Building Savings and Protecting Assets
Ntongi McFadyen, Save the Children
STRIVE Mozambique
Harnessing the Power of Cross-sectoral Programming
to Alleviate HIV/AIDS and Food Insecurity
May 30, 2013
Washington,
DC
Harnessing
the Power of
Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
STRIVE Mozambique context
• Chronic food insecurity and child malnutrition
• Nampula Province:
– 63% of children under 5 chronically malnourished
– Smallholder, subsistence-oriented farming
– Hunger season from December to March
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Program activities
• STRIVE activities implemented in 2008-2012:
–Village Savings and Loan (VSL) groups
–Rotating labor scheme, Ajuda Mutua (AM)
• 10,000+ participants in VSL groups - potential to
impact more than 25,000 children
• Overlay with SANA, a USAID Title II food security
program addressing nutrition, agriculture, and
disaster risk reduction.
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Impact evaluation
• To assess program effect on:
– HH food security, HH and child food diversity, and
child anthropometric measures
– Intermediary outcomes: income, assets and social
capital
• Household cohort survey:
– August 2009 and August 2012
– 9.1% attrition rate
– 1543 program beneficiaries and residents of the
comparison group area
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Nampula Province
Erati
No VSL, No AM
Memba
No VSL, No AM
No VSL, No AM
(Control)
Nacala Velha
VSL Only
VSL
Only
Mossuril
VSL Only
Ajuda Mutua
Only
VSL +
Ajuda Mutua
Meconta
Ajuda Mutua
Mogincual
VSL + AM
Angoche
VSL + AM
Moma
Ajuda Mutua
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Qualitative follow-up study
• To explore factors leading to the change in outcomes
• Subsample of households from impact evaluation
with measured improvements in income and social
capital
• In-depth interviews conducted in Nov-Dec 2012
– 43 VSL participants in Mossuril district
– 42 VSL&AM participants in Angoche district
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Results overview
VSL
AM
VSL+AM
Household
Income per capita
+
+
+
Assets*
+
+
+
Mos. of adequate food**
+
+
+
Food diversity (FCS)
+
Not sig.
Not sig.
+
Not sig.
Not sig.
Stunting
Not sig.
-
-
Wasting
Not sig.
Not sig.
Not sig.
Underweight
Not sig.
Not sig.
Not sig.
(+) =
better
than
control
Child
Food diversity (FCS)
*aluminum panels, toilets
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
(-) =
worse
than
control
Difference in Difference design
Effect of participation = Difference for VSL group – Difference for comparison group
VSL
Effect of
participation
Comparison Group
Difference for
comparison
group
Difference
for VSL
group
‘Counterfactual’ for
VSL Group
What would have happened
in absence of treatment
Baseline (2009)
Time
End Line (2012)
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Results
Income and Assets
VSL vs. Control
Total per capita
Income
1,000 Mzn = $38
VSL
Comparison
Group
Total Durable
Assets
VSL
†DD = .85*** (log. scale);
Ratio of difference is 2.3
Baseline (2009)
Comparison
Group
†DD = 1.124***
Endline (2012)
† Propensity score weighted difference in difference, controlling for natural shocks
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Results
Food Security and Dietary Diversity
VSL vs Control
Mo. Adequate
Food
VSL
Dietary Diversity
(FCS)
Comparison
Group
VSL
†DD = .416***
Comparison
Group
†DD = .889***
Baseline (2009)
Endline (2012)
† Propensity score weighted difference in difference, controlling for natural shocks
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Key drivers of impact
• Income
– Men have a central decision-making role in allocating savings and
loans, although women participation is more dominant in VSL
– Use of loans to invest in agriculture and business; large changes in
income driven by investment in high value crops
– Exposed to business training but sense of limited non-farm
opportunities; no apparent income gains from livestock
• Assets
– Households acquiring a range of durable assets (improved toilets,
aluminum and zinc panels, bicycles, clocks, radios, etc)
– Given a lump sum, are durable assets an easy and low risk
purchase? Or are they a preference?
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Key drivers of impact
• Food security
–
–
–
–
Share-out almost always timed to align with the hunger season
Women referred to making food and daily needs purchases
Men referred to making agriculture and durable good investments
Members associated dietary diversity with desire for variety in
tastes, rather than nutritional quality
• Child anthropometrics (stunting, wasting, underweight)
– Some VSL members exposed to nutrition messages through SANA;
acknowledgement of different food needs among children and
equity in intra-household distribution of food
– In hierarchy of needs, potential investment in children’s nutrition
appears to be crowded out by other priority needs
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Questions
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity
Implications going forward
VSL - overlayed with SANA - was not enough to improve health
and nutrition outcomes for children, in this context:
– Would the explicit integration of health and nutrition within VSL yield
nutritional outcomes for children? Is the problem not a priority or is
the solution not well understood?
– Would increased engagement of resource gatekeepers (men,
grandmothers) change allocations to prioritize nutritional needs?
VSL contributed to income, asset, and risk mitigation gains:
– Would children’s nutritional needs eventually compete for finite
resources as households work their way through priority
expenditures? Can VSL achieve this, and under what timeframe?
– What additional avenues can accelerate outcomes, e.g., readily
available nutritional foods at a lower cost?
In other contexts, how has VSL shown to have built and
protected assets?
Harnessing the Power of Cross-sectoral Programming to Alleviate HIV/AIDS and Food
Insecurity