Conditional Cash Transfer Research Articles

Doubly robust estimation of multivariate fractional outcome means with multivalued treatments

. This article suggests a doubly robust method of estimating potential outcome means for multivariate fractional outcomes when the treatment of interest is unconfounded and can take more than two values. The method involves maximizing a propensity score weighted multinomial quasi-log-likelihood function with a multinomial logit conditional mean. We show that this estimator, which we call weighted multivariate fractional logit (wmflogit), consistently estimates the potential outcome means if either the propensity score model or the conditional mean model is misspecified. Our simulations demonstrate this double robustness property for the case of shares generated using a Dirichlet distribution. Finally, we advocate for the use of wmflogit by applying it to estimate time-use shares of women participating in the Mexican conditional cash transfer program, Progresa, using Stata’s fmlogit command developed by Buis.

Combining social protection interventions for better food security: Evidence from female-headed households in Amhara region, Ethiopia.

Ethiopia introduced its flagship poverty-targeted social protection program, the Productive safety net program (PSNP), in 2005 and Community-Based Health Insurance (CBHI) in 2011. Although both programs operate in several districts with some overlaps, evidence is scarce on how these large-scale programs jointly affect the food security of vulnerable groups. This study examines the impacts of a combination of these programs on food security outcomes among female-headed households in a chronically food-insecure and drought-prone district. Cross-sectional data were collected from 365 female-headed households selected through multi-stage sampling technique and analyzed using Inverse-probability-weighted regression adjustment (IPWRA) strategy to assess the effect of the programs on food security. The results show that while 63.6% of sample households are enrolled in CBHI and 48.8% are beneficiaries of PSNP's conditional cash transfer (CCT) component, membership in both social protection programs was 38.9%. The IPWRA analysis finds that inclusion in the CCT combined with CBHI, on average, increased dietary diversity score by 0.918 (95% CI 0.779-1.057) and food consumption score by 0.576 (95% CI 0.464-0.688). It also reduced household food insecurity access scale by 8.658 (95% CI -9.775 - -7.541). In all assessments, a combination of CBHI and CCT always produced results of a larger magnitude than each of CBHI and CCT alone. The findings provide evidence of the potentials of integrating social protection programs to increase food security outcomes among the most vulnerable and marginalized groups in a developing country. In addition, the results have also useful implications to achieve sustainable development goals related to ending hunger and achieving food security among vulnerable groups.

The hidden costs of austerity for social programmes in the Global South: Qualitative insights from two complementary services in Ghana's Livelihood Empowerment Against Poverty Programme

AbstractPromoted by the International Monetary Fund (IMF) in particular, fiscal austerity measures have been extensively implemented across the world in the last decade as a policy prescription to address the impacts of economic shocks. Consequently, the implementation of austerity has engendered a vast body of austerity impact assessment literature in the Global North, in particular. Although austerity measures have been equally implemented (and longer) in Global South contexts, the same level of intellectual curiosity has not been dedicated to understanding the human and social costs of austerity in the Global South. To help fill this gap, this paper examines the implications of fiscal austerity for the delivery of two complementary programmes linked to Ghana's conditional cash transfer (CCT) — the Livelihood Empowerment Against Poverty (LEAP) programme. The paper adopts a qualitative design where semi‐structured interviews are conducted with (a) two LEAP officers, (b) two headteachers and (c) 35 LEAP beneficiaries in northern Ghana. The findings show that within the current context of fiscal austerity, mainly mediated through the government's commitment to “cut expenditures to the bone”, the two complementary services have been unfunded and thus do not exist in practice. The non‐existence of complementary services has dire consequences for children's education as well as undermines Ghana's poverty reduction attempts through the implementation of the LEAP programme.

Analisis Kinerja Aparatur Pemerintahan Dalam Penyaluran Program Keluarga Harapan (PKH) Pada Masyarakat Miskin Di Kelurahan Kenangan Baru Kecamatan Percut Sei Tuan Kabupaten Deli Serdang

The Family Hope Program (PKH) is a conditional cash transfer targeting Very Poor Families (KSM) with the aim of alleviating poverty. This article aims to analyze the performance of government officials in distributing PKH to the poor in Kenangan Baru Village and to find out what are the inhibiting factors in distributing PKH in the Village. The problem in this research is focused on the less than optimal distribution of PKH aid funds and also the target of receiving PKH assistance that has not been realized properly. In order to approach this problem, the theoretical reference from Mondy, Noe and Premeaux regarding performance measurement includes Quantity, Quality, Independence, Initiative, Adaptation, Cooperation. The data collected is based on data collection techniques through observation, interviews, and documentation. Then analyzed using a descriptive qualitative method. This study concludes that the quantity of work; PKH distribution has been carried out well, Quality of work; not yet precise target and timing of distribution of funds, the independence of the apparatus; have not been able to work with minimal help from others, Initiative; in response to data problems PKH companions visited KPM homes, Adaptation; PKH assistants adapt well to KPM in monthly activities, Cooperation; lack of coordination between assistants and apparatus in the Kelurahan. Obstacles in PKH distribution are not synchronized KPM data, lack of KPM participation in monthly activities, limited companion human resources, and undisbursed aid funds.

The Effectiveness of Conditional Cash Transfer Program: A Case of Rural and Urban Beneficiaries in Philippines

This paper analyzes the effectiveness of the Conditional Cash Transfer (CCT) program in the Philippines in terms of its effect on conditionality goods as reflected by food, health, and education expenditures of households from rural and urban areas that benefitted the program. The CCT program in the Philippines is known as Pantawid Pamilyang Pilipino Program (4Ps) that seeks to address the problem on poverty by improving the socioeconomic status of poor households through targeted investments in health and education. This study used the Propensity Score Matching methodology in estimating the average treatment effect on the treated to capture the effect of CCT on conditionality goods. The study finds that CCT has a significant effect on education for household beneficiaries in rural areas and has improved the quality of food consumed by household beneficiaries in urban areas. Also, a decreased in the per capita total expenditure and per capita food expenditure of the household beneficiaries is revealed in urban areas driven by their improved saving behavior. Thus, the CCT program, at some point, is effective in meeting its short-term goal, but it must be more targeted in order to improve its impact on other conditionality goods.

Do conditional cash transfers reduce hypertension?

Progresa, an anti-poverty conditional cash transfer program, has been a model for similar programs in more than 60 countries. Numerous studies have found positive impacts on schooling, the nutritional and health status of children and adolescents, and household consumption. However, the effects on the health of older adult beneficiaries have been particularly understudied. In this paper we analyze the effects of Progresa on middle-aged and older adult health, focusing on a high prevalence chronic condition: hypertension. Our results show that Progresa had significant benefits in terms of improved hypertension diagnosis and use of treatment drugs. However, we did not find significant changes in uncontrolled hypertension as measured by systolic and diastolic blood pressure biomarkers in household survey data. Thus, while cash transfer programs may facilitate financial access to healthcare visits and the ability to buy prescribed medicines, by itself the program might not improve hypertension outcomes without complementary healthcare system follow-up to ensure dosage titration and medication adherence.

Income determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians

Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world’s largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR:0.59; 95%CI:0.57-0.61), mortality by 39% (RR:0.61; 95%CI:0.57-0.64), and case fatality rates by 25% (RR:0.75; 95%CI:0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR:0.45, 95% CI:0.42-0.47), 54% mortality (RR:0.46, 95% CI:0.42-0.49), and 37% case-fatality (RR:0.63, 95% CI:0.51 −0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030.

Can redistributive policies promote reconciliation beyond its scope? The impact of inequality reduction programs on peacebuilding in Colombia

AbstractTransitional justice jurisdictions aim to promote reconciliation. Although previous research focuses on truth commissions, the reconciliatory role of redistributive justice is less clear. This article investigated the association of conditional cash transfers and victims’ reparation with demand for redistribution, belief in forgiveness, support for the peace process and community participation in Colombia. We analysed three nationally representative samples of the Latin American Public Opinion Project (LAPOP) surveys in 2011 (Study 1; n = 1503), 2016 (Study 2; n = 1563) and 2018 (Study 3; n = 1663). Consistently across studies, conditional cash transfers (and not victim reparation programs) predicted higher community participation, with little effect on other reconciliation indicators. Further, redistribution is indirectly associated with other reconciliation indicators through community participation, supporting the observation that transitional justice relates to reconciliation when it satisfies a need for agency and empowerment. We discuss how the null effects of the victim reparation program suggesting context‐specific constraints.

The medium-term impact of a conditional cash transfer programme on educational outcomes in England

ABSTRACT This paper uses longitudinal data from England to examine the medium-term impact of a means-tested conditional cash transfer programme, Education Maintenance Allowance (EMA), on higher educational participation and attainment. Combining regression modelling with entropy balancing, this paper finds that two-year EMA recipients are more likely to participate in higher education than non-recipients. Moreover, the impact of EMA is more substantial for male students, those with higher prior academic attainment, and students whose parents have higher educational qualifications. These findings suggest that even though EMA is a costly programme, it will benefit young people over a longer time frame.

Income Segregation, Conditional Cash Transfers, and Breast Cancer Mortality Among Women in Brazil

Women living in income-segregated areas are less likely to receive adequate breast cancer care and access community resources, which may heighten breast cancer mortality risk. To investigate the association between income segregation and breast cancer mortality and whether this association is attenuated by receipt of the Bolsa Família program (BFP), the world's largest conditional cash-transfer program. This cohort study was conducted using data from the 100 Million Brazilian Cohort, which were linked with nationwide mortality registries (2004-2015). Data were analyzed from December 2021 to June 2023. Study participants were women aged 18 to 100 years. Women's income segregation (high, medium, or low) at the municipality level was obtained using income data from the 2010 Brazilian census and assessed using dissimilarity index values in tertiles (low [0.01-0.25], medium [0.26-0.32], and high [0.33-0.73]). The main outcome was breast cancer mortality. Mortality rate ratios (MRRs) for the association of segregation with breast cancer deaths were estimated using Poisson regression adjusted for age, race, education, municipality area size, population density, area of residence (rural or urban), and year of enrollment. Multiplicative interactions of segregation and BFP receipt (yes or no) in the association with mortality (2004-2015) were assessed. Data on 21 680 930 women (mean [SD] age, 36.1 [15.3] years) were analyzed. Breast cancer mortality was greater among women living in municipalities with high (adjusted MRR [aMRR], 1.18; 95% CI, 1.13-1.24) and medium (aMRR, 1.08; 95% CI, 1.03-1.12) compared with low segregation. Women who did not receive BFP had higher breast cancer mortality than BFP recipients (aMRR, 1.17; 95% CI, 1.12-1.22). By BFP strata, women who did not receive BFP and lived in municipalities with high income segregation had a 24% greater risk of death from breast cancer compared with those living in municipalities with low income segregation (aMRR, 1.24: 95% CI, 1.14-1.34); women who received BFP and were living in areas with high income segregation had a 13% higher risk of death from breast cancer compared with those living in municipalities with low income segregation (aMRR, 1.13; 95% CI, 1.07-1.19; P for interaction = .008). Stratified by the amount of time receiving the benefit, segregation (high vs low) was associated with an increase in mortality risk for women receiving BFP for less time but not for those receiving it for more time (<4 years: aMRR, 1.16; 95% CI, 1.07-1.27; 4-11 years: aMRR, 1.09; 95% CI, 1.00-1.17; P for interaction <.001). These findings suggest that place-based inequities in breast cancer mortality associated with income segregation may be mitigated with BFP receipt, possibly via improved income and access to preventive cancer care services among women, which may be associated with early detection and treatment and ultimately reduced mortality.

Paradigma de activación y políticas sociales en América Latina

De la mano del neoliberalismo, a partir de los años 70, se configura una nueva forma de concebir la gestión social de la desocupación y de la pobreza que se caracteriza por incluir distintos programas sociales agrupados bajo el concepto de paradigma de activación o workfare. El eje central de esta transformación se vincula a un cambio en el diagnóstico sobre los problemas del empleo y la pobreza que comienza a estar fuertemente sesgado hacia las características que asume la oferta de fuerza de trabajo, es decir, que se plantea a nivel individual y microsocial. En América Latina esta reconfiguración se cristaliza en la proliferación de un conjunto de Programas de Transferencias Monetarias Condicionadas (PTMC). En este marco, el objetivo central de este artículo es analizar, desde una perspectiva crítica, cuáles son los soportes teóricos sobre los que se sustenta la implementación.

Implementation of Family Hope Program (PKH)

This study examines the implementation of a conditional cash transfer program (CCT) in a rural Indonesian village using Charles O. Jones' model of policy execution. Qualitative data collected through observation, interviews, and documentation revealed the program's strengths and weaknesses. While organizational structures and policy interpretations aligned with central government guidelines, limitations emerged in program application. Key shortcomings included inadequate human resource allocation for participant monitoring, lack of access to necessary facilities, and insufficient community awareness. These findings highlight the importance of context-specific adjustments and improved resource allocation within CCT programs to maximize their impact. Highlight : Organizational structures and policy interpretations: The study found that the program's organizational structures and policy interpretations aligned with central government guidelines. Limitations in program application: Key shortcomings included inadequate human resource allocation for participant monitoring, lack of access to necessary facilities, and insufficient community awareness. Context-specific adjustments and improved resource allocation: The findings highlight the importance of context-specific adjustments and improved resource allocation within CCT programs to maximize their impact. Keywords: Conditional Cash Transfer (CCT), Charles O. Jones' model, policy execution, rural Indonesian village, strengths, weaknesses.

Extended cost-effectiveness analysis of interventions to improve uptake of diabetes services in South Africa.

The rising prevalence of diabetes in South Africa (SA), coupled with significant levels of unmet need for diagnosis and treatment, results in high rates of diabetes-associated complications. Income status is a determinant of utilization of diagnosis and treatment services, with transport costs and loss of wages being key barriers to care. A conditional cash transfer (CCT) programme, targeted to compensate for such costs, may improve service utilization. We applied extended cost-effectiveness analysis (ECEA) methods and used a Markov model to compare the costs, health benefits and financial risk protection (FRP) attributes of a CCT programme. A population was simulated, drawing from SA-specific data, which transitioned yearly through various health states, based on specific probabilities obtained from local data, over a 45-year time horizon. Costs and disability-adjusted life years (DALYs) were applied to each health state. Three CCT programme strategies were simulated and compared to a 'no programme' scenario: (1) covering diagnosis services only; (2) covering treatment services only; (3) covering both diagnosis and treatment services. Cost-effectiveness was reported as incremental net monetary benefit (INMB) using a cost-effectiveness threshold of USD3015 per DALY for SA, while FRP outcomes were reported as catastrophic health expenditure (CHE) cases averted. Distributions of the outcomes were reported by income quintile and sex. Covering both diagnosis and treatment services for the bottom two quintiles resulted in the greatest INMB (USD22 per person) and the greatest CHE cases averted. There were greater FRP benefits for women compared to men. A CCT programme covering diabetes diagnosis and treatment services was found to be cost-effective, when provided to the poorest 40% of the SA population. ECEA provides a useful platform for including equity considerations to inform priority setting and implementation policies in SA.

Intersectorality in a conditional cash transfer programme: Actors, convergences and conflicts.

This study aimed to analyse intersectoral arrangements among the health, education and social assistance sectors in the operationalization of the Bolsa Família Program (BFP). A qualitative approach was carried out, in a peripheral region of a large urban centre of Southeast Brazil. Data content analysis was performed on the basis of reference in the Actor-Network Theory (ANT) using statements by the actors and considering ideas in dispute and work processes in the geopolitical territorial context. Seventeen managers of Municipal Secretariats of Health, Education and Social Assistance were interviewed, as were basic education, primary health care and social assistance professionals. One-off, episodic and discontinuous intersectoral actions were identified, with limited integration among sectors. Convergences and conflicts were found with respect to the institutional processes of BFP. The convergences referred to the conceptions shared among the actors about the role of intersectoral collaboration, as they recognize themselves as providing care to the same vulnerable population. Considering the multiple vulnerabilities of these families, the convergence of actions from different sectors can impact factors that condition inequalities. The conflicts were related to institutional conditions, to sectorized work processes and to a lack of understanding by professionals about the duties of their respective sectors.

Experimental Evidence from a Conditional Cash Transfer Program: Schooling, Learning, Fertility, and Labor Market Outcomes after 10 Years

Abstract Conditional cash transfer (CCT) programs are the antipoverty program of choice in many developing countries, aiming to improve human capital and break the intergenerational transmission of poverty. A decade after a randomized 3 year CCT program began, earlier exposure during primary school ages when children were at risk of dropout led to higher labor market participation for young men and women and higher earnings for men. The findings highlight the roles of the different CCT program components with variation in timing of access to nutrition, health, and education investments translating into substantial differential effects on learning outcomes for men and reproductive health outcomes for women.

The path towards an HIV-free generation: engaging adolescent boys and young men (ABYM) in sub-Saharan Africa from lessons learned and future directions

ABSTRACT This paper highlights the pressing need to address the HIV epidemic among adolescent boys and young men (ABYM) in sub-Saharan Africa. Despite progress in HIV prevention, ABYM still experience low diagnosis rates, treatment adherence, and linkage to care. The paper emphasizes ABYM’s vulnerability due to societal norms, limited healthcare access, and economic pressures. It calls for gender-responsive interventions, including comprehensive sexual education, youth-friendly health services, community engagement, and targeted outreach. Comprehensive sexual education is pivotal in HIV prevention for ABYM, providing them with age-appropriate sexual health knowledge and safer sexual practices to reduce HIV incidence. Harmful masculine norms must be countered to promote respectful relationships, benefiting boys, men, and their partners. Inadequate access to youth-friendly health services hampers HIV prevention. Establishing spaces with confidential, non-judgmental care offering testing, counselling, circumcision, and provision of pre-exposure prophylaxis (PrEP) is essential, especially considering ABYM’s unique clinic experiences. Engaging communities, leaders, educators, and peers combats stigma and discrimination. ABYM’s input in intervention design, targeted outreach, and innovative technology enhances effectiveness of HIV prevention programmes. Economic factors should also be addressed. Comprehensive multi-sectoral interventions, including conditional cash transfers, effective for AGYW, could benefit ABYM. Addressing structural factors alongside behaviour change and social support is key.

Health Expenditure and Utilisation of Poor Families in a Low-Income Community under the Philippine Conditional Cash Transfer Program

Pantawid Pamilyang Pilipino Program (4Ps) is the Philippine version of the conditional cash transfer (CCT) program that measures human development through the provision of conditional cash grants to the poorest of the poor. This research determines the health expenditure and utilisation of the poor families in a low-income community under the CCT program. A cross-sectional research design was adopted using mixed methods of data collection from 177 households between May and June 2017. Results reveal that most families under CCT devote the largest portion of household health expenditure for inpatient health seeking. About 40% of the total expenditure is covered by the National Health Insurance Program and the cost for hospitalisation mostly comes from the out-of-pocket source. Moreover, the common problems encountered during health utilisation and spending are poor customer service of healthcare facilities and uncompensated hospital bill by health insurance.

The role of rules and norms in conditional cash transfer programs – Latin American experience

The most important element of conditional cash transfer (CCT) programs is conditioning the social transfer on some pre-defined requirements concerning healthcare and education. The conditioning (co-responsibility) is justified by the belief that higher accumulation of human capital will allow the beneficiaries to permanently lift out of poverty. The literature on the subject is ample, focused mostly on the cost effectiveness of CCTs and their impact on poverty rates and income inequalities. Usually ignored are the rules and norms – important from the institutional perspective – that affect the behavior of participants as well as non-participants and influence their attitudes towards work, childcare, social responsibility, etc.&#x0D; The aim of the paper is twofold. First, to identify rules and norms that matter for the effects and efficiency of CCTs. Second, to define the channels through which they impact the behavior of economic agents. The research hypothesis assumes that conditionality of transfers increases the efficiency of public social spending and can be applied broadly, in many contexts. To verify the hypothesis, an extensive meta-analyses of available studies was performed. The initial conclusions suggest that CCTs could be successfully used in developed countries as well as in poorer regions.

Ending child labour: does conditional cash transfer matter? Evidence from Indonesia

Purpose This study aims to investigate the extent to which the Indonesian conditional cash transfer (CCT), known as the Family Hope Program (FHP), impacts the probability of children engaging in labour activities.Design/methodology/approach This study utilizes data from the Indonesian Family Life Survey in 2014, focussing on periods following the implementation of the FHP. To estimate the impact of FHP on child labour in Indonesia, the authors employ a propensity score matching strategy to balance the characteristics observed between the participant and non-participant groups.Findings The estimates show that FHP has no statistical impact on child labour across all matching techniques. This implies that receiving the CCT does not always help poor households decrease the probability of stopping their children from participating in labour activities.Social implications The conditions applied to the beneficiaries, which only require children to attend school without requiring them to stop working, may not effectively address the issue of child labour. The current structure and design of the FHP need to be re-evaluated and improved to effectively combat child labour.Originality/value Despite numerous studies examining the impact of CCT on child labour which remains inconclusive in Indonesia, this study contributes to the existing literature by considering children participating in labour activities across all types of work without focussing on specific education levels or regions.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-07-2023-0580

Do conditional cash transfers create resilience against poverty? Long-run evidence from Jamaica

Conditional Cash Transfer programs (CCT) have become the prominent component of social assistance programs in many developing countries. A major objective of CCT programs is breaking the cycle of intergenerational poverty and building a population resilient to adverse shocks that may push a person into poverty. The literature to date has not provided conclusive evidence for the long-run impact of CCT programs on beneficiaries’ resilience against poverty. To fill this gap, I exploit the age-based eligibility thresholds and regional variation in the proportion of persons receiving benefits from the Jamaican CCT program to identify its long-run impact on resilience against poverty. I find that child beneficiaries of the program are up to 8.4 percentage points more resilient against poverty when they become adults than they would have been in the absence of the program. Furthermore, these benefits are only evident in females, and are realized after beneficiaries are in their early 20′s. Overall, this study provides further justification for the expansion of CCTs or similar programs targeting children living in less-developed countries.