Early Childhood Development and Social Capital: complementarities and their measurement.

Transcription

1 Early Childhood Development and Social Capital: complementarities and their measurement. Orazio Attanasio, UCL & IFS), PI Lynnette M. Neufeld, (INSP, Mexico) Co-PI Pat Engle (California Polytechnic), Co-PI Lia Fernald (UC Berkeley) Sandra Polanía (UCL and IFS), Co-PI May 15 th Background and Introduction The importance of interventions during the early years of life is now widely recognized. Some important studies, such as the celebrated Jamaica study, described in Grantham- McGregor et al. (1991) have shown that appropriate stimulation, especially if combined with nutritional supplementation, can achieve important medium and long run outcomes in terms of general child wellbeing and specifically cognitive development, if delivered in an appropriate fashion and targeted at the right age group. The original studies have been widely replicated in a variety of contexts, as described in Grantham- McGregor et al. (2007). While the specific content of early childhood stimulation programs and the age group to which they should be delivered (children 0 to 4 yrs of age) is well known, the best delivery mechanism or programmatic context is less clear. Stimulation programs can be implemented using diverse modalities. For example, the level of community input in the identification of promoters to be trained, or even the inclusion of local promoters versus more highly trained promoters from outside the community. Which modalities are used has implications both for potential impact of the interventions and for their cost. Ultimately therefore, this is a key issue for cost effectiveness and sustainability of a program. In this respect, the possibility of catalyzing and using resources available in poor communities is particularly attractive both because it would provide a cheap and effective way of delivering ECDs and because it would provide an important role for local individuals and, therefore, empower them. An interesting alternative is the use of existing social programs that have worked successfully in the community and have had important social components. A new generation of social programs that has received considerable attention in the literature and among policy makers are Conditional Cash Transfers. One of the firsts and best evaluated CCTs has been PROGRESA/Oportunidades in Mexico. As many other CCTs, Oportunidaes has an important social component. Evaluations of Oportunidades have shown that the program has an impact on child growth (Rivera et al., 2004; Leroy et al., J Nutr). However, no impact has been found on the cognitive or motor development of children (report by Fernald and Gertler in the 2004 evaluation papers). One of the main focuses of Oportunidades, in addition to the cash transfers, nutritional supplements, is the transfer of knowledge to mothers that could be used to improve child outcomes. The methodology used for these health talks at the beginning of the program may not have been adequate to gain the type of impact expected. In the case of the talks related to the nutritional supplements, Bonvecchio et al (2007) found that they were infrequent and not adequately adapted to the local context.

2 Furthermore, the main focus was on hygiene, health, contraception and similar themes, without any related to the cognitive development of young children. An existing Intervention and Study. In this context, a new experiment has recently been developed in collaboration between Oportunidades, the Instituto Nacional de Salud Publica, and the Consejo Nacional de Fomento Educativo (CONAFE). For the past 15 years, CONAFE has been identifying and training women from small rural communities to provide training sessions for mothers to provide early childhood stimulation (ECS) to their children 0 to 4 years of age. The study is designed to test whether including the CONAFE program into the package of benefits received by beneficiaries of Oportunidades has an impact on child growth, health and development. The study has been designed and is led by Lynnette Neufeld as principal investigator with the participation of Patricia Engle, Lia Fernald and Lourdes Schnaas as co-investigators. The ECS intervention was designed by CONAFE and is centered around group meetings in which mothers of children are advised on ways to interact with their young children that will promote their cognitive, motor and social development. The children participate in the sessions themselves so that the sessions are interactive and participatory. In the implementation of the program in communities, CONAFE puts strong emphasis on community participation. The promoter to be trained is identified by community consensus, after some direction from the program facilitators as to the key desirable traits for that person. The intervention trial currently underway is a randomized controlled effectiveness trial with 6 arms. The randomization is at the level of the locality: 90 localities with predominantly indigenous population and 90 with predominantly non-indigenous were randomly assigned to one of three groups (so to have 30 communities in each of the 6 arms): a control group where only measurement is performed, a first treatment where the CONAFE intervention is implemented in exactly the manner that they currently do in their program, and one in which participation to the CONAFE group intervention is imposed as a conditionality for Oportunidades. All children aged 6 to 18 months at baseline, beneficiaries of the Oportunidades program in the communities were invited to participate at baseline. Over 2000 children were identified and measured. Baseline data include anthropometry, household characteristics, care giving practices and development. Shortly after the completion of the baseline assessment, the CONAFE program contacted the local leaders and initiated the process of implementation in the 120 intervention communities. In the first intervention group, this was done exactly as they normally do so. In the co-responsibility group, this was done with strong promotion of the CONAFE program by the Oportunidades contacts in the community. Because participation in the program as a co-responsibility is not formally in the constitution of the Oportunidades program, it was not possible to truly implement as such (i.e., take away benefits for non-participators). In this manner the co-responsibility was implied, but not overtly stated to avoid legal difficulties. The baseline for this study was conducted in October to December, 2008 and the intervention is now underway in all intervention communities. A follow-up measurement will be made in mid This will include process indicators to document how well the

3 CONAFE intervention has been implemented in the community as well as some evaluation of knowledge, attitudes and practices of the promoters and mothers in themes related to child development and the program itself. The end-line evaluation including measures of child development, health and growth will be conducted at the end of The proposed study. The CONAFE/INSP/Oportunidades intervention is based on group meetings and puts much emphasis on community initiatives and on the development of community spirit, rallying the community around the need to improve the conditions of their children. This makes it very interesting because it provides a possibly very effective way to deliver an ECD intervention and might, in addition, deliver desirable by-products, such as improvement in social capital that can provide important externalities in other dimensions of the life of these communities. A further very important research question is whether the mode of implementation, i.e., the usual implementation process of CONAFE or by implied coresponsability modifies the impact of the intervention on social capital. The first aim of this study is to measure the social capital in the communities in which the ECD intervention is implemented and test the hypothesis that the intervention we have described briefly above has an effect on our measure of social capital. We will then try to link the development of social capital and the effectiveness of the intervention in terms of cognitive development outcomes. The idea is that social capital could be an important and useful intermediate output in the process of human capital formation and cognitive development. The hypothesis that we will be testing is whether communities in which the program has a larger effect on social capital are also those in which it has the largest effects on cognitive development. In other words, we will be investigating the degree of complementarity between the intervention considered and social capital in the creation of human capital and in particular cognitive development. The first problem to solve in implementing such a research program is to devise a quantitative measure of the different dimensions of social capital (i.e. collective action, trust and norms). For this purpose we will use a mixed strategy by conducting experimental games and survey methods that have been successfully used in a variety of contexts. For example, Attanasio et al (2007), Ñopo et al. (2008) and Chong et al. (2008) have used versions of public good games and trust games to measure social capital in different contexts in Latin America. In these studies, survey methods and game played a key role in achieving a more comprehensive and detail analysis of social capital among the pools. We plan to use two types of games within the communities in the RCT to measure social capital. First, as many of the studies in the literature, we will be using, public good games. In these games, social capital is measured in terms of deviations from the individual optimal in situations in which this is different from the social optimal. While at some level, the ability to provide public goods, which these games measure, seems a natural measure of social capital, trust in the community and so on, it can also be interpreted as a measure of altruism, given that individuals behaving socially deviate from the individual optimal. For this reason, we will also implement a game that uses a different definition of social capital. In particular, we will use a game (Minimal Effort Game) which is characterized by multiple equilibria that are Pareto ranked. Our measure of social capital

4 is the ability to coordinate on the optimal equilibrium. This game has been used in a similar context by Attanasio, Choi and Polania (in progress). The study has two main goals. First and foremost, we want to estimate the impact that the intervention that is being studies has on social capital as measured by behaviour in the games that will be implemented. The availability of a RCT and of a rigorous measures based on the games, makes this estimation relatively straightforward. Putting it differently, the context of this experiment puts us in a unique position to estimate the effect that a program with a strong emphasis on community participation has on the level of trust and collaboration within community. For this reason, constructing appropriate quantitative measurements is particularly important. Second, we will also try to establish the existence of feedbacks and complementarities between social capital and the ECD intervention. In particular, one would like to know whether social capital facilitates the working of this type of interventions based on community actions. The analysis of this type of relationship is not without problems, however. One has to take into account the possibility that observed correlations (for instance between observed social capital and effectiveness of the intervention) might be driven by a third variables that simultaneously affects the two. To address these issues, at least in part, it will be necessary to make more structural assumptions in the analysis. For instance, if one observes that the program has no impact on the level of social capital, as the existence of the program is the only thing that differentiates treatment and control localities, one could exploit differences in the level of social capital to check whether they are related to different impacts of the program on cognitive development. This type of analysis would be more complicated if one were to find that the program does affect social capital and behaviour in the games. The findings of our study could be of considerable importance for the design of CCTs and more generally social policy. Should we find, for instance, that the type of interventions considered has an effect on social capital, one could put renewed emphasis on the community aspects of CCTs. Playing games in the communities might have ethical considerations. However, it should be stressed that the games we will be playing do not have any chance or gambling element, that stress the importance of cooperation and trust and that they have been playing in many different contexts already. Participation in the games is obviously voluntary and we will provide standard informed consent modules when registering participants for them. Finally it should be stressed that while salient for this population, the possible winnings in the games is not very large. References Attanasio, O., Choi S. and S. Polania (in progress): Mesauring social capital with experiments: which games for which concepts. UCL Mimeo, Attanasio, O., Pellerano, L and S., Polania (2007): Building Trust? Conditional Cash Trasnfers and Social Capital IFS, Mimeo. Bonvecchio, A, Pelto, G.H., Escalante, E.m Monterrubio, E., Habicht, J.P., Nava, F. Villanueva, M.A., Safdie, M. And J.A. Rivera (2007), Journal of Nutrition, 137,

5 Chong A.,& Ñopo H and J. C. Cardenas, "Hasta que punto los latinoamericanos conf'ian y cooperan? Experimentos de campo sobre exclusión social en seis países de América Latina," RES Working Papers 4578, Inter-American Development Bank, Research Department. Grantham-McGregor, S. M., C. A. Powell, S. P. Walker, and J. H. Himes (1991). Nutritional Supplementation, Psychosocial Stimulation, and Mental Development of Stunted Children: The Jamaican Study, Lancet 338(8758): 1 5. Grantham-McGregor, S., Y. Cheung, S. Cueto, P. Glewwe, L. Richter, B. Strupp, and T. I. C. D. S. Group (2007): Developmental potential in the first 5 years for children in developing countries," Lancet, 369 LeRoy, J.L., Vermandere, H., Neufeld, L>M> and S.M. bertozzi, (2008) Improving Enrollment and Utilization of the Oportunidades Program in Mexico Could Increase Its Effectiveness, Journal of Nutrition, 138, pp Ñopo, H., Chong A, and J. C. Cardenas, "Lo que se dice del comportamiento social y acciones reveladas: Evidencia de seis ciudades latinoamericanas utilizando muestras representativas," RES Working Papers 4576, Inter-American Development Bank, Research Department. Rivera JA, Sotres-Alvarez D, Habicht JP, Shamah T, Villalpando S. Impact of the Mexican program for education, health, and nutrition (Progresa) on rates of growth and anemia in infants and young children: a randomized effectiveness study. JAMA. 2004;291(21):