presents the main regressions results on outcomes for households in the behaviorally enhanced treatment arms over the corresponding outcomes for households which received only cash, as well as an analysis of ‘nudge dosage’ and how it affects the results. Section 7 concludes by discussing the results, limitations of the study, and directions for further work.

## **Section 2: Background: Madagascar and the Human Development Cash Transfer**

# **2.1: Madagascar’s Economic and Human Development Trajectory**

Although Madagascar has sustained consistently high rates of economic growth each year since 2013, this has yet to make a significant dent on poverty: the country remains one of the world’s poorest, with, the poverty rate inching down from <mark>77.7% in 2014 to 75.1% in 2018</mark> (World Bank 2018b, <mark>World Bank 2019).</mark> Almost 80 percent of the population lives on less than US$1.90 per day.<sup>6</sup> These 20 million people make Madagascar the country with the sixth highest number of people in poverty in the world.<sup>7</sup> Close to 60 percent of the population is extremely poor based on the national consumption-based poverty methodology.<sup>8</sup> Many of the rural poor are deprived in multiple dimensions including consumption, literacy, education, basic household assets, and access to public services such as electricity. Madagascar’s Human Capital Index score of 0.37 means that Madagascar is achieving only 37 percent of its possible human capital potential, below the SubSaharan Africa average of 0.4. Madagascar also has the world’s fourth highest rate of chronic malnutrition,<sup>9</sup> with one child in two under five years old suffering from stunting. About 1.4 million children were estimated to be out of primary school in 2012, the fifth largest number in the world.

## **2.2 Social Protection and the Human Development Cash Transfer Program**

Starting in 2016, the Government of Madagascar began seeking to address these high levels of poverty and low levels of human development (especially among children) by implementing a Human Development Cash Transfer (HDCT) program in partnership with the World Bank and UNICEF. Under this program, bi-monthly payments are made to 39,000 households with children under 12, potentially reaching 97,000 children in 7 districts with particularly low levels of human development, with payments made to the children’s mother, who was expected to be the primary caregiver. The HDCT program suite contains a comprehensive, multidimensional intervention package consisting of a bi-monthly cash transfer set at about 30% of average household consumption in selected areas. While a portion of the cash transfer for households with children over six years old is conditioned on regular primary school attendance, households with younger children receive an unconditional transfer coupled with encouragement to attend child nutrition and family well-being sessions.

## **Section 3: Interventions: Rationale and Design**

Our study tests the additionality on early childhood development and antecedent behaviors and outcomes relevant to these from one of three variants of a suite of behavioral interventions layered onto the cash itself. All the variants incorporate ‘Mother Leader’ groups, where a set of beneficiaries from a program village are organized into a group headed by a beneficiary mother elected by the members (see Section 3.1 below for details). In addition to this, the second and third ‘enhanced arms’ use trained facilitators to deliver a “nudge” intervention – either ‘plan-making’ or ‘self-affirmation’ – to Mother Leader groups on cash transfer days. This “nudge” part of the second and third enhanced arms began with the fourth cash transfer tranche, or about 14 months before the midline, supplementing the ML program which had been ongoing since program implementation began approximately 18 months before the midline. For simplicity, we refer to the midline as being 18 months after

> 6 The headcount measuring the percent of the population under the extreme poverty rate of US$1.90 (in PPP terms) was 76.2 percent  in 2017 (http://www.worldbank.org/en/country/madagascar/overview).

> 7 This is after Nigeria, India, the Democratic Republic of Congo, Ethiopia and the Republic of Yemen. <u>https://worldpoverty.io/</u>

> 8 <mark>Osborne, Theresa Kay; Belghith, Nadia Belhaj Hassine; Bi, Chiqiao; Thiebaud, Alessia; Mcbride, Linden; Jodlowski, Margaret Christine. 2016.</mark> _<mark>Shifting fortunes and enduring poverty in Madagascar : recent findings (Vol. 2) (English)</mark>_ <mark>. Washington, D.C.: World Bank Group.</mark>

> 9 Chronic malnutrition affects 47.3 percent of children in Madagascar between 6-59 months (World Food Programme Country Brief, May 2018). The four highest rates are in Papua New Guinea, Burundi, Eritrea and Madagascar.

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