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General

Study Overview

Title:

Cluster-randomised trial and process evaluation of a disability-inclusive Ultra-Poor Graduation Programme in Uganda

Study is 3ie funded:

No

Study ID:

RIDIE-STUDY-ID-626008898983a

Initial Registration Date:

04/20/2022

Last Update Date:

03/31/2022

Study Status:

Ongoing

Location(s):

Uganda

Abstract:

 

There is little evidence how to support ultra-poor persons with disabilities into sustainable livelihoods. DIG is a Disability Inclusive Graduation programme targeting ultra-poor women and/or persons with disabilities living in rural Uganda. The programme is an adaptation of a poverty-graduation formula that has been shown to be effective in many contexts but not for persons with disabilities.  The programme is being delivered by a consortium of BRAC Uganda, Humanity and Inclusion (HI), and the National Union of Women with Disabilities of Uganda (NUWODU).  

 

The DIG programme works with project participants over 18 months. Participants receive a consumption stipend, training, access to savings-and-loans groups, and a capital asset that will form the basis of their new livelihood. In addition, the programme has been adapted to address the barriers that persons with disabilities face, such as by supporting access to assistive technology and addressing stigma to facilitate social participation. The delivery partners identified over two-times as many eligible households in the target districts than they had a budget to reach. Households were clustered by geographical proximity for the purposes of delivering the intervention. We supported selection with a ‘lottery’ to randomly select which clusters would receive the programme. Before the intervention started, we conducted a survey among project participants and an equal number who will not be offered the programme. The primary outcome of the trial is per-capita household consumption. There are a number of secondary outcomes. We are following-up those research participants and conducting a process evaluation of the programme implementation, mechanisms, and context using complementary qualitative and quantitative methods.

 

Registration Citation:

Categories:

Private Sector Development
Social Protection

Additional Keywords:

Disability, livelihoods, poverty graduation

Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:

Calum Davey

Affiliation:

LSHTM

Name of Second PI:

Munshi

Affiliation:

Sulaiman

Study Sponsor

Name:

BRAC Uganda

Study Sponsor Location:

Uganda

Research Partner

Name of Partner Institution:

BIGD, BRAC University

Type of Organization:

Research institute/University

Location:

Bangladesh

Intervention

Intervention Overview

Intervention:

Tthe NGO BRAC has developed an “Ultra-Poor-Graduation Programme” (UPG programme) that aims to help extremely poor people move out of poverty. The core graduation programme follows a sequence of activities to generate sustainable livelihoods for the participants and their households. DIG adapted the generic graduation model described above for persons with disabilities. The programme was co-designed over nine-months by BRAC, HI, and National Union of Women with Disabilities of Uganda (NUWODU). They consulted government officials, civil society, ultra-poor women and men, persons with disabilities, and participants from BRAC’s existing poverty graduation project in Uganda. 

Additional disability-specific components were intended to reduce barriers and enable participation. The programme provided access to occupational, physical and psychosocial therapy and referrals through local technical staff hired by the project. Bi-monthly home visits provided life-skills training and emotional support. Attitudinal barriers among project participants, project staff, BRAC Uganda staff and key external stakeholders were addressed through sensitivity training provided by NUWODU, local DPOs and HI. The programme supported advocacy, including sensitising village leaders on disability inclusion through NUWODU’s District Women’s Associations. DIG aimed to shift norms and behaviours at community level by bringing together local DPO leaders, local and religious leaders in VPRCs to advocate for the empowerment of persons with disabilities. DIG also delivered disability-awareness training to civil-society organisations. 

Theory of Change:

The main graduation-programme components are: 

1. Livelihoods. Receipt of assets, technical training, and individual-level support for income generation. The livelihoods component should lead to improved enterprise management skills, asset accumulation/diversification and increased income.
2. Social protection. Six-month consumption stipend, healthcare subsidy and rehabilitation, physiotherapy, and psychosocial support, and activities to support beneficiaries to overcome access barriers to government and NGO social entitlements (disability-specific and general) and support services (health, education, social protection). Social protection should result in increased household food intake, dietary diversity and improved health, increased access to health services, social safety nets and support mechanisms.
3. Financial Inclusion. Financial literacy training, VSLA formation, and on-going coaching. Financial inclusion should result in improved financial management skills and increased savings, developing ability and confidence to access financial services, cope with shocks, and invest in productive assets.
4. Social Empowerment. Home coaching to provide individual counselling and life-skills, individual empowerment plans (supported by HI), the formation of inclusive Village Poverty Reduction Committees (VPRCs). The presence of these, and the VSLAs, means that while principally a household-level programme, the programme also has important village-level components. Social empowerment should result in better social integration within households and communities and improve participant confidence and aspirations. 

Multiple Treatment Arms Evaluated?

No

Implementing Agency

Name of Organization:

BRAC Uganda, Humanity and Inclusion, and the National Union of Disabled Women of Uganda

Type of Organization:

NGO (International)

Program Funder

Name of Organization:

FCDO

Type of Organization:

Public Sector, e.g. Government Agency or Ministry

Intervention Timing

Intervention or Program Started at time of Registration?

Yes

Start Date:

10/05/2020

End Date:

04/30/2022

Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:

Randomized control trial

Other (not Listed) Method:

Additional Evaluation Method (If Any):

Other (not Listed) Method:

Method Details

Details of Evaluation Approach:

The aim of the impact evaluation is to estimate the effect of the DIG Programme on persons with disabilities and their families in Uganda.

Primary objective:

1. Estimate the effect of the DIG programme on poverty, livelihood, and social participation of persons with disabilities and their families.

Secondary objective:

1. Estimate the differential effect of the DIG programme on poverty, livelihood, and social participation of persons with disabilities and their families, compared to the effect among people without disabilities. 

The overall effect of the intervention will be estimated using a cluster-randomised design. For the purposes of intervention delivery and the evaluation, ‘clusters’ are villages with at least 10 eligible households, or groupings of nearby smaller villages that include 10 or more eligible households; this cluster size was necessary for the VSLA and VPRC groups. The programme team identified many more eligible households than they had funding to support. The implementing partners (BRAC, HI, and NUWODU) decided that the fairest way to determine which households received the DIG programme was to conduct a lottery. The lottery was conducted at the village level (i.e. villages will be selected at random and all eligible households in those villages will receive the programme). This was to reduce resentment between eligible households (although note that many households in selected villages will not be eligible for the DIG programme and will not receive any intervention) and because the village-savings-and-loans associations were delivered at the village level. The lottery was supported by the research partners so that it met the criteria for the evaluation; however, even without an evaluation the lottery would still have been conducted with a similar design. 

Outcomes (Endpoints):

Household expenditure will be averaged across the household members to measure per capita monthly expenditure. For example, if the total household expenditure for the month was US$90, and the household has eight members, then the per-capita expenditure was 90/8=US$11.25.  

The secondary outcomes will measure anticipated changes on the theory of change. These are: 

• Monthly household income from agricultural and non-agricultural sources (household level)
• Participation of the project participant in livelihood activities 
• Participation of the project participant in social activities 
• Health and wellbeing of the project participants

Unit of Analysis:

Households, within clusters (villages)

Hypotheses:

1. The DIG programme increases livelihoods for participants 
2. The DIG programme increases participation for persons with disabilities 
3. The DIG programme was suitably adapted to persons with disabilitise 

Unit of Intervention or Assignment:

Number of Clusters in Sample:

192

Number of Individuals in Sample:

5700

Size of Treatment, Control, or Comparison Subsamples:

96 in each arm (treatment and control)

Supplementary Files

Analysis Plan:

Other Documents:

Data

Outcomes Data

Description:

Data were (for the baseline) and will be (for the endline) collected using questionnaires administered to members of selected households in both the control and intervention arms. One questionnaire refers to features of the household and should be completed by the person in the household identified as best able to answer accurately, usually the household head. Another questionnaire refers to the project participant and should be completed by this person.

Data Already Collected?

No

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Treatment Assignment Data

Participation or Assignment Information:

Yes

Description:

Data Obtained by the Study Researchers?

Data Previously Used?

Data Access:

Data Obtained by the Study Researchers?

Data Approval Process:

Approval Status:

Data Analysis

Data Analysis Status:

Study Materials

Upload Study Materials:

Registration Category

Registration Category:

Prospective, Category 1: Data for measuring impacts have not been collected

Completion

Completion Overview

Intervention Completion Date:

Data Collection Completion Date:

Unit of Analysis:

Clusters in Final Sample:

Total Observations in Final Sample:

Size of Treatment, Control, or Comparison Subsamples:

Findings

Preliminary Report:

Preliminary Report URL:

Summary of Findings:

Paper:

Paper Summary:

Paper Citation:

Data Availability

Data Availability (Primary Data):

Date of Data Availability:

Data URL or Contact:

Access procedure:

Other Materials

Survey:

Survey Instrument Links or Contact:

Program Files:

Program Files Links or Contact:

External Link:

External Link Description:

Description of Changes:

Study Stopped

Date:

Reason: