Admissible evidence in the court of development evaluation? : the impact of CARE’s SHOUHARDO Project on child stunting in Bangladesh

Along with the rise of the development effectiveness movement of the last few decades,
experimental impact evaluation methods – randomised controlled trials and quasiexperimental
techniques – have emerged as a dominant force. While the increased use of
these methods has contributed to improved understanding of what works and whether
specific projects have been successful, their ‘gold standard’ status threatens to exclude a
large body of evidence from the development effectiveness dialogue.
In this paper we conduct an evaluation of the impact on child stunting of CARE’s
SHOUHARDO project in Bangladesh, the first large-scale project to use the rights-based,
livelihoods approach to address malnutrition. In line with calls for a more balanced view of
what constitutes rigor and scientific evidence, and for the use of more diversified and holistic
methods in impact evaluations, we employ a mixed-methods approach. The results from
multiple data sources and methods, including both non-experimental and quasi-experimental,
are triangulated to arrive at the conclusions. We find that the project had an extraordinarily
large impact on stunting among children 6–24 months old – on the order of a 4.5 percentage
point reduction per year. We demonstrate that one reason the project reduced stunting by so
much was because, consistent with the rights-based, livelihoods approach, it relied on both
direct nutrition interventions and those that addressed underlying structural causes including
poor sanitation, poverty, and deeply-entrenched inequalities in power between women and
men. These findings have important policy implications given the slow progress in reducing
malnutrition globally and that the widely-supported Scaling Up Nutrition initiative aimed at
stepping up efforts to do so is in urgent need of guidance on how to integrate structural
cause interventions with the direct nutrition interventions that are the initiative’s main focus.
The evaluation also adds to the evidence that targeting the poor, rather than employing
universal coverage, can help to accelerate reductions in child malnutrition. The paper
concludes that, given the valuable policy lessons generated, the experience of the
SHOUHARDO project merits solid standing in the knowledge bank of development
effectiveness. More broadly, it illustrates how rigorous and informative evaluation of complex,
multi-intervention projects can be undertaken even in the absence of the randomisation, nonproject
control groups and/or panel data required by the experimental methods.
Keywords: development effectiveness; impact evaluation; experimental methods; child
malnutrition; Bangladesh.