Learning through monitoring :
            lessons from a large-scale nutrition program in Madagascar
WPS4058

# Learning through Monitoring:

Lessons from a Large Scale Nutrition Program in Madagascar<sup>†</sup> Emanuela Galasso and Jeffrey Yau _Development Research Group Bureau of Economics World Bank Federal Trade Commission*_

## Abstract:

Monitoring data is generally collected as a by-product of the process of monitoring program implementation. Yet this rich source of data has not been exploited to assess the effectiveness of the program. In this paper we use detailed administered data from a large-scale, community-based nutrition program in Madagascar, to argue that this data can be used to estimate the _differential_ effect of increased exposure to the program and study how these returns to exposure evolve over time. We find that the returns to exposure are positive: communities exposed for additional one (or two) years display on average lower malnutrition rates of around 7-9 percentage points. Moreover, we find that the returns are decreasing as time and duration increase, though they do not dissipate to zero. These results are consistent with the hypothesis that the returns to the program reflect learning effects from the intervention. Finally, the results show higher differential returns to the program in poorer areas and areas more vulnerable to diseases. These findings have important implications for how such programs should be scaled-up within a country.

_Keywords_ : impact evaluation, duration, nutrition intervention, community-based program, large-scale programs, propensity-score, matching _JEL classification_ : I12, C14, C31 World Bank Policy Research Working Paper 4058, November 2006 _The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the view of the World Bank, its Executive Directors, or the countries they represent. Policy Research Working Papers are available online at http://econ.worldbank.org._ † This research has been sponsored by the World Bank Research Grant “Community Nutrition: Evaluation of Impacts in Africa”, a comparative meta-analysis on the effectiveness of community-based nutrition programs in Madagascar and Senegal. We thank Claudia Rokx, the project task manager for her enthusiastic support to the evaluation effort, Harold Alderman for useful discussions throughout the project, Rinku Murgai, Martin Ravallion and seminar participants at the NEUDC at Brown University, the World Bank and Virginia Tech. We are extremely grateful to the Seecaline project management unit, to Malalanirina Ratomaharo in particular, and to all the provincial directors for providing the monitoring data and sharing their vast knowledge of the program. We thank Bart Minten for sharing the data on the Commune Census. We wish to thank Quinghua Zhao for providing technical help in the data entry. The findings, interpretations and conclusions of this paper are those of the authors and should not be attributed to the World Bank, its Executive Directors, or countries they represent, the Federal Trade Commission or any individual commissioner.

Correspondence by emails to <u>egalasso@worldbank.org</u> or yyau@ftc.gov 1