Evaluation of a disability-inclusive ultra-poor graduation programme in Uganda: study protocol for a cluster-randomised controlled trial with process evaluation.

Disability Financial support Income generation Randomised controlled trial Social protection

Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
21 Mar 2024
Historique:
received: 25 08 2023
accepted: 07 03 2024
medline: 22 3 2024
pubmed: 22 3 2024
entrez: 22 3 2024
Statut: epublish

Résumé

There is little evidence on how to support ultra-poor people with disabilities to adopt sustainable livelihoods. The Disability-Inclusive Graduation (DIG) programme targets ultra-poor people with disabilities and/or women living in rural Uganda. The programme is an adaptation of an ultra-poor graduation model that has been shown to be effective in many contexts but not evaluated for people with disabilities. The DIG programme works with project participants over a period of 18 months. Participants receive unconditional cash transfers for 6 months, training, access to savings-and-loans groups, and a capital asset that forms the basis of their new livelihood. The programme is also adapted to address specific barriers that people with disabilities face. Eligible households are clustered by geographical proximity in order to deliver the intervention. Eligibility is based on household screening to identify the 'ultra-poor' based on proxy means testing-both households with and without people with disabilities are included in the programme. Clusters are randomly selected prior to implementation, resulting in 96 intervention and 89 control clusters. The primary outcome of the trial is per-capita household consumption. Before the start of the intervention, a baseline household survey is conducted (November 2020) among project participants and those not offered the programme, a similar endline survey is conducted with participants with disabilities at the end of programme implementation in July 2022, and a second endline survey for all participants in October 2023. These activities are complemented by a process evaluation to understand DIG programme implementation, mechanisms, and context using complementary qualitative and quantitative methods. Ethical approval for the research has been received from Mildmay Uganda Research Ethics Committee and London School of Hygiene and Tropical Medicine. DIG is a promising intervention to evaluate for people with disabilities, adapted to be disability inclusive across programme components through extensive consultations and collaboration, and has proven efficacy at reducing poverty in other marginalised groups. However, evaluating a well-evidenced intervention among a new target group poses ethical considerations. Registry for International Development Impact Evaluations, RIDIE-STUDY-ID-626008898983a (20/04/22). ISRCTN registry, ISRCTN78592382 . Retrospectively registered on 17/08/2023.

Sections du résumé

BACKGROUND BACKGROUND
There is little evidence on how to support ultra-poor people with disabilities to adopt sustainable livelihoods. The Disability-Inclusive Graduation (DIG) programme targets ultra-poor people with disabilities and/or women living in rural Uganda. The programme is an adaptation of an ultra-poor graduation model that has been shown to be effective in many contexts but not evaluated for people with disabilities.
METHODS METHODS
The DIG programme works with project participants over a period of 18 months. Participants receive unconditional cash transfers for 6 months, training, access to savings-and-loans groups, and a capital asset that forms the basis of their new livelihood. The programme is also adapted to address specific barriers that people with disabilities face. Eligible households are clustered by geographical proximity in order to deliver the intervention. Eligibility is based on household screening to identify the 'ultra-poor' based on proxy means testing-both households with and without people with disabilities are included in the programme. Clusters are randomly selected prior to implementation, resulting in 96 intervention and 89 control clusters. The primary outcome of the trial is per-capita household consumption. Before the start of the intervention, a baseline household survey is conducted (November 2020) among project participants and those not offered the programme, a similar endline survey is conducted with participants with disabilities at the end of programme implementation in July 2022, and a second endline survey for all participants in October 2023. These activities are complemented by a process evaluation to understand DIG programme implementation, mechanisms, and context using complementary qualitative and quantitative methods. Ethical approval for the research has been received from Mildmay Uganda Research Ethics Committee and London School of Hygiene and Tropical Medicine.
DISCUSSION CONCLUSIONS
DIG is a promising intervention to evaluate for people with disabilities, adapted to be disability inclusive across programme components through extensive consultations and collaboration, and has proven efficacy at reducing poverty in other marginalised groups. However, evaluating a well-evidenced intervention among a new target group poses ethical considerations.
TRIAL REGISTRATION BACKGROUND
Registry for International Development Impact Evaluations, RIDIE-STUDY-ID-626008898983a (20/04/22). ISRCTN registry, ISRCTN78592382 . Retrospectively registered on 17/08/2023.

Identifiants

pubmed: 38515150
doi: 10.1186/s13063-024-08040-w
pii: 10.1186/s13063-024-08040-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

206

Informations de copyright

© 2024. The Author(s).

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Auteurs

Elijah Kipchumba (E)

Independent Evaluation and Research Cell (IERC), BRAC International, Kampala, Uganda.
Trinity College Dublin, Dublin, Ireland.

Calum Davey (C)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.
Centre for Evaluation, London School of Hygiene & Tropical Medicine, London, UK.

Sarah Marks (S)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.

Anthony Mugeere (A)

Department of Sociology and Anthropology, Makerere University, Kampala, Uganda.

Shanquan Chen (S)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.

Lena Morgon Banks (LM)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.

Kazi Eliza Islam (KE)

BRAC International, Dhaka, Bangladesh.

Tom Shakespeare (T)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.

Hannah Kuper (H)

International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK. hannah.kuper@lshtm.ac.uk.

Munshi Sulaiman (M)

BRAC Institute of Governance and Development, BRAC University, Dhaka, Bangladesh.

Classifications MeSH