Relationships in the Implementation of Conditional Cash Transfers: The Provision of Health in the Oportunidades-Prospera Programme in Puebla, Mexico

Abstract

This article explores interactions between the front-line officers and recipients of Oportunidades-Prospera, a conditional cash transfer (CCT) in Mexico. Like other CCTs, Oportunidades-Prospera provided monetary transfers to families with the requirement of following certain conditions, including receiving preventive healthcare and workshops. This produced constant and compulsory physician-recipient interactions. This article examines these through observations of programme delivery and interviews with physicians at health centres of two localities of Puebla. The results show that officers’ strategies of implementation and attitudes towards recipients were influenced by the programme’s use of health services as conditionalities, promoting a relationship of authority and obedience. This, however, was exacerbated by the officer’s job position. Those with a permanent contract systematically fostered authoritarian interactions compared to officers with temporary contracts. Ultimately, this study reveals factors that influence officer-recipient relationships in CCTs and their centrality for programme delivery and for the success of social policies more broadly.