Livelihood Empowerment Against Poverty Research Articles

The politics of the targeting and expansion of pro-poor programs in Ghana

ABSTRACT The paper examines how the Livelihood Empowerment Against Poverty program in Ghana is politicised and its implications for poverty reduction. Data from 26 in-depth interviews and 12 focus group discussions were analysed. The paper observes that a broad cross-party consensus exists because the Livelihood Empowerment Against Poverty (LEAP) program has been politicised by the two main political parties, namely the National Democratic Congress and the New Patriotic Party, who target the policy to their politically supportive districts and communities. The key pathway for the politicisation and subsequent expansion of the program is partisan manipulation of the District Level Implementation Committees (DLICs), partisan selection of beneficiaries, and party membership card as a requirement for inclusion. These political considerations tend to result in wrong targeting, where undeserving beneficiaries are included, thereby undermining sustained poverty reduction and inclusive development potential of the LEAP program.

The hidden costs of austerity for social programmes in the Global South: Qualitative insights from two complementary services in Ghana's Livelihood Empowerment Against Poverty Programme

AbstractPromoted by the International Monetary Fund (IMF) in particular, fiscal austerity measures have been extensively implemented across the world in the last decade as a policy prescription to address the impacts of economic shocks. Consequently, the implementation of austerity has engendered a vast body of austerity impact assessment literature in the Global North, in particular. Although austerity measures have been equally implemented (and longer) in Global South contexts, the same level of intellectual curiosity has not been dedicated to understanding the human and social costs of austerity in the Global South. To help fill this gap, this paper examines the implications of fiscal austerity for the delivery of two complementary programmes linked to Ghana's conditional cash transfer (CCT) — the Livelihood Empowerment Against Poverty (LEAP) programme. The paper adopts a qualitative design where semi‐structured interviews are conducted with (a) two LEAP officers, (b) two headteachers and (c) 35 LEAP beneficiaries in northern Ghana. The findings show that within the current context of fiscal austerity, mainly mediated through the government's commitment to “cut expenditures to the bone”, the two complementary services have been unfunded and thus do not exist in practice. The non‐existence of complementary services has dire consequences for children's education as well as undermines Ghana's poverty reduction attempts through the implementation of the LEAP programme.

“They are my people, add them!” The politicisation of poverty reduction programmes in the Global South: Ghana’s Livelihood Empowerment Against Poverty cash transfer programme in focus

ABSTRACT Numerous impact assessments have shown that Ghana’s cash transfer programme, the Livelihood Empowerment Against Poverty (LEAP), has contributed to poverty alleviation and improved schooling. Although the LEAP programme has been extensively evaluated, its political dimensions have been under-researched. Within this context, the present article aimed at understanding the pathways of politicising the LEAP programme. Drawing on semi-structured interviews with 25 LEAP beneficiaries and 5 programme officers, the data demonstrates how the political actors abuse the targeting system by prioritising “their people” at the expense of other beneficiaries in five districts of northern Ghana.

The dose-response association between LEAP 1000 and birthweight – no clear mechanisms: a structural equation modeling approach

BackgroundBirthweight is an important indicator of maternal and fetal health globally. The multifactorial origins of birthweight suggest holistic programs that target biological and social risk factors have great potential to improve birthweight. In this study, we examine the dose-response association of exposure to an unconditional cash transfer program before delivery with birthweight and explore the potential mediators of the association.MethodsData for this study come from the Livelihood Empowerment Against Poverty (LEAP) 1000 impact evaluation conducted between 2015 and 2017 among a panel sample of 2,331 pregnant and lactating women living in rural households of Northern Ghana. The LEAP 1000 program provided bi-monthly cash transfers and premium fee waivers to enroll in the National Health Insurance Scheme (NHIS). We used adjusted and unadjusted linear and logistic regression models to estimate the associations of months of LEAP 1000 exposure before delivery with birthweight and low birthweight, respectively. We used covariate-adjusted structural equation models (SEM) to examine mediation of the LEAP 1000 dose-response association with birthweight by household food insecurity and maternal-level (agency, NHIS enrollment, and antenatal care) factors.ResultsOur study included a sample of 1,439 infants with complete information on birthweight and date of birth. Nine percent of infants (N = 129) were exposed to LEAP 1000 before delivery. A 1-month increase in exposure to LEAP 1000 before delivery was associated with a 9-gram increase in birthweight and 7% reduced odds of low birthweight, on average, in adjusted models. We found no mediation effect by household food insecurity, NHIS enrollment, women’s agency, or antenatal care visits.ConclusionsLEAP 1000 cash transfer exposure before delivery was positively associated with birthweight, though we did not find any mediation by household- or maternal-level factors. The results of our mediation analyses may serve to inform program operations and improve targeting and programming to optimize health and well-being among this population.Trial RegistrationThe evaluation is registered in the International Initiative for Impact Evaluation’s (3ie) Registry for International Development Impact Evaluations (RIDIESTUDY- ID-55942496d53af) and in the Pan African Clinical Trial Registry (PACTR202110669615387).

‘Joy, not sorrow’: Men's perspectives on gender, violence, and cash transfers targeted to women in northern Ghana

Evidence indicates that cash transfers can decrease intimate partner violence (IPV) against women, although most research has focused on women's perspectives and experiences, with less attention to men. We analyzed data from four focus group discussions with male partners of women who participated in the Ghana Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer program. We elicited men's perceptions of poverty, relationship dynamics, IPV and cash transfers targeted to their wives using thematic analysis. Men largely viewed the effects of the cash transfer as positive – they felt decreased provider role strain when women used the cash to cover household expenses such as food and school fees. Men also indicated that they felt respected when women used the cash to cover sudden expenses, such as funeral costs, thus preventing the need to borrow from community members and exposing their inability to fulfill provider roles. These feelings of relief and respect helped improve men's overall wellbeing, their marital relationships and reduced the potential for IPV. Despite these positive results, men revealed that they still expected to be informed and consulted about the transfer and its expenditure, and felt disrespected when women did not do so, thus heightening the potential for household conflict. Further research and innovation in programming is needed to integrate gender transformative strategies into cash transfer programs, explicitly aimed at changing gender norms to enhance and sustain beneficial impacts on gender relations and IPV.

Ghana's Livelihood Empowerment Against Poverty (1000) Program Seasonally Impacts Birthweight: A Difference-in-Differences Analysis.

Objectives: Low birthweight (LBW) prevalence remains high in African countries and evidence of cash transfer impacts on birthweight, particularly by season of infant birth, is limited. This study examines overall and seasonal cash transfer impacts on LBW in rural Ghana. Methods: Data come from a longitudinal, quasi-experimental impact evaluation of the Livelihood Empowerment Against Poverty (LEAP) 1,000 unconditional cash transfer program for impoverished pregnant or lactating women in rural districts of Northern Ghana. LEAP1000 program impacts on average birthweight and LBW were estimated for a multiply imputed sample of 3,258 and a panel sample of 1,567 infants using differences-in-differences models and triple difference models to assess impacts by season. Results: LEAP1000 decreased LBW prevalence by 3.5 and 4.1 percentage points overall and in the dry season, respectively. LEAP1000 increased average birthweight by 94, 109, and 79g overall, in the dry season, and in the rainy season, respectively. Conclusion: Our findings of positive LEAP1000 impacts on birthweight across seasons and on LBW in the dry season demonstrate the need to take seasonal vulnerabilities into account when designing and implementing programs for rural populations in Africa.

The discursive construction of gender identities and roles for women in cash transfer programmes: Implications for gender power relations

Cash transfer (CT) programmes in Global South countries do not only provide cash grants to extremely poor households to smoothen consumption and improve human capital development, but they also promote collective action, strengthen relation-building and social transformation. Ghana’s Livelihood Empowerment Against Poverty (LEAP) is one of many such programmes with considerable success in providing cash to extremely poor households, mostly with women as caregivers, but there are also some concerns worth highlighting. The questions are: first, how does Ghana’s LEAP CT programme perpetuate or transform gender power relations? Second, how do women caregivers exercise agency within the intersecting relations of the programme in the cultural context? Gender, power, and discourse are the theoretical underpinnings of the article with an ethnographic-discourse strategy inspired by a dialectical-relational approach to critical discourse analysis. The discursive analysis of the practices of the LEAP CT programme officials and the women caregivers demonstrate that the LEAP CT programme, at the institutional level, discursively reproduces and naturalises gender identities, roles and subject positions for women despite prioritizing women as the recipients of the cash. However, it also reveals nuances of women agency evident at the intersecting and participatory practices of women caregivers in the programme and in the socio-political contexts of the local communities. Whilst the first finding affects women negatively, the second presents a potential for transforming gender power relations in institutions and local communities in Global South countries as it challenges the taken-for-granted notions of gender relations for a better world. The study contributes to an improved situated understanding of unequal and pervasive gender power relations in Global South countries’ social protection interventions.

Effect of social protection programmes on household food security: a case of the Livelihood Empowerment Against Poverty (LEAP) programme in the Tolon District of Ghana

Effect of social protection programmes on household food security: a case of the Livelihood Empowerment Against Poverty (LEAP) programme in the Tolon District of Ghana

Eradicating extreme poverty in Africa through productive inclusion: A comparative assessment of two social protection programmes in Ghana

Ghana has experimented with two social protection programmes: the Livelihood Empowerment Against Poverty (LEAP) programme, and the Japan Social Development Fund (JSDF) pilot project aimed at reducing extreme poverty and enhancing the standard of living of beneficiaries. This study comparatively assessed how the LEAP programme and the JSDF-LEAP project have contributed to improving the standard of living of beneficiaries. A sample of 167 respondents, comprising 81 LEAP households, 82 JSDF-LEAP beneficiaries and four District Social Welfare Officers took part in the study. The study findings suggest that cash transfers alone such as the LEAP programme may not yield significant improvement in the standard of living of the extremely poor without complementary programmes such as the JSDF-LEAP project to address the livelihood and other socio-economic challenges that they encounter. The study recommends a holistic approach to tackling extreme poverty through ‘cash plus’ programmes. Points for practitioners The findings of this study highlight the need for public administration practitioners involved in poverty eradication programmes to pursue a simultaneous design involving the implementation of both cash transfers and productive inclusion programmes as the preferred strategy for improving the standard of living of the extremely poor. Moreover, this research has also revealed that for social protection programmes to be successfully implemented, carefully designed systems and structures must be put in place at the national level, through the regional, district and community levels at the design and implementation phases of such interventions.

Life-Changing Coping Mechanisms and Resilience Strategies of Post-Natal Unmarried Teenage Mothers in the Central Region, Ghana

Aim: The paper aimed at exploring the life-changing coping and interventional strategies adopted by unmarried teenage mothers in Enyan Denkyira in the Central Region of Ghana.
 Methods: The paper adopted the phenomenological design and through Snowballing and Purposive techniques, sampled 15 unmarried teenage mothers, 10 church leaders, and 2 District Assembly officials who accounted for their daily coping mechanisms and interventional strategies existing for teenage mothers in the Enyan Denkyira District.
 Results: The study revealed that teenage mothers in Enyan Denkyira continued to engage in labor-intensive occupations such as fetching water for construction works and washing other people's clothes to make ends meet. It was evident that when the support they got from sympathizers did not come and their other sources of income also failed, they were pushed into relying on men which made them become perpetual victims of unprepared pregnancy and premature motherhood.
 Conclusion: It was therefore recommended that the Livelihood Empowerment Against Poverty (LEAP) money should be expanded to benefit more teenage mothers. Also, religious bodies, institutions, and the family must be encouraged and supported by the government to continue to play their roles as sources of social protection for teenage mothers instead of neglecting them.

Examining the role of sub-national level leadership in the implementation of cash transfer programs: evidence from Ghana

Purpose Although the last two decades have witnessed the implementation of several poverty reduction strategies in developing countries, many have failed to achieve their goal partly because of defective implementation strategies. This paper examines the implementation of one of Ghana’s flagship poverty reduction programs, the Livelihood Empowerment Against Poverty (LEAP), with a focus on how leadership at the sub-national level influences the implementation of the program.Design/methodology/approach Using qualitative research approach, the study selected research participants from two Municipal Assemblies in the Greater Accra Region of Ghana. Using a combination of Focus Group Discussions, Key Informant Interviews and Participant Observation, data were collected from a total of 44 respondents including beneficiaries, officials from the local government (district) and community level actors.Findings The paper shows that leaders at the sub-national level were more reactionary than proactive, thereby playing passive roles in the implementation of the LEAP program. It shows that the interaction between LEAP beneficiaries and district officials is rather low, which among others limits the effective utilization of the cash grant by the beneficiaries. It maintains that, for the LEAP program to achieve its overall goal of reducing poverty, leaders at the sub-national level ought to deploy more transformational leadership tendencies to incite beneficiaries to leap out of poverty through skill and human capital development.Originality/value The empirical literature is largely silent on the role of leadership in the implementation of cash transfer programs, such as Ghana’s LEAP program at the sub-national level. This study therefore explains the extent to which district level leaders contribute to the effective utilization of cash transfer grants and the human capital development of LEAP beneficiaries in Ghana.

Health services availability and readiness moderate cash transfer impacts on health insurance enrolment: evidence from the LEAP 1000 cash transfer program in Ghana

BackgroundExpanding health insurance coverage is a priority under Sustainable Development Goal 3. To address the intersection between poverty and health and remove cost barriers, the government of Ghana established the National Health Insurance Scheme (NHIS). Government further linked NHIS with the Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer program by waiving premium fees for LEAP 1000 households. This linkage led to increased NHIS enrolment, however, large enrolment gaps remained. One potential reason for failure to enroll may relate to the poor quality of health services.MethodsWe examine whether LEAP 1000 impacts on NHIS enrolment were moderated by health facilities’ service availability and readiness.ResultsWe find that adults in areas with the highest service availability and readiness are 18 percentage points more likely to enroll in NHIS because of LEAP 1000, compared to program effects of only 9 percentage points in low service availability and readiness areas. Similar differences were seen for enrolment among children (20 v. 0 percentage points) and women of reproductive age (25 v. 10 percentage points).ConclusionsWe find compelling evidence that supply-side factors relating to service readiness and availability boost positive impacts of a cash transfer program on NHIS enrolment. Our work suggests that demand-side interventions coupled with supply-side strengthening may facilitate greater population-level benefits down the line. In the quest for expanding financial protection towards accelerating the achievement of universal health coverage, policymakers in Ghana should prioritize the integration of efforts to simultaneously address demand- and supply-side factors.Trial registrationThis study is registered in the International Initiative for Impact Evaluation’s (3ie) Registry for International Development Impact Evaluations (RIDIE-STUDY-ID-55942496d53af).

Wood Fuel Producers’ Insight on the Environmental Effects of Their Activities in Ghana

ABSTRACT Drawing on a qualitative approach, this paper examines wood fuel producers’ insight on the environmental effects of their activities in the forest area of the Kintampo North Municipality. Tape-recorded interviews were transcribed and analyzed thematically based on manual analysis. Results indicated that wood fuel producers have no option than to engage in the activities of charcoal production and fuelwood collection due to absolute poverty, unemployment, and the need for energy for cooking and heating. However, producers of wood fuel do not establish their plantations for wood fuel extraction; rather depend on the natural forest for their extraction. This resulted in environmental effects including deforestation, forest degradation, and loss of biodiversity. Since the current state of wood fuel extraction presents dire environmental consequences to the forest resources, we recommend Forestry Commission and the Municipal Assembly initiate tree planting exercises to make wood fuel a sustainable energy in Ghana. Poverty reduction programs such as Livelihood Empowerment against Poverty (LEAP) targeted at supporting inhabitants who want to engage in other forms of livelihood activities including shear butter processing to alleviate them from absolute poverty are strongly recommended. This will help reduce their over-dependence on the forest resources for survival.

The locational and gendered impacts of Livelihood Empowerment Against Poverty (LEAP) on children education in Ghana

PurposeThis study seeks to identify locational and gendered determinants of inclusion of households in Livelihood Empowerment Against Poverty (LEAP) and estimate the respective impacts of LEAP on children education enrolment of beneficiary households in Ghana.Design/methodology/approachThe study used secondary data of the Ghana Living Standard Survey Round 7 and employed the propensity score matching (PSM) model for the analysis of the objectives.FindingsThe PSM results established that different factors determine the inclusion of households in LEAP in rural and urban areas. Similarly, different factors determine the inclusion of male-headed and female-headed households in the programme. The impact of LEAP on children education is higher in urban areas compared to rural areas. The impact of LEAP on children's education is 10.4% higher in urban areas than in rural areas. Lastly, female-headed households are better at using the cash received from LEAP to take care of their wards' education relative to male-headed households.Practical implicationsThe study recommends that different selection criteria should be used in selecting male-headed and female-headed as well as urban and rural poor households for inclusion in the LEAP programme. Female-headed households should be prioritised for benefiting from LEAP. The social welfare department disbursing the LEAP funds in rural areas should intensify education on the need for LEAP beneficiary households to enrol their wards in schools.Originality/valueIn this paper, the authors demonstrate that household inclusiveness of LEAP is influenced by locational and gendered factors. Also, the impact of LEAP on children education enrolment is relatively higher in urban areas than rural areas. Lastly, female-headed households relatively educate their wards with LEAP benefits than male-headed households.

The Mediating Effect of Healthcare Utilization on Livelihood Empowerment against Poverty (LEAP) and Health Security of Older Adults in Ghana: A Case Study on the Ga-West Municipality in Accra, Ghana

The concept of health security has aroused several interpretations because of theoretical technique indifferences or academic methodology. The focus has been on human security, old age health security (OAHS), whereas there remain issues of low healthcare utilization by older people from rural Ghana while there are social assistance programs. The study aimed at investigating the mediating effect of healthcare utilization on Livelihood Empowerment against Poverty (LEAP) and old age health security OAHS. With purposive sampling technique, participants were selected to participate in the study with standardized quantitative questionnaire to measure the variables involved in the study and a regression technique to analyze the data. The result of the mediation analysis showed a partial mediation between LEAP and Healthcare Utilization (HU) was found to have bridged the gap between the LEAP and OAHS. The LEAP policy also caused an increase in Health Utilization and, subsequently, an increase in old age health security (OAHS). The study is essential to help the National Health Insurance Authority NHIA in restructuring health care premiums to incite utilization of health facilities by the aged.

Community perceptions of enrolment of indigents into the National Health Insurance Scheme in Ghana: a case study of the Livelihood Empowerment against Poverty Programme

BackgroundThe Livelihood Empowerment against Poverty (LEAP) programme in Ghana as part of its beneficiary programme, identifies the poor/indigents for exemptions from premium payments in the National Health Insurance Scheme (NHIS). This paper sought to understand community perceptions of enrolling the poor in the NHIS through LEAP in order to inform policy.MethodsThe study adopted a descriptive cross-sectional study design by using a qualitative approach. The study was conducted in three geographical regions of Ghana: Greater Accra, Brong-Ahafo and Northern region representing the three ecological zones of Ghana between October 2017 and February 2018. The study population included community members, health workers, NHIS staff and social welfare officers/social development officers. Eighty-one in-depth interviews and 23 Focus Group Discussions were conducted across the three regions. Data were analysed thematically and verbatim quotes from participants were used to support the views of participants.ResultsThe study shows that participants were aware of the existence of LEAP and its benefits. There was, however, a general belief that the process of LEAP had been politicized and therefore favours only people who were sympathizers of the ruling government as they got enrolled into the NHIS. Participants held the view that the process of selecting beneficiaries lacked transparency, thus, they were not satisfied with the selection process. However, the study shows the ability of the community to identify the poor. The study reports varying concepts of poverty and its identification across the three ecological zones of Ghana.ConclusionThere is a general perception of politicization and lack of transparency of the selection of the poor into the NHIS through the LEAP programme in Ghana. Community-based approaches in the selection of the indigent are recommended to safeguard the NHIS-LEAP beneficiary process.

Can open-defecation free (ODF) communities be sustained? A cross-sectional study in rural Ghana.

Community-led total sanitation (CLTS) is a widely used approach to reduce open defecation in rural areas of low-income countries. Following CLTS programs, communities are designated as open defecation free (ODF) when household-level toilet coverage reaches the threshold specified by national guidelines (e.g., 80% in Ghana). However, because sanitation conditions are rarely monitored after communities are declared ODF, the ability of CLTS to generate lasting reductions in open defecation is poorly understood. In this study, we examined the extent to which levels of toilet ownership and use were sustained in 109 communities in rural Northern Ghana up to two and a half years after they had obtained ODF status. We found that the majority of communities (75%) did not meet Ghana's ODF requirements. Over a third of households had either never owned (16%) or no longer owned (24%) a functional toilet, and 25% reported practicing open defecation regularly. Toilet pit and superstructure collapse were the primary causes of reversion to open defecation. Multivariate regression analysis indicated that communities had higher toilet coverage when they were located further from major roads, were not located on rocky soil, reported having a system of fines to punish open defecation, and when less time had elapsed since ODF status achievement. Households were more likely to own a functional toilet if they were larger, wealthier, had a male household head who had not completed primary education, had no children under the age of five, and benefitted from the national Livelihood Empowerment Against Poverty (LEAP) program. Wealthier households were also more likely to use a toilet for defecation and to rebuild their toilet when it collapsed. Our findings suggest that interventions that address toilet collapse and the difficulty of rebuilding, particularly among the poorest and most vulnerable households, will improve the longevity of CLTS-driven sanitation improvements in rural Ghana.

Assessing the Livelihood Empowerment Against Poverty (LEAP) program as a conditional income transfer: a search for a conceptual framework

Purpose Ghana has implemented different kinds of pro-poor program and policies since its independence to reduce poverty. The Livelihood Empowerment Against Poverty (LEAP) is one of such program. LEAP is a social cash transfer program and its implementation has been under the auspices of the Ministry of Gender, Children and Social Protection since 2008. It provides direct cash and health insurance coverage for extremely poor households across the country to alleviate short-term poverty and encourage long-term human capital development. This paper examines the LEAP program in terms of how it has achieved its aim and the opportunities for improvement.Design/methodology/approach Primary data were obtained from interviews of 110 beneficiaries of the program. The study proposes a conceptual framework that links poverty reduction and social policies to assist researchers analyze pro-poor or social cash transfer program.Findings The findings show that the program is challenged with administrative bureaucracies, irregular inflow of funds, perceived political interferences, inconsistent implementation strategies and low value of the cash transfer (which results in little or no impact on consumption). However, the data also show that LEAP has positive impacts on nonconsumption spending like children's schooling. The program' exit strategy does not impact much on beneficiaries to allow them exit without the tendency of being poor.Practical implications This paper discussed the LEAP program as a social cash transfer to the poor in Ghana. The study constructed a conceptual framework to help researchers and practitioners analyze the implementation of pro-poor interventions. This conceptualization allows for cash transfer program to empower beneficiaries and exits them to allow for other beneficiaries to enroll, ensuring reduction in poverty over time. Generally, the beneficiaries have benefited from the LEAP in the areas of consumption, education and healthcare with few beneficiaries being able to accumulate some few assets. The LEAP program has no exit plan.Originality/value This study adds to literature by offering a conceptual framework to help researchers and policy makers in dealing with social assistance policies to the poor. The study also gave an insight into how pro-poor policy strategies could be crafted.

Buying out the political support of the poor with Ghana’s leap programme: An empirical fact or fiction?

There is a consensus around the view that pro-poor programmes constitute an effective response to extreme poverty. However, available evidence indicates that the political class in many nascent democracies use such programmes to extract electoral returns from the poor beneficiaries. The Livelihood Empowerment against Poverty (LEAP) programme attempts to support the poor to leap out of poverty. Using concurrent mixed methods approach, this article examined the extent to which LEAP benefits get to the poor, and also to ascertain if the recipients feel compelled to reciprocate government’s generosity by supporting the incumbent electorally. The results suggest that the selection of LEAP communities and beneficiaries are motivated by partisan consideration. Thus, politicians use LEAP to reward party supporters. It concludes that LEAP benefits constitute insufficient motivation to swing the political support of beneficiaries toward the incumbent since most of them were affiliated to either NPP or NDC prior to their selection.

Performance of a novel machine learning-based proxy means test in comparison to other methods for targeting pro-poor water subsidies in Ghana

Access to safe drinking water is still very low among the poorest households in sub-Saharan Africa, and economic shocks can make water access even more difficult for poor consumers. Water subsidies can be a solution to enhance access to safe water services, but they are often ineffective as they regularly fail to reach the very poor. In this study, we developed a new Machine Learning-based proxy means test (ML-based PMT) to identify the poorest households and field-tested it in comparison to four other methods (the Demographic and Health Survey (DHS) wealth index, the Poverty Probability Index (PPI), Community Based Targeting (CBT) and the Ghana Government's Livelihood Empowerment Against Poverty (LEAP) program). We first developed our new ML-based PMT by applying machine learning techniques to the nationally-representative 2016–2017 Ghana Living Standards Survey and compared its performance with an existing PMT (the PPI). We then compared the strengths and weaknesses of this new method in three rural towns of southwestern Ghana against the four other methods, with respect to the characteristics of households they identified, their ease of implementation, their cost, and their acceptability among local stakeholders. In our field assessment we found that our new ML-based PMT performed better than most other approaches at screening out households having assets associated with wealth, but it had higher implementation costs than CBT and LEAP. Local government officials considered CBT to be more transparent than the PMTs, while community members perceived the PMTs to be fairer.By highlighting the strengths and weaknesses of five different targeting methods, this study provides guidance to practitioners in choosing the most appropriate methods to target poor households eligible for water subsidies in rural Ghana.