It Takes Time and Effort to Create Measurable Change
Many governmental and non-governmental organizations active in the developing world offer interventions designed to alleviate poverty and improve livelihoods. However, these interventions are rarely subjected to scrutiny to determine their efficacy. Rather, it is typical for inputs (such as training or material goods) to be measured, and in some cases, “success” of the intervention is assumed based on the numbers of inputs provided.
Heifer International, an American-based NGO active in more than 30 countries worldwide, has taken a different approach. Heifer wished to systematically evaluate the efficacy of their well-known “pass on the gift” program, wherein the offspring of donated livestock are given by recipients to their neighbors and fellow women’s group members. While Heifer’s programs have been successful in many ways, the organization desired a more systematic evaluation of the impact of their programs on child-specific outcomes, namely: growth and diet quality. These were of particular interest to Heifer, as their programs did not specifically target these outcomes, focusing rather on economic improvement at the household level. In addition, Heifer wished to better understand the time frame for these (and other) changes at the child and household level. Finally, Heifer wished to objectively analyze if the time- and labor-intensive community development training which forms the backbone of their program was as valuable as they thought, or if a simple training program could produce similar results.
To pursue these interests, Heifer developed a collaboration with researchers based at Tufts University Friedman School of Nutrition Science and Food Policy. With funding from the Feed the Future Nutrition Innovation Lab, the researchers embarked on two distinct projects to answer these questions. Nepal was selected as the country site, due to Heifer’s long history in this nation. The first project was conducted in Nawalparasi, Nuwakot and Chitwan districts. Over two years, researchers visited 431 households six times. Half of the households received Heifer’s intense community development intervention after the baseline survey was completed (Group 1); the remaining households (Group 2) received this intervention starting one year later. The researchers found that household economic status improved more and faster in Group 1 than Group 2. Also, child linear growth improved more in Group 1 households compared to Group 2.
After controlling for many variables, it was clear that child linear growth (height) related to the duration of household participation in the intervention. This was promising, but the growth improvement, though significant, was not as dramatic as hoped. Fortunately, the Nutrition Innovation Lab provided funding to allow an additional household visit at 48 months after the baseline survey had been completed. Findings were impressive. The prevalence of wasting, underweight, and (to a lesser extent) stunting decreased strikingly between 24 and 48 months. This finding suggested that “premature” program evaluation may lead to incorrect conclusions about program efficacy and effects.
A second research project was initiated in Banke district, Nepal. In this investigation, 974 households were randomized by cluster to receive (a) the “full Heifer intervention” (now including a new nutrition training curriculum, which was introduced as a result of the findings in the first project), (b) nutrition and livestock training provided by Heifer but given without the context of the community development component, or (c) no inputs (control group). These households were visited five times over 33 months. Again, household wealth improved more in the “full Heifer intervention” group. Likewise, after adjusting for many variables, child growth (weight, height and weight-for-height) improved more in this group, as did child diet quality (consumption of animal source foods and dietary diversity) and child health (fewer episodes of illness). The children living in households which received “training only” were similar to those in the control group. Thus, intensive and holistic interventions favor greater improvement in these measures of child well-being.
The combined lessons of this research support the notion that programs such as Heifer’s take time to create change, and that it is important to build in this idea to program evaluations. Also, although more costly and difficult to implement, solid measureable change is more likely after intensive community development interventions that training alone. Heifer and the research collaborators look forward to exploring these themes in more detail in the future and using the findings to refine and improve Heifer’s programs worldwide.
1. Miller LC, Joshi N, Lohani M, Rogers BL, Loraditch M, Houser R, et al. Community development and livestock promotion in rural Nepal: effect on child growth and health. Food Nutr Bull 2014; 35 (3): 312-26.
2. Miller LC, Joshi N, Lohani M, Rogers B, Kershaw M, Houser R, et al. Duration of programme exposure is associated with improved outcomes in nutrition and health: the case for longer project cycles from intervention experience in rural Nepal. J Development Effectiveness 2016; 9 (1): 101-19.
3. Miller LC, Joshi N, Lohani M, Rogers B, Mahato S, Neupane S, et al. Greater improvements in child growth and diet quality after a holistic community development intervention than after nutrition training alone. Nutrition Innovation Lab 6th Annual Symposium; July 2017; Kathmandu, Nepal 2017.