1. An Introduction to Household Economic Strengthening
Conduct an introduction exercise and – as needed – an icebreaker. 2 truths and a lie, interview your neighbor, etc. In Abuja, we started very late so we did timed 2 min intros for each person (name, org, position, why here) – bland but concise!
Introduction to HES

2. The LIFT II Project
Funded by USAID Global Health Bureau’s Office of HIV/AIDS
Five-year project, through July 2018
Three core partners (FHI360, CARE and World Vision) and numerous resource organizations
Offers:
Support for linkages between Nutrition Assessment, Counseling and Support (NACS) and economic strengthening, livelihoods, and food security ES/L/FS services
Strengthened community services that provide ES/L/FS support as a component of a continuum of care for families.
Access to tools and resources
M&E Support
Program quality and implementation support
Introduction to HES

3. Training objectives Introduce LIFT
Understand economic strengthening (ES) and its rationale
Learn about major concepts and approaches in ES
Review lessons in ES programming
Share additional resources
Introduce more in-depth training
From this training we expect you will develop a broad understanding about why economic strengthening is important for HIV/AIDS and OVC programs. You will have a basic knowledge of the issues, and available tools and resources to consider when designing and implementing programs.
For the purposes of this training, our focus is primarily on supporting access to food rather than availability and utilization.

4. What is Economic Strengthening?
“A portfolio of interventions to reduce the economic vulnerability of households and empower them to provide for the essential needs of the children they care for, rather than relying on external assistance.” (PEPFAR working definition, 2011)

5. Why is Economic Strengthening Important?
Enables households to meet their needs.
Health, nutrition and economic well-being are closely linked.
Positive health and nutrition outcomes usually can’t be achieved while households lack access to income.
For LIFT, economic strengthening supports PEPFAR’s primary objectives:
HIV prevention
Care, treatment and support
Impact mitigation
First ask the participants for their opinions before showing the slides.
Links to prevention, c&s, impact mitigation. Complements other programs.
[provide an example of returning to clinics due to economic circumstances]

6. ES Benefits: Practical Examples
ES for OVC Caregivers in Uganda: Caregivers who joined savings groups with literacy training increased household assets and improvements among OVCs in # of meals eaten and living conditions over non-participants.
Note that there is still a limited evidence base in many areas, such as ES impacts on vulnerable children (as noted in the CPC report). However, there are some cases that we can learn from.
Sources:
SAWSO, Empowering Better Care: Report on economic strengthening for OVC caregivers in Uganda, Project participants demonstrated improvements in number of meals eaten, support for educational success, hygienic living conditions, and understanding of health risks and behaviors relative to non-participants.
Guaranteed labour in India: NREGS and Child Well Being, 2011.
Savings groups in Burundi: Iyengar, Radha and Guilia Ferrari. Women’s Empowerment in Burundi: Impact Evaluation Paper, London School of Economics, 2011
CPC Livelihoods and Economic Strengthening Task Force. The Impacts of Economic Strengthening Programs on Children. Review of 43 studies. Found that
© Paul Rippey

7. ES Benefits: Practical Examples
FONKOZE in Haiti: By offering a continuum of provision, protection and promotion services, FONKOZE provides integrated programming to move people along the economic strengthening pathway
Note that there is still a limited evidence base in many areas, such as ES impacts on vulnerable children (as noted in the CPC report). However, there are some cases that we can learn from.
Sources:
SAWSO, Empowering Better Care: Report on economic strengthening for OVC caregivers in Uganda, Project participants demonstrated improvements in number of meals eaten, support for educational success, hygienic living conditions, and understanding of health risks and behaviors relative to non-participants.
Guaranteed labour in India: NREGS and Child Well Being, 2011.
Savings groups in Burundi: Iyengar, Radha and Guilia Ferrari. Women’s Empowerment in Burundi: Impact Evaluation Paper, London School of Economics, 2011
CPC Livelihoods and Economic Strengthening Task Force. The Impacts of Economic Strengthening Programs on Children. Review of 43 studies. Found that

8. ES Benefits: Practical Examples
Savings Groups in Burundi: Providing social messaging through savings groups was found to improve financial decision making authority for women, reduce exposure to violence, reduce acceptance of violence, and increase consumption of household goods relative to luxury goods.
Note that there is still a limited evidence base in many areas, such as ES impacts on vulnerable children (as noted in the CPC report). However, there are some cases that we can learn from.
Sources:
SAWSO, Empowering Better Care: Report on economic strengthening for OVC caregivers in Uganda, Project participants demonstrated improvements in number of meals eaten, support for educational success, hygienic living conditions, and understanding of health risks and behaviors relative to non-participants.
Guaranteed labour in India: NREGS and Child Well Being, 2011.
Savings groups in Burundi: Iyengar, Radha and Guilia Ferrari. Women’s Empowerment in Burundi: Impact Evaluation Paper, London School of Economics, 2011
CPC Livelihoods and Economic Strengthening Task Force. The Impacts of Economic Strengthening Programs on Children. Review of 43 studies. Found that
© SAWSO

9. Risks of Not Addressing Economic Needs?
Brainstorm with the group. Possible answers: cannot afford health and education investments. Cannot maintain adequate nutrition. Cannot support vulnerable members of their household.

10. Understanding Your Beneficiary
Vulnerability:
- high
- moderate
- low
Challenges:
- human
natural
physical
financial
social
Who is the target population?
What assistance is needed to build capability?
Interventions:
- social protection
- asset protection
- income growth
What are the challenges?
Walk through iterative process of fully understanding the beneficiary as first step to effective HES design. Need to walk in the beneficiary’s shoes to understand their day to day lives in order to design effective HES…participants are the ideal group to do this as they know the realities facing the hhs they are working with….
What do they need to do to build capability?
Capabilities & Interests:
Education
Skills - Employability
Action required:
- persevere
- organize
- build
What are the interests & capabilities?

11. Poverty Tax Challenge
“Poverty Tax” causes the poorest to pay the most to meet their basic & essential needs
Understanding delivery and cost of basic services
Opportunity to reduce the cost of basic services
Opportunity to reduce the cost of inputs for income generating activities

12. Group Discussion: Households and ES
Break into groups
Discuss one household that you have previously supported with ES or that requires ES
Share:
What factors made them require ES
How they supported themselves financially
What major risks/poverty taxes they face
How they would deal with negative events
Facilitate the group discussion. Ask one person from each group to share a particularly interesting household story. Bring out commonalities across the cases.

13. Important Concepts in ES
Households often become poor after experiencing a shock (e.g. sickness caused by HIV)
Vulnerability to shocks varies between households, within households and over time
Household livelihood strategies are shaped in part by vulnerability
Coping mechanisms and safety nets are important to building resilience to shocks
Tailor interventions to vulnerability , capacity and risk tolerance
With support, households can transition along a pathway to graduation from external support
Build on the discussions of specific households from the previous discussion in reviewing this slide. Refer back to it frequently in making new points to illustrate your meaning.
Households have different levels of vulnerability to risk. This influences their livelihood strategies and their willingness to invest in new opportunities. It also influences the types of ES programming that are most appropriate for them. This is never static. It is an ongoing process. Households may move in and out of poverty due to shocks and coping mechanisms. It is critical to understand where your target households are before starting to work with them.
Appropriate ES interventions vary for households and can be sequenced to encourage movement along a pathway out of poverty. It’s a process rather than being immediate.
ES programming can be implemented in ways that do not create risk to the individuals, support the development of safety nets and link to household-level consumption smoothing
Effective ES programming often requires combining pull interventions (creating new economic opportunities that are suitable for the participation of the poor) with push interventions (supporting vulnerable households to be able to access those opportunities).

14. Types of Coping Strategies
Minor Coping
Moderate Coping
Severe Coping
Selling protective assets
Seeking wage labor
Migrating for work
Borrowing
Reducing spending and food consumption
Drawing on social assets
Selling productive assets
Borrowing at exorbitant rates
Further reducing spending and food consumption
Depending on charity;
Breaking up household
Migrating under distress
Going without food

15. Types of ES Interventions
Income
Promotion
Income Growth
Protection
Income Stabilization
Risk Reduction
Provision
Loss Management
Destitute / Distress
ES interventions aim to reduce household vulnerability
Three categories (though overlapping):
Provision
Protection
Promotion
Important here to discuss selection of interventions. Talk at about PPP at a high level as three categories of interventions, with overlap between them. Walk through how each of the PPP interventions is suitable to support the evolution of the household.
LIVELIHOOD
PHASE
Time

16. HOUSEHOLD VULNERABILITY HOUSEHOLD LIVELIHOOD & FOOD SECURITY
OBJECTIVES
HIGH
HOUSEHOLD VULNERABILITY
LOW
LOW
HOUSEHOLD LIVELIHOOD & FOOD SECURITY
HIGH
Promotion
Expand household income and consumption
Smooth household income and promote asset growth
Protection
Smooth household consumption and manage household cash flow
Walk through the objectives that can be supported at each level.
Build self-insurance methods and protect key assets
Provision
Recover assets and stabilize household consumption

17. Current State of ES Programming
A lot of poor practice
Requires specialized skill sets and expertise (just as effective health programs do)
Traditionally, many ES activities have been implemented poorly, with untrained staff and have had limited results
Budgets have often been insufficient
Some interventions that are no longer widely practiced elsewhere (e.g. NGOs providing loans) are still widespread in ES programming
Limited learning from practices and experiences elsewhere

18. Common Problems and Effective Solutions in Economic Strengthening
No demand for products produced by target households or no jobs available
Consult market assessments / labor market assessments.
Balance “push” and “pull” interventions.
Organization’s services end once the project’s funding runs out.
Design approaches for sustainability of access to products and services from the beginning.
Organizations provide services that they have no experience or capacity in (example: microfinance)
Avoid areas with weak or no capacity.
Engage in strategic partnerships .
Projects repeat mistakes that have already been made elsewhere
Focus on learning from other experiences prior to starting implementation.
Share learning widely.
Building on the current state of ES programming, we are presenting common problems and effective solutions. For each problem, first ask the group to brainstorm their own solutions. Facilitate a discussion on these before revealing the second column.
For each solution, discuss why it is effective and provide an example.

19. Common Problems and Effective Solutions in Economic Strengthening
Projects do not know their performance and only measure what donors require.
Implement a results measurement system with baselines and regular monitoring.
Same activities are provided to all target households, even though needs and capabilities vary.
Tailor interventions to households.
Households that improve their economic situation stop receiving services and subsequently relapse.
Work to develop household resilience.
Link graduates to new services to ensure incentive for graduation.
For each solution, discuss why it is effective and provide an example.
Ask the participants to identify other problems that they have faced. Then brainstorm solutions together for it.
You can pass out the list of standards of practice after reviewing this list.

20. Food Transfers Cash Transfers Asset Transfers Labor Schemes Provision
Objective: Recover assets and stabilize household consumption (food, healthcare, shelter, clothing, etc.)
Food Transfers
Cash Transfers
Asset Transfers
Labor Schemes
Having reviewed overall good practices, we will now focus on better understanding various types of ES interventions.
If there is limited time, have the participants select the interventions that they are most interested in and focus on those.
Consumption support may not seem productive, but it may allow households to rebuild and maintain productive assets by helping to smooth consumption so they do not have to sell productive assets.
Provisioning should be continued until they have developed appropriate protection strategies to ensure they do not end up in the same situation.

21. Provision – Food transfers
Potential Benefits
Can avoid sale of productive assets.
Allows income to be used for other purposes
May improve nutritional status, enabling productive activities.
Potential Concerns
Hording food
Sale of food items
Intra-household utilization
Market impact (both locally and non-locally sourced)
Administration and handling costs
Ask what types of beneficiaries they think would best use these transfers. Where there are availability problems, where people are not physically able to go to market, where there are concerns about how cash transfers would be used, or about what types of food would be purchased with cash. Issues of local procurement.

22. Provision – Cash transfers
Unconditional or conditional transfers
Potential benefits:
Can support consumption and investment
Low administration fees (if ongoing)
Potential concerns:
Unconditional transfers may be misused
Cash safety
Difficult to monitor spending
Lump sums may be overwhelming for beneficiaries
Few suppliers who accept vouchers
Ask: Are people who can manage cash transfers as vulnerable as those who require food transfer?
Note the increasing trend toward cash rather than food transfers.

23. Provision – Cash Transfers: Conditional and Unconditional
Potential Benefits
Can support consumption and investment
Low administration fees (if ongoing)
Potential Concerns
Unconditional transfers may be misused
Cash safety
Difficult to monitor spending
Lump sums may be overwhelming for beneficiaries
Few suppliers who accept vouchers

24. Provision – Physical asset transfers
Common asset transfers:
Livestock and poultry
Seeds / seedlings
Tools / machines
Typically requires a holistic look at the sectors related to the assets
Potential Benefits
Can generate income
Potential Concerns
Significant training or prior experience is needed
Ask: Are people who can manage physical assets as vulnerable as cash or food transfer recipients?
Livestock and poultry; require significant investment in housing, feed and healthcare. Need to ensure linkages are in place. But may provide a relatively quick income stream for the beneficiary.
Seeds and seedlings; useful when recovering from poor season; consider the cost of fertilizer, ability and willingness to farm and protect crops, time to maturity and yield. While fruit trees and other commodities may provide a higher income, the time to maturity and yield may be prohibitive.
Tools and machines; consider whether they can afford the maintenance and upkeep; no point providing a tractor or grind mill if they cannot pay for the fuel or repairs.

25. Exercise:
Discuss which provision strategy you would use in each of the following scenarios:
Marginal, remote area is hit poor weather for consecutive years and agricultural households have little to eat. They are selling off agricultural equipment and livestock. There is limited availability of nutritious food in local markets for them to purchase.
Households in urban areas have plenty of food options but no income to purchase it owing to the sickness or death of their primary wage earner.
Encourage participants to point out what information they lack or would need to know.
Ask the group about potential risks of provision strategies:
No incentive to stop receiving them.

26. Protection
Objectives: Build lasting self-insurance methods and protect key assets; Smooth household consumption and manage household cash flow.
Financial safety nets
(savings, microinsurance)
Social safety nets
(social capital, supporting institutions)
Financial literacy
Extending legal services
(protecting assets and inheritances)
Beneficiaries that have access to appropriate protection strategies will be better able to cope with shocks. However, some provision activities may also act as protection activities by helping smooth consumption and protect productive assets.
If there is limited time, have the participants select the interventions that they are most interested in and focus on those.

27. Protection – Financial safety nets
Financial safety nets help households smooth consumption to purchase goods and services, such as food and healthcare.
Examples of financial safety nets include:
Savings
Microinsurance
By accessing savings or insurance households are better able to protect their productive assets following a shock and therefore maintain current and future earning potential.

28. Protection – Savings Groups
Savings enable the poor to self-ensure
Cash based savings provide liquid assets to smooth consumption
Savings groups are informal where small amounts can be saved and lent to members
What ways do they save? Physical assets.
What problems are there with those types of savings? Illiquid, can become a liability rather than an asset, inflation decreases value of investment
What are some of the problems with VSLAs?

29. Protection – Savings Groups
Potential Benefits
Increases capital available for smoothing consumption
Interest paid on savings provides a return on investment
Improves social capital; collective bargaining and marketing
Group managed; they determine savings and lending rates
Potential Concerns
Requires income stream to ensure that households have money to save
Retro-fitting savings and loans to existing groups may be problematic
What ways do they save? Physical assets.
What problems are there with those types of savings? Illiquid, can become a liability rather than an asset, inflation decreases value of investment
What are some of the problems with VSLAs?

30. Protection – Burial Societies & Stokvels
The vulnerable self-insure, which means they assume all the risk of a shock.
Informal ‘insurance’ mechanism spreads the risk of a shock between the vulnerable and less vulnerable.
Lessons learned:
Important aspect is the social network which burial societies and stokvels are built. For example burial societies often assist addressing numerous shocks to the household, not just in time of death.
Provide an excellent structure to disseminate information, products or services.
What other agent models can you use? Cell phones, NGOs, etc
Consider presenting the following case study: Health Care International – a Lagos based health maintenance organization, utilizing an agent model with an MFI.

31. Protection – Burial Societies & Stokvels
Potential Benefits
Provide numerous services to cope with shocks via social networks
Important risk reduction strategy
Potential Concerns
Informal management of funds
Protection – Burial Societies & Stokvels
What other agent models can you use? Cell phones, NGOs, etc
Consider presenting the following case study: Health Care International – a Lagos based health maintenance organization, utilizing an agent model with an MFI.

32. Protection – Strengthening Social Safety Nets
Support increased access to existing social safety net programs that people can fall back on in times of need.
Safety nets can be provided by government agencies, CBOs, and other community groups.
Examples of social safety nets include several previously mentioned provision activities:
Transfers, cash and in-kind transfers such as school supplies and uniforms
Food-based programs such as supplementary feeding programs and food stamps, vouchers, and coupons
Fee waivers and exemptions for health care, schooling
Important to raise the issue of the sustainability of safety nets…they are not all equal!

33. Protection - Extend legal protection
Facilitating access to legal services helps protect control and access to protective assets. Work with legal service providers to:
Help enforce inheritance laws
Protect asset ownership (e.g. land, housing)
Questions to consider:
What protection is there currently for widows and OVCs?
Is there a need for advocacy to help enforce existing laws?
How can social norms support formal legal protections?

34. Protection – Financial literacy
The vulnerable often have inconsistent and variable income streams
Financial literacy can be provided by external parties or directly by the NGO
Potential Benefits
Enables better management of household cash flows, understanding profit and loss, and effective use of financial goods and services.
Potential Concerns
Training must be of adequate quality and duration to be effective

35. Linkages to formal credit and savings
Promotion
Objectives: Smooth household income and promote asset growth; Expand household income and consumption
Linkages to formal credit and savings
Enterprise development / value chain development
Workforce development (vocational and skills training)
Target households:
Have some assets
Able to take on higher risk activities.
If there is limited time, have the participants select the interventions that they are most interested in and focus on those.
With effective protection strategies in place, households are able to consider employing their assets in higher return (but riskier) opportunities to further increase their income. Initially, they may still be quite risk averse and engage in activities that only marginally increase income. One effective way to do this is to diversify income streams so that income is smoothed. Households may then look to continue to increase income through further riskier activities.
Ask: Who would be the most appropriate for being involved in promotion?

36. Promotion – Formal savings and credit
Microfinance is the delivery of appropriate financial products and services for the poor. It includes, savings, insurance and credit.
Potential Benefits
Can support the development of viable livelihoods
Potential Concerns
Risks creating asset loss and indebtedness
Access to financial products and services, like loans, should not be a one off opportunity. The poor use access to savings and credit as working capital to purchase inventory.
If savings and credit are provide once or on an inconsistent basis, then they may be forced to consume their inventory or other assets.

37. Formal savings and credit, continued
Lessons learned:
Ongoing access to finance is critical. Borrowers will generally want rising amounts and easy access.
It is very difficult for NGOs to manage microfinance. Partnering with specialized agencies is advisable.
Borrowers will often assume NGOs are providing loans as grants. Working with a formal credit provider increases the chances that loans will be repaid.
Vulnerable households are often not attractive to lenders.
Borrowers who are late on payments you provide often will not attend your other activities (such as trainings)
Rather than providing finance, consider:
Providing loan fund and operating costs to the MFI
Creating a loan guarantee fund to share the risk
Revenue sharing with MFI and CSO

38. Promotion – Enterprise development
Enterprise development includes linkages of microenterprises to business development services and technical services
Examples:
Identifying products, pricing, mapping
Marketing
Business registration and legal support
Potential Benefits
Can support the growth of new businesses
Potential Concerns
New services are not always economically viable
Extended advisory services are important to ensure that businesses can continue to grow and cope with market changes and shocks.
Often these services are provided by specialized for-profit providers as this ensures that the services are relevant and the training is appropriate quality.

39. Examples of promotion – Value chain development
Value chain development addresses the constraints that prevent pro-poor growth of an industry
Example interventions:
Supporting linkages of firms to markets
Supporting improved technical capacity
Potential Benefits
Can create large-scale and sustainable benefits
Potential Concerns
Can be costly
Requires significant technical expertise
Extended advisory services are important to ensure that businesses can continue to grow and cope with market changes and shocks.
Often these services are provided by specialized for-profit providers as this ensures that the services are relevant and the training is appropriate quality.

40. Examples of promotion – Workforce development
Most prefer employment to entrepreneurship.
Access to employment can offer reliable livelihoods.
Workforce development interventions could include:
Apprenticeships and internships
Vocational skills training
Workforce readiness; preparing resumes, appropriate attire, tools and resources, skills training
Lessons learned:
Ensure there are job opportunities before training
Link trainees to employers from the beginning
Ensure the quality of the training

41. Take-Home Tips for Effective ES Interventions!X Y Z
Optional, if there is time.
First ask the group to contribute their suggestions. Write these up on the board and ask others to agree or disagree with each. Then add others that have not been mentioned.

42. Take-Home Tips for Effective ES Interventions!
Focus on capabilities not income-level
Space for the resourceful and innovative
Group vs. individuals interventions
Training has to be tailored to recipients’ capabilities
Optional, if there is time.
First ask the group to contribute their suggestions. Write these up on the board and ask others to agree or disagree with each. Then add others that have not been mentioned.

43. Take-Home Tips for Effective ES Interventions!
Program design must take into account differing levels of poverty
Subsidies should be ‘SMART’ and have a clear, finite, facilitative application
The way you enter is the way you exit
Continually link activities to further capability building opportunities
Optional, if there is time.
First ask the group to contribute their suggestions. Write these up on the board and ask others to agree or disagree with each. Then add others that have not been mentioned.

44. Quiz!
Select eager participants to engage in a quiz. This can be set up like jeopardy so that they have to buzz in to give their answer. Bring prizes to distribute to the winning individual!
Sample Questions:
Is the following an example of a conditional or unconditional transfer?
Should NGOs directly offer credit? Why or why not?
Name three types of protection interventions.

45. Next Steps and LIFT Support
Continue to be a resource to USAID/Lesotho and PEPFAR implementing partners on ES/L/FS activities and linkages between NACS and ES/L/FS activities.
Continue to work with MSH, ASSIST (URC) FANTA-3 (FHI 360) to tailor potential linkages between Nutrition Assessment, Counseling and Support and ES activities to the Lesotho context.

46. Additional Resources MicroLinks (www.microlinks.org)
CGAP (
CYES Network (
SEEP Network (
Savings Revolution (
Here are links that you can use to follow up on what we’ve discussed today.

47. Thank you! John Fay Consultant john.fay@sharedvalueafrica.com
Jacky Bass Project Director
Additional Information and Resources can be found at: