A comparative study of effectiveness and cost-effectiveness of alternative poverty eradication interventions in extremely poor areas of Northern Ghana

我们的研究直接解决了以下首要问题：哪些因素决定了进入和摆脱贫困的途径以及人们对这些途径的体验，以及政策如何以可复制和扩大的方式创造可持续的摆脱极端贫困的途径？这项研究比较了替代消除贫穷项目的效力和成本效益，并评估了它们的可扩展性和可持续性。报告特别回答了以下问题：--对极度贫困的农村地区来说，最有效的消除贫困战略是什么：综合发展项目、贫困毕业方案还是现金转移方案？-哪种战略在减贫方面更具成本效益，原因是什么？-这些战略一旦在国家一级扩大并长期实施，其效力和成本效益如何？这项研究将评估在加纳北部贫困地区实施的三项减贫方案的效力和成本效益，它们的共同目标是通过解开贫困陷阱来长期消除贫困：1)加纳政府实施的增强生计能力减贫方案，这是一项针对极端贫困家庭的现金转移方案；2)由地球研究所实施的SADA-千禧村项目，其中包括一系列干预措施，旨在解决卫生、教育和生产领域的多种失败；3)由当地非政府组织实施的受BRAC启发的贫困毕业方案，其目标是最贫穷的人，并向家庭提供生产性资产赠款、现金消费支助和其他服务。这项研究有三个主要目标。首先，我们打算在可供选择的消除贫穷方案之间作出选择。这些信息将特别有利于所审议项目的资助者和实施者，但所吸取的经验教训将更广泛地适用于在低收入国家实施的类似项目。第二，我们打算通过开发复杂干预措施的成本效益分析方法来作出方法学上的贡献。这些方法目前发展不足，没有明显的方法来说明体制环境的复杂性、不同项目组成部分之间的协同作用以及在扩大干预措施时是否存在规模经济。第三，我们打算通过调查极端贫困的机制和分析在什么条件下具体干预措施可以解开贫困陷阱，来提高我们对贫困的理解。这项研究将首先利用完善的影响评估方法，依靠严格的评估设计和可靠的控制小组，分析干预措施的有效性。这项分析将应用于非常富裕的家庭数据集，这些数据集除了标准的货币贫困外，还允许对贫困进行多个维度的分析。第二阶段的研究将超越对项目效果的有效性和统计意义的分析，着眼于干预措施的成本效益。将获得成本数据，并计算主要贫困目标的成本效益比，例如减少贫困人数和营养不良率。在第三阶段，我们将评估干预措施的可扩展性和可持续性。为此，我们将使用新的统计技术推断干预措施对其他地理区域和时间的影响，并在存在规模经济和不同项目实施方式的情况下模拟不同的成本结构。模拟和相关的敏感性分析将对干预措施在长期以及在国家和区域各级的效力和成本效益产生影响预测。

Our research addresses directly the following overarching question: What factors shape pathways into and out of poverty and people's experience of these, and how can policy create sustained routes out of extreme poverty in ways that can be replicated and scaled up? The study compares the effectiveness and cost-effectiveness of alternative poverty eradication projects and assesses their scalability and sustainability. In particular, it answers the following questions:- What is the most effective poverty eradication strategy for an extremely deprived rural area: an integrated development project, a poverty graduation programme, or a cash transfer programme?- Which strategy is more cost-effective at poverty reduction and for what reasons?- What are effectiveness and cost-effectiveness of these strategies once they are scaled up at the national level and implemented over the long term?The study will assess effectiveness and cost-effectiveness of three poverty reduction programmes implemented in deprived areas of Northern Ghana, which share the goal of eradicating poverty over the long term by unlocking poverty traps: 1) the Livelihood Empowerment Against Poverty (LEAP) programme implemented by the Government of Ghana, a cash transfer programme targeted to extremely poor households; 2) the SADA-Millennium Village Project implemented by the Earth Institute, consisting of a package of interventions directed to address multiple failures in the health, education and production domains; 3) the BRAC-inspired Poverty graduation programme implemented by local NGOs, which targets the poorest of the poor and provides households with a productive asset grant, cash consumption support, and other services. The research has three main goals. First, we intend to inform choices between alternative poverty eradication programmes. This information will particularly benefit the funders and the implementers of the projects considered, but the lessons learned will have a wider application to similar projects implemented in low-income countries. Second, we intend to make a methodological contribution by developing methods of cost-effectiveness analysis of complex interventions. These methods are currently under-developed and no obvious methodology exist to account for the complexity of the institutional environments, the presence of synergies among different project components, and the presence of economies of scale when interventions are scaled up. Third, we intend to improve our understanding of poverty by investigating the mechanisms underlying extreme poverty and by analysing under what conditions specific interventions can unlock poverty traps. The research will first analyse the effectiveness of the interventions using well-established impact evaluation methodologies relying on rigorous evaluation designs and solid control groups. The analysis will be applied to extraordinarily rich panel household datasets which allow the analysis of poverty over multiple dimensions in addition to standard monetary poverty. The second phase of the research will go beyond the analysis of effectiveness and statistical significance of project effects, by looking at the cost-effectiveness of the interventions. Cost data will be obtained and cost-effectiveness ratios will be calculated for main poverty targets, such as reduction in poverty head-count and malnutrition rates. In a third phase we will assess the scalability and the sustainability of the interventions. To this aim we will extrapolate the effects of the intervention over other geographic areas and over time using novel statistical techniques, and we will simulate different cost structures in the presence of economies of scale and different modalities of project implementation. Simulations, and related sensitivity analyses, will generate impact predictions of the effectiveness and cost-effectiveness of the interventions over the long term and at the national and regional levels.