Randomised controlled trials and their critical role at GIF

This month we are publishing a series of blogs to mark the 2019 Nobel Memorial Prize in Economic Sciences – awarded to Michael Kremer and Esther Duflo (founding Board members of GIF), who share the prize with Abhijit Banerjee. The economists have used randomised controlled trials (RCTs) to determine how best to lift people out of poverty and improve their health. Here, our Chief Analytics Officer, Dr Ken Chomitz, highlights the critical role RCTs play at GIF.

GIF warmly congratulates Abhijit Banerjee, Esther Duflo, and Michael Kremer on receiving the Nobel Memorial Prize in Economics. Their pioneering work with RCTs has transformed the way that development economics is done; and has shaped the way that GIF uses evidence to pursue development impact. Duflo and Kremer played a formative role in setting up GIF and guiding its evolution, an association we acknowledge with gratitude and pride.

The Nobel winners’ emphasis on rigorous measurement and iterative experimentation is deeply embedded in the way that GIF selects, manages, and scales up its investments. GIF uses evidence, including RCTs, to select fledgling innovations that promise to improve the lives of people living on less than $5/day. Here, RCTs can play an important role in changing our prior beliefs – in convincing us that a seemingly implausible intervention might actually work. For instance, there have been many failed attempts to develop low-cost educational technologies (‘edtech’) that could be effective in developing countries. This poor track record might tend to discourage interest in pursuing edtech innovations. Education research organisation Educational Initiatives came to GIF with rigorous evidence showing that their Mindspark software substantially accelerated student learning, with only a few hours’ use per week. Building on these promising results, GIF gave a $2.3 million grant to Educational Initiatives to create the conditions for mainstreaming and scaling such an effective software in public schools. The grant was accompanied by an RCT evaluation to assess the efficacy of this software in a public school setting, and to understand the process standardisation requirements for its integration with regular curriculum and classroom instruction. GIF is looking forward to the three-year results later next year. Based on the early evidence, the Government of India has issued guidelines for its scale-up, and State governments have initiated procurement of such solutions using the national government’s budget allocation for ICT in schools.

This spirit of iterative experimentation underlies GIF’s approach to scaling up innovations. We often build RCTs into those investments and use the results to inform decisions on whether to further scale up the innovation – and if so, how, and by whom. For instance, we learned that an exciting HIV prevention approach, successful in one context and implemented by a talented team, didn’t show clear results when transplanted to a different setting. We declined to support the innovation further. On the other hand, GIF supported testing of Lively Minds, an Early Childhood Education innovation in Ghana. Lively Minds has been working with government-run Early Childhood Education (ECE) centres for 4 to 5-year-olds to improve the quality of ECE instruction using a community-led play-based learning program run by trained kindergarten teachers and voluntary involvement of mothers. GIF supported an RCT evaluation of Lively Minds’ program by the Institute for Fiscal Studies. They report that “preliminary results suggest that the Lively Minds program is an effective and potentially scalable way to improve children’s cognitive and socio-emotional development, health, and school readiness.”

GIF has found these methods to be useful in a wide variety of contexts. For instance:

Skills training: In one of the only long-term studies of the impact of youth interventions in Africa, GIF supported an evaluation of a training program run by a group called Educate!. Latest RCT results show that four years after Educate!, graduates are better off than their peers in key areas linked to improved life outcomes.

Humanitarian assistance: The current $3.4 billion annual humanitarian aid spend is characterised by several inefficiencies. Much of the funding goes to in-kind transfers – such as food and clothing – while these needs might be better met via cash transfers. Yet small cash transfers don’t enable refugees – often displaced for decades – to invest in sustainable livelihoods. GIF is supporting Give Directly to undertake an RCT evaluation of the effectiveness of large lump-sum cash transfer programs. Crucially, the investment will also add to the understanding on how to promote harmonious co-existence of refugees and host communities.

Family planning: GIF supported an RCT to rigorously test the impact of a radio messages to influence attitudes about contraception in Burkina Faso, where many women express a desire for greater control over the number or timing of births. The behaviour change campaign, conducted by Development Media International, reached over 2 million people, focusing on overcoming the informational barriers and social norms that prevent the uptake of modern contraceptives and thereby contribute to maternal and child mortality. Endline results are expected by the end of 2019.

Behavioural nudges: To alleviate poverty, more than 120 developing countries give cash grants directly to households, totalling more than $200 million per day. But people beset by poverty may have difficulty in planning and budgeting. Small, quick behavioural nudges might help the recipients to use the funds more efficiently. GIF is supporting the scale-up of the use of behavioural nudges in cash transfer programs implemented by the World Bank. We are working with ideas42, a leader in behavioural nudges, and the World Bank’s Social Protection team, to rigorously test nudges in cash transfer programs in several sub-Saharan African countries. This is a process of learning and iteration through repeated RCTs and building strong partnerships. By testing similar approaches in different locations, we hope to identify key replicable design features of nudges. We believe that this process can create a strong body of evidence and practice that will facilitate World Bank support for, and country uptake of, incorporating nudges into cash transfer programs.

These examples only scratch the surface of GIF’s work. We are also engaged with RCT evaluations in other domains, including the efficacy of iron fortified rice in reducing anaemia through a pilot that harnesses Tamil Nadu’s free rice distribution system; and two assessments of the impact on smallholder incomes of providing comprehensive bundles of farm services.

Congratulations again from everyone at GIF to this year’s Laureates, with thanks for your inspiration and guidance.