Keystone VIII by World Vision India

A Q UA RT E R LY R E S E A R C H P U B L I C AT I O N F RO M WO R L D V I S I O N I N D I A

ISSUE NO.:8 | NOV 2018

TABLE OF CONTENTS Saving New-born Lives – Impact of CANAH Project IMPACT REPORT

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Livelihood Transitions: Case study of a Marginal Farmer, Bundelkhand CASE STUDY

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Impact of Microfinance on Child Well Being: A Study of IMPACT Initiative IMPACT REPORT

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Economic Resilience for the Extreme Poor –A study from World Vision India’s Intervention in Assam RESEARCH PAPER

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INTRODUCTION Keystone, World Vision Indiaâ&#x20AC;&#x2122;s quarterly research publication, continues to capture and communicate the evidence for the impact of the work done in the organisationsâ&#x20AC;&#x2122; operational areas. In this eighth issue of Keystone,

we have a mix of content; a research paper, impact reports and a case study. These articles capture our work in promoting maternal and new born health in one of the high burden districts of India. They also highlight our success

in building the economic resilience of the most vulnerable through initiatives like microfinance, graduation model and improved agricultural practices.

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Saving New-born Lives - Impact of CANAH Project IMPACT REPORT

This report by Paul Mathai captures the summary of the impact of World Vision India’s work done along with UNICEF through CANAH Project to address the maternal and neo natal health in Chattisgarh based on the evaluation of this project.

Introduction Chattisgarh is one among the Indian states, that has tremendously improved the health status of women and children. The state was able to reduce its maternal mortality from 221 in 2011 to 173 in 2016 and its infant mortality rates from 70 in 2003 to 39 now. In spite of improvement, the state has still a lot more to improve. Many new-borns still die of preventable causes. The neonatal mortality is 31, which is higher than the country average. Moreover, under five deaths stands at 37 per 1000 live births1. Along with UNICEF, World Vision India responded to this situation in Chattisgarh through a project called Chattisgarh Action for Neo-natal and Maternal Health (CANAH). An evaluation was done to capture the effectiveness of this project in achieving its goals. The following report captures the broad findings of the evaluation.

The project CANAH was started in 2017 with the aim of • Improving knowledge and skills of Front Line Workers (FLWs) on maternal and new-born care at both facility as well as community level. • Mobilising community through awareness generation on the importance of maternal and neonatal health care, by specially addressing grandmothers, fathers and traditional healers in the community. • Strengthening of community structures such as Village Health Sanitation and Nutrition Committees to ensure sustenance and continuity of the work.

Sustainablity (Social accountability) Engagemnt with VHSNC 1. Identification & Assessment of VHSNCs 2. Capacity Building 3. CVA to strengthen the VHND process

Capacity Building (Supply Provision) FLWs (AWW, ANM, Mitanins) Through 1. Electro Games as job aids 2. IECs (Flip books + Pamphlets) 3. ttC modules based on the Priority chart approach 4. Referal for Service Provision

The Approach

Community Engagement (Demand Creation) focusing SBCC 1. Awareness through Nukkad natak, IEC distribution, Wall paintings 2. Priority Chart 3. Counselling (based on the cohorts by ttC)

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1 All statistics are sourced from Niti Aayog.

Breadth of Impact In the state of Chattisgarh, Bilaspur is one of the high priority districts for healthcare needs. Therefore, the CANAH project in coordination with the Bilaspur district administration, planned for Social and Behaviour Change and Communication (SBCC) strategies, to increase awareness and stimulate demand for the services and promote social change around neonatal and maternal health. CANAH project operated in 899 villages in seven blocks of Bilaspur District namely â&#x20AC;&#x201C; Bilha, Gaurella, Kota, Pendra, Marwahi, Masturi and Takhatpur, and reached a population of 22,49,126.

Depth of Impact Over the span of less than a year (April 2017 to December 2017), CANAH project was able to bring improvement in the lives of mothers and children.

Improving knowledge One of the proposed outcomes of the project was to improve the knowledge and skills of Front Line Workers (FLWs) on maternal and new born care at both facility as well as community level. The project made good progress on recalling of key messages, which is evident from the two-time pointâ&#x20AC;&#x2122;s data. As per the caregiver survey, there was a significant increase in the ability of women to recall key messages is evident in Figure 2. This was achieved through building the capacity of 3437 FLWs which improved their knowledge and skills and helped them provide timely counselling to pregnant women and lactating mothers. Baithaks (meetings) and IEC materials were used to spread these key messages. It also highly influenced the quality of service of the FLWs and yielded better results. , as it is evident from the end line results that 84.39%. The percentage of women who know at least two danger signs of pregnancy has increased from 17.73% (baseline) to 84.39% (endline). Accordingly, the percentage of women who know at least three neonatal danger signs also increased from 7.46% to 59.20%. The practice of increased food consumption during recent pregnancy has increased to 56.33% as compared to the baseline figure of 40.07%.

Community Mobilisation Community mobilisation was done through awareness generation on the importance of maternal and neonatal health care by specially addressing grandmothers, fathers and traditional healers in the community. Both Hanuman2 and

Daadiman3 models are very innovative and effective in bringing larger levels awareness among men and grandmothers. The project has reached out to 21507 men and 14394 grandmothers through counselling that greatly contributed in helping pregnant women and lactating mothers to access and practice the key messages. This is evident through the improvement in healthcare indicators.. As per the endline survey 85.69% of children are exclusively breast fed until 6 months of age compared to the baseline results of 80.50%. Besides, 42.25% mothers had four or more ante natal visits while they were pregnant compared to 32.53% in baseline. Also, the percentage of women who took IFA tablets during pregnancy has increased from 11.44% to 41.60%. Qualitative evidence also supports this. Eight out of ten communities were able to articulate the danger signs and symptoms for pregnant women and children. Women said that, they were able to get help from their mothers-in-law, husbands, relatives, Anganwadi centress, dhai, doctors and nurses during pregnancy. Anganwadi workers, were able to see the behavioural changes in mothers, as they began to regularly visit Anganwadi centres for the baithaks, receiving health services like ready to eat, hot meal and participation in immunisation during VHND. They feel it is only because of the increased knowledge among pregnant women, lactating mothers and grandmothers through the CANAH Project interventions. The project was successful in addressing some of the myths and misconceptions prevalent in the communities, as suggested by the focussed group discussions and key informant interviews held with AWWs, health and ICDS department officials.

Strengthening community based structures Strengthening of community structures such as Village health Sanitation and Nutrition Committees to ensure sustenance and continuity of the work. The project established a strong partnership with key stakeholders, such as Health Department and ICDS. Having access to various government offices and ensuring mutual participation in each otherâ&#x20AC;&#x2122;s programme is commendable. The project was successful in aligning direct services with the existing government programmes and giving active handholding support to strengthen the AW system fully and VHSNC partially. It was found that out of nine VHSNCs assessed six are functioning well (3 very good and 3 good), two are average and one is performing poor.

2 Hanuman Model: A trained volunteer (male champion or Hanuman) who reaches out to the husbands through household visits and group sessions to provide the key messages on the maternal and neonatal care 3 Dadimaan model: Positive deviant grandmothers from the villages were identified and trained. These trained grandmothers counsel therest of grandmothers in the community, meeting once in every month

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Proportion Of Women Who Took Iron/Folate During Previous Pregnancy.

Proportion Of Women Who Gave Birth To Their Youngest Child At A Health Facility

Proportion Of Infants Whose Births Were Attended By Skilled Birth Attendant Proportion Of Mothers Who Received At Least Two Tetanus Vaccinations Before The Birth Of Their Youngest Child Proportion Of Mothers Who Report That They Had Four Or More Antenatal Visits While They Were Pregnant With Their Youngest Child Proportion Of Children Exclusively Breastfed Until 6 Months Of Age

Proportion of mothers of children aged 0–23 months who report that their youngest child was wrapped with a cloth or blanket immediately after birth

Proportion of children aged 0–23 months who received all three components of essential newborn care

Proportion of children under 2 years receiving early initiation of breastfeeding

Proportion of children aged 6-23 months receiving continued breastfeeding

Effectiveness: Improved wellbeing of mothers and children All these initiatives with the frontline workers, pregnant women, lactating mothers, grandmothers, men and fathers, community based structures and traditional healers have resulted in better health outcomes for mothers and children. They often access health care services, nutritional practices and neonatal care. The project made good progress towards its three outputs, which is evident from the two-time point’s data.

Quality of evidence The evaluation used a mixed methodology to study the effectiveness of this project. For the quantitative study, the evaluation employed a random cluster sample of households from 30 clusters and 35 households in each cluster. It surveyed a total of 1050 households and 1170 respondents. The tools

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used included Caregiver survey (HH), Key Message Recall Tool and a VHSNC study tool. Trained volunteers and staff did the data collection. Qualitative Study: Appropriate samples from 10 villages randomly selected, among the 30 clusters selected for the quantitative survey, for administering the qualitative tools for different target groups such as frontline workers, pregnant women and lactating mothers, husbands and grandmothers. FGDs and KII tools were administered. The findings of Quantitative results and Qualitative Exercises were triangulated together, validated, and recorded. The triangulation process helped in validating the data through cross verification of data generated through different methods and present it appropriately.

Conclusion and Recommendations CANAH project had a very clear perspective of its target audience namely the pregnant women and mothers of children below 2 years of age, grandmothers and husbands, which helped the project to have very focussed approach and key specific interventions resulting in achieving the preferred project goal. The most contributing factors towards the success of the project include good networking and coordination with health and ICDS departments. Capacity building of Frontline workers has boosted their confidence

and they are able to take up the ownership even after the withdrawal of CANAH project in seven blocks of Bilaspur District. Both Hanuman and Daadima models are very innovative and effective in bringing larger level awareness among men and grandmothers and this can be replicated in other parts of the country in addressing reproductive and child health.

Story of Change Ranu Yadav owing to their poor family condition could not take adequate care during her pregnancy. She engaged in carrying heavy loads as a daily wage labourer. Her earlier miscarriage during pregnancy alerted the AWW to provide specific care and messaging to Ranu. A counselling session was commenced at Bandhamoda Anganwadi center on 6/11/2017 and key messages were delivered. However, Ranu delivered a premature baby.The Anganwadi worker and staff of CANAH Project provided counselling on neonatal care, kangaroo care and explained the consequences of low birth weight to the mother and family.Then the child was brought to the child specialist and received free treatment. As a result, the childâ&#x20AC;&#x2122;s weight increased to1.3 kg. Earlier the child was even not able to breastfeed, but later was breastfed.The nurses stated that the child would not have survived but they could see the changes in the childâ&#x20AC;&#x2122;s health after timely counselling and proper care was provided.When the evaluators met the family the child weighed 2 kg and is steadily improving.

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Livelihood Transitions: Case study of a Marginal Farmer, Bundelkhand CASE STUDY

This case study by Salmon Jacob narrates the transition of Sukhal Patel from an agricultural labourer to a successful farmer. World Vision India’s climate resilient agricultural practices promoted in drought prone regions are also discussed here.

Background Climatic changes in the form of variations in rainfall patterns – i.e. decline in the precipitation, untimely / unseasonal rains, erratic rainfall, hail storms – as well as rising temperatures have been experienced by communities across India in recent years. This has impacted the daily lives and livelihoods of the common people, particularly the small and the marginal farmers. These farmers have witnessed much crop failures on account of issues like water shortages, untimely rains, heat waves conditions, pest attacks, declining soil quality etc. impacting their livelihoods, causing distress migration to urban areas in search of work as casual labours and the situation has even brought to light cases of farmer suicides, an indication of their inability to cope with the financial losses incurred. The Bundelkhand region of the country in particular has been witnessing such issues over the years, and the situation has worsened with recurrent droughts in recent years. According to a study published in the ‘Journal of Hydrologic Engineering’1 in March 2015, Sagar district has recorded 18 drought events during the period 1976 to 2009, which is an indication of the vulnerability – particularly towards droughts, and its impact on the small and marginal farmers. Similarly, as per a study published in the ‘Journal of Atmospheric and Climate Sciences’2 in July 2014, the trend of the annual rainfall in Sagar district, over a period from 1949 to 2010, recorded a decline of about 156.4 mm, which gives an indication of the changes in the rainfall pattern of the district. Occurrences of hail storms in parts of the Bundelkhand region including Sagar district, in recent years, have further led to issues of crop losses. According to the report published in the Hindustan Times on 14th March 20163 , the farmers from Sagar district incurred huge crop losses due

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to hail storms. About 1982 farmers committed suicide during the period February 2016 to February 2017 in the state of Madhya Pradesh, as reported in Hindustan Times on April 14, 20174, which included cases from Sagar district as well. It is generally felt that small and marginal farmers, are the most vulnerable group with low capacities to cope with the extreme weather events, issues of crop losses and prone to financial instability / financial crisis. The case study presented in this paper, discusses the context of a marginal farmer from Sagar district of Bundelkhand region, who through systematic and appropriate cropping techniques, has been able to cope with extreme weather conditions as well as attain financial stability.

Case study of a marginal farmer Sukhlal Patel is a 57-year-old agricultural farmer from Naroda village of Khurai block in Sagar district, Madhya Pradesh. While many farmers in the region incurred huge agricultural loses due to un-seasonal rains and hail storms, Sukhlal is a successful marginal farmer, who has learnt the art of managing his crops, in-spite of harsh environmental conditions, to get gainful results. Until about five years back, Sukhlal was a farmer who depended only on wheat cultivation in his 2.25 acre land. Sukhlal recalls that there was no end to his struggles, as he had recurring crop failures and went through financial crisis. The wheat he cultivated mostly went to meet his household food requirements, and all he used to get from selling the excess wheat was about Rs. 3000/- for the year. In order to meet his household financial needs, he then used to work as a daily labourer.

1 “Spatiotemporal Analysis of Drought Characteristics in the Bundelkhand Region of Central India using the Standardized Precipitation Index”, published in “Journal of Hydrologic Engineering” March 2015 2 “Climate Change, Variability and Rainfall Probability for Crop Planning in few districts of Central India” published in the ‘Journal of Atmospheric & Climate Sciences’ in July 2014

A New Beginning Sukhlal recalls that, things changed after he attended a training programme organised by World Vision India, on organic farming and mixed farming techniques. The motivation and guidance from World Vision India staff enabled Sukhal to make a decision to take up the challenge of trying out mixed farming with organic farmings methods. Sukhlal divided the available field of 2.25 acres, into smaller plots of approximately 0.75 acre, and started to grow onion, tomato, brinjal, okra, ginger, green chillies, guard, carrot etc along with a portion of wheat. Multiple vegetables were grown in the available area – both simultaneously as well as on rotational basis. So the plot used for brinjal was used for growing garlic in the next cropping cycle, similarly the plot used for okra was used for growing ginger in the next cycle. By this method of crop rotation, Sukhlal says that the soil stays healthy and maintain good nutrient content. He also introduced banana plantation along the boundry of his farm and some other fruit trees as well. He set up vermi-composting beds to make vermi-compost and also started making farm yard manure and other organic nutrient mixes at the household level. He mentioned that through the application of organic manure, instead of chemical fertlisers, his soil quality improved and the crop

produce is visibly of a better quality, than the produce using chemical fertilisers. The cattle (cows) at home, in addition to meeting the dairy needs of the household, also contribute to the raw material needed to produce the organic manure for his farm. Though he does not have an organic grower certification, his produce is able to fetch a better price in the wholesale market compared to the others, due to its higher quality. Secondly, he says, that unseasonal rains or hail storms no longer cause big damage, and even though one crop may get affected, he would still have the other crop produces that would allow him to tide over the effect.

The Economic Benefits His life has changed for good, in the last 5 years. He says that by switching to mixed farming and chemical free agricultural practices, in the second year, he was able to get an income of about 2 lakhs per year from his land. Additionally he was able to save on the input cost which he earlier used to spend on chemical fertilisers, to the tune of about Rs. 7,000 to 10,000 a year. He no longer needs to work as daily labourer, as he is able to earn sufficiently well from his farm. Moreover, occasionly he employs 2 to 3 people to work in his farm – a

Net income from the agricultural produce over last five years in Rupees

Table No. 1: Production quantity of some vegetables in Sukhlal’s farm S.No.

Fig 2: Sukhlal with his onions produce

Vegetables

Production (Kg)

Onion

9,000

Garlic

800

Tomato

40,000

Brinjal

40,000

3 “Wind, rain & hail hit crops in large parts of MP”, published in Hindustan times on 14th March 2016 4 “For Madhya Pradesh police, farmers don’t die of debt”, published in Hindustan times on 14th April 2017

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Vegetables grown by the farmer

Approx Production cost per acre in Rs.

Approx. Production cost in 0.75 acre in Rs.

Approx. gross returns from the crops produced Rs.

Approx. net income from the crops produced Rs.

Onion

11,253

8,439

1,17,000

1,08,561

Garlic

23,295

17,471

40,000

22,529

Tomato

14,620

10,965

5,60,000

5,49,035

Brinjal

19,400

14,550

5,20,000

5,05,450

Table No. 2: Approximate net income from some of the vegetables grown

significant shift from the past.

The Impact

Presently, it is estimated that, Sukhlal is in a position to make a decent income in the range of 5 to 7 lakhs per year. There is an operational cost involved, however, even after investing in the operational cost, he is able to make a decent income. The quantity of some of the vegetables presently grown is given in table no.1, which gives a glimpse of the progress made by Sukhlal

Some of the visible indications of his success as a marginal farmer, has been in the form of his investments in assets that he made during the last 2 to 3 years, which is further adding value to his development, as well as the quality of life.

In order to arrive at an estimated net income from the vegetables grown like onion, garlic, tomato and brinjal, the production cost was calculated based on the published papers in the International Journal of Current Microbiology and Applied Sciences in November 20185, study published by ABSSS in July 20176 and the paper published by Jawaharlal Nehru Krishi Vishwa Vidyalaya, Jabalpur, in 20157. The table no.2 shows the estimated net income from the vegetables grown by Sukhlal, which gives an indication of the economic benefit.

One of the indicators of his economic wellbeing, is that he bought himself a second hand tractor three years back, which he uses in his own farm and other needs like taking the produce to the mandi. He also lends the tractor to other farmers during ploughing and other requirements, which further provides him with additional income. Last year Sukhlal bought a crop harvester-binder machine, which is an additional asset to him and also helps in improving his income levels. He rents this machine to other farmers during harvest season. The machine harvests the crop and also ties

Sukhlal also has 12 cows at present, to meet his household dairy needs. It is an additional income as well. Over the years, he has steadily increased the number of cattle, which also contributes to the raw material needed to produce the organic manure for his farm.

Fig.6: Sukhlal with his tractor & the harvester-binder machine.

5 Benefit - Cost Analysis of Onion Producer in Sagar District of Madhya Pradesh, India; published in the International Journal of Current Microbiology and Applied Sciences , Nov 2018. 6 Vegetable Cultivation As An Alternative Source Of Income For Small Farmers In Bundelkhand”, ABSSS, July 2017. 7 “An economic analysis of production and marketing of garlic crops in Ratlam District of Madhya Pradesh”

Fig.7: Sukhlal at his present house & the new house under construction

the harvest into bundles, making it convinient for the farmer. It therefore has a good local demand. House that he is building just adjacent to his present house. The present house where he has been staying is a small two-room house with tiled roof and a cow shed. The new house which Sukhlal builds is a two-storey RCC house, and is expected to be completed in two months time.

CONCLUSION At a time when small and marginal farmers from the Bundelkhand region were migrating to urban areas as casual labourers and facing economic crisis, Sukhlal Patel has shown that with the application of appropriate cropping techniques and hard work, a marginal farmer can not only survive but make significant progress in crop productivity and make economic gains. World Vision India has been instrumental in facilitating the last mile knowledge transfer to the small and marginal farmers, to adopt context specific appropriate agricultural practices, as well as encourage the farmers to switch to chemical free farming practices. Sukhlal Patel has shown the courage to apply the knowledge gained through trainings and exposure visits. He switched from mono culture type of cultivation to a mixed farming method as well as crop rotation method, along with development and application of organic manures. Sukhlal says that right technique and loads of hard work is the key to his success. As World Vision India envisages to promote climate resilient agricultural practices to build more resilience into the marginal farmers, Sukhlal Patelâ&#x20AC;&#x2122;s success stands out as an excellent example, which can motivate many more such farmers from the region, to move from despair to growth and development.

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Impact of Microfinance on Child Well Being: A Study of IMPACT initiative IMPACT REPORT

This is a summary of a research by Binu Zachariah that captured the effectiveness of microfinance on the life of poor families especially children and women through IMPACT. This study was supported by the Department of Social Work of Loyola College & Subrmania Siva.

IMPACT (Innovative Microfinance for Poverty Alleviation and Community Transformation) is the micro finance partner of World Vision India . Globally, IMPACT1 is part of Vision Fund International MFI network that operates in 31 countries around the world in partnership with World Vision. IMPACT is a unique MFI as it works alongside World Vision India, complementing their development and humanitarian programs through micro credit so that poor families can improve the well-being of their children. While the services of MFI are directed mostly at parents, it is intentional about building brighter futures for children. Supporting communities with income generating activities alongside development efforts of World Vision India, results in a truly holistic, integrated approach to community development that empowers poor families to become self- reliant and come out of poverty.

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The goal of the study This research was aimed at studying the effectiveness of microfinance on the life of poor families especially children and women in the districts of Perambalur and Thiruvarur in Tamilnadu. The research helped to study the utilisation of loans availed by the women and assessed its effectiveness on alleviating poverty on the wellbeing of children, women and their families.

Research Methodology The ex-post facto study design was used to evaluate the effectiveness of the microfinance. Mixed method (both Quantitative and Qualitative) research design was used for the study. A total of 214 participants took part in both FGDs (qualitative) and survey (quantitative) and they were selected using probability sampling technique, systematic random sampling method. 1 IMPACT is the micro finance partner of World Vision India and is registered as a NonProfit Micro finance Institution (under Sec 8 of the Companies Act 2013) that offers small loans ranging from Rs.10000 to Rs.50000 /- to the entrepreneurial poor living in the rural areas of India.

The findings The study findings reveal that the microfinance plays an important role in the lives of poor families. It has an impact on the overall improvement of women and children in the economically backward areas. The following are the key findings of the study.

Improved living conditions for communities living in poverty The financial services reached the most deserving communities. It was found that 66% of the participants reported having engaged both in agriculture and cattle rearing or either of these and a considerable number engage in agriculture as daily wage labourer. The study shows that the women are able to meet the educational and health needs of children through microfinance. The women were motivated to look for more economic activities that would fetch them better income. It was expressed through the FGD that the money transactions due to microfinance has increased the purchasing capacity of their basic household needs.

Improved contribution to child well being More than three-fifth (61%) of the participants reported that household resources were controlled by women in their family. From this data, it is inferred that there is increased awareness among the family members to allow the women to have control over the productive assets. This increases their capacity for decision making. 87% of the women have reported that they have medium to high level financial independence. Nearly 48% of the women have high to medium level decision making ability on financial aspects. This is a remarkable improvement as they were dependant on their spouses. Around seven-tenth (70%) of the participants reported that the loan from IMPACT had prepared them to become small entrepreneurs. 77% of the respondents from Perambalur and two-third (66%) of the respondents from Mannargudi reported that the loan from IMPACT had prepared them to become entrepreneurs in one way or the other . It shows that the women have gained the confidence and were motivated to do livelihood activities that helped in improving their family income. 71% of the participants reported having savings. It was observed that the additional financial services by IMPACT helped the clients to have an understanding on the importance of saving for their future especially their children’s future.

Empowerment of Women and families It is observed that while a little more than twofifth (41%) of the participants reported having high score for effectiveness of microfinance on family empowerment, around one-third (35%) of the participants also reported having medium score for its effectiveness on family empowerment. On the whole it has helped women become more social by taking part in meetings and able to manage bank transactions by themselves without anyone’s ’s support. They have also become aware of their rights and the welfare schemes of the government. There is also an increased ability to defend oneself against violence in the household and community. The women also make efforts to meet with the government officials and give petitions. This has improved their bargaining capacity and leadership skills. The family has gained the increased access to income, productive assets and household property. The family’s capacity to access markets and their mobility has increased. There is empowerment in the family due to economic independence. It was evidencedthat this economic independence has enabled women to be empowered and they are able to stand up to their rights without fear. It was expressed that there is an increased ability to defend oneself from violence in the household and community. Only 3% of the respondents said that there was violence in the families, whereas a vast majority (97%) of the respondents remarked that violence has reduced or is non- existent in the families. It was observed that 25% of the participants mentioned that before getting the loan, their family left the village in search of work. The decision was taken together by both husband and wife (11%). After getting access to the loan, the pattern of migration reduced. A vast majority (83%) of the respondents have not migrated to any place for work, since they have their own house and have found employment/self-employment within their community. . The researchers have concluded that IMPACT’s microfinance has led to social, economical and behavioural transformation among women resulting in empowerment and in creating a better life for their children.

Way Forward • IMPACT can plan to conduct skill development programs or entrepreneurship development programs that can help people to improve their skills and thereby give them opportunities for better income

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• IMPACT can work out financial literacy, skill development program with World Vision India in locations where World Vision currently works • Arrange a summer camp for children similar to LSTD or LSE by World Vision India during their vacation so that the children from surrounding locations learn critical life skills, and values and are motivated to plan for their future . • IMPACT can consider revising the rate of interest as this can help people to pay the loan amount more easily

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• To increase the loan amount according to their repaying capacity. • IMPACT can develop new loan products to include educational loan, housing loan and loan for construction of toilet • Extend the duration of loan repayment depending on the size of the loan as applicable Please write to binu_zachariah@wvi.org for the complete report.

Economic Resilience for the Extreme Poor A Study from World Vision India’s Intervention in Assam RESEARCH PAPER This research paper by Subramania Siva and Priskila Macwan discusses the Graduation Model implemented by World Vision India to improve the economic resilience of the extreme poor in Udalgiri block, Assam.

Abstract This paper attempts to look at graduation model as a successful intervention to move communities out of poverty. In Assam’s Udalguri district, the graduation model was implemented from August 2014 to September 2016 by World Vision India – a child-focused humanitarian organisation working in over 6200 communities in India. Graduation Model refers to the approach that helps vulnerable households move from extreme poverty to the next level to have food security, livelihood assets and linkages with development programmes within a period of 24 months. This study focused on vulnerable poor in the communities, mainly single mothers, widows, landless labourers, poor households with a chronically ill person, poor households with a person with disability and households with malnourished children. 300 participants were selected through screening in this programme. Baseline survey data has been collected and at the end of the tenure, we conducted an end-line survey with the same set of questionnaires to see the shift between two time points. This ethnography study resulted in 99% success (297 participants moved from extreme poverty to sustainable development) of the programme, by comparing the baseline and end line data. The paper therefore suggests that graduation model is a successful approach to assist vulnerable households to move out from extreme poverty. Keywords: Graduation Model,Vulnerable Poor, Economic Assistance

Introduction The intervention area is in Udalguri block under Udalguri district spreads below the foothills of Bhutan. The area was cut off by lack of transportation and proper road communication facilities. The economic condition of the communities was very low. People lived from hand to mouth. Less than 10% have 1-2 bighas1 of land,

1 5 bighas = 1 acre in Assam

which are hardly cultivable due to scarcity of water. People were deprived of medical treatment due to inaccessibility, lack of health care structure and poverty. Education and building leadership were absent. The term “graduation” refers to participants moving out of safety net programmes and “graduating” into income-earning activities that let them sustain themselves without external subsidies. Graduation model approach targeted extremely poor households. The programme incorporates women empowerment to increase women’s control over household economic resources and greater power in decision-making. The graduation approach brings together several components that have proven necessary for sustained upward economic mobility, social protection and financial inclusion for the poorest and most vulnerable.

Components of Graduation Approach 1. Specific Targeting – Based on developed targeting criteria, we reached out to vulnerablepoor households through the process of PRA and door-to-door survey. 2. Safety Net – Through consumption support, beneficiaries are encouraged to focus on their new business, while a consumption stipend of Rs.20 a day for 45 to 90 days, depending on the particular enterprise selected by the households, takes care of their daily basic requirement. As per World Vision India guideline, the support was given in kind and to ensure the use of the stipend for the right purpose, beneficiaries were linked with grocery shops (e.g., Rice, oil, sugar, etc) or petty business (e.g., selling fodder, livestock medicine) undertaken by them under this programme. Through this process, participants linked to Government welfare schemes to benefit by safety net. 3. Savings – At the initial stage of the programme,

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Soon after business selection, in a week’s time, beneficiaries are given specific training on the chosen enterprise after which, within 30 days, the asset is transferred. Once the asset is handed over to beneficiaries, within a time period of 15 to 30 days, the first referral is given to identify any issue with the on-going business, which strengthens beneficiaries who are failing or falling back. Later, the refresher training continues, every quarter.

beneficiaries are motivated to get into the habit of saving by informal savings in a piggy bank, for a minimum of Rs.10 a day. Once they are assisted with assets, they are linked to formal savings by opening accounts and depositing a regular amount of a minimum of Rs. 100 a month. 4. Skill Training - The technical skills training starts with counselling individual beneficiaries and the family members to have positive thinking and effectively participate in the programme. Then, beneficiaries are taken through confidence building and enterprise development training where they understand poverty cycle, the society in which they live, graduation approach and its process of bringing impact in one’s life and business requirement and finally select business as per one’s interest and capacity.

First six months

The life skills coaching also starts soon after transferring asset, through weekly home visit and group visit, where they are given awareness on social, health and hygiene issues, financial literacy, writing numbers and signing name and following day-to-day business transaction and family wellbeing. Regular coaching and mentoring steadily builds the beneficiaries’ confidence level to perform better, as guided under the programme. The technical training and life skill coaching were provided to motivate and empower beneficiaries to choose and do business with appropriate skills. Support for productive asset (Market Analysis and Asset Transfer): Based on the market study, enterprise list was prepared and shared with beneficiaries who chose income-generating activity, which has a market for the goods and services. The productive asset support was given in two to three phases and the beneficiaries were encouraged to choose different businesses each time, so they are not affected much the little progress in one particular business. This gives them a different coping mechanism to depend on.

Second Six months

Third Six months

Fourth six months

Deployment of field staff and building their capacity

Asset transfer (In kind)

Handholding support at household level and in group (Social, Livelihood & Financial aspect)

Area level information collection

Handholding support at household level and in group (Social, Livelihood & Financial aspect)

Monthly meeting of committee

Beneficiary selection

Monthly meeting of committee

Quarterly Refresher training

Counseling, confidence building training & selection of enterprise

Quarterly Refresher training

Enterprise development training Formation of committee

Graduation Training for beneficiaries Table 1: 24-month break-up of graduation approach

Asset transfer (In kind) Monthly meeting of committee Handholding support at household level and in group

Graduation training for field staff

KEYSTONE | ISSUE NO:8 | NOV 2018

End line assessment Phase out with Graduation ceremony

The first phase was supported with a maximum of Rs.5 000. As most of the beneficiaries were new to business, they needed time to learn and develop confidence. This also gave them the freedom to change the income-generating activity, if they faced any major challenge. At the same time, programmes like this with a fixed time line and budget also reduced the risk of the beneficiaries investing the entire asset money at once and being left with no further support. Prior to transferring productive primary asset, beneficiaries were supported to ensure availability of supportive assistance. For example, for a readymade garments’ business, garments are the primary asset whereas trunks to keep the garments safe and bags to carry garments for sale become supportive asset.

Literature review Since 2002, BRAC’s challenging the Frontiers of Poverty Reduction (CFPR)/Targeting the Ultra Poor (TUP) programme had supported over half a million very poor households to increase their income and assets in a sustained fashion in Bangladesh. Households not only earned and saved more but also diversified their assets and income sources: the value of productive assets tripled (Bandiera et al. 2016). Impacts were observed to be even larger seven years after the asset transfer, and five years after the end of the programme (the change in spending on nondurables was 2.5 times higher after seven years than after four, and the increase in land access doubled). Graduation programmes have statistically significant impact on consumption, participants’ productive assets and savings habit. Impact assessments also show that participants spent more time working, went hungry on fewer days, experienced lower levels of stress and reported improved physical health. New results from one of the CGAP–Ford Foundation sites in India almost six years after the end of the programme revealed even greater impact, with a doubling in per capita consumption compared with the three-year mark (The Economist 2015). Additional research in Ghana compared the transfer of assets alone (goats) to the receipt of the full package of graduation components; after three years, the value of the assets held by households that received the full package was significantly higher and more diversified than for the goats-only households whose livestock value and total consumption did not increase. The total per household cost of the programmes (including consumption assistance, seed capital, training, mentoring, staffing, monitoring, and office overhead), over the entire duration of the

programmes, ranged from US$330 to US$700 in Bangladesh, India,Yemen, Ethiopia, and Pakistan. The cost-effectiveness of the program is high, with annual household income gains as a percentage of total program costs ranging from about 7 percent to 25 percent in the five sites where the program had positive impact. At BRAC, the initial investment of US$365 was estimated to yield total benefits of US$1,168 over a projected span of 20 years (the discounted sum of consumption and asset gains in 2007 U.S. dollars).

Methods The Graduation Model initiated with identifying Village Council Development Committee (VCDC). The committee used appropriate tool to identify extreme poor from 56 villages and finally selected 300 participants for Graduation Model. As per baseline, target HHs were food insecure, had low income, were daily wage labourers, lacked own property / asset or land, were not protected by safety net, absent from financial inclusion and absent of WASH component, those relevant participants information was collected through census survey as termed as Baseline data. At the end of the tenure, we did the end line survey with the same set of questionnaire to see the shift between two time points. World vision conducts Participatory Rural Appraisals (PRAs) in selected villages from to identify the subset of the population most likely to be Ultra Poor. The PRA consists of a social mapping and a wealth ranking. Following identification, all the participants are selected to receive assets. WV took few steps before asset distribution as follows: counselling and confidence building training conducted to enhance the capacity, Enterprise development training done along with business plan. WV staff meet with participants to select the livelihood option best suited to the household. WV purchases and distributes assets such as livestock and inventory to participants. The grants are also used to finance other inputs, such as fodder and sheds for livestock. After transferring asset participant is regularly motivated with weekly house visit and refresher trainings. In this sample, 90% of participants chose livestock, receiving either 2 cows, 4 goats or 1 cow and 2 goats. The value of the asset transferred was approximately US$150, or Rs.10000/-which is around 20% of baseline annual household expenditure. Over the next 18 months, WV staff meet weekly with participants. These meeting are primarily held to provide information and training on topics related to the household’s enterprise (such as proper care for livestock) as well broader social and health issues. Additionally, participants were encouraged

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to save Rs.10 (approximately $US 0.25) per week at these meetings. To support participant needs in terms of consumption, stipend Rs.20/- was given as allowance provided for 12 weeks. Approximately 18 months after receipt of the asset, the participants are ‘’graduated” to sustainable livelihood by achieving 75% of indicators. WV conducted a threeday Refresher course for program participants to address Loan repayment, number of social, health and community issues as most of the Ultra Poor households do not have prior experience with formal financial institutions like Post office or MFIs. This training is also to explain the functioning of a Graduation approach, its rules and regulations, group solidarity and the role of savings in one’s financial life.

understand their lives, the process through which these changes took place and the factors that held them back. The study analysed how vulnerable poor households build resilience, improve their conditions and graduate out of extreme poverty, as well as understand the dynamics that prevent many of them from moving up.

Tools included • Observations • Community wealth ranking • In-depth interviews • Conversations with participants and key informants • Life histories of beneficiaries

The Ethnographic Research While the empirical surveys provide quantitative data on the improvements in economic, social and health conditions of participants, we conducted a year-long ethnographic research to better

Results: • The Graduation approach increased ultra-poor households’ consumption, a common measure of

Overall Result of the programme – 99% Key Indicators

Baseline

1 Year MIS

At least two income sources in the family

109

297 HH

Income of family increased significantly

All 300 HH Below 1600 per month

297 - Increased to above 1600 to 3000 per month

Growing saving habits and deposits

293 – Link to post office & Bank

All members of the family are getting at least two fullmeals every day

300

Participant planted at least two fruit plants or cultivates two types of vegetables in own garden

300

All children of below 5 years of the family are immunised

62/74

12 – under Immunization process

All school going aged children are admitted and continuing in school

95/168

73 – Admitted to school and are regularly attending

Eligible couple in the family practising family-planning method

212

Residential house of the family is safe

287

Household has access to basic medical services and facilities

300

Participant can write their names and numbers (1-10) properly

279

Participant has voter identity card

192

Participant has ration card

277

All members of the family wear clean clothes and maintain cleanliness in their house

300 HH - Behavioural change is evident

Household has proper access to safe drinking water

300

Family members are using safe and hygienic latrines

248

Reason of 3% failure mentioned below . 2

KEYSTONE | ISSUE NO:8 | NOV 2018

2 As per the programme requirement, 3 participants could not meet the criteria, as two of them passed away and another participant, a woman, had to move to other places due to internal fight. She could not attend programmes, was not available during visits and could not maintain assets.

well-being. • Consistent with increasing food expenditure, household members were able to afford two meals per day more often.

The Graduation Approach is not a short-term escape from extreme poverty but instead seeks to equip participants with self-confidence to sustain themselves after the end of the programme.

• 97.33% of the participants Savings habit range from 2000 to 7000 increased significantly and persistently, and gains were largest in countries with mandatory savings.

The Graduation approach should form an integral component of national social protection to eradicating extreme poverty by 2030, as suggested by SDGs.

• 82.66% of the participants have access to sanitary latrine, which will impact health management

Recommendations for future study

• Number of income sources also increased, which will result in spending for children’s education. • 67.66% of the participants practise family planning. • 92.33% of the participants have voter cards • 94.33% of the participants have ration cards • 99.66% of the participants have job cards

Conclusion: The Graduation approach focused on helping most vulnerable households to move out of extreme poverty through sustainable livelihoods and increased income. This approach is process oriented with rigor on the steps to be carried out along with time (24 months). The graduation programme combines support for immediate needs with longer term investments in training, financial services and business development so that within two years the vulnerable-poor are equipped to help themselves move out of extreme poverty.

• Which components of the Graduation approach drive results? While many anti-poverty solutions aim to improve livelihood through provision of assets, temporary financial support, mandatory savings or skill trainings, none have packaged and applied these approaches together in a way, which is both cost effective and has demonstrated clear impact in the lives of the ultra-poor. They are often bypassed under the scale of poverty alleviation initiatives. • Does Graduation approach affect others in the community and nearby communities? Yes, this study affected the lives of vulnerable poor. • Does Graduation approach sustain over a longer time horizon? Yes, it provides suggestions on comparative costbenefit analyses of Graduation and alternative approaches that target the vulnerable-poor in longer run.

References 1. Bandiera, Oriana, Robin Burgess, Narayan Das, Selim Gulesci, Imran Rasul, and Munshi Sulaiman. “Can Basic Entrepreneurship Transform the Economic Lives of the Poor?” London School of Economics Economic Organisation and Public Policy Discussion Papers EOPP 043, April 2013. 2. Banerjee, Abhijit, Esther Duflo, Nathanael Goldberg, Dean Karlan, Robert Osei, William Parienté, Jeremy Shapiro, Bram Thuysbaert, and Christopher Udry. 2015. “A Multi-faceted Program Causes Lasting Progress for the Very Poor: Evidence from Six Countries.” Science 348 (6236): 1260799-1–1260799-16. doi:10.1126/science.1260799. 3. Banerjee, Abhijit, Esther Duflo, Raghabendra Chattopadhyay, and Jeremy Shapiro. “Targeting the Hard-Core Poor: An Impact Assessment.” Center for Microfinance Working Paper, November 2011. 4. Banerjee, Abhijit, Esther Duflo, Raghabendra Chattopadhyay, and Jeremy Shapiro. “Targeting Efficiency: How well can we identify the poor?” Center for Microfinance Working Paper Series No. 21, December 2007. 5. Banerjee, Abhijit V., and Esther Duflo. 2007. “The Economic Lives of the Poor.” Journal of Economic Perspectives 21 (1): 141–168. 6. Blattman, Christopher, Eric Green, Julian Jamison, Christian Lehmann, and Jeannie Annan. Forthcoming. “The returns to microenterprise support among the ultra-poor: A field experiment in post-war Uganda.” American Economic Journal: Applied Economics 7. Blattman, Christopher, Nathan Fiala, and Sebastian Martinez. 2014. “Generating Skilled Self-Employment in Developing Countries: Evidence from Uganda.” Quarterly Journal of Economics 129 (2): 697–752.

8. Haushofer, Johannes, and Jeremy Shapiro. “Household Response to Income Changes: Evidence from an Unconditional Cash Transfer Program in Kenya.” Working Paper, 2013. http://www.princeton. edu/~joha/publications/ Haushofer_Shapiro_UCT_2013.pdf. 9. Karlan, Dean and Bram Thuysbaert. “Targeting Ultra-Poor Households in Honduras and Peru.” NBER Working Paper No. 19646, November 2013. doi:10.3386/w19646. 10. United Nations High Level Panel of Eminent Persons on the Post-2015 Development Agenda. 2013. A New Global Partnership: Eradicate Poverty and Transform Economies through Sustainable Development. New York: United Nations Publications. 11. World Bank. 2013. The World Bank Annual Report 2013. Washington, DC: World Bank. doi:10.1596/978-0-8213-9937-8. 12. Bandiera, Oriana, Robin Burgess, Narayan Das, Selim Gulesci, Imran Rasul, and Munshi Sulaiman. 2016. “Labor Markets and Poverty in Village Economies.” Quarterly Journal of Economics. 13. http://www.cgap.org/web-publication/graduation-pathways-increasingincome-and-resilience-extreme-poor 14. http://www.cgap.org/publications/creating-pathways-poorest 15. Sulaiman, Munshi, Nathanael Goldberg, Dean Karlan, and Aude de Montesquiou. 2016. “Eliminating Extreme Poverty: Comparing the Cost Effectiveness of Livelihood, Cash Transfer, and Graduation Approaches.” Forum. Washington, D.C.: CGAP.C 16. http://www.poverty-action.org/impact/ultra-poor-graduationmodelzzzzzzzeb-publication/graduation-pathways-increasing-incomeand-resilience-extreme-poorttp://www.cgap.org

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