Community Monitoring Improves Public Service Provision at Scale: Experimental Evidence from a Child Development Program in Nicaragua

Abstract

Expanding small-scale interventions without lowering quality and attenuating impact is a critical policy challenge. Community monitoring overs a low-cost quality assurance mechanism by making service providers account-able to local citizens, rather than distant administrators. This paper provides experimental evidence from a home visit parenting program implemented at scale by the Nicaraguan government, with two types of monitoring: (a) institutional monitoring; and (b) community monitoring. We find d a positive intent-to-treat effect on child development, but only among groups randomly assigned to community monitoring. Our findings show promise for the use of community monitoring to ensure quality in large-scale government-run social programs.

Supporting child and family resilience in the face of political violence: Evidence from a home visit parenting program

“…Home visitors demonstrated early stimulation activities and provided information regarding developmental milestones, parenting strategies, and health and social support services in the community (see Section 5 in Supporting Information for details). Treatment compliance was imperfect, as is common in large‐scale field studies (Lopez Boo et al, 2020). Participation in home visits was thus measured as assignment to home visits (1 = randomly assigned to the home visit program, 0 = randomly assigned to control condition; based on community of residence at T1); and the number of home visits received , estimated by multiplying caregiver‐reported duration of home visit receipt in months by caregiver‐reported frequency of home visits (once a month, twice a month, or weekly; i.e., four times a month).…”

“…Further, there is already promising evidence on the programs' effectiveness. An experimental impact evaluation found positive effects on children's behavior, language, and cognitive development 9 months after the program ended (Lopez Boo et al, 2020). There were no observed effects on caregiver depressive symptoms or stimulation practices, but the impact evaluation used only a subset of the sample that we used in this study, did not account for exposure to political violence in the study sample, and did not measure one of the key parenting measures we expected to be influenced by political violence: harsh discipline practices.…”

“…Sample selection was designed to be representative of high poverty rural communities in the north, central, and Atlantic coast regions of Nicaragua (details of community selection are described in Lopez Boo et al, 2020). In each of the 210 participating communities, 45 children were randomly selected for participation in the T1 interview from a sampling frame that included all households with children younger than six.…”

“…There are three main mechanisms through which home visits may support child and family resilience in the face of political violence. First, a primary aim of most home visit programs, including the one in Nicaragua, is to strengthen children's developmental contexts by connecting families to health, education, and social support resources in their communities (Duffee et al, 2018; Lopez Boo et al, 2020; Michalopoulos et al, 2019). These social connections may provide a vital source of resilience in the context of political violence, buffering the negative effects of political violence on caregivers' sense of social support.…”

Violencia de pareja y desarrollo infantil temprano

“…La muestra cuenta con 8 921 niños de entre 0 y 5 años y 7 436 madres o cuidadoras de 7 133 hogares. Estos se ubican en alguno de los 37 municipios que tienen un Índice de Pobreza Extrema mayor a 0,2 en zonas rurales del país con bajo acceso a servicios de primera infancia (23). En cada comunidad se hizo un censo para identificar a todos los hogares con niños menores de 6 años, y de esa lista se seleccionaron de manera aleatoria 30 hogares para componer la muestra del estudio.…”