A comparative study of effectiveness and cost-effectiveness of alternative poverty eradication interventions in extremely poor areas of Northern Ghana

Our research addresses directly the following overarching question: What factors shape pathways into and out of poverty and people's experience of these, and how can policy create sustained routes out of extreme poverty in ways that can be replicated and scaled up?

The study compares the effectiveness and cost-effectiveness of alternative poverty eradication projects and assesses their scalability and sustainability. In particular, it answers the following questions:

- What is the most effective poverty eradication strategy for an extremely deprived rural area: an integrated development project, a poverty graduation programme, or a cash transfer programme?
- Which strategy is more cost-effective at poverty reduction and for what reasons?
- What are effectiveness and cost-effectiveness of these strategies once they are scaled up at the national level and implemented over the long term?

The study will assess effectiveness and cost-effectiveness of three poverty reduction programmes implemented in deprived areas of Northern Ghana, which share the goal of eradicating poverty over the long term by unlocking poverty traps: 1) the Livelihood Empowerment Against Poverty (LEAP) programme implemented by the Government of Ghana, a cash transfer programme targeted to extremely poor households; 2) the SADA-Millennium Village Project implemented by the Earth Institute, consisting of a package of interventions directed to address multiple failures in the health, education and production domains; 3) the BRAC-inspired Poverty graduation programme implemented by local NGOs, which targets the poorest of the poor and provides households with a productive asset grant, cash consumption support, and other services.

The research has three main goals. First, we intend to inform choices between alternative poverty eradication programmes. This information will particularly benefit the funders and the implementers of the projects considered, but the lessons learned will have a wider application to similar projects implemented in low-income countries. Second, we intend to make a methodological contribution by developing methods of cost-effectiveness analysis of complex interventions. These methods are currently under-developed and no obvious methodology exist to account for the complexity of the institutional environments, the presence of synergies among different project components, and the presence of economies of scale when interventions are scaled up. Third, we intend to improve our understanding of poverty by investigating the mechanisms underlying extreme poverty and by analysing under what conditions specific interventions can unlock poverty traps.

The research will first analyse the effectiveness of the interventions using well-established impact evaluation methodologies relying on rigorous evaluation designs and solid control groups. The analysis will be applied to extraordinarily rich panel household datasets which allow the analysis of poverty over multiple dimensions in addition to standard monetary poverty. The second phase of the research will go beyond the analysis of effectiveness and statistical significance of project effects, by looking at the cost-effectiveness of the interventions. Cost data will be obtained and cost-effectiveness ratios will be calculated for main poverty targets, such as reduction in poverty head-count and malnutrition rates. In a third phase we will assess the scalability and the sustainability of the interventions. To this aim we will extrapolate the effects of the intervention over other geographic areas and over time using novel statistical techniques, and we will simulate different cost structures in the presence of economies of scale and different modalities of project implementation. Simulations, and related sensitivity analyses, will generate impact predictions of the effectiveness and cost-effectiveness of the interventions over the long term and at the national and regional levels.

There is an increasing demand - from policy-makers, donors and academia - for impact evaluations that go beyond statistical significance and effect sizes and that address cost-effectiveness, scalability and sustainability of interventions. Our research will first benefit the organisations implementing and funding the development projects considered: DFID, the Earth Institute and the Government of Ghana. The results of our study will also benefit other implementers, including NGOs but also major organisations such as the World Bank and IFAD, that operate at the local level in poverty reduction efforts in West Africa and other low-income countries. Our methodological innovations will benefit research and funding institutions dedicated to the evaluation of poverty reduction project such as IFPRI, J-Pal, 3ie and the World Bank. Finally, we will benefit scholars and students in international development in the UK and Ghana. We will reach these multiple audiences with the following dissemination and capacity building activities:

- An inception workshop will be held in Accra at the University of Ghana with all the stake-holders of the three projects considered. In this workshop we will discuss an activity plan and stakeholders will contribute to defining the objectives of the study;
- Two sensemaking workshops will be conducted in Ghana at the end of the study. The first will be held in Accra and will target the Government of Ghana, the funders and the implementers of the project considered and of similar poverty reduction projects. The second workshop will be held at the University of Development Studies in Tamale and will target members of NGOs and local government officers that are implementing the interventions in the field. Both workshops will be learning events in which researchers and policy-makers will reconcile multiple sources of evidence and policy goals;
- Three papers on the methodological contributions of the study and its applications will be published in peer-reviewed journal such as the Journal of Development Studies, the World Bank Economic Review and the Journal of Development Economics. The papers will be presented at ISSER in Accra and at least one event in London to be organised jointly with 3ie;
- Summary briefs of the effectiveness and cost-effectiveness studies will be produced by the IDS communication department and will be particularly targeted to senior officers of the organizations involved. The investigators will also develop a methodological toolkit on cost-effectiveness analysis of complex interventions. The toolkit and the case studies provided by the research will be used in Impact Evaluation Course offered by one of the investigators at the IDS thus reaching a wider audience of development professionals working in evaluation;
- There will be three capacity building events (one held at the IDS and two at ISSER) for graduate students and officers of governments, NGOs and international organisations. Capacity building events will occur in occasion of research team meetings and will consist of teaching exchanges in the form of master classes, workshops and short courses. The event in the UK will be organised by ISSER and will focus on data collection methods and analysis of household surveys in difficult field contexts. The events in Ghana will focus on quasi-experimental impact methodologies and cost-effectiveness analysis of complex interventions and will be led by IDS and Essex;
- Following IDS Open Access policy, all research output will be made available on a project webpage on the IDS website. The page will contain summaries of the research projects, audiovisuals of the workshops and conferences, a downloadable version of the cost-effectiveness toolkit, the stata computer codes used in the empirical analysis, and pdf versions of the reports and papers produced by the team. The website will also offer an opportunity to visitors and events' participants to provide feedback via a blog page.