India’s National Deworming Day (NDD), initiated in 2015, is the world’s largest single-day public health intervention, providing children between the ages of 1-19 with free deworming tablets. As part of Evidence Action’s technical assistance to the Government of India and select state governments for the August NDD treatment round, we are collaborating on several tailored strategies to target hard-to-reach children, including migrant workers in the north-eastern state of Tripura.

In the second of two blog posts for The Stone Family Foundation, Arjun Pant discusses the Dispenser for Safe Water program’s path toward financial sustainability.

In the first of two blog posts for The Stone Family Foundation, Dispensers for Safe Water Director Arjun Pant reflects on key lessons learned as the program rapidly scaled its operations.

Earlier this year, Mr. Paul Byatta assumed leadership of our Africa operations as Regional Director, following five years of  regional growth in our Deworm the World Initiative and Dispensers for Safe Water programs. We took the opportunity to interview Paul to learn more about what makes him tick.

In our Dispensers for Safe Water program, which provides access to safe drinking water by installing chlorine dispensers near community water sources in Kenya, Uganda, and Malawi, we verify their use by measuring the adoption rate of chlorine among the households that our dispensers serve. Through the survey conducted in late 2017, we found that our population reached declined from 4.7 million, which is based on surveys conducted for each new dispenser installation during program scale-up from 2012-2016, to 4.0 million people program-wide today.

A 2005 randomized controlled trial conducted in Kenya found that girls who were told about the dangers of sugar daddies were 28% less likely to be pregnant at year-end than girls who were simply told to abstain, and girls who received no sexual education beyond that offered in school. Based on this success, Young 1ove worked with a group of partners, including the Government of Botswana, the Abdul Latif Jameel Poverty Action Lab (J-PAL), Botswana-Baylor Children’s Clinical Centre of Excellence, and Evidence Action, to evaluate the idea again through a similar program, No Sugar. This second round of evaluation delivered mixed results and all partners involved in the program made a decision not to scale the No Sugar intervention. Here are our three biggest takeaways from the experience.

What happens when you tell middle-school and teenage girls in Africa about the dangers of sexually engaging with older men who offer them financial favors? Does it affect their choice of sexual partner? A Kenya-based, 2005 randomized controlled trial suggested it might. In 2014, Botswana-based non-profit Young 1ove brought together a group of partners to re-evaluate the idea through a program, “No Sugar,” designed to be scaled-up across Southern Africa. The evaluation yielded mixed results; consequently, the Government of Botswana, Young 1ove, and other partners are not scaling up No Sugar as it was originally designed. Instead, Young 1ove is redesigning the program for further evaluation of impact, before potentially scaling it up in future.

At Evidence Action, we determine impact based on data, and in partnership with governments, we reached over 280 million children in 2017 alone through our Deworm the World Initiative. Our focus on scale means we rarely have the opportunity to zoom in on an individual’s experience. So in February, we jumped at the chance to visit these two girls, who we first met on a deworming day in Kenya back in 2013.

In late 2017, we had a fantastic opportunity to participate in a ‘Teaching at the Right Level’ (TaRL) workshop in India hosted by Indian education non-profit and pioneer of the TaRL model, Pratham. The crux of the workshop was our favorite theme here at Evidence Action: how to translate rigorous research into effective, scaled action.

At Evidence Action, we often use mobile technology to collect program data that informs decision making. Recently, we experimented with Echo Mobile as a tool for monitoring Winning Start, a program in our Beta incubator that deploys post-university youth to public schools where they help children develop basic reading, writing, and numeracy skills. 
 

2017 Deworm the World Initiatives Milestones: What We've Achieved This Year

Parasitic worm infections disproportionately affect people living in poverty, especially those who are difficult to reach with mass drug administration. Evidence Action is committed to supporting innovations that enable treatment for all children at risk of worm infections regardless of their circumstances.Here’s a look at some targeted strategies implemented in Kenya to improve coverage of hard-to-reach children over the past year.

This year, our Dispensers for Safe Water program once more provided access to safe water for nearly 5 million individuals across Kenya, Uganda, and Malawi. We estimate that this simple and low-cost innovation has prevented over 2.5 million cases of diarrhea in children and saved over 2,000 young lives to date.

In the last three years, Evidence Action Beta has grown and matured in significant ways.

Evidence Action is pleased to announce that GiveWell has recognized three of our programs this year: Deworm the World Initiative, No Lean Season, and Dispensers for Safe Water.

Evidence Action is pleased to introduce our new Chief Innovation Officer: Anne Healy. 

Evidence Action’s Deworm the World Initiative is proud to provide technical assistance to Thrive Networks and the Government of Vietnam as the government takes action towards keeping children healthy and in school by strengthening and improving school-based deworming. On November 6 and 7, over 700,000 primary school children across 3,000 schools in four provinces in northern Vietnam were targeted to receive a deworming tablet in their classroom. This is the third round of school-based deworming that Thrive Networks and Evidence Action have supported the Government of Vietnam to implement.  

Last week, Evidence Action participated in USAID’s Global Innovation Week, 2017. The event brought together innovators from all sectors of international development and aid, from water and sanitation to agriculture to technology. 

Testing of No Lean Season, an innovative intervention with the potential to improve millions of lives in low and middle income countries, is expanding to Indonesia. 

Evidence Action has been working with the Government of India to prepare for the second round of National Deworming Day (NDD) for 2017, aimed at treating children in areas with high prevalence rates of parasitic worms. The Government of India conducted NDD on August 10. Three-hundred and ten million children across 34 states and UTs were targeted to receive a single deworming tablet from their teachers across schools and anganwadis in India.

Evidence Action’s Deworm the World Initiative analyzes the cost per child treated in the geographies where we work to provide information on the real costs of deworming. Understanding how the costs per child change with scale and over time is vital for implementation purposes and as the global community and policymakers work to secure adequate resources for national deworming programs.

We know what works to deliver literacy among kids in low and middle incomes countries. The only question now is how do we act on this knowledge. At Evidence Action, we are putting this rigorous evidence to work through Winning Start—a project that aims to improve student literacy and numeracy outcomes by pairing post-university youth volunteers with remedial students. 

Evidence Action is excited to share new progress about our work in India. We are now providing technical assistance to Karnataka state, partnering with the Government of Karnataka to strengthen the anganwadi and school-based mass deworming program.