Evidence shows that ultra-poor households are typically unable to participate in mainstream poverty alleviation programmes. In response, an international NGO called BRAC in Bangladesh implemented the Challenging the Frontiers of Poverty Reduction: Targeted Ultra-Poor (CFPR: TUP) programme that explicitly targets those living below $0.60-$0.70/day. The innovative scheme combines the provision of income generating assets with an integrated approach that includes multifaceted training on entrepreneurial activities, health, nutrition, social and political awareness training over a period of two years. A number of papers have established the positive impact of the programme on various socioeconomic indicators of participants and the positive spill overs to non-participants. This is the first paper to evaluate the effects of CFPR on nutritional outcomes using data from a randomised control trial covering 26997 households and panel data over a four year period. We find large improvements in nutritional outcomes among household members who participate in CFPR. The impact is most notable for children under 5 where the likelihood of wasting reduces by 8 percentage points (pp) and the likelihood of being underweight by 19 pp. Behavioural changes, such as increased duration of exclusive breastfeeding, administration of vitamin A appear to be the primary drivers of nutritional improvements for children; while food security and hygiene practices are important pathways for improvements in adults’ nutritional status. Spill over effects on non-participants are generally half the size of the main effect, and are only found for poor non-participants suggesting that behavioural changes are more likely to be adopted by groups of similar socioeconomic status. Overall, we conclude that asset transfer programmes such as the CFPR can have large positive long term health effects and lead to positive externalities.

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doi.org/10.1016/j.jhealeco.2018.09.011, hdl.handle.net/1765/111960
Journal of Health Economics
Erasmus School of Health Policy & Management (ESHPM)

Raza, W., Van de Poel, E., & van Ourti, T. (2018). Impact and spill-over effects of an asset transfer program on child malnutrition: Evidence from a randomized control trial in Bangladesh. Journal of Health Economics, 62, 105–120. doi:10.1016/j.jhealeco.2018.09.011