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Globally, access to good quality abortion services and post-abortion care is a critical determinant for women’s survival after unsafe abortion. Unsafe abortions account for high levels of maternal death in Kenya. We explored women’s experiences and perceptions of their abortion and post-abortion care experiences in Kenya through person-centred care. This qualitative study included focus group discussions and in-depth interviews with women aged 18-35 who received safe abortion services at private clinics. Through thematic analyses of women’s testimonies, we identified gaps in the abortion care and person-centred domains which seemed to be important throughout the abortion process. When women received clear communication and personalised comprehensive information on abortion and post-abortion care from their healthcare providers, they reported more positive experiences overall and higher reproductive autonomy. Communication and supportive care were particularly valued during the post-abo...
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February 27, 2020
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Over 700 million people live on less than US$1.90 per day. Many of these families depend on insecure and fragile livelihoods. Globally nearly half of all deaths in children under five are attributable to undernutrition, translating into the loss of about three million young lives a year. Recent research has shown that holistic livelihoods programs, such as the Graduation Approach can have a wide range of benefits for these poor families, from increasing household consumption and income to improving food security and mental health. The Graduation model provides families with a range of services, including income-generating assets, training, access to savings accounts, consumption support, and coaching visits, and variations of the model have been successfully replicated in several contexts. The aim of this research in Burkina Faso is to rigorously evaluate whether an adapted Graduation program design, which focuses on strengthening the household’s ability to cope with crises, leads to i...
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February 25, 2020
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As in many other developing countries, children under the age of five in rural parts of Ghana often fail to reach their development potential. This study evaluated the impacts of the Lively Minds program, a low-cost, community-run, play-based preschool learning program, that engaged both teachers and parents on early childhood development. Key Findings: At the end of the one-year study: The Lively Minds program increased children’s cognition, with significant improvements in emergent-numeracy, executive function, and fine motor skills. The effect of the program on the cognitive skills of children from the poorest 20 percent of households was twice as high as that of children from better-off households. There was also a significant improvement in the literacy skills of the disadvantaged children that was not observed for the rest. Children’s socio-emotional development improved, with the program leading to a reduction in externalizing behavior, including both conduct problems and hypera...
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February 25, 2020
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Context: A growing body of evidence indicates that nonclinical health care facility staff provide support beyond their traditional roles, particularly in low- and middle-income countries. It is important to examine the role of health facility cleaners in Kenya—from their perspective—to better understand their actual and perceived responsibilities in maternity care. Methods: In-depth, face-to-face interviews using a semistructured guide were conducted with 14 cleaners working at three public health facilities in Nairobi and Kiambu Counties, Kenya, in August and September 2016. Results were coded and categorized using a thematic content analysis approach. Results: Cleaners reported performing a range of services beyond typical maintenance responsibilities, including providing emotional, informational and instrumental support to maternity patients. They described feeling disrespected when patients were untidy or experienced bleeding; however, such examples revealed cleaners' need to bette...
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February 12, 2020
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In 2016, the Liberian government delegated management of 93 randomly selected public schools to private providers. Providers received US$50 per pupil, on top of US$50 per pupil annual expenditure in control schools. After one academic year, students in outsourced schools scored 0.18σ higher in English and mathematics. We do not find heterogeneity in learning gains or enrollment by student characteristics, but there is significant heterogeneity across providers. While outsourcing appears to be a cost-effective way to use new resources to improve test scores, some providers engaged in unforeseen and potentially harmful behavior, complicating any assessment of welfare gains.
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January 31, 2020
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This brief draws on mixed-methods data collected in 2019 as part of the Gender and Adolescence: Global Evidence (GAGE) programme—a unique longitudinal mixed-methods research and impact evaluation study that is focusing on what works to support the development of adolescents’ capabilities during the second decade of life (10–19 years) (GAGE consortium, 2019 forthcoming). In Cox’s Bazar, GAGE partnered with researchers from Yale University and the World Bank to implement the Cox’s Bazar Panel Survey (CBPS) in order to provide accurate data to humanitarian and government stakeholders involved in the response to the influx of refugees.
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December 30, 2019
How large economic stimuli generate individual and aggregate responses is a central question in economics, but has not been studied experimentally. We provided one-time cash transfers of about USD 1000 to over 10,500 poor households across 653 randomized villages in rural Kenya. The implied fiscal shock was over 15 percent of local GDP. We find large impacts on consumption and assets for recipients. Importantly, we document large positive spillovers on non-recipient households and firms, and minimal price inflation. We estimate a local fiscal multiplier of 2.7. We interpret welfare implications through the lens of a simple household optimization framework.
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Working Paper
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December 19, 2019
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Global efforts are underway to improve education quality—to ensure children are not only in school but learning and developing to their full potential. Although many theories exist on the best approaches to improve education quality, policymakers and implementers need evidence on which programs are effective at helping children actually learn while in school. Innovations for Poverty Action (IPA) is a research and policy nonprofit that discovers and advances what works to reduce poverty and improve lives. In addition to conducting rigorous research, IPA reviews and consolidates research for policymakers and practitioners. The objective is to distill complex, nuanced, and dynamic research findings into focused and actionable recommendations. This brief summarizes and provides key lessons from multiple meta-analyses and over two-dozen randomized evaluations (both IPA and non-IPA studies) on improving learning outcomes in low-income countries, with a focus on basic education. 
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December 17, 2019
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The Liberian Education Advancement Partnership (LEAP), originally known as Partnership Schools for Liberia (PSL), began in 2016 with 93 public schools, and has since expanded to an additional 101 schools. The model is similar to charter schools in the United States or academies in the United Kingdom. LEAP schools remain public schools, charge no fees, and are staffed by public school teachers, but each school is managed by one of eight private contractors, including three for-profit companies and five charities which have taken responsibility for everything from teacher in-service training to fixing leaks in the roof.  While originally motivated by the government’s desire to improve test scores, the initiative has been dogged by the expulsion of students by private operators, an alleged coverup of sexual abuse of minors, and cost overruns.  This brief summarizes the results of a three-year randomized control trial, comparing outcomes for children in LEAP schools to those in regular gov...
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December 15, 2019
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The work of Nobel Laureates Banerjee, Duflo and Kremer has centered around the use of randomized control trials to help solve development problems. To date, however, few field experiments have been undertaken to evaluate the effects of humanitarian assistance. The reasons may lie in challenges related to logistics, fragility, security and ethics that often loom large in humanitarian settings. Yet every year, billions of dollars are spent on humanitarian aid, and policymakers are in need of rigorous evidence. In this paper, we reflect on the opportunities and risks of running experiments in humanitarian settings, and provide, as illustration, insights from our experiences with recent field experiments of large-scale humanitarian aid programs in the Democratic Republic of Congo.
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December 01, 2019
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Little evidence exists on women’s experiences of care during abortion care, partly due to limitations in existing measures. Moreover, globally, the development and rapid growth in the availability of medication abortions (MA) has radically changed the options for safe abortions for women. It is therefore important to understand how women’s experiences of care may differ across medication and manual vacuum aspiration (MVA) abortions. This study uses a validated person-centered abortion care scale (categorized as low, medium, and high levels, with high levels representing the greatest level of person-centered care) to assess women’s experiences of care undergoing medication abortions vs. MVA. This paper reports on a cross-sectional study of 353 women undergoing abortions at one of six family planning clinics in Nairobi County, Kenya in 2018. Comparing abortion types, we found that the MVA sample was more likely to report “high” levels of person-centered abortion care compared to the MA s...
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November 25, 2019
We study a simple savings scheme that allows workers to defer receipt of part of their wages for three months at zero interest. The scheme significantly increases savings during the deferral period, leading to higher post-disbursement spending on lumpy expenditures. Two years later, after two additional rounds of the savings scheme, we find that treated workers have made permanent improvements to their homes. The popularity of the scheme suggests a lack of good alternative savings options, and analysis of a follow-up experiment shows that demand for the scheme is also due to the scheme’s ability to address self-control issues.
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Working Paper
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October 30, 2019
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Innovations for Poverty Action (IPA) invita a organizaciones y asociaciones civiles que trabajen con individuos en situación de riesgo expuestos a la violencia a participar en la convocatoria para participar en el proyecto “Construyendo Policías Eficaces, Resilientes y Confiables en México”. El proyecto “Construyendo Policías Eficaces, Resilientes y Confiables en México” de la Universidad de Yale liderado por el Dr. Rodrigo Canales, tiene por objetivo diseñar y evaluar cómo las fuerzas policiales pueden enfrentar el reto de reducir la violencia, aumentar la legitimidad institucional y confianza en las instituciones, y fortalecer el estado de derecho. En el marco del proyecto, se realizará una intervención comunitaria en conjunto con la Secretaría de Seguridad Ciudadana de la Ciudad de México. Esta intervención busca atender dinámicas de violencia grupal en territorios específicos para cambiar el comportamiento de individuos en situación de riesgo de ejercer violencia o ser víctima. Una...
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Research Resource
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October 24, 2019
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Globally, violence against women is a leading cause of premature death and morbidity for women and almost one-third of women report experiencing intimate partner violence (IPV) or sexual violence by a non-partner at some point in their life. Yet rigorous evidence on scalable and effective ways to reduce IPV is limited, in part because measuring IPV is challenging. Current standards of practice for reducing gender-based violence are also relatively limited in scope, focusing mainly on changing gender norms. Designing and testing new approaches has the potential to yield more effective solutions. IPA’s Intimate Partner Violence Initiative, a partnership with the International Rescue Committee, exists to address these challenges. The initiative designs and tests innovative solutions to IPV, leverages existing research to identify factors that contribute to IPV and works to address methodological and measurement challenges in violence research and related fields. With our academic and impl...
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October 22, 2019
French
Améliorer les opportunités d’emploi productif et inclusif est un enjeu essentiel pour une croissance durable et pour une réduction de la pauvreté en Côte d’Ivoire. La Côte d’Ivoire fait face à un défi majeur de qualité de l’emploi. L’emploi est fortement concentré dans des activités indépendantes agricoles et non-agricoles. En moyenne, l’emploi indépendant a une productivité et des revenus relativement faibles, ce qui mène à un sous-emploi important en fonction des revenus. Dans ce contexte, une stratégie productive et inclusive de promotion de l’emploi devrait à la fois se concentrer sur la création de nouveaux emplois, considérer l’amélioration de la qualité des emplois existants et l’inclusion des pauvres, des femmes et des population rurales dans des emplois productifs. Améliorer les opportunités d’emploi productif pour les groupes de population vulnérables est un enjeu essentiel pour une croissance durable et pour une réduction de la pauvreté en Côte d’Ivoire.La disponibilité de n...
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Report
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October 04, 2019
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Lás microempresas, así como los proveedores de productos, enfrentan desventajas en comparación con las empresas más grandes respecto al abastecimiento de inventario porque, para reabastecerse, deben viajar con frecuencia y pagar costos más altos. Los investigadores evaluaron Agruppa, un servicio de tecnología que usa teléfonos móviles, el cual crea grupos virtuales de compradores para comprar a granel de forma más económica. La evaluación descubrió que la demanda inicial del servicio era alta, lo que ahorraba tiempo y gastos a los dueños de negocios, y aumentaba las ganancias de ciertos productos básicos. Sin embargo, dado que los dueños de negocios redujeron las ventas de otros productos, los ingresos y las ganancias cayeron en promedio y la demanda del servicio disminuyó con el tiempo. Agruppa finalmente cerró, lo que evidencia los desafíos de competir contra mercados centralizados.
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September 26, 2019
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Numerosos gobiernos en países de ingresos medios y bajos, como Brasil y México, han adoptado programas de transferencias monetarias condicionadas (TMC) como una red de protección social, pero la mayoría de los beneficiarios de estas transferencias tienen poca o nula experiencia en el manejo de productos financieros formales. Para contribuir a cerrar la brecha respecto a la capacidad financiera de los beneficiarios del programa de transferencias condicionadas del Gobierno de Colombia, Fundación Capital diseñó LISTA, un programa basado en la noción de "liberar la educación financiera" del aula mediante el uso de aplicaciones diseñadas para usarse en tabletas. Los investigadores colaboraron con la Fundación Capital y el Gobierno de Colombia para realizar una evaluación aleatoria (RCT por sus siglas en inglés) de LISTA para estudiar su impacto sobre el conocimiento y el comportamiento financiero. LISTA tuvo impactos positivos significativos en el conocimiento financiero, las actitudes, las...
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September 22, 2019
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Objective: Despite the recognized importance of person-centered care, very little information exists on how person-centered maternity care (PCMC) impacts newborn health. Methods: Baseline and follow-up data were collected from women who delivered in government health facilities in Nairobi and Kiambu counties in Kenya between August 2016 and February 2017. The final analytic sample included 413 respondents who completed the baseline survey and at least one follow-up survey at 2, 6, 8, and/or 10 weeks. Data were analyzed using descriptive, bivariate, and multivariate statistics. Logistic regression was used to assess the relationship between PCMC scores and outcomes of interest. Results: In multivariate analyses, women with high PCMC scores were significantly less likely to report newborn complications than women with low PCMC scores (adjusted odds ratio [aOR] 0.39, 95% confidence interval [CI] 0.16–0.98). Women reporting high PCMC scores also had significantly higher odds of reporting a...
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Published Paper
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September 20, 2019
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Recent research suggests giving cash directly to the poor can have a range of benefits for recipients in the first few years, including increased consumption, assets, and food security, but little evidence exists on the long-term effects of cash transfers, particularly as a way to spur entrepreneurship and increase earnings. To shed light on this question, researchers conducted a randomized evaluation in Uganda of a government self-employment program that provided cash grants of about $400 per person to groups of young adults to start a skilled trade. An IPA research team followed up after two, four, and nine years—providing some of the longest-term rigorous evidence on how start-up cash grants impact measures of poverty. Key Findings: »  Four years after grants were distributed, recipients were more likely to be practicing a skilled trade and earning 38 percent more than their peers who hadn’t received grants. The boost in earnings seemed to be driven by recipients’ work in skilled tr...
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September 17, 2019

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