2024 Dignity Report

How can we ensure development programs truly improve and uphold people’s dignity? What actually works? Once we decided to start building evidence to answer these questions the next step was figuring out what are the best possible options to test in an RCT. We consulted the literature, built a list of ideas, ran a prioritization study, and began to test out some ideas in a collaboration with the Care2Play consortium. Now we are preparing to pilot a package of the most promising ideas for affirming dignity.

Prioritization Study on Dignity Interventions

We started with a study alongside the University of Notre Dame’s Pulte Institute in identifying and prioritizing interventions likely to increase people’s felt respect for dignity. This was done in two stages. First we consulted with 70 academics and development practitioners interested in dignity. They were asked to prioritize the ten most promising interventions from a list of 64 practices identified in the literature. The top ten interventions identified in the first stage were then presented to a sample of 251 Kenyan citizens for feedback and ranking.

Three interventions emerged as particularly promising:

1. Providing in-person meetings with recipients to explain the progress of the program and provide updates
2. Supporting community-based organizations to organize the community to speak up or protest in challenging aspects of the program 
3. Participatory co-design workshops with potential recipients to discuss and provide feedback on the design of the program before it is implemented

Proposing interventions for the RCT

As we moved forward with our research, we decided to articulate an interim list of promising ideas, in part to explain our plans to possible partners for the potential RCT. The three interventions identified above were given priority for testing, but we thought there were more that were worth considering.

One other element we have included, since it seems relevant to all possible interventions, is training for staff. We have developed and piloted a version of this training in concert with the Care2Play consortium – Rocket Learning, Saajha, Trickle Up, Indus Action, and IDinsight. This group works to provide socially and economically disadvantaged children with stimulating environments in their early years, starting in Delhi capital territory. Dignity was identified as a central component of the C2P intervention. During the sessions, we discussed informative content on dignity (articles, videos, scenarios), engaged in role-play activities, shared personal stories, and reflected on experiences from the field. One parent served by these staff members shared how important it is to them that we get dignity right:

“If you don’t talk respectfully, I won’t want to meet you again. If I don’t feel good talking to you once, I will refuse to meet you again.”

Learning more

We know though that we still have a lot to learn. We should be cautious with these interventions. They are not yet tested. Interventions that appear impactful in theory may not be feasible or convincing to our implementing partners in practice. The RCT group may differ significantly from the initial study group, and dignity is understood differently across various social and cultural contexts. Many dignity recommendations focus on changes to power structures and social relations, which may be beyond our current capacity to deliver or test in the RCT. Overly standardized interventions could lead to depersonalization and mechanically implemented ‘best practices’ without upholding the spirit of dignity work. Finally, the language and visual presentation used in interventions can significantly influence their perceived respectfulness and thus require careful consideration.

Therefore we have begun conducting informal observations of organizations with admirable dignity practices. We plan to conduct participatory piloting and human-centered design workshops with our implementing partners and the populations they serve, use Elicitation Workshops to forecast the potential impact of our interventions, and include in our RCT careful monitoring of implementation and collecting regular qualitative feedback to generate insights on which parts of the package make the most difference in these contexts. As part of this effort, we will check whether our ideas align with the definition of dignity used by the communities we are serving and whether our primary metrics match those definitions and baseline levels of experiences of respect. We will gather qualitative feedback on both the shortlist of interventions and how they might be implemented. 

Our aim with these pilot studies is to explore these initial ideas and evaluate their feasibility and effectiveness in practice. This is just the starting point, and we will further refine our approach after engaging in detailed discussions with the implementation team. Doing research in a way that respects dignity means being able to learn from the people we are studying. We intend to document this entire process, enabling us to reflect on our research decisions later and to provide a foundation for future research to learn and build on.

We consider this RCT a pioneering attempt in the field of dignity research. While we are focused on our goal of making a significant leap in our understanding of dignity interventions, we also recognize our commitment to make the research process itself respectful. One way we aim to do so is by keeping us accountable to all the people involved and even the wider community. We welcome feedback from everywhere on ways to strengthen this study. Your insights and suggestions are invaluable as we strive to enhance our research approach and make sure this opportunity is used with utmost respect and humility. 

Piloting these interventions is only part of the solution. To truly understand what works, we must also ensure we have rigorous tools to measure the impacts of our interventions. Measuring respect for dignity is not just about accountability—it is about learning how these practices resonate with participants and how they can be improved to uphold dignity across diverse contexts better. This critical step is explored in Chapter 2, where we discuss the methods and tools developed to capture the essence of dignity in measurable ways.