Afghan Children Pay the Price of Brutal War

This blog by César Chelala highlights the issues that children are facing in Afghanistan, which heavily impact their health, education and overall well-being. The post is a part of Wikichild's series on under-5 mortality rates, along with it's spotlight on the recent Save the Children report "State of the World's Mothers 2013: Surviving the first day".

Decades of insecurity and war in Afghanistan have provoked a heavy toll on children’s lives and well-being. An under-5 mortality rate of 199 per 1,000 live births as reported by UNICEF is among the highest in the world. That means that more than one out of every five children is dead by the time they are five. In addition, health and education systems suffer from lack of funds and qualified professionals, a situation worsened by the security situation.

The statistics are frightening. More than 60% of all child deaths and disabilities are due to respiratory and intestinal infections, and of vaccine-preventable diseases such as measles. Diarrhea kills tens of thousands of children every year. Many also die from severance of breast-feeding before time. An estimated 7.5 million children and adults are at risk from hunger and malnutrition, the latter affecting children's growth in particular.

According to United Nations statistics, malnutrition among children has increased by 50 percent or more countrywide when compared to 2012. This is happening despite billions of dollars in humanitarian aid by Western governments. One of the most affected places is the malnutrition ward at Bost Hospital, in war-torn Helmand Province, but a similar situation can be found even at Indira Gandhi Children’s Hospital in Kabul.

Although it is difficult to pinpoint the causes for the increase in malnutrition levels, experts indicate several factors that contribute to it such as widespread poverty, difficulties in the implementation of feeding and therapeutic programs, and lack of breastfeeding. Despite low incomes, many mothers are lured by the beautiful pictures on milk cartons, and tend to believe that this milk provides better nutrition for their children.

Children in Afghanistan can also be affected by polio, since Afghanistan is one of only four countries in the world where the disease is still endemic. Despite high vaccination rates, however, there were 47 documented cases of polio in the country.

Some cities, such as Jalalabad, the largest city in eastern Afghanistan, located at the junction of the Kabul and Kunar rivers, are high risk areas for polio due in large part to the massive and continuous population movements from and into polio infected areas. In South Asia in 2000, over 40 percent of the confirmed cases of polio occurred in Pakistan and Afghanistan.

To control the spread of disease, UNICEF and the Department of Public Health in Nangarhar, one of Afghanistan’s 34 provinces, have launched the “Women Courtyard” initiative, aimed at providing local women with information about polio and other vaccine-preventable diseases, as well as such related issues as hygiene and waterborne illnesses.

While this is an important initiative, certain popular traditions still constitute a hindrance to its successful implementation. One such tradition is that babies cannot leave their homes before the 40th day after birth, a tradition which prevents many newborns from being vaccinated at the appropriate time.

To make matters worse, deadly attacks have targeted schools and impeded access to critical health care. According to Daniel Toole, UNICEF Regional Director for East Asia and the Pacific, “We have had attacks on villages and on schools by both anti-government elements as well as by coalition forces and international troops that have hit civilians."

Just in the first four months of 2013 over 400 children were killed and maimed as a result of the protracted conflict. Statistics seem to show that 2013 may well have been the second most deadly year since 2001.

The result of this conflict is that not a single child growing up in Afghanistan today has known peace in his/her lifetime. Deteriorated mental health is one of the consequences of a permanent state of war. A UNICEF study has found that the majority of children under 16 years of age in Kabul suffer from psychological trauma resulting in serious mental health problems including psychiatric disorders and post-traumatic stress syndrome.

Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors, or seeing close relatives being beaten or executed. A study published in the Lancet has pointed out, “In Afghan children’s lives, everyday violence matters just as much as militarized violence in the recollection of traumatic experiences.”

Daniel Toole remarked at a press briefing in Geneva, “Afghanistan today is without doubt the most dangerous place to be born,” a sad commentary on the beleaguered country.

- César Chelala

César Chelala, MD, PhD, is an international public health consultant and the foreign correspondent for the Middle East Times International (Australia). He also is a co-winner of an Overseas Press Club of America award for an article on human rights.

This blog first appeared 11 January, 2014 on The WIP blog site. 

See related articles:

Levels and Trends in Child Mortality 
Childhood Under Fire: The impact of two years of conflict in Syria

UNICEF Child Well-being measure

UNICEF - Towards a Post-2015 World Fit for Children

UNICEF Report Card 10: Measuring child poverty

Children and Malnutrition

Sanitation in schools

This blog, written by Wikichild co-ordinator Melinda Deleuze, is a part of the Wikiprogress September spotlight on "Education and skills". Also, in conjunction with the OECD's 2013 World Water Week, the post discusses the need for improved water and sanitation in schools and various organizations' efforts.

It is important to focus on improving school’s sanitation standards, because children are often the most vulnerable to diseases, according to wateraid.org. Children also take new ideas and habits back to their homes and families, increasing programs’ impact. 

Only 49% of schools around the world provide drinking water to its pupils and 11% of schools provide water for handwashing. In Kenya, although 63% of schools provided drinking water, only 27% had treated water. Also, while 63% of schools in Kenya have handwashing water available to its students, only 8% of schools have soap. Studies show that handwashing with soap can reduce the risk of diarrheal disease by more than 42% (Curtis and Caincross, 2003). 

Over the past few years, multiple organizations have been working hard to increase the number of schools with drinking water, sanitation facilities and handwashing stations. According to the Sanitation and Water for All project update (April 2013), in the past year, Nigeria mobilized private sector resources for provision of WASH facilities in over 700 schools.

Sustaining and Scaling School Water, Sanitation and Hygiene Plus Community Impact (SWASH+), also known as "WASH in schools", is a project established to identify, develop, and test innovative approaches to school-based water, sanitation and hygiene in Kenya. Funded by the Bill and Melinda Gates Foundation and the Global Water Challenge, the project has been running since 2006 with the help of CARE, Emory University’s Center for Global Safe Water, the Government of Kenya, Kenya Water for Health Organisation, Water.org, and SANA. SWASH+ has worked in 185 primary schools in four districts in Nyanza Province, gathering data, learning about challenges and testing solutions for school water, sanitation and hygiene (WASH). SWASH+ provides a base package, which includes:

1. Provision of water for drinking in safe storage containers
2. Daily treatment of drinking water with an appropriate technology
3. Provision of water for handwashing
4. Daily provision of soap

After the 5-year project, SWASH+ found that:

• Absenteeism is significantly reduced among girls, with an average of 6 days fewer absences per year.
• There was a 45% overall reduction of ascaris, and an even greater decrease among girls. Also, the intensity of hookworm infection significantly declined among boys.
• Unfortunately, there were higher quantities of E. coli bacteria on pupils’ hands who received hygiene, water treatment and sanitation facilities. A study by the European Journal of Tropical Medicine and International Health (2009) found that only 32% of Kenyans wash their hands after fecal contact.

Sapling handwashing, Malawi. Photo: Plan Malawi

Another program working towards increasing drinking water, sanitation facilities and handwashing stations in schools is the Pan African School Led Total Sanitation (SLTS) program. This program is targeting 742 schools in 6 sub-Saharan countries (i.e. Sierra Leone; Ethiopia; Uganda; Kenya; Zambia; Ghana; Niger; Malawi). In each country, the SLTS program follows the same process to facilitate the necessary activities to trigger the schools’ and communities’ progress:

1. Discuss with the government’s Health and Education sectors, plan at different levels and reach an agreement;
2. Train teachers who then train students how to use the school latrine and surrounding water and sanitation areas, as well as playing games which help internalize sanitation and hygiene concerns;
3. Register households for monitoring;
4. Conduct a school sanitation campaign, cleaning the whole school compound;
5. Group community into Development Units and establish these groups’ meeting places and times (meetings take place at schools);
6. Establish a committee of six for each Development Unit who facilitate discussion and prepare a report;
7. Monitor progress with these reports.

The SLTS program’s 5-year period runs through next year (2014), and this process can be reviewed and changed before the next Pan Africa program begins.

Water and sanitation needs to improve in schools in order to increase school attendance among girls and decrease sickness among all children. Top-down and bottom-up forces are needed to help children become more educated and safer around the world. 

  

 Melinda Deleuze

Schools tackling obesity and malnutrition

This blog, written by Wikichild co-ordinator Melinda Deleuze, is part of the Wikiprogress Series on Health and Child Well-being. Discussing what schools can do to tackle childhood obesity, the post also leads up to the Wikiprogress September spotlight on Education and skills.

Every time I return to the United States, one of the first things that strikes me is the number of overweight children I see in the airport. During the summer months, the focus has been on feeding hungry American children nutritious food. There are hundreds of programs run by churches, nonprofits and civic groups which receive USDA reimbursements for that purpose. In Arkansas alone, more than $97,000 in grant money was distributed. Now that school is back in session, the aim is not only to give children the nutrition they need, but also to tackle the widespread issue of childhood obesity. 

Child and adolescent obesity is exceedingly prevalent in the US, Canada and Greece. It is also on the rise in most developed countries and in Asia. Over the past 3 decades, childhood obesity rates in America have tripled. Today, nearly one in three children in America are overweight or obese. Approximately 12% of children ages 2 to 5 are obese and 18% of those ages 6 to 19 are considered obese. The figures are higher among African American and Hispanic populations, where nearly 40% of the children are overweight or obese. 

          Percent of overweight children*                            Percent of children who eat breakfast every day*

                11, 13 and 15 years old                                                        11, 13 and 15 years old

Obesity has many negative consequences, and last week the American Medical Association pronounced childhood obesity a disease. Obese children and adolescents are at greater risk for bone and joint problems, sleep apnoea, and social problems. Also, school children suffering from obesity are at higher risk of developing psychological problems. An obese child is at a higher risk of becoming an obese adult. Therefore, iIt is important to intervene earlier in life in order to combat and reverse adult weight issues that could cause severe health complications.

Schools play an essential role in tackling obesity among children and adolescents by establishing a healthier diet, increasing activity and educating about food and nutrition. In America, there are 32 million students who eat school lunches and 12 million who eat a school breakfast every school day. Ensuring that these meals are healthy and nutritious is part of the solution to childhood obesity, as well as improving children’s overall health and wellness. In January 2012, standards for school meals in US public schools were updated to the following criteria:  

• Ensure students are offered both fruits and vegetables every day of the week;

• Increase offerings of whole grain-rich foods;

• Offer only fat-free or low-fat milk;

• Limit calories based on the age of children being served to ensure proper portion size;

• Increase the focus on reducing the amounts of saturated fat, trans fats, added sugars, and sodium.

Schools are required to meet these standards in order to receive federal meal reimbursements. Fewer children ate school lunches after the standards began to take effect, especially those who paid full-price for their lunches; however, breakfast consumption at school increased. More schools provided grab-and-go breakfasts, breakfast in the classroom and second-chance breakfasts, as well as traditional breakfasts served in the cafeteria at no charge. Additionally, in July 2014, schools nationwide will be forced to remove junk food, soda and sugary snacks from their vending machines and menus. Some other recommendations in order to improve diets are encouraging parents to bring non-food treats for birthday celebrations and selling non-food options for fundraisers. 

     Percent of children who eat fruit daily*       Percent of children who exercise at least one hour daily*

                   11, 13 and 15 years old                                                        11, 13 and 15 years old

A school’s curriculum and efforts to increase physical activity can have a major impact on reducing obesity. What children eat at school is only part of the problem, because their amount of physical activity has a serious impact on their weight. Quality exercise can burn up just about anything a child ingests. Unfortunately, only 9 states require recess at the elementary level, while 41 states do not. Physical activity could be added to the classroom, for example by having students act out words, instead of sitting in chairs the entire lesson. Also, schools should not allow physical activity to be withheld (e.g. withholding recess) or used as punishment (e.g. making a student run laps). Another idea is to perform a “walkability assessment” to determine the environmental factors which deter students from walking to school, such as unsafe crossings and broken sidewalks. 

 

Schools can also use the classroom to teach children of all ages about eating nutritious, well-balanced meals. Gardens offer great opportunities to educate younger children about how healthy food is produced, while providing a fun and physical activity. Fruits and vegetables could also be used to teach shapes and colors. Teachers of older students could use fruits and vegetables from the garden when learning about weights and measurements. Also, adolescents should learn about counting calories, burning calories and daily nutritional value charts. Children who have a healthy association with food and who understand the benefits of a balanced diet will be at a lower risk for obesity.

Finally, if schools notified parents about their children’s state of health and informed them of ways they could help, then parents could reinforce good eating habits and encourage activity. Several programs have begun sharing students’ body mass index (BMI) scores, along with fitness test results, with parents. This height-to-weight information allows parents to continue conversations with their children and bring in a pediatrician if necessary. This program was piloted in Cambridge, Massachusetts, and obesity among 5 to 13 year old students decreased 6% in less than a decade. If schools decide to notify parents about their child’s BMI, they should respect the sensitivity and confidentiality of the information in order to avoid bullying and eating disorders.

Changes need to be made, in both the school and home settings, in order to improve the health of children. Early interventions are the best way to tackle obesity issues. There are several resources available to schools and parents to facilitate change and increase healthy habits:

 The Let’s Move! campaign

National Institute of Health’s suggestions

Key strategies for schools to prevent obesity

The school "walkability" checklist

Healthy eating tips for preschoolers

Nutrition and wellness tips for younger children

Garden-oriented curriculum

My Plate Pledge for kids

Melinda Deleuze

Wikichild co-ordinator  

*These charts and data are from the UNICEF Report Card 11: Child well-being in rich countries

Free and Appropriate Public Education

Four years ago on the inauguration of the first African American president of the United States, we titled our Whole Child Newsletter "Someday Happens," reflecting a T-shirt I saw at the ceremonies that day. Today, independent of political views, I'm wondering when someday will happen for the millions of kids promised a "free and appropriate public education." Although that phrase was first introduced in reference to children with disabilities, it applies too often to kids from all walks of life in all parts of the United States.

An education based solely on mastery (however that is defined) of English language arts and mathematics is not appropriate.

An education filled with support and care and mastery of nothing is not appropriate.

An education that must be purchased in lieu of free opportunities nearby fails to serve the common good and fulfill the social compact promised by the American Dream.

When will someday happen for each child, in each school, and in each community? It will happen the day we as a society, the grown-ups, decide to make it so.

We know what it takes. Over the nearly six years of the ASCD Whole Child Initiative, we've defined excellence for each child in increasingly descriptive terms. 

• We started with the five tenets of a whole child education, then described each of those tenets with 10 school-level actions that indicate those tenets are being met. 

• We introduced a sixth set of indicators to ensure that such an education, one that meets the requirements of our tenets to ensure that each child is healthy, safe, engaged, supported, and challenged, is sustainable and not dependent on a single leader, program, funding stream, or flavor-of-the-month goal. 

• And just this summer, we launched the ASCD School Improvement Tool, which cross references those same tenets and indicators to the typical school improvement components of school climate and culture, curriculum and instruction, leadership, assessment, family and community engagement, and staff capacity and professional development to provide both the most thorough definition of a whole child approach to education and an assessment tool that measures progress against such a standard.

In that same time span, 45 states and the District of Columbia adopted a new definition of what the challenged tenet looks like in student learning: the Common Core State Standards. Let us be clear that that'sone tenet out of five, not the whole; not the answer in and of itself. But let us also be clear that the Common Core State Standards do set a new path of excellence in two traditional subject areas. Full, faithful implementation of these standards within a whole child approach has the potential to eliminate birthplace as the most accurate predictor of success.

Full, faithful implementation of the Common Core State Standards within a comprehensive, sustainable whole child approach to education—this is what "someday" looks like. This is what "free and appropriate" looks like. This is what it takes at the school level to prepare each of our young people for postsecondary education, meaningful careers, and active participation in a global society.

By Molly McCloskey

ASCD - The Whole Child is a membership organisation that produces programs products, and services that are essential to the progress of education globally. Education is essential to child development and we at Wikichild work closely with ASCD to enrich our education content, accessible in the Child Articles section on our platform.  

This articles first appeared on the The Whole Child Blog. 

For up to date information on child well-being visit the Wikichild homepage

Visit Wikichild's Twitter for regular updates on Child well-being @Wiki_child

In Support of the Whole Child

This is a joint posting by 13 Huffington Post Education, Parenting and Health bloggers: Martin J. Blank, Sam Chaltain, Peter DeWitt, John M. Eger, Larry Ferlazzo, Jenifer Fox, Shaun Johnson, Natalia Mehlman Petrzela, Jennifer Peck, Kate Quarfordt, Sean Slade, Dr. Jim Taylor, & Jill Vialet.

In Support of the Whole Child

We are at a crossroads in this nation regarding the direction that public education will take in the coming decades. Do we focus on a curriculum that concentrates on a few core subjects or do we gain an appreciation for how public education can develop all aspects of the child to the benefit of each of them as well as society in general? Do we place test preparation ahead of actually educating our children and test scores ahead of broader and more holistic approaches to evaluating students' competencies? These questions lay at the heart of the current debate about the future of public education in America.

The recent Programme for International Student Assessment (PISA) results, which placed American children far down the rankings compared to students from other developed nations, sparked a firestorm of debate over what we must do to our public education system. Some commentators declared the results to be our Sputnik moment, prompting others to demand that we double down on the testing philosophy and regimen that emerged out of the No Child Left Behind legislation. At the same time, the results of the PISA research have provoked in many commentators more innovative thinking about what a public education system in America that is designed for the 21st century should look like.

What was pervasive throughout this debate has been a faulty assumption that our current education crisis boils down to a black-and-white choice between academic achievement or a holistic approach to teaching and learning. However, the very meaning of the word 'holistic' defies this presumption by encompassing the whole child including the intellectual, artistic, physical, social, emotional, spiritual, and civic development of students. A holistic approach brings together elements that support the development of a child who is healthy, knowledgeable, motivated, and engaged, seeking to ensure all that is required for successful life and preparation for society.

Equally pervasive following the most recent PISA results were the questions around the mechanics of education, the length of the school day, the correct amount of seat time minutes, which curricula to adopt and which to discard, and the ideal education and qualifications for successful teachers. Though all these concerns may play a role in improving the quality of our public education system, they are all just parts of a larger enterprise -- they are all the process, the steps, to achieve the goal but can only have relevance and meaning once the goal has been decided.

And so the real debate should be: what do we want to achieve out of our public education system? Before we work out the how of public education reform, we must first figure out the what and why: what is our goal and why is that our goal? Ironically, the starting point for determining this goal -- whichever path we choose to follow -- should be the same question:

What do we want our children to be like when they are 25?

Think of that child, that teenager, that young adult and describe them. What words do we use?

Prepared, proficient, adequate, struggling or resilient?

Critical thinker, problem solver, collaborator or rote-learner?

Do we just cite their grade or do we describe them?

At the core of the question is what are they like? Happy, healthy, engaged, enthusiastic, passionate? An active citizen or a bystander? Are they an adult ready for the world or one who has been tracked out of a future? These words should inspire us to map backwards and create a design for our students and we need to work together to get there.

And as -- if not more -- important is the question: what do our children want to be like when they are 25? How would they describe themselves? Are they content with an education system which at times seems more designed to sort, test and label students than develop, educate or prepare them?

The authors of this article believe that answering this question results in one response -- someone who is knowledgeable, emotionally and physically healthy, civically active, artistically engaged, prepared for economic self-sufficiency, and ready for the world beyond formal schooling.

In short, a focus on the whole child -- not as proponents of one side of a polarized debate, but as champions of dissolving the false dichotomy on which the debate rests and ensuring our students get the future they deserve.

We believe that a whole child approach to education -- one that develops the child not just cognitively, but socially, emotionally, mentally, physically and civically -- is fundamental and essential to our nation and our future. It is an approach which cares as much about the health, safety, engagement and support of our students as the challenges we present to them. It is everything we need to prepare that individual of 25 and to expect, request or do anything less is a disservice to both them and our society at large.

And we are not alone in this goal:

Give the pupils something to do, not something to learn; and the doing is of such a nature as to demand thinking; learning naturally results. - John Dewey

I am entirely certain that twenty years from now we will look back at education as it is practiced in most schools today and wonder that we could have tolerated anything so primitive. - John W. Gardner

To be successful, one needs a threshold level of cognitive ability. But many other things are
just as important: creativity, personal discipline, the ability to relate to other people - James Comer

Surely, we should demand more from our schools than to educate people to be proficient in reading and mathematics. Too many highly proficient people commit fraud, pursue paths to success marked by greed, and care little about how their actions affect the lives of others. - Nel Noddings

Excellence in education is when we do everything that we can to make sure they become everything that they can. - Carol Tomlinson

To the doctor, the child is a typhoid patient; to the playground supervisor, a first baseman; to the teacher, a learner of arithmetic. At times, he may be different things to each of these specialists, but too rarely is he a whole child to any of them. --From the 1930 report of the White House Conference on Children and Youth

This isn't rocket science, it's just common sense.

Join us as we explore these issues of importance to public education reform. Join us in demanding real change to our public education system to ensure each child, in each school, in each community, is healthy, safe, engaged, supported and challenged.

Sean Slade, MEd., serves as the Director of Whole Child Programs at ASCD a global educational leadership organization. He has over 20 years of experience in education in a career that has encompassed 4 continents and 5 countries.

He writes regular blogs for Washington Post’s The Answer Sheet, as well as ASCD'sInservice and Whole Child blogs.

This blog first appeared on the Huffington Post Education Blog

Impact of daycare interventions in Latin America

Urbanisation and increased female labour market participation have led to increased demand for daycare services, which in developing countries is partly met by government daycare programmes. Some of these programmes offer subsidised community daycare services, in which women from the community provide full time childcare in their home, food and some recreational or educational activities for the children. Other programmes offer public preschool education to children between 3 and 5 years of age. But do these daycare interventions benefit the child’s development?

Impact evaluations of these programmes were undertaken to assess their effectiveness by comparing the wellbeing of children cared for at daycare (or preschool) to those cared for at home. To synthesise the evidence, researchers of the National Institute of Public Health in Mexico (myself and Jef Leroy, currently at the International Food Policy Research Institute) and the Center for Research and Teaching in Economics (Maite Guijaro), undertook a systematic review. The study, The impact of daycare programmes on child health, nutrition and development in developing countries: a systematic review examined the effects of daycare interventions (formal out-of-home care) on the health, nutrition and development of children under five years of age, in low- and middle-income countries.

Photo sourced by 3ie

The systematic review identified 13,190 studies, but only six, based in Latin America, met the inclusion criteria in terms of scope, type and quality. Four studies evaluated community-based interventions and two looked at preschool interventions.

The findings showed that attending daycare had positive effects on language skills, social and emotional development of children in the short run. In the medium term, school attendance, student behaviour and test scores witnessed a positive trend. In fact, the effects on the children were more pronounced depending on the exposure to the programme. For example, the Bolivia daycare programme had a positive effect (2-11% increase) on bulk (gross) and fine motor, language and psycho-social skills for children with more than seven months of exposure to the programme. On medium-term outcomes, the Argentina study found that one year of preschool increased mathematics and Spanish test scores at third grade of primary education by eight percent. In Uruguay, it was found that children who attended at least one year of preschool, increased their schooling by nearly one additional year by the age of 15.

On child health outcomes, only one study from Colombia evaluated the impact on prevalence of diarrhoea and acute respiratory infections. Although this study found reductions in the prevalence of both diseases with longer exposure to the programme, it is not clear if the results are a true health effect of the programme or if the comparison group of children with less than one month of exposure to the programme, might have suffered from a steep increase in infections right after joining a daycare centre.

However, no conclusions could be drawn with respect to the nutrition outcomes. One study from Guatemala analysed child dietary intake and found positive impacts, a study from Bolivia found no impact on child growth, and two additional studies from Colombia found inconsistent results on child anthropometrics, such as height and weight.

Finally, the reviewed studies did not provide a good description of the type and quality of care children receive in the absence of the programme. This represents an important limitation of the reviewed studies since the potential impact a daycare programme might have is determined by the “net” treatment, which is the difference in the type and quality of care between daycare interventions and the alternative forms of child care in the absence of the programme. For instance, a positive “net” treatment effect can be expected if daycare interventions provide a high quality childcare alternative to mothers who take care of their children while working. However, a negative “net” treatment effect could be anticipated if children who receive adequate family care are enrolled into a low-quality daycare programme.

Policy implications

The evidence shows that daycare interventions in Latin America, community-based or school-based, have had a positive impact on child development. However, there is not enough evidence to conclude that these programmes have improved child health and nutrition. Based on this information, should policymakers decide not to implement daycare interventions until there is conclusive evidence about its impacts?

Considering the proven impact daycare interventions can have on improving child development in the short and medium term and the increasing demand for out-of-home care, these programmes should be implemented if they provide a high quality alternative to the care children normally receive.

However, it is crucial that new programmes are evaluated and closely monitored, not only to add to the very limited knowledge base of programme effectiveness and pathways of impact, but also to guarantee that unintended negative effects are identified and corrected.

(Paola Gadsden is the Coordinator of Analysis and Evaluation of Public Policies for the State of Morelos, Mexico)

3ie funds impact evaluations and systematic reviews that generate high quality evience on what works in development and why. Evidence on development effectiveness can inform policy and improve the lives of poor people.