Millennium Villages Project Research Articles

Model villages in the neoliberal era: the Millennium Development Goals and the colonization of everyday life

What explains the recent re-emergence of ‘model village’-style social experiments, and what does this tell us about the contradictions of neoliberal development? This paper focuses on two experiments of this kind – the Millennium Villages Project in sub-Saharan Africa and the Rural Cities Project in southern Mexico – both of which aim to achieve the Millennium Development Goals through an integrated set of interventions at the village level. Drawing on Henri Lefebvre's work on the colonization of everyday life, I argue that the Millennium Development Goals function in these cases to facilitate and legitimate the production of social reality based on a naturalised vision of market society. These utopian projects embody the paradoxical character of neoliberalization, demonstrating the necessarily social production of the supposedly natural order on which neoliberalism is discursively premised, while reproducing the strategies of social engineering that the neoliberal project is rhetorically oriented against.

The Impact of Social Grants on Rural Women: Perspectives from ABET Practitioners

The most recent census information available, as well as other reports and studies reveal that out of a population of about 52 million South Africans, approximately 30 percent live on social grants. This translates to at least 15.6 million social grant recipients countrywide. This study examines how social grants have contributed to the well-being and especially livelihoods of rural people. It also examines how the grants have enabled and empowered recipients, encouraged self-reliance and created opportunities for socioeconomic growth and development towards poverty alleviation for rural recipients. Proponents of Adult Basic Education and Training (ABET) tend to link issues of education and development to literacy. This study examines how social grants contribute to improvements in families’ livelihoods and the well-being of individuals who receive them. In addition, it seeks to establish whether there is a link between the provision of social grants, as a social policy model, and literacy, development and education. While the social grant is meant to bridge economic disparities by assisting the poor, this study is located at an intersection of two schools of thought about this policy – those in support of and those against it. Jeffrey Sachs’ Millennium Villages Project underpins the theoretical framework of this study as it gives hope for those critics who believe that Africa will forever be dependent on foreign aid and hand-outs. Qualitative and document analysis methods were used to collate and analyse journals and diaries kept by grant recipients in fifteen (15) rural households in the Free State over a period of two years. The main findings of the study reveal that social grants, as an economic intervention, are contributing substantively towards poverty reduction. However, the recipients feel that the social grant is a gift from government and believe that it will be forfeited, if they become self-reliant. The study concludes that more income-generating activities should be encouraged through the provision of loans or seed-funds as CARE-South Africa had done in their community development interventions to grant recipients. Social grants are only a means of survival, but community education can bring about for development – along with other adult education programmes – and is a key element in addressing sustainable development. DOI: 10.5901/mjss.2013.v4n13p541

Role of Community Capacity Building in Ensuring Sustainability of Food Security Project: A Case of the Millennium Villages Project in Bar Sauri, Gem- Kenya

Role of Community Capacity Building in Ensuring Sustainability of Food Security Project: A Case of the Millennium Villages Project in Bar Sauri, Gem- Kenya

Role of Community Capacity Building in Ensuring Sustainability of Food Security Project: A Case of the Millennium Villages Project in Bar Sauri, Gem- Kenya

This study explored the functional role of community capacity building in ensuring sustainability of Bar-Sauri Millennium Villages Project beyond the five years funding period. The study used descriptive survey research design, an interview schedule and questionnaires to establish the sustainability of tangible benefits of MVP. The questionnaire was administered to 380 respondents selected by simple random sampling. A response rate of 79% was obtained. Descriptive statistical techniques were used to present the findings. Data was analyzed using SPSS version 19. The findings indicate that there were trained community leaders to help villagers understand the MVP goals however, the residents of Bar-Sauri were not competent enough in sustaining the MVP if the donor funding ends. The MVP has introduced several sustainability interventions; most effective strategy being financial literacy. From the study, the following strategies for capacity building for new projects similar to MVP were found out: Training in marketing, involving the community in the conception stage of the project and in the decision making stages concerning the project, Training in farm management and post harvesting practices such as storage, diversification of agricultural activities, improvement of educational institutions in the millennium village. The study recommended that further research should be carried out in Bar-Sauri encompassing other variables not included in this study. A similar research should be conducted in other MVP sites in Africa: That is Ruhiira in Uganda, Pampaida in Nigeria, Bonsaaso in Ghana, Mwandana in Malawi. Studies that relate to the effective implementation of programs and support policies for MVPs in Kenya and Africa should be carried out. Studies should cover strategies used by successful MVPs in sustaining the project beyond the donor funded period to scale up to other local, national and international food security programs.

Mobile phones and social structures: an exploration of a closed user group in rural Ghana

BackgroundIn the Millennium Villages Project site of Bonsaaso, Ghana, the Health Team is using a mobile phone closed user group to place calls amongst one another at no cost.MethodsIn order to determine the utilization and acceptability of the closed user group amongst users, social network analysis and qualitative methods were used. Key informants were identified and interviewed. The key informants also kept prospective call journals. Billing statements and de-identified call data from the closed user group were used to generate data for analyzing the social structure revealed by the network traffic.ResultsThe majority of communication within the closed user group was personal and not for professional purposes. The members of the CUG felt that the group improved their efficiency at work.ConclusionsThe methods used present an interesting way to investigate the social structure surrounding communication via mobile phones. In addition, the benefits identified from the exploration of this closed user group make a case for supporting mobile phone closed user groups amongst professional groups.

Measuring Socio-economic Status in the Millennium Villages: The Role of Asset Index Choice

How are poverty analyses and poverty traps assessments affected by the choice among conventional methods of asset index construction? To address this question, this article uses panel data from four sites in the Millennium Villages Project (MVP) in Malawi, Tanzania, Mali and Ghana to study the relationship between eight asset indices and the sensitivity of findings related to poverty rates, poverty transitions and poverty traps to the index used. We find that although estimations of poverty rates and transitions are largely consistent across indices, evidence of poverty traps can be conditional on which asset index is used. The asset indices studied include structural income, principal components, factor analysis and a reduced set of assets reflecting the portfolio assessed in the Demographic Health Survey (DHS) data.

An impact evaluation design for the Millennium Villages Project in Northern Ghana

This article details the design of an impact evaluation of the Millennium Villages Project in Northern Ghana. The evaluation is particularly challenging because the intervention cannot be randomised; it is clustered in a group of homogeneous communities and likely to generate spill-over effects. We propose a difference-in-differences design selecting control communities based on a propensity score and collecting five rounds of yearly data. We address a number of evaluation questions in relation to testing the breaking of the poverty trap, assessing project externalities, the role of qualitative research, cost-effectiveness and project synergies, sustainability and scalability in the presence of scale economies.

Physical condition of Olyset® nets after five years of utilization in rural western Kenya

BackgroundLong-lasting insecticidal nets (LLINs) are a cornerstone of malaria control at present, and millions are used each day across the globe. However, there is limited information about the durability of LLINs under different conditions of utilization and there is no consensus about when a LLIN ceases to be protective due to physical deterioration. This knowledge is important for malaria control programmes to plan for procurement and replacement.MethodsA cross-sectional survey of 208 households where Olyset® nets distributed five years ago were still present was conducted in the village of Sauri, western Kenya, in the context of the Millennium Villages Project. Information on bed net utilization and maintenance was collected in each household through a structured questionnaire, and one five-year-old Olyset® net from each sampled household was randomly selected and collected for physical examination. All holes larger than 0.5 cm were measured in each net, registering their position, and a hole index was calculated following WHO guidelines. Nets were classified as in good condition, moderately damaged or badly torn based on the hole index. The analysis explored the associations between demographic and socioeconomic characteristics of households, patterns of bed net utilization and maintenance and physical condition of the nets. Additional analysis was conducted using malaria prevalence data collected in a separate survey to explore if there was any association between the condition of the net collected in a household and the presence of malaria parasites in members of that household.Results81.4% of Olyset® nets distributed five years ago were still present in the surveyed households, and 98.97% of the nets were reportedly used the previous night. Nets had an average of 34.2 holes (95% CI 30.12-38.22), and the mean hole index was 849 (95% CI 711–986), IQR 174–1,135. 15.2% of nets were still in good condition, 46.1% were moderately damaged and 38.7% were badly torn after five years of utilization. There was no association between household characteristics or patterns of bed net utilization or maintenance and physical condition of the nets. The only predictor of the physical condition of the net was the cleanliness at the time of examination. There was a difference of 17.6 percentage points in the proportion of households with at least one blood smear positive for Plasmodium falciparum between households with a net in good condition (5.3%) and those with a moderately damaged or badly torn net (22.9%), 95% CI (0.04-0.305), t=2.77 with unequal variance, p=0.009.ConclusionsOlyset® nets were used extensively in Sauri, western Kenya after five years of distribution, regardless of their physical condition. However, only 15% were found in good condition. Nets in good condition seem to be still protective after five years of utilization, while nets with more than 100 cm2 of holed surface may be associated with higher malaria parasitaemia at household level. Continued replacement of damaged nets and promotion of net maintenance and repair may be necessary to maintain the protective effectiveness of LLINs.

Using Social Networking to Understand Social Networks: Analysis of a Mobile Phone Closed User Group Used by a Ghanaian Health Team

BackgroundThe network structure of an organization influences how well or poorly an organization communicates and manages its resources. In the Millennium Villages Project site in Bonsaaso, Ghana, a mobile phone closed user group has been introduced for use by the Bonsaaso Millennium Villages Project Health Team and other key individuals. No assessment on the benefits or barriers of the use of the closed user group had been carried out.ObjectiveThe purpose of this research was to make the case for the use of social network analysis methods to be applied in health systems research—specifically related to mobile health.MethodsThis study used mobile phone voice records of, conducted interviews with, and reviewed call journals kept by a mobile phone closed user group consisting of the Bonsaaso Millennium Villages Project Health Team. Social network analysis methodology complemented by a qualitative component was used. Monthly voice data of the closed user group from Airtel Bharti Ghana were analyzed using UCINET and visual depictions of the network were created using NetDraw. Interviews and call journals kept by informants were analyzed using NVivo.ResultsThe methodology was successful in helping identify effective organizational structure. Members of the Health Management Team were the more central players in the network, rather than the Community Health Nurses (who might have been expected to be central).ConclusionsSocial network analysis methodology can be used to determine the most productive structure for an organization or team, identify gaps in communication, identify key actors with greatest influence, and more. In conclusion, this methodology can be a useful analytical tool, especially in the context of mobile health, health services, and operational and managerial research.

L'affrontement entre les objectifs de développement et l'évaluation d'impact

Résumé Deux courants ont récemment refaçonné l’aide au développement. Le mouvement en faveur des objectifs a unifié et inspiré les acteurs de l’aide avec des objectifs quantifiables ; le mouvement en faveur de l’évaluation a émis des normes pour mesurer les effets réels de l’aide. Ces deux courants semblent complémentaires, mais dans certains projets de l’aide ils se sont heurtés de manière improductive. Je passe en revue un tel affrontement, dans le projet Villages du Millénaire (MVP) mis en œuvre par les Nations Unies. L’histoire nous donne des leçons sur la façon dont les nouveaux objectifs de développement et les évaluations d’impact à venir pourraient davantage se renforcer mutuellement.

Poverty project opens to scrutiny

The Millennium Villages Project (MVP) a joint venture between Columbia University and the non-profit organization Millennium Promise is simultaneously applying a raft of aid interventions – from bednets for malaria control to fertilizers – to help impoverished villages to meet the United Nation’s eight Millennium Development Goals (MDGs) including reducing hunger extreme poverty and the burden of major diseases. In a paper published online in The Lancet the project claimed a significant milestone: it reported that after three years of interventions child mortality was decreasing three times faster in the project’s villages than in the host nations in general. But the analysis was criticized for underestimating improvements in child mortality and overestimating those in the Millennium Villages. As a result the paper was partially retracted and MVP’s founder Jeffrey Sachs has now created a faculty committee to oversee MVP research and increase interactions with outside researchers. Whether the MVP ultimately proves a success or failure it will still provide useful information so it is important to improve its evaluation mechanisms.

The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment

Simultaneously addressing multiple Millennium Development Goals (MDGs) has the potential to complement essential health interventions to accelerate gains in child survival. The Millennium Villages project is an integrated multisector approach to rural development operating across diverse sub-Saharan African sites. Our aim was to assess the effects of the project on MDG-related outcomes including child mortality 3 years after implementation and compare these changes to local comparison data. Village sites averaging 35,000 people were selected from rural areas across diverse agroecological zones with high baseline levels of poverty and undernutrition. Starting in 2006, simultaneous investments were made in agriculture, the environment, business development, education, infrastructure, and health in partnership with communities and local governments at an annual projected cost of US$120 per person. We assessed MDG-related progress by monitoring changes 3 years after implementation across Millenium Village sites in nine countries. The primary outcome was the mortality rate of children younger than 5 years of age. To assess plausibility and attribution, we compared changes to reference data gathered from matched randomly selected comparison sites for the mortality rate of children younger than 5 years of age. Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT01125618. Baseline levels of MDG-related spending averaged $27 per head, increasing to $116 by year 3 of which $25 was spent on health. After 3 years, reductions in poverty, food insecurity, stunting, and malaria parasitaemia were reported across nine Millennium Village sites. Access to improved water and sanitation increased, along with coverage for many maternal-child health interventions. Mortality rates in children younger than 5 years of age decreased by 22% in Millennium Village sites relative to baseline (absolute decrease 25 deaths per 1000 livebirths, p=0·015) and 32% relative to matched comparison sites (30 deaths per 1000 livebirths, p=0·033). An integrated multisector approach for addressing the MDGs can produce rapid declines in child mortality in the first 3 years of a long-term effort in rural sub-Saharan Africa. UN Human Security Trust Fund, the Lenfest Foundation, Bill & Melinda Gates Foundation, and Becton Dickinson.

Capitalizing on the Characteristics of mHealth to Evaluate Its Impact

The field of mHealth has made significant advances in a short period of time, demanding a more thorough and scientific approach to understanding and evaluating its progress. A recent review of mHealth literature identified two primary research needs in order for mHealth to strengthen health systems and promote healthy behaviors, namely health outcomes and cost-benefits (Mechael et al., 2010). In direct response to the gaps identified in mHealth research, the aim of this paper is to present the study design and highlight key observations and next steps from an evaluation of the mHealth activities within the electronic health (eHealth) architecture implemented by the Millennium Villages Project (MVP) by leveraging data generated through mobile technology itself alongside complementary qualitative research and costing assessments. The study, funded by the International Development and Research Centre (IDRC) as part of the Open Architecture Standards and Information Systems research project (OASIS II) (Sinha, 2009), is being implemented on data generated by 14 MVP sites in 10 Sub-Saharan African countries including more in-depth research in Ghana, Rwanda, Tanzania, and Uganda. Specific components of the study include rigorous quantitative case-control analyses and other epidemiological approaches (such as survival analysis) supplemented by in-depth qualitative interviews spread out over 18 months, as well as a costing study to assess the impact of mHealth on health outcomes, service delivery, and efficiency.

Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions

To provide cost guidance for developing a locally adaptable and nationally scalable community health worker (CHW) system within primary-health-care systems in sub-Saharan Africa. The yearly costs of training, equipping and deploying CHWs throughout rural sub-Saharan Africa were calculated using data from the literature and from the Millennium Villages Project. Model assumptions were such as to allow national governments to adapt the CHW subsystem to national needs and to deploy an average of 1CHW per 650 rural inhabitants by 2015. The CHW subsystem described was costed by employing geographic information system (GIS) data on population, urban extents, national and subnational disease prevalence, and unit costs (from the field for wages and commodities). The model is easily replicable and configurable. Countries can adapt it to local prices, wages, population density and disease burdens in different geographic areas. The average annual cost of deploying CHWs to service the entire sub-Saharan African rural population by 2015 would be approximately 2.6 billion (i.e. 2600 million) United States dollars (US$). This sum, to be covered both by national governments and by donor partners, translates into US$6.86 per year per inhabitant covered by the CHW subsystem and into US$2.72 per year per inhabitant. Alternatively, it would take an annual average of US$3750 to train, equip and support each CHW. Comprehensive CHW subsystems can be deployed across sub-Saharan Africa at cost that is modest compared with the projected costs of the primary-health-care system. Given their documented successes, they offer a strong complement to facility-based care in rural African settings.

The Monitoring and Evaluation System of the Millennium Villages Project- Potou/Senegal: Close Look at the Mid- term Evaluation Report

This paper explores the monitoring and evaluation system of the Millennium Villages Project in Potou, rural Senegal. It specifically focuses on the first evaluation report undertaken in 2009 after three years of intervention to assess the impacts of the project on communities in Potou. Theory of change, causal attribution, scaling-up, use of evaluation, and learning are the key issues that are addressed throughout the paper. Interviews with beneficiaries and project staff as well as the analysis of the project’s evaluation report revealed that the project has created many positive impacts in the communities of Potou. However, unintended negative results have been observed in the sectors of education, health, and agriculture. Given the weaknesses that have been identified in the evaluation method, this paper suggests some strategies to strengthen the methodology of future evaluations, thus allowing for distinct attribution of the impacts to the project.

Millennium villages: A lasting impact?

Haruni Odhiambo Nyariru is making an addition to his home. Martin Omondi Onyango bought a cow and a goat, covers his younger brother’s school fees and is building a house for his mother. Now that she is harvesting 30 bags of maize (of 90 kilogrammes each) instead of 12 from her two acres, Wilfreda Ongonda Ochieng says that her family is eating better and that she has a surplus to sell. These farmers attribute the small but real changes in their lives to gains made since the advent of the Sauri Millennium Villages Project in western Kenya.

Scaling Up for the “Bottom Billion”: “5×5” Implementation of Community Mental Health Care in Low-Income Regions

Common mental disorders pose tremendous health and social burdens in the poorest countries. This Open Forum describes a planning framework to advance effective, sustainable design and implementation of mental health services in these settings. It builds on research in treatment dissemination and on the authors' experience in several initiatives-including the Millennium Villages Project in sub-Saharan Africa and the Partners In Health system in Haiti (Zanmi Lasante). The authors describe a "pyramid of care" approach that specifies five key skill packages to address common mental disorders in low-resource settings and five implementation rules: assess context first; identify priority care pathways and map them across skill packages; specify decision supports, supervision, and triage rules; use quality improvement practices; and plan for sustainability and capacity building. The framework addresses the need for a shared vocabulary and a set of tools to coordinate and compare efforts to scale-up mental health treatment across diverse settings.

When does rigorous impact evaluation make a difference? The case of the Millennium Villages

When is the rigorous impact evaluation of development projects a luxury, and when a necessity? The authors study one high-profile case: the Millennium Villages Project (MVP), an experimental and intensive package intervention to spark sustained local economic development in rural Africa. They illustrate the benefits of rigorous impact evaluation in this setting by showing that estimates of the project's effects depend heavily on the evaluation method. Comparing trends at the MVP intervention sites in Kenya, Ghana, and Nigeria with trends in the surrounding areas yields much more modest estimates of the project's effects than the before-versus-after comparisons published thus far by the MVP. Neither approach constitutes a rigorous impact evaluation of the MVP, which is impossible to perform due to weaknesses in the evaluation design of the project's initial phase. These weaknesses include the subjective choice of intervention sites, the subjective choice of comparison sites, the lack of baseline data on comparison sites, the small sample size, and the short time horizon. The authors describe one of many ways that the next wave of the intervention could be designed to allow proper evaluation of the MVP's impact at little additional cost.

Future Occurrence of Threshold-Crossing Seasonal Rainfall Totals: Methodology and Application to Sites in Africa

Abstract A statistical simulation framework is developed to explore the future frequencies of threshold-crossing events, focusing here on low seasonal rainfall totals. Global change (GC) is represented by a trend on the seasonal mean rainfall total. Natural decadal to multidecadal variability (MDV) is represented by an autoregressive process. Interannual variability (IV) of seasonal totals is represented by white noise with either a normal or skew normal distribution consistent with parameters observed in the historical record at the location being modeled. Monte Carlo simulations are undertaken for various combinations of the above components, and the authors evaluate the extent to which future event frequencies can be estimated from the statistics of previous years. The sample of four study locations used to illustrate the approach is drawn from the Millennium Villages Project in Africa, where the potential of index insurance as a development and adaptation tool has been considered, thereby bringing a targeted problem setting to the analyses. The simulations highlight a number of general principles. For example, it is shown that a 10% change in the mean rainfall can lead to a change of order times 2 in the number of threshold-crossing low seasonal rainfall totals, even without invoking any change in the characteristics of the IV. The magnitudes of change are also shown to be sensitive to the threshold studied, as well as to site-specific climate features (here, coefficient of variation and skewness). The framework developed permits quantification of how, especially in the near term (of order 30 years), MDV can strongly add to uncertainty about future event frequencies. Therefore, statistical treatment of estimated MDV magnitudes will often be a key input to optimal risk management, with further enhancements expected through explicit MDV forecasts. The results highlight the importance of finding optimal ways to update climate statistics such as event thresholds, in the presence of GC and MDV.

Testing institutional biomass cookstoves in rural Kenyan schools for the Millennium Villages Project

Cooking tests were conducted in randomly selected school kitchens in the Sauri Millennium Villages Project site, located in Siaya District of Nyanza Province in Western Kenya. The tests compared fuel consumption measurements obtained using a traditional three-stone fire with those from newly introduced institutional stoves based on the “rocket” design. The key metric used was Specific Fuel Consumption (SFC), defined as the weight of firewood consumed in cooking a single batch of food divided by the total weight of food, measured after cooking. Tests followed the normal cooking practices in the school kitchens and included the typical range of foods prepared for midday school meals programs. The study included two types of tests: paired tests, in which most conditions were controlled between one test conducted on a three-stone fire and a matching test conducted on a “rocket” stove; and unpaired tests, in which conditions were similar, but not strictly controlled, among two large sets of relatively independent three-stone fire and rocket stove tests. Results from both paired and unpaired experiments, averaged across all types of food cooked, showed that the use of rocket stoves yielded significantly lower SFC values without prolonging cooking time when compared with three-stone fires. An analysis comparing results from paired and unpaired cooking tests suggests that, due to high variance and sources of bias in unpaired tests, experimental design should favor paired tests.