UK Department for International Development IMPACT EVALUATION OF THE SADA MILLENNIUM VILLAGES PROJECT IN NORTHERN GHANA: ENDLINE SUMMARY REPORT Authors: Chris Barnett, Edoardo Masset, Tony Dogbe, Dee Jupp, David Korboe, Arnab Acharya, Kelsy Nelson, Rachel Eager, Tom Hilton August 2018 Submitted by Itad In association with: Itad in association with IDS, LSHTM and PDA Ghana April 2018 REPORT MILLENNIUM VILLAGES IMPACT EVALUATION: ENDLINE SUMMARY REPORT Acknowledgements This report has been prepared by the team for the impact evaluation of the Millennium Villages Project. The team is composed of staff from Itad, the Institute of Development Studies, the London School of Hygiene and Tropical Medicine, and Participatory Development Associates Ltd (PDA Ghana). The team is fully independent of the Earth Institute, the Millennium Promise and the Savannah Accelerated Development Authority (SADA) who implement the project. The authors of this report are Edoardo Masset, Chris Barnett, Tony Dogbe, Arnab Acharya, Dee Jupp, David Korboe, Kelsy Nelson and Rachel Eager. The report was edited and proofread by Chris Steel, with valuable support from Efi Alamanos. The findings of this report are the full responsibility of the authors, and any views contained in it do not necessarily represent those of the UK Department for International Development (DFID) or of the people consulted. The team is nonetheless very grateful to all the researchers that have assisted with data collection, the staff at DFID, and everyone else that has provided support, information and comments – including the work of the Earth Institute during the enumeration phase. We are particularly indebted to the support provided by Stephen Adam, Lynne Henderson, Martin Kanyagui, James Bianco and Tom Crowards of DFID Ghana, as well as Seth Ohemeng-Dapaah, Joseph Akolgo, Rafael Flor and Yanis Ben Amor of the Millennium Promise and the Earth Institute. We have also valued comments and technical advice from Patrick Nolen of the University of Essex (and advisor to DFID), plus members of the Evaluation Advisory Group and Peer Review Group. Open data access During this evaluation, we have worked closely with the UK Data Archive (UKDA) to make the evaluation datasets available for re-analysis; alongside cooperation from the Earth Institute and the Center for International Earth Science Information Network (CIESIN) at Columbia University. The UKDA curates the UK's largest collection of digital research data in the social sciences and humanities. It currently hosts all five rounds of household data collected for the impact evaluation of the Millennium Villages in northern Ghana (from 2012 to 2016). These are available on request from: https://discover.ukdataservice.ac.uk/catalogue/?sn=7734 Disclaimer This report has been prepared by Itad for the named client, for services specified in the Terms of Reference and contract of engagement. The information contained in this report shall not be disclosed to any other party or used or disclosed in whole or in part without agreement from Itad. For reports that are formally put into the public domain, any use of the information in this report should include a citation that acknowledges Itad as the author of the report. This confidentiality clause applies to all pages and information included in this report. ‘Itad’ and the tri-colour triangles icon are a registered trademark of ITAD Limited. Itad in association with IDS, LSHTM and PDA Ghana April 2018 REPORT MILLENNIUM VILLAGES IMPACT EVALUATION: ENDLINE SUMMARY REPORT Contents EXECUTIVE SUMMARY ......................................................................................................................................... VI CHAPTER 1. INTRODUCTION ................................................................................................................................ 17 1.1 Background to the Millennium Villages Project............................................................................................ 18 1.2 Lessons from other integrated rural development programmes ................................................................. 20 1.3 Understanding the Millennium Villages Project model ................................................................................ 22 1.4 Overview of the evaluation design ............................................................................................................... 25 1.5 Aims and structure of the report .................................................................................................................. 26 CHAPTER 2. THE CONTEXT IN NORTHERN GHANA ............................................................................................... 28 2.1 Poverty in northern Ghana ........................................................................................................................... 28 2.2 Selection of Millennium Villages Project sites .............................................................................................. 29 2.3 Political and administrative changes over the MVP period .......................................................................... 30 2.4 The Savannah Accelerated Development Authority ..................................................................................... 30 2.5 Non-governmental organisations and other operations in the MVP area ................................................... 31 CHAPTER 3. METHODOLOGY ................................................................................................................................ 34 3.1 Evaluation design .......................................................................................................................................... 34 3.2 Methodology for estimating difference-in-difference analysis .................................................................... 36 3.3 Data collection and sample characteristics .................................................................................................. 38 3.4 Institutional assessment ............................................................................................................................... 42 3.5 Participatory rural appraisal ......................................................................................................................... 43 3.6 Reality check approach ................................................................................................................................. 44 3.7 Analysis and synthesis .................................................................................................................................. 45 CHAPTER 4. THE IMPACT ON THE MILLENNIUM DEVELOPMENT GOALS .............................................................. 47 4.1 Impact heterogeneity and spillover effects .................................................................................................. 60 CHAPTER 5. BREAKING THE POVERTY TRAP ......................................................................................................... 63 5.1 Impact on household monetary poverty ...................................................................................................... 63 5.2 Household income and expenditure............................................................................................................. 66 5.3 Breaking the poverty trap and distributional effects .................................................................................... 72 CHAPTER 6. MULTIDIMENSIONAL POVERTY ........................................................................................................ 74 6.1 Impact on multidimensional poverty ............................................................................................................ 74 6.2 Perceptions of well-being ............................................................................................................................. 77 6.3 Summary ....................................................................................................................................................... 79 CHAPTER 7. HEALTH OUTCOMES ......................................................................................................................... 80 7.1 Health causal chain ....................................................................................................................................... 80 7.2 Project implementation ................................................................................................................................ 83 7.3 Impact on service provision .......................................................................................................................... 83 7.4 Impact on child health outcomes ................................................................................................................. 90 7.5 The cost and effectiveness of MVP health interventions ............................................................................. 96 7.6 Summary ....................................................................................................................................................... 96 CHAPTER 8. EDUCATION ...................................................................................................................................... 98 8.1 Education sector causal chain ....................................................................................................................... 98 8.2