Cash transfers are great – lots of people are telling you that on a continuous basis. However, it is an open question as to whether such programs can improve the wellbeing of their beneficiaries well after the cessation of support. As cash transfer programs continue to grow as major vehicles for social protection, it is increasingly important to understand if these programs break the cycle of intergenerational poverty, or whether the benefits simply evaporate when the money runs out…
conditional cash transfers
This post was co-authored with Katrina Kosec of IFPRI.
A whirlwind, surely incomplete tour of cash transfer impacts on health
Your run-of-the-mill conditional cash transfer (CCT) program has significant impacts on health-seeking behavior. Specifically, there are conditions (or co-responsibilities, if you prefer) that children get to school and/or that they get vaccinated or have some wellness visits. While the school enrollment effects are well established, the effects on both health seeking behavior and on health outcomes have been much more mixed. CCTs have led to better child nutritional status and improved child cognitive development in Nicaragua, better nutritional outcomes for a subset of children in Colombia, and had no impacts for child health in studies on Brazil and Honduras. CCTs conditioned only on school enrollment did not lower HIV infections among adolescent girls in South Africa; and in Indonesia CCTs increased health visits but did not translate into measurably improved health. Unconditional cash transfer programs have also had mixed results on health, with better mental health and food consumption in Kenya, better anthropometric outcomes for girls (not boys) in South Africa, no average impacts (although some for the poorest quarter) on child outcomes in Ecuador, and no average impacts on maternal health care utilization in Zambia (albeit yes effects for women with better access to such services).
On September 30, the Guardian ran several articles (see here, here, and an editorial here) linking the halving of Peru’s stunting rate (from 28 to 14% between mid-2000s and 2015) to its CCT program Juntos. Of course, it is great to hear that the share of stunted children in Peru declined dramatically over a short period. However, as I know that while CCT programs (conditional or not) have been successful in improving various outcomes including child health, the effect sizes are never this dramatic, I was curious to see whether the decline was part of a secular trend in Peru or actually could be attributed primarily to Juntos…
This post is jountly authored by Martina Björkman Nyqvist, Lucia Corno, Damien de Walque and Jakob Svensson.
Conditional cash transfers (CCTs) and other types of financial incentives have been used successfully to promote activities that are beneficial to the participants such as school attendance and health check-ups for children. CCTs pay a certain amount if the condition is verified.
Lotteries can also be used as an incentive. Instead of being paid a certain amount, the participants who satisfy the condition receive a lottery ticket, a random draw is performed among the tickets, and a predetermined number of winners earn a lottery prize. The value of the lottery prizes would be higher than the typical CCT amount, but the number of recipients of the prizes would be lower.
Co-authored with Richard Akresh and Harounan Kazianga
Yesterday, in Part I of this post, we argued the extant empirical evidence suggests that the conditions cause a substantial amount of the desired behavior change intended by CCT programs. In other words: the “substitution effect” due to the condition may well be larger than the “income effect” of the transfers. For example, in the case of the Malawi experiment, the income effect was responsible for less than half of the total impact on school enrollment.
One of the questions discussed at the recent World Bank workshop on the "Second Generation of CCT Evaluations" (website, complete with at least some of the presentations, here) was the role of the first C in the performance of the CCT: how important is the condition in accounting for the outcomes of conditional cash transfer programs?
I am writing to follow up on Berk’s post about using regression discontinuity design to evaluate the impacts of conditional cash transfer (CCT) programs. It happens that some colleagues and I at the International Food Policy Research Institute recently completed two papers using a unique regression discontinuity design (RDD) to evaluate the impacts of El Salvador’s Comunidades Solidarias Rurales (CSR) program. T