Despite the availability of inexpensive and easy-to-use technologies and simple behaviors that can prevent diarrhea, it kills more than half a million children a year, predominantly in the developing world. More troubling still, social scientists have found it challenging to get high adoption rates and maintain participation amongst poor households, even when the technology is provided free.
In a randomized controlled trial in Karachi, Pakistan, I test the hypothesis that perhaps families need tools that clearly demonstrate the impact of health interventions – in this case, chlorine tablets for water purification.
Evidence Action works on programs for which there is a solid evidence base of positive impact, often in the form of randomized control trials. We develop the business models to scale these evidence-based programs so they benefits millions of the most poor and marginalized people. Evidence Action doesn’t work exclusively on a particular sector, like water or microfinance, or has a commitment to a particular kind of service delivery model. We are guided by evidence of impact first. So, what do we consider when assessing interventions to explore or support?
How much evidence is enough before we know that a global development intervention works for people? How much evidence is enough to know that a program is worth scaling to millions of people because it works and benefits lives across multiple settings and contexts?
These are great questions that Michael Hobbes raises in an article in the most recent issue of The New Republic. In fact, we at Evidence Action think a lot about this. Our mission is to scale programs that have been proven to work so they benefit millions of people.
Unfortunately, Mr. Hobbes used a poor example to raise these questions by focusing on deworming. In the case of mass deworming of children and our Deworm the World Initiative, the policy has followed the (rigorous) evidence. Deworming has a well-proven, clear causal chain from intervention to effect.