capable of predicting which practices will lead to improvement and which wont? c. Which factors affect diffusion of practices across lines? Do these factors differ depending on whether the suggested improvement comes from management or production floor workers? d. Which production lines and manager characteristics correlate with resistance to change? Mid-level management training is very commonly noted by key stakeholders as a critical bottleneck. Hence, there is demand for information about what works with regard to this training. We, the PIs, have been working on related projects in the sector in Bangladesh for more than two years. During this time, we have built important relationships with a number of foreign buyers (Tesco, Sainsburys and H&M, for example), the industry associations (BGMEA and BKMEA), relevant government ministries (Commerce and Revenue), and foreign aid agencies (GIZ and DIFD). We will use these links both to inform the work during the project and to disseminate the results as we obtain them. While the project fits squarely in the innovation theme, there is an important gender component as well. An estimated 80% of workers in the garment sector are female. Improving productivity in the sector, therefore, has the potential to have a tremendous impact on incomes of and job opportunities for women, as well as to reduce their working hours and to afford them more stable jobs.

Agency: GTR | Branch: ESRC | Program: | Phase: Research Grant | Award Amount: 1.42M | Year: 2014

The DIRTS project will use a randomized controlled trial to measure the impact of improved flows of extension information, access to agricultural input packages, and rainfall index insurance on agricultural intensification, specifically the use of fertilizers and improved seeds. To further examine the importance of weather-related risk to farm investment, all farmers in our study will be able to purchase a commercial rainfall index insurance product, developed by the Ghana Insurers Association (GIA). In 2014 we will offer free insurance to a randomly-selected subset of our sample, and actuarially-fair insurance to everyone else. Based on past experience, we expect take-up to be at or near 100% for the free insurance, and low for actuarially-fair insurance. We anticipate a strong investment response to the free insurance. In year 2, given that communities now have experience with the insurance, we expect that there will be strong demand at actuarially fair and higher prices. We will also experiment with marketing by local notables, to see if this increases demand. Second, to test the importance of unsure, untimely and costly access to agricultural inputs, DIRTS will make commercial fertilizer and improved seeds available to selected communities at different points during the year instead of just prior to land preparation. These inputs will be sold at market price by existing agro-input dealers, who are based in the districts. The project will facilitate linkages between these suppliers and the communities and subsidize transport. Third, to test the importance of imperfect farmer knowledge of farming best practices, randomly selected communities will be provided with more intensive extension through a Community Extension Agent (CEA). CEAs will be based in their own communities and will use Android phones to deliver standardized weekly extension messages, and will use mobile technology (pre-loaded database) to offer appropriate and time-sensitive advice to the farmers. For this study, 3240 households in 162 communities will be randomized into one of four treatment groups: insurance and extension; insurance and agricultural inputs; insurance, extension, and agricultural inputs, and insurance only. Two main evaluation tools will be used to study DIRTS households: comprehensive annual surveys to collect household and plot level data, and weekly tracking of household labor surveys during the agricultural season. Field work for DIRTS will run from January 2014 to March 2016 in 9 districts in northern Ghana. During the study period, project staff will use social media outlets and meetings with key stakeholders in the insurance and agricultural sectors to disseminate technical knowledge, focus group discussion results, and preliminary findings. At the end of the study period, local and international dissemination conferences will be held to publicize results.

Agency: GTR | Branch: ESRC | Program: | Phase: | Award Amount: 100.08K | Year: 2013


Agency: NSF | Branch: Standard Grant | Program: | Phase: ECONOMICS | Award Amount: 383.45K | Year: 2013

Proposal Title: Direct and Indirect Impacts of Credit Scoring for Small and Medium Enterprises
Proposal Number: SES - 1326433
Principal Investigator: Dean Karlan

Lack of access to finance remains one of the core challenges to small firm growth in low- and middle-income countries. Many small and medium enterprises (SMEs) have high returns to capital but if banks cannot identify these borrowers, they may restrict lending or misallocate funds, limiting production and employment growth. Many low- and middle-income countries do not have credit bureaus or other effective public systems that aggregate information valuable for screening, further exacerbating the challenge of identifying high return borrowers.

While a lack of adequate financing may constrain the expansion of individual firms, the provision of credit to a single business is likely to have spillover effects on other firms and on consumers. Firms operate in a web of competitors and suppliers, and these businesses will also be affected by credit that is provided to a single loan recipient. For example, standard economic theory suggests that competitor firms will see decreased demand when competitors gain access to credit. At the same time, increased demand for supplier inputs can lead to increased upstream profitability. Classic theories of economic development stress the importance of these linkages in the takeoff to development.

This study uses a randomized controlled trial methodology to evaluate the impact of providing credit to SMEs, examining both the direct effects on recipient firms and the indirect spillover effects on competitors and firms linked to treated businesses through supply chains. A large development bank in the Philippines is implementing a new credit scoring system at 45 branches across the country. The new system will process all SME loans and assign a credit score to each loan applicant. Credit scores falling in a certain range below the cut-off for automatic loan approval will be randomly approved or denied. The randomized design generates exogenous variation in access to credit among SME loan applicants, enabling us to measure the impact of credit on firms.

An important and innovative aspect of this evaluation is its focus on spillovers across firms. The project will measure vertical spillovers by surveying firms in the supply chains of loan applicants, and exploit variation in the number of firms receiving credit in different industries and markets to measure horizontal spillovers on firms competing directly with treatment and control businesses. Identifying competitor and supply chain markets and the horizontal and vertical interactions of sample firms constitutes a new approach to the study of firms in low- and middle-income countries. The findings are highly policy relevant. Evidence that providing credit to one firm has positive market spillovers, perhaps though increasing competition or allowing suppliers to invest more, would provide a strong justification for increasing access to credit. On the other hand, if gains to the firm receiving credit come entirely at the expense of losses to its competitors, then subsidized credit would accomplish little, suggesting that the gains from microcredit may be overestimated.

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