By Vivian Welch, Editor in Chief
Blog series: Responding to Covid-19: evidence from Campbell reviews, Part 3
With the Covid-19 global pandemic, non-essential businesses have come to a standstill to respect social distancing measures, resulting in job losses, economic uncertainty and risk of global food insecurity. Up to half a billion people could be pushed back into poverty, eradicating the progress made during the Millennium Development Goals period in parts of sub-Saharan Africa and Middle-East and North Africa. These effects will be disproportionately experienced by vulnerable populations globally, including women, informal workers, undocumented migrants and the global poor.
Oxfam has called for a global “Economic Rescue Plan for All” to rebuild the global economy, with a focus on reducing inequalities with six foci: 1) cash grants, 2) supporting small business, 3) suspending and canceling debts for low-income economies, 4) issuing special drawing rights, 5) increasing aid to the lowest-income countries, and 6) adopting emergency solidarity taxes.
In these uncertain times, it is unclear what will work and how best to implement programmes. Evidence from Campbell systematic reviews can be used to inform policy decisions aimed at building a more equal post-Covid-19 economy. Below are some examples relevant to the Covid-19 economic response.
Strategies to support youth employment
With unemployment rates skyrocketing, youth may be at the greatest risk of insecure jobs and labour market prospects. Thus, programmes to support youth employment are needed. A Campbell systematic review of youth employment active labour market programmes found that youth entrepreneurship promotion and skills training lead to small increases in both earnings and employment, whereas subsidised employment and employment services had negligible effects.
In the immediate Covid-19 economy, some entrepreneurs are using technology to develop new businesses or pivot existing businesses to adapt to the Covid-19 environment. In another Campbell systematic review, technical and vocational education and training for youth in low- and middle-income countries was found to have small positive effects on employment and earnings, with great variation in effects. These reviews collectively suggest strategies to increase youth employment may be an important part of the post-Covid-19 economic recovery plans.
Reducing gender inequalities
Two-thirds of the health workforce, with greater risk of exposure to Covid-19, are women. Also, women are more likely to hold jobs with less security than men globally, thus facing low wages, job insecurity and inadequate coverage for medical leave. Women are disproportionately involved in taking care of children, neighbours and family who require care due to Covid-19 closures and isolation measures. Women are also increasingly at risk of domestic violence as highlighted in a prior Campbell blog post on Covid-19.
A Campbell systematic review found that business training for women increased the likelihood of self-employment by over 70%, and cash transfers did not influence this effect. Benefits of vocational training aimed at women in low- and middle-income countries were positive but small. However, programmes with a gender focus and those in Africa and Asia had larger effects. The review also found that gender norms and structural barriers such as transport and care responsibilities decreased participation. In the post-Covid-19 economy, programmes aimed at women need to test design variations to overcome these structural barriers, with rigorous evaluation and monitoring of outcomes.
Cash transfers are an effective way of reaching poor women, according to a Campbell systematic review, and, when combined with conditions around certain behaviours, such as children’s school attendance, help support inter-generational poverty reduction. Tied to conditions around preventive health care, such as vaccination, they may be a very effective method to address poverty and resilience in the recovery from the Covid-19 pandemic.
Any interventions designed to reach women and reduce gender inequalities need to ensure that women have access to, and control over, funds and decisions related to these programmes. A Campbell systematic review on microcredit found that, despite the hype about microcredit, these programmes have no effect on women’s control over household spending. In the economic response to Covid-19, attention needs to be paid to who accesses programmes, to ensure that women are reached.
People with disabilities
People with disabilities account for about 15% of the global population. They are at risk of missing out on government relief due to lack of accessibility, losing supports due to physical distancing measures. They may also be at a lower priority for life-saving treatment, according to current algorithms for treatment triaging. A Campbell evidence and gap map found very little rigorous evidence related to supporting the income and livelihood of people with disabilities. A Campbell systematic review found that individualised funding for people with a disability is preferred by recipients and also has positive effects on health and social outcomes. The review found that barriers to implementation, such as bureaucratic processes that result in delays and hidden costs, need to be considered.
Support for small and medium enterprises
Small and medium enterprises (SMEs) are part of the emergency relief measures for Covid-19 across the world. A Campbell systematic review provides evidence that support to SMEs improves revenue, job creation and investment, with small effects. Implementation costs must be considered when assessing whether these programmes are cost-effective and these costs were not well-reported in studies. In the post-Covid-19 economy, different strategies such as matching grants, technical assistance and tax simplification may be useful in job creation, and ongoing evaluation and monitoring of their effects and implementation costs are needed.
Financing for the poorest
T
he poorest have already been disproportionately affected by Covid-19 measures through loss of income and increased risk of exposure to infection. This is due to the nature of their work in unstable, poorly protected jobs as, for example, personal support workers, garbage removal workers and grocery store employees.
Financial inclusion interventions seek to increase access to credit, savings and insurance for the poorest people and households. A Campbell systematic review found that programmes to increase access to credit and insurance interventions have small positive effects on income, assets or spending, and effects on social and health outcomes are inconsistent.
Access to savings programmes had more positive effects for poor people. In the post-Covid-19 economy, improving access to savings, credit and insurance may be useful to reach the poorest. Given the mixed effects to date, further evaluation of design variations to achieve the greatest reach to the poorest and greatest impact on longer-term health and social outcomes are needed.
Food security
Growing food insecurity around the world requires a coordinated response, according to the World Food Programme. A Campbell systematic review provides evidence that cash-based transfers improve food security in humanitarian circumstances. Unconditional cash transfers led to greater improvements in dietary diversity and quality than food transfers, but food transfers are more successful in increasing per capita caloric intake than unconditional cash transfers and vouchers.
Agriculture is also a major part of rural livelihoods and income generation. A Campbell review shows that agricultural certification schemes can be effective in improving prices and income from agriculture, but certification costs have traditionally prevented poor farmers from joining the schemes.
Another Campbell review found that providing smallholder farmers with new biological or chemical inputs such as orange-fleshed sweet potatoes can improve income and food security. In another review, farmer field schools, a participatory method of supporting farmers, have been shown to be an effective way of improving smallholder yields and farm income, but have so far not been proven effective at scale.
How to contribute
Systematic reviews provide a reliable, comprehensive and rigorous summary of existing evidence that can be used to inform policy. As we move forward with plans for the easing of lockdown measures and rebuilding an equitable economy, more rigorous systematic reviews are needed on the social and economic policy response to Covid-19.
We are pleased to announce that our journal, Campbell Systematic Reviews, will provide fast-track editorial processing for all Covid-19-relevant reviews. Also, we are developing guidance for a rapid review process to urgently meet decisionmakers’ needs for evidence. Please get in touch if you would like to contribute to Campbell’s Covid-19 response: info@campbellcollaboration.org.