Evaluation of a disability-inclusive ultra-poor graduation programme in Bangladesh: study protocol for a cluster-randomised controlled trial

BACKGROUND: There remains a lack of evidence on which livelihoods interventions are effective for persons with disabilities, particularly given the fact that the impact of interventions varies according to contextual factors. The disability-inclusive ultra-poor graduation (DIUPG) programme is an adaptation of the ultra-poor graduation programme (UPG), designed to tackle extreme poverty among persons with disabilities. The DIUPG programme has been previously evaluated in Uganda and found to have successfully improved household consumption, amidst the challenges of COVID-19 and funding cuts. The current evaluation of DIUPG programme therefore creates the opportunity to generate comparative data on the programme in a different context (Bangladesh), which will aid understanding of the transferability and robustness of the intervention. METHODS: The DIUPG provides standard UPG support such as asset transfers, combined with disability-specific elements such as rehabilitation and psychosocial therapy. The evaluation will adopt a cluster-randomised superiority trial design with two parallel groups, with clusters comprising branch office catchment areas of the intervention implementer. The units of participation in DIUPG are households living in these geographical areas. Household eligibility is determined through household screening utilising standardised measures to identify ultra-poor households that have members with disabilities. Clusters are randomly selected prior to DIUPG implementation, resulting in 48 intervention and 24 control clusters. The primary outcomes of the evaluation are per capita household income, income and employment of persons with disabilities, per capita food consumption and expenditures, and per capita non-food expenditures. Prior to intervention implementation, baseline data is collected in the treatment and control arms (May-June 2023). After DIUPG conclusion (20 months), endline data are collected (October-November 2025) in both arms. DISCUSSION: There is a general paucity of evidence regarding what interventions work to create better livelihoods for persons with disabilities and their families. Evaluating the DIUPG programme in Bangladesh will generate crucial evidence demonstrating whether similar benefits of the programme as observed in Uganda accrue in a distinct context. TRIAL REGISTRATION: ISRCTN registry ISRCTN10602983. Retrospectively registered on 05/05/2025.