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Impact assessment on project addressing specific elements of the community

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Anonymous 81

Public Health Nutritionist

Normal user

14 May 2013, 14:31

We are on process to start a multi-year food security and livelihood program. the key program activities includes cash-for-work, provision of assets and skill development, awareness raising on IYCF for project beneficiaries. the targeting is based on wealth and will target poor household. the issue facing is in setting up the impact assessment methodology particularly on nutritional status like stunting. for baseline, we have tried to look at the existing different surveys but all of them are population surveys we couldn't find surveys analysed by wealth. because of this, we are planning to conduct baseline survey by ourselves. so, I was wondering if anyone forward me advice how should I setup the assessment methods. is it possible to take the anthropomorphic measurement of children whose parents (poor HHs) are targeted in the FSL program? this could be exhaustive (if beneficiaries small) or SRS (if the beneficiaries higher).

Mark Myatt

Consultant Epideomiologist

Frequent user

15 May 2013, 11:50

I assume here that you are talking about a simple before vs. after assessment.

Making an accurate assessment of "wealth" is a difficult thing to do (you are probably more interested in poverty anyway ... "will target poor household[s]"). How do you intend to do this? This will (in some assessment models) need to be the same for both targeting and assessment so you need a practicable and sensitive case-definition of "poor household" for both purposes. A semi-quantitative wealth ranking exercise (e.g.) might work well for targeting but not for surveying (I have never tried this ... it might work). You could use anthropometry (H/A would probably be best) but this can be fussy to use as a targeting criteria in the field.

Cash-for-work, asset provision / creation, and skill development are components of wealth creation / poverty reduction program. This means that you are intervening against your targeting criteria. A poor household at baseline will (if your intervention worked) not be a poor household at the end-of-program evaluation. You may then say your intervention did not work when it actually worked very well. I suppose you could use a longitudinal sample (i.e. follow children through time) but this has the problem that stuntedness in children aged over about 30 months may persist until the pre-adolescence growth spurt. This will dilute any effect you might have (as well as being quite difficult to do well).

If your targeting criteria is a risk criteria for your outcome of interest (it really should be) then we can assume that incidence / prevalence of your outcome is much higher in your target group (i.e. without an intervention) than in the non-target group. This means that a high proportion of the incidence / prevalence of the outcome of interest in the general population should be in your target group. If you intervene in your target group with an effective intervention then you should have a large effect on the incidence / prevalence of your outcome of interest in the general population. This means that you can sample the general population for your baseline and endpoint assessments. This makes for simple surveys. With this last approach you need to be sure that your targeting criteria captures a large proportion of those at-risk and it can be applied.

Is this any help?

Anonymous 81

Public Health Nutritionist

Normal user

17 May 2013, 21:01

Dear Mark,
I thank you for your usual support. To give you additional information, we don't have issues on doing the wealth classification. very recently we did HEA and we are clear about the profile of the community in terms of wealth category and characteristics. the issue we have is how to assess the impact of the FSL on the poor household particularly on nutritional status. so, i was wondering if you further simplify your advice particularly on the last statements which said as "With this last approach you need to be sure that your targeting criteria captures a large proportion of those at-risk and it can be applied".

Thanks

Mark Myatt

Consultant Epideomiologist

Frequent user

20 May 2013, 15:34

Two things here (I think) ...

(1) "how to assess the impact of the FSL on the poor household particularly on nutritional status" - I think you might want to look at using anthropometry. You could use H/A for this or a combination of W/A and MUAC. You might also want to look at food security / dietary intake data using something like the household dietary diversity score or a fuller food frequency questionnaire. You'd want survey to be at fixed times in the year to avoid mistaking seasonal effects for program effects. If you are asking specifically about assessing impact in poor HHs then you will need a good way of identifying these HHs (see below) either as you sample or from a larger sample.

(2) "advice particularly on the last statements" - For the first part "targeting criteria captures a large proportion of those at-risk" you might ask:

  Is it sensitive (i.e. does it select all or almost all at-risk HHs)?

Without sensitivity you will not capture the majority of at-risk HHs and have little overall effect The last part "and it can be applied" means that the targeting criteria is well defined and practicable. You might ask:
  Is it easy to use?
  Is it cheap?
  Is it reliable (i.e. two people will tend to select the same HHs)?
  Is it accurate (i.e. it selects the HHs it should select)?

You might also ask:
  Is it specific (i.e. does it avoid putting resources where they are not needed)?

Is this any help?

Sonya LeJeune

Normal user

30 May 2013, 10:37

Hi
I just wanted to add something about interpreting your results, even though you are at the start of your work, it is worth thinking about this now, as that might help with fieldwork.

espeically to take care when looking for a direct causal link between the food security (FS) situation and the nutritional status of the child.
after all FS is not the only factor that can affect the nutritional status, also, as per your HEA assessment, the unit of analysis was the HOUSEHOLD whereas the child is just one member of that household unit.
and of course seasonality has an impact on the nutritional status of the child.

I am not saying you should avoid anthropometric assessment, but I am just advising caution with interpretation of results.

good luck

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