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Study Overview

Impact of a disability-targeted livelihoods programme in Bangladesh: a cluster randomised controlled trial
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There is little evidence on the impact of livelihood interventions amongst people with disabilities. Effective programmes are critical for reducing the heightened risk of poverty and unemployment facing persons with disabilities. STAR+ is a skills development and job placement programme targeted to out-of-school youth with disabilities living in poverty. It is a disability-targeted adaptation to an existing, effective intervention (STAR), which has been designed to address barriers to decent work for people with disabilities. This study will involve a cluster randomised control trial of the STAR+ programme, which is being delivered across 39 of the 64 districts of Bangladesh.

The project implementer, BRAC, has identified 1,500 youth with disabilities eligible for STAR+ across its 91 branch office (typically a geographical areas covering about 6-7 km radius from local BRAC office) catchment areas (clusters). BRAC has limited funding to deliver STAR+ and so 46 of the 91 branches have been randomly allocated to implement STAR+ (intervention arm). The remaining 45 branches will not deliver STAR+ at this time (control arm). Participants in the control-arm will receive usual care, meaning they are free to enrol in any other livelihood programmes run by BRAC or other organisations including standard STAR. The cRCT will assess the impact of STAR+ after 12 months on employment status and earnings (primary outcomes), as well as poverty, participation and quality of life (secondary outcomes). Analysis will be through intention-to-treat, with a random effect at cluster level to account for the clustered design. Complementary qualitative research with participants will be conducted to triangulate findings of the cRCT, and a process evaluation will assess implementation fidelity, mechanisms of impact and the role of contextual factors in shaping variations in outcomes.

Registration Citation:
Economic Policy
Social Protection
Additional Keywords:
disability; Bangladesh; livelihoods
Secondary ID Number(s):
Grant number PO8073 (PENDA project, UK Foreign, Commonwealth and Development Office)

Principal Investigator(s)

Name of First PI:
Lena Morgon Banks
London School of Hygiene & Tropical Medicine
Name of Second PI:
Narayan Das
BRAC Institute of Governance and Development

Study Sponsor

Foreign, Commonwealth and Development Office
Study Sponsor Location:
United Kingdom

Research Partner

Name of Partner Institution:
BRAC Institute of Governance and Development
Type of Organization:
Research institute/University

Intervention Overview


The STAR+ programme was developed by BRAC and partners through consultations with key stakeholders (youth with disabilities, OPDs, government actors), a context analysis and needs assessment, which were conducted between October 2018-April 2019. 

STAR+ will be delivered over 10 months. The core components of STAR+ include:

  1. Sensitisation events with families, communities and employers: Community events will address stigma, discrimination and misconceptions about the ability of people with disabilities to work. These events will use behaviour change messaging that has been developed by BRAC through formative research.  
  2. Provision of assistive devices and rehabilitation support: Participants will undergo a medical assessment during enrolment, and those who are assessed as having unmet needs for assistive devices or rehabilitation support will be provided with them.
  3. Accessible and inclusive technical and soft skills training: Over 6 months, participants will receive on-the-job training in their chosen trade five days a week, and classroom one day a week. Adaptations have been made to the trainings to ensure they are accessible and inclusive. Participants will receive a stipend from BRAC during their training.
  4. Job matching: Near the end of the 6-month training, BRAC staff and partners will identify waged job placements for participants in their chosen trade. It is expected that these placements will primarily be with enrolees’ current training workplaces, although other employers will be identified for individuals who are not retained. BRAC staff will monitor the transition to paid work for three months.
Theory of Change:

The expected outcomes of STAR+ are increased employment and earnings (primary outcomes), decreased poverty, improved quality of life, social participation and attitudes of others. 

The STAR+ programme is expected through the following pathways

1. Increased retention in employment: youth with disabilities are provided with increased practical skills that are relevant to employers in the local market. The sensitisation of employers and support in providing accommodations, along with working alongside an apprentice with a disability makes them more willing to hire people with disabilities.

2. Higher earnings: as a result of increased retention in employment, youth are earning a regular salary. 

3. Decreased household poverty: the person with a disability is in employment and earning an income, and is now contributing to household finances

4. Improved quality of life and social participation: provision of assistive devices, rehabilitation improves functioning, leading to improved quality of life and social participation. Further, participating in employment can improve self-esteem and sense of identity, leading to increased quality of life and confidence to participate. 

5. Improved societal attitudes: community sensitisation events targeted to the community alongside the greater visibility of people with disabilities in the workplace shifts societal attitudes on the value of people with disabilities and their ability to work. 


Multiple Treatment Arms Evaluated?

Implementing Agency

Name of Organization:
Type of Organization:
NGO (International)

Program Funder

Name of Organization:
Foreign, Commonwealth & Development Office
Type of Organization:
Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?
Start Date:
End Date:
Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:
Randomized control trial
Other (not Listed) Method:
Additional Evaluation Method (If Any):
Other (specify)
Other (not Listed) Method:
Process evaluation, qualitative research

Method Details

Details of Evaluation Approach:

The study’s main design is a multicentre cRCT. BRAC’s 91 branch office catchment areas will serve as the clusters for this trial. These clusters cover 39 of the 64 districts of Bangladesh. Of the 91 branches, 46 have been randomly allocated to being implementers of STAR+. The remainder of branches will serve as control areas and will not implement STAR+ during the study timeframe. BRAC has identified youth with disabilities meeting the STAR+ eligibility criteria in both the control and intervention clusters. Baseline data collection was collected after randomisation but before participants were invited to enrol in STAR+ to minimise anticipatory behaviour. Follow-up will be conducted 14 months after the completion of the delivery of STAR+ (24 months after baseline).  Analysis will be intention to treat. 

Outcomes (Endpoints):

Primary outcomes: 

1) Employment status: Engaging in any activity for pay or profit (including in kind) during the preceding month.

2) Earnings: Average hourly and total earnings in the preceding month. Market equivalent cash value will be used to estimate in-kind payment values.

Secondary outcomes: 

3) Household poverty (monetary): Household consumption and income per capita is below national poverty line (based on annual definitions produced by the Bangladesh government)

4) Household poverty (multidimensional): Household defined as poor using an adapted version of the Global Multidimensional Poverty Index (2020 revision)

5) Subjective well-being: Total score on an 8-item tool on self-reported well-being

6) Social attitudes: Total score on 9-item tool on social attitudes

7) Empowerment: Total score on 7-item tool on decision-making

8) Violence: Experienced violence (physical, verbal) or discrimination in the last 12 months


Unit of Analysis:

1) Participation in STAR+ will lead to increased employment and earnings amongst youth with disabilities.

2) Participation in STAR+ will lead to decreased household poverty and improved participation, quality of life amongst youth with disabilities. 

Unit of Intervention or Assignment:
Cluster (BRAC branch office catchment area)
Number of Clusters in Sample:
Number of Individuals in Sample:
1500 individuals
Size of Treatment, Control, or Comparison Subsamples:
46 clusters in intervention arm, 45 in control arm (approximately 750 people in each arm)

Supplementary Files

Analysis Plan:
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Outcomes Data

Individual survey (with some household-level details)
Data Already Collected?
Data Previously Used?
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Treatment Assignment Data

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Data Analysis

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Study Materials

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Registration Category

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

Completion Overview

Intervention Completion Date:
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Unit of Analysis:
Clusters in Final Sample:
Total Observations in Final Sample:
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Preliminary Report:
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Data Availability

Data Availability (Primary Data):
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Other Materials

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Description of Changes:

Study Stopped