DOES PARTICIPATION IMPROVE DEVELOPMENT OUTCOMES?
Using difference-in-difference estimates, the study finds that children ages 0–3 received significantly fewer appropriate vaccines per year of exposure after a hospital was transferred to the NGO. Interestingly, the reduction in immunization rates was confi ned to the relatively better-off, with no negative effect on the poor, who were exempt from the user fees charged by the NGO. It is useful to note that vaccination is not generally a candidate for decentralization, because of significant interpersonal and interjurisdictional externalities.51
The Poverty Impact of Participatory Projects Evidence on the poverty impacts of participatory development projects and decentralization reforms is scarce. This section draws some lessons from the little evidence there is, with some important qualifiers: the number of studies is small; the studies examine fairly disparate interventions; and, with a few exceptions, outcomes are typically assessed within a relatively short time span, even though, as discussed in chapter 3, some outcomes, such as changes in income or assets, are likely to be realized only over much longer time periods. It is also unclear whether most projects operate at a scale that could plausibly affect average poverty levels in program communities or even effect a permanent change in the income or assets of participating households. Participatory projects provide a bundle of interventions, of which the encouragement or facilitation of participation is but one. Most provide resources for local public goods, productivity-enhancing investments, or private transfers, and many provide all three, often bundled with some form of microcredit. All of these interventions inject resources into communities and could thus have an independent effect on income. Many community-driven development programs are also moving decisively toward greater support for livelihood activities. Such projects tend to encompass a broad array of productive activities, including crop production and nontraditional agricultural activities, such as aquaculture and medicinal plants, livestock, agro-forestry, fishing, and fish farming. Most programs also support postproduction activities, which can include agro-processing enterprises as well as rural marketing services. Projects usually provide some type of grant to eligible members or groups for productive investments, which can be either individual or collective and often include a training component, which may cover
Evidence on the poverty impacts of participatory development projects and decentralization reforms is scarce.
Participatory projects provide a bundle of interventions.
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