ABOUT THE TALKChild stunting affected an estimated 36 percent of children under age 5 in Indonesia in 2013. To address this problem, the Millennium Challenge Corporation and the Government of Indonesia implemented a $120 million project that combined 1) a health and education-focused community-driven development program, 2) intensive training for health providers on infant and young child feeding, 3) training for sanitarians on a local variation of community-led total sanitation, and 4) a national communications campaign related to stunting, breastfeeding, healthy eating, and hygiene. We present the results of an RCT conducted from 2014 to 2019 in three provinces in which the project was implemented. The project had a modest impact on some short- and medium-term outcomes related to maternal and child health, including iron-folic acid receipt and consumption, children receiving the number of recommended meals per day, and exclusive breastfeeding; but no effect on the number of prenatal or postnatal checkups women received, on the share of women delivering babies with a skilled provider, the share of children immunized, on children being appropriately diagnosed for stunting, the incidence of diarrhea, or villages becoming open-defecation free. Most importantly, we find no impacts on most longer-term health outcomes, especially undernutrition outcomes like stunting. We hypothesize that we fail to see impacts on many expected outcomes due to implementation delays and quality challenges and nationwide improvements that also caused positive changes in the control group. This evaluation also demonstrates the challenges in developing a realistic and evidence-based theory of change, as many expected outcomes may have been overambitious given the context and implementation conditions. ABOUT THE SPEAKERAmanda Beatty is an MPA/ID 2001 and a senior researcher at Mathematica, based in Cambridge, MA. Most of her research is related to education and community-driven development, mainly in Indonesia. Before joining Mathematica, she worked at the World Bank, Millennium Challenge Corporation, and RAND.
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