Kenya OVC-CT Programme Operational and Impact Evaluation

4 Welfare indicators – baseline levelsThis section presents the baseline levels of the key non-income welfare indicators which will formthe focus of the evaluation of programme impact at follow-up. It also compares the recipient andcontrol households, and the conditional and unconditional programme populations on a range ofsuch measures. While they cannot be expected to be identical, substantial differences are ofinterest because it means that the ‘starting points’ for these indicators are not the same.Once the follow-up survey has been implemented the programme’s impact on a range of health,education and other welfare indicators will be assessed by comparing the change that hasoccurred amongst the programme recipients, against the change experienced by the control group.Similarly, judgements can be made about the impact of imposing conditions by assessing makingthis comparison separately for the conditional and unconditional treatment locations. In theory, thisapproach should ‘cancel out’ any differences in starting levels of the indicators and their (timeinvariant)determinants. It will also be possible to test for impact on welfare indicators by estimatingeconometric models that regress the change in each indicator on a range of explanatory variables.4.1 Child welfareThe estimates in this section relate to all children living in OVC households (i.e. including non-OVCs). 30 This is because the benefits of the cash support are expected to affect all children in thehousehold. Furthermore, in programme locations where conditions are being imposed, they areapplied to all children in the household, not just OVCs. Therefore the programme is expected tohave a positive welfare impact on all children in OVC households, not just OVCs.Table 4.1 below presents the baseline health and nutrition indicator levels. This is a puzzling table.Overall the health indicators suggest that levels of child health are often worse amongst OVChouseholds in control locations as compared to treatment locations. In particular, the incidence ofmalnutrition is higher, and children are more likely to have been ill with a fever, cough or diarrhoea.This is somewhat counter-intuitive given that control households appear to be somewhat better offeconomically than recipients (see Section 2, Table 2.3 above) and that relatively better offhouseholds are probably more likely to seek and have access to healthcare services.The differences between the recipient households in conditional and unconditional locations aremore surprising still. Children in the conditional locations have substantially worse (chronic)malnutrition indicators, while most other health indicators are substantially better. This appearscontradictory (although not impossible) and raises concerns about whether some estimates mayhave been systematically skewed by inaccurate reporting by survey respondents in recipienthouseholds in conditional locations. It is known that the programme had begun to disseminateinformation about its activities and it is possible that some households may have given falselypositive reports because they believed it would have an impact on the level of support they wouldreceive. It should be noted, however, that conditionality was assigned by district, and thereforethese variations could simply reflect differences in household behaviour, food supply and/or in thesupply of health services across districts. 31 This requires further investigation.30 A similar table for OVCs alone can be found in Annex A (Table A.1).31 It would clearly be of substantial concern if there has been extensive deliberate misreporting. Someindicators are essentially unfalsifiable, however, eg card-based vaccination coverage rates, anthropometricmeasures. Furthermore, the programme had not developed detailed policies on conditions at the time of thebaseline survey. Some additional analysis will be undertaken around this issue in the follow up survey.34