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MAIN TAKEAWAYS

• All combinations of resilience interventions led to households with a greater reliance on positive coping mechanisms after they experienced a shock
  ◦ Additionally, the households that received the whole PAHAL combination of interventions (or the “full integration” combination) reported feeling less vulnerable to future shocks than comparison households
  ◦ The “full integration” approach might not be working for the most vulnerable households who suffer from extreme losses following a shock
  ◦ It is unclear what capacities lead to these improved resilience outcomes

• The combination of interventions that emphasized water activities led to the greatest resilience outcomes and proved to be the most cost-effective of all combinations of interventions
  ◦ Participation in the Water group led to the greatest number of positive resilience outcomes, was the most cost-effective per dollar spent on the PAHAL project, and the second most cost-effective combination from the perspective of the households, per dollar spent on their own preparation
  ◦ The Water group has a high rate of return because incomes for this group are much higher than households that did not receive this combination of interventions

• The combination of interventions that emphasized financial services activities has the greatest value for households, per dollar they spend on their own preparation
  ◦ This result is primarily due to households having significantly lower debt, and lower interest rates on that debt, than households that did not receive this combination

• No combination had an impact on preventing or mitigating actual exposure to shocks and stresses

Introduction

Many people in Nepal, especially those living in the Middle Hill and Mountain regions, continue to struggle with food insecurity and poor nutrition despite progress Nepal has achieved in lowering its overall poverty rate. In the remote and rugged terrains of Nepal, persistent food insecurity is a result of complex, interlinked risks and vulnerabilities. The Promoting Agriculture, Health, and Alternative Livelihood (PAHAL) project worked in these areas to improve food security by strengthening livelihoods and increasing the capacity of vulnerable households to prevent, mitigate, adapt to, and recover from shocks and stresses in communities with deep poverty and high rates of malnutrition.

The PAHAL Theory of Change (TOC) stated that food security outcomes can only be achieved if individuals, households, and communities can effectively cope with and adapt to shocks and stresses that impede food security. PAHAL aimed to facilitate access to and control of a target set of resources (i.e., resilience capacities) to prepare for, cope with, and mitigate shocks and stresses over time. The TOC hypothesizes that if people and communities have improved access and control of resilience capacities and the ability to use them to more effectively manage risk, then they will employ a greater set of strategies to recover from existing shocks and stresses (absorptive resilience), mitigate the very presence or nature of shocks and stresses over time (adaptive resilience), and participate and receive support from an enabling environment to maximize access to and use of absorptive or adaptive capacities (transformative resilience). If men, women, boys, and girls absorb, adapt, and transform in the face of shocks and stresses, the TOC predicted they will be more food secure.

PAHAL began in 2014 and was completed early in 2020. At the time of data collection in 2018 and 2019, PAHAL was moving towards “full integration” of a multi-sectoral approach that weaves all activity components together to reinforce and increase their combined impacts. This approach purposefully layers and integrates program interventions to build resilience capacities. For example, ecological system interventions improve access to water, which are then layered with economic system interventions that increase access to productive loans and a robust agricultural input system, allowing individuals to apply their increased capacity on climate-sensitive techniques for effective agriculture production leading to improved food access and availability. This “full integration” approach attempts to tackle the ecosystem and institutional levels of resilience in addition to more singular food security approaches at the household level.

Causal Design partnered with Mercy Corps to evaluate the impact of the PAHAL’s program approach, as well as examine if their “full integration” intervention approach leads to greater food security outcomes than a traditional food security approach that relies on promoting only agricultural productivity, Water, Sanitation, and Hygiene (WASH), and nutrition. Additionally, this evaluation also examined if some sub-set of interventions are also effective, perhaps to consider as a cost-effective alternative to PAHAL’s “full integration” approach that relies on layering many sectoral interventions. The key outcomes of interest were resilience outcomes such as improved use of positive coping strategies in response to a shock, reduced severity and frequency of shocks, reduced feelings of vulnerability to future shocks, as well as improved short-term food security measures.