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The small study in Rwanda that could change the way the US does foreign aid (Vox)

September 13, 2018

By Dylan Matthews 

From the article: 

The US Agency for International Development (USAID), the US government’s main foreign aid organization, has started doing something radical. It has begun testing programs it runs in Africa, and seeing if they actually do any more good than just handing out cash. And with the first such evaluation now in, the answer seems to be that they’d be better off giving away cash.


It gets better for the cash side, though. Remember how 34 villages got a much, much bigger transfer, of $532 per household? Not only did wealth and consumption on regular goods like food and housing go up in that group, as you’d expect after giving someone a whole bunch of cash, but beneficiaries had more diverse diets, healthier child heights relative to age, and, most strikingly, lower child mortality.

This was a study covering a year period. Any intervention having a noticeable impact on child mortality, let alone an intervention that did nothing directly related to health, is surprising. And yet in only a year, child mortality among people getting the big cash transfer was 70 percent lower. In the control group, 13 out of 2,596 children died. Among the group getting the big transfer, only two out of 1,200 children died.

That’s a really startling finding. It’s such a big shock that I’m not even really sure I believe it. A 2013 literature review by the Center for Global Development’s Amanda Glassman, Denizhan Duran, and Marge Koblinsky identified three cash studies with infant or maternal mortality as a measured outcome. Two, in Mexico and India respectively, found that cash reduced mortality, while the third, in Nepal, did not find any significant effects. Nothing in that evidence base suggested a 70 percent reduction in one year was possible. I’m certainly open to the idea that the cash had some effect, but maybe the big difference between the treatment and control villages was a fluke. 

Read the full article here


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