Emerging Evidence and Lessons on the Ultra-Poor Graduation Approach (Part Four)
Part Four: Adapting to COVID-19
By Andie Procopio, IMPAQ International
Welcome to the fourth and final post in our series following three USAID-funded food security and resilience activities as they apply the Ultra-Poor Graduation Approach (Graduation Approach).
This time we will discuss how an unprecedented shock — the COVID-19 pandemic — provided a unique opportunity to reassess activity components and adapt implementation modalities to ensure households are progressing towards graduation from extreme poverty.
The blogs are based on a webinar organized by IDEAL in 2020, where field-based program staff from Bangladesh, Ethiopia, and Uganda discussed how their respective activities have worked to lift households out of extreme poverty, even in the midst of the COVID-19 pandemic.
The blog series aims to answer the following questions:
Part One: What is the Graduation Approach and how did these activities adapt the approach to their context?
Part Two: What are the key preliminary findings?
Part Three: What are the significant lessons learned?
Part Four: How did the activities adapt interventions in the face of COVID-19?
Context Assessments
Nobo Jatra: Participants and implementers were struck by the Amphan Cyclone in May 2020, which caused devastating damage and losses to livelihoods at a time when communities were already weakened by COVID-19 and the government lockdowns essential to curb its spread. In response, Nobo Jatra implemented a COVID-19 and cyclone response simultaneously. World Vision led two assessments to understand the extent to which households were affected by the lockdown and the cyclone. The assessments found that 84.9% of households reported reduced incomes due to movement restrictions, reduced demands for services, and a lack of markets. As a coping mechanism, 56.4% of households had to borrow food or rely on help from relatives or neighbors, 14.2% of these households reported selling productive assets, and 12.5% of households also reported taking loans to meet immediate household consumption needs. Based on these findings, Nobo Jatra adapted to provide one-time cash grants to meet immediate household needs and distributed sanitation kits to households and health service facilities.
Graduating to Resilience: To better understand how to adapt to the nation-wide lockdown, Graduating to Resilience did an assessment of cell phone ownership, access, type, and the ability to charge among participants. Calling SIM card numbers used for activity cash distributions showed that cell phone ownership among primary participants was about 80%, and 99% of respondents reported access to a cell phone. Of those, 98.9% of respondents in the host community and 96.5% of respondents in the refugee settlement said they were able to keep their phones charged. With this information, the team felt comfortable rolling out the quarterly and bi-annual remote data collection and an in-depth context assessment. In April 2020, three context assessment tools were deployed to measure COVID-19 awareness, capture participant experiences, and conduct market research.
Graduating to Resilience carried out a second context assessment approximately two months after the first (June 2020) to understand how participants and markets were faring post-lockdown. Assessment data informed decisions like whether or not to provide additional cash support to participants. Participants’ adoption of positive coping strategies indicated this additional stipend was not necessary. For instance, 86.7% (n=357) host community and 89.2% (n=364) refugee participants took steps to prepare for the COVID-19 lockdown. Of those, 97.8% (n=349) host community and 98.1% (n=357) refugee respondents stored food. Other positive coping strategies included:
- Relying on produce from their own garden (host community: 68.2%, n=281; refugee settlement: 38.5%, n=157)
- Relying on food saved from past season (host community: 48.2 percent, n=199; refugee settlement: 13.0%, n=53)
- Diversifying income and adapting livelihoods, specifically having more than one business (host community: 15.5%, n=64; refugee settlement: 8.8%, n=36)
- Changing to a business that can operate under the new restrictions, such as selling food or other essential items (host community: 14.3%, n=59; refugee settlement: 27.5%, n=112)
Additionally, 99.7% (n=386) of host community respondents and 99.0% (n=403) of refugee respondents reported washing their hands frequently for 20 seconds or more with soap and water. While 92.5% (n=358) of host community respondents and 80.6% (n=328) of refugee respondents stated they wore a mask when outside of the home.
Graduating to Resilience also used an adaptive scenario planning approach, which included regularly taking proactive measures to understand the current context, how each component of the activity is being implemented, and predicting possible future scenarios to be prepared for likely, but unknown situations.
Livelihoods for Resilience: The activity’s gender team led a rapid gender analysis to understand the impact of COVID-19 on female activity participants. Gender experts used a key informant interview tool to interview female community facilitators (frontline staff), who in turn interviewed female activity participants using a storytelling tool.
Rapid gender analysis findings included the following (it should be noted that these findings are from the early days of the pandemic, when concerns over its impact were possibly at their highest and the restrictions were strict):
- Loss of social ties/access to information: communities were aware of COVID-19 and taking precautions, including cutting social ties. This had negative impacts, particularly for women’s access to information.
- Access to health services: health facilities were accessible but people were afraid to go for fear of being quarantined. The increase in transportation cost and a lack of support network caused a decline in people seeking medical services.
- Economic impacts: households faced financial strains due to the shutdown of small businesses, movement/market restrictions, and increased transportation and living costs. As businesses shut down, the prices of goods and services increased. As a result, households began selling assets.
- Caregiving and household chore burden: household members were at home since businesses and schools were closed, increasing the burden on women.
- Reports of increased gender-based violence and early marriage.
This assessment helped inform the Livelihoods for Resilience activity’s gender programming, particularly a shift to one-on-one visits rather than group meetings, and interventions to increase women’s access to information.
Remote Implementation
Nobo Jatra: Assessment findings also informed longer-term adaptations to ensure continuity in implementation. Since cell phone saturation was almost 100% among participants thanks to the digital cash transfers provided under the Ultra-Poor Graduation program, Nobo Jatra was able to switch to remote monitoring and leverage phones for follow-up support and messaging. Facilitators and staff switched to contacting households using mobile phones as an alternative to in-person and group coaching visits. This included voice messages twice a week to households on topics like COVID-19, gender-based violence, and child marriage. Once government lockdowns were relaxed, staff resumed in-person household visits and coaching sessions, which also included messaging on COVID-19, nutrition and health for pregnant and lactating women, and children.
Graduating to Resilience: Despite operating in a remote area with poor cell phone and internet connectivity, Graduating to Resilience was able to adapt a very interactive, in-person approach to remote implementation using cell phones that participants owned or accessed from a family member or neighbor. These adaptations were made easier as all frontline staff had been provided a smartphone for data collection prior to COVID-19. Group coaching and focus group discussions were implemented using conference call options, and individual coaching and household interviews were conducted with coaches and community-based trainers (CBTs) over the phone. Coaching messages and data collection tools were shortened for easier phone delivery and were further adapted to be delivered via SMS.
The traditional nutrition screening method, using Mid- to Upper-Arm Circumference (MUAC) tapes to identify malnourished children by trained personnel, was no longer possible. To adapt, coaches reinforced messages on identifying malnutrition among households with children. They did this by explaining common signs of malnourishment — such as rapid and abnormal loss of weight, loss of appetite, and refusing to breastfeed — to empower parents and guardians to identify cases among their children for immediate action. As restrictions lifted, the activity provided training to parents and guardians on how to use the MUAC tape to identify cases of malnutrition within their households. This is done with the coach present — at a safe distance — in order to support households if referrals for additional care are necessary. These methodologies will continue to solidify parents’ and guardians’ knowledge of the signs and symptoms of malnutrition so they can continue identifying cases within their families and the community even after the activity ends.
Savings Groups
Nobo Jatra: Village Savings and Loans Associations (VSLAs) quickly adapted and showed that they are resilient, resourceful, and at the frontlines of the COVID-19 crisis. Following the USAID Collaborating, Learning, and Adapting (CLA) Framework, Nobo Jatra developed a remote monitoring tool to gauge what VSLAs wanted to do and how to restructure under the Government of Bangladesh (GOB) COVID-19 restrictions. This process allowed VSLA members to take a lead and determine next steps for their groups: 20% of the savings groups wanted to start giving out loans again, and 20% wanted to start paying back loans. Group leaders, in consultation with members, voted to change meeting processes, scaled up health and hygiene awareness activities, created social funds for COVID-19, and revised lending methods to cope with the lockdown restrictions. One hundred groups also opted to pilot digital finances through a partnership with DreamSave to manage financial records, achieve savings goals, build credit history, and connect to formal financial services.
Graduating to Resilience: Qualitative data indicated participants were continuing to save when restrictions forced VSLA activities to close down by purchasing livestock, using Mobile Money, and saving at home or with friends. Still, participants wanted to start saving in their VSLAs despite the restrictions. VSLAs were adapted so that groups of 25 met in groups of five with precautions like handwashing, wearing masks, and social distancing. VSLAs were divided into two groups with CBTs and the Treasurer leading one group, and the coach and Secretary or Chairperson leading another. Participants arrive at staggered times to keep the numbers below five at any given time. The loans continued to be based on share value, with loan requests made one week in advance. VSLA welfare funds were used to purchase soap and masks for members who needed them to ensure the health and safety of participants. Routine monitoring continued, and qualitative data collection was used to monitor aspects of VSLAs like social cohesion, trust, and participant satisfaction. Finally, Graduating to Resilience began piloting digital savings platforms to ensure VSLA participants have access to savings and loans in the event of a regional lockdown in the future.
Livelihoods for Resilience: The sustainability of Village Economic Social Associations (VESAs) depends on the trust between group members and the strict following of guidelines, such as where people sit, how savings are collected, and how money is counted. As a consequence, it took a while to determine how to adapt VESAs under the restrictions that limited gathering in large numbers and still ensure transparency and openness. The activity’s solution was to meet in small groups with members representing friends and neighbors, and rotating between groups. This adaptation allowed different members to engage with the groups and ensured information was exchanged among all participants, while aligning with Government of Ethiopia (GOE) guidelines of gatherings of maximum 10 people (five people in some cases).
Markets and Private Sector Engagement
Nobo Jatra: A key adaptation in response to COVID-19 related to market systems development and private sector partnerships. Prior to COVID-19, a national pharmaceutical company had been engaging village agents as last-mile access points for health and hygiene products. This company pivoted their partnership with Nobo Jatra to train the village agents on health and hygiene messaging in order to raise demand for these products. As a result, there was a correlation between training of village agents and increased demand for hand sanitizer, disinfectants, soaps, and other hygiene products. This is another example of how Nobo Jatra has been able to pivot based on the local context.
Graduating to Resilience: Linkages to the private sector were adapted to remote implementation where CBTs used mobile phones to connect with participants and aggregate the service and product needs of the households. The CBT then used mobile phones to contact local input dealers to arrange the delivery of those products or services. For cases of animal care and treatment, the CBTs connected households to a sub-county veterinary officer from the Government of Uganda.
As previously mentioned, Graduating to Resilience adapted to mobile phone-based remote interventions. At the onset of the COVID-19 restrictions, the activity realized that it could not reach all participants as about 20% did not own a cell phone despite reporting access to a family member’s or a neighbor’s phone. To remedy this situation, Graduating to Resilience linked participants to a private sector partner offering loans for cell phones. This linkage will continue post-COVID-19 as it will support other activity interventions like in-person coaching, dissemination of market information through SMS, voice messaging, and a mobile savings group app. In Cohort 2, the activity will ensure this linkage at the outset, recognizing the importance of digital literacy to ensure participants’ ability to navigate an increasingly technological world.
Livelihoods for Resilience: Under normal circumstances, households selling goats and sheep are able to find markets and sell their animals easily, even in remote locations. For these households, holidays such as the Ethiopian Easter, Christmas, and New Years are key times to sell animals and earn an income. In 2020, COVID-19 restrictions forced market closures a few weeks before Ethiopian Easter. Due to the risk to participant livelihoods from these market closures, the Livelihoods for Resilience activity became more involved in the market than usual and negotiated with local governments to enable small-scale direct sales of livestock in areas where larger markets were closed. Livelihoods for Resilience also communicated with traders to facilitate market linkages between farmer groups and buyers. These interventions are not normally done by the project, but were considered necessary, as typical market linkages were broken.
The final major impact of COVID-19-related restrictions was the loss of off-farm income generating opportunities, which are especially critical for women and youth. Livelihoods for Resilience had previously established a micro-franchise network for women in rural communities to engage in door-to-door sales of fast-moving consumer goods such as soap. The activity decided to work through the micro-franchise network to encourage hand washing while also facilitating income for saleswomen. To do this, Livelihoods for Resilience expanded the network by bringing in new sales agents from participant households and new wholesalers to stock soap in implementation districts. Every participant household received three vouchers for two large bars of soap to redeem every month for three months from a micro-franchise saleswoman or sales agent. This salesperson then collected a commission from the wholesaler. This system helped get soap into the hands of households, encouraging COVID-19 preventative practices, and also increased income for micro-franchise sales agents. The end goal of this adapted intervention is for households receiving the vouchers to become accustomed to acquiring their soap through this network and to continue to do so even after their vouchers are finished.
Summary
Each activity in this series provides excellent examples of how to manage adaptively: intentionally making decisions and adjustments in response to new information and changes in context. In these uncertain times, each activity had to:
- Embrace failure as an option as they created and implemented the remote approaches. In many cases, new methods were piloted, refined, and successes were quickly scaled up.
- Remain flexible and adjust to rapidly changing government guidelines. Communication was crucial in relaying changing standard operating procedures, including safety precautions, to all field staff and participants. As a result, leadership and staff remained comfortable with changing guidelines and remained open-minded while adapting to the ever-changing context.
- Think outside the box to try new approaches, such as creating vouchers for soap or the family MUAC approach to monitor the nutrition status of children.
- Implement simple solutions that could be applied quickly and easily, such as using cell phones to overcome the challenges presented by COVID-19 restrictions.
- Engage the private sector so participants were able to overcome the shock of COVID-19. Nobo Jatra pivoted an existing relationship with a private sector entity to train the village agents on health and hygiene messaging to raise demand for these products. Graduating to Resilience sought out a new relationship to provide loans for mobile phones, and Livelihoods for Resilience built upon an existing network of soap suppliers to improve livelihoods and reinforce public health messages.
Conclusion
Evidence supports the efficacy of the Graduation Approach to lift those living in ultra-poverty up and into a place of self-reliance and sustained food security. As the Graduation Approach is adapted to new contexts, USAID has been seeking to shift their microenterprise and microfinance programming to include interventions that address multiple challenges simultaneously, such as using the Graduation Approach and building inclusive market systems. As more Resilience Food Security Activities (RFSAs) are incorporating the Graduation Approach, we hope this exploration of emerging lessons and evidence will help guide programmatic design and decision-making and continue the conversation on lessons learned from the application of the approach on integrated food security programs.
If you missed the previous blog posts in the series, find them here!
- Part One: Information about the Graduation Approach and how the activities adapted to their unique contexts.
- Part Two: Preliminary outcomes and how each activity achieved them.
- Part Three: Lessons learned on private sector engagement, achieving nutrition outcomes, participatory targeting, and addressing gender and social norms
