In Brazil, Costa et al show that where the Bolsa Familia program had significantly reach, it was associated with lower oral cancer mortality. How so? A key factor was the way in which the program facilitates access to early diagnosis and treatment – activities that, by design, fall under the wider remit of co-responsibilities to be fulfilled. The study also provides a precious summary connecting to other important health related studies of Bolsa, among other its effects on cervical cancer and oral health care.
Double bonus on Brazil: Jones examines the youth’s schooling trajectories and transitions to social adulthood in the context of Bolsa, while Torres et al report that the program increased children’s consumption of macronutrients.
But conditional cash transfers (CCTs) don’t always generate positive health effects: for instance, the PNBSF program in Senegal meant to enroll beneficiaries in free community-based health insurance (CBHI) schemes. An evaluation by Bousmah et al found “almost no significant effect [of PNBSF] on any of the outcomes pertaining to health service utilisation and health-related financial protection” (see figure 1, p.7). This is due to demand and supply side issues, i.e., 69% of cash beneficiaries without insurance had little knowledge of CBHI’s existence; and medicine shortages limited the subsidized ones, leading to high out-of-pocket health expenditures.
And on another CCTs, the Philippines’ Pantawid, a “policy evaluation” conducted by Malinao et al recommends that the beneficiaries’ ATM accounts should be converted into saving accounts to encourage, indeed, savings. And another paper on Pantawid by Yee et al found that distance to and quality of education and health facilities matter in child schooling and vaccination behaviors.
In nearby Indonesia, a study by Ameliany et al on the use of e-wallets under the PKH program in Aceh sheds light on the different factors shaping beneficiaries’ perception of such delivery modality, e.g., see section 4.1 detailing 8 factors like (similarly to the Philippines) distance and travel costs to financial institutions. Bonus: a qualitative study by Chotim and Tedja provides sobering insights into the administration of PKH in Depok City.
One last resource on CCTs: does their transfer size always matter? In Bangladesh a study by Bharati and Fakir evaluated the effects of the Primary Education Stipend Program providing tiny benefits equivalent to about 1.5% of food consumption. Yet those transfers helped, for example, improving bolstering households’ protein consumption and minor asset holdings among women – although they also increased domestic workload for women and reduced their measures of life satisfaction.
BTW, still in Bangladesh Kirkwood et al evaluated a combined nutrition-specific (nutrition counselling) and nutrition-sensitive (agricultural training and unconditional cash transfers) intervention. Among the effects, the program led to behavioral change across five key indicators of women empowerment (control over use of income, input into productive decisions, respect among household members, self-efficacy, and input into health and nutrition decisions).
What about labor markets effects in the region? In Vietnam, Nguyen and Tarp evaluate the effects of a national cash transfer program reaching 3% of the population. They found no evidence of a labor supply disincentive effect for adults aged 15-64. Furthermore, transfers lead adults to shift from self-employed non-farm work to wage employment.
Bonus on Vietnam: shocks are not always negative… a “positive shock” can represent, for instance, a cash inflow such as a lottery. Dang et al show that families that won a lottery didn’t alter school enrolment rates, but their spending for children’s education rose (it did so by 0.12% for every 1% increase in lottery winnings).
Did you know of India’s KALIA, the “Krushak Assistance for Livelihood and Income Augmentation” program? It delivered multiple interventions, including unconditional cash transfers to small farmers owning less than 2 hectares of land in the state of Odisha (it pays about $315 at the start of the crop season, with support provided up to 5 seasons). An evaluation by Karan and Dey finds that KALIA didn’t affect indebtedness levels, but reduced informal credit and that for personal consumption. While intended for agricultural purposes, the size of the transfer was too small to induce significant short-run productive investments.
More from India: Kumar and Singh show that India’s NREGA program reduces school absenteeism, particularly among children (and especially girls) from scheduled caste and tribes. Although the hallens through which those effects are attained are not analyzed, the authors suggest results may be due to better wages and enhanced school affordability. And a paper by Paul et al quantifies the costs and rate of return of JEEViKA, a women’s self-help group to promote financial inclusion. Findings? For every INR invested in the program, consumption is increased between INR 0.75 and 4.9 pending on assumptions.
Speaking of gender, Casabianca et al study a skills-based entrepreneurship program in Uganda that teaches business management skills (accounting, inventory management, etc) alongside entrepreneurship skills (raising capital, growing a customer base, identifying market opportunities). Results show that treated women are more likely to report intimate partner violence while experiencing less of it.
Another paper on violence: in Burkina Faso, Musizvingoza et al documented that boys living in households receiving safety nets (which in the study include the CSSPP program’s combo of cash, nutrition, water, sanitation, and hygiene measures) were 1.9 times more likely to be exposed to psychological violence than their uncovered peers (for girls the odds coefficient was 1.6). Unfortunately, the paper provides limited explanation for the outcome, beyond acknowledging that it “… could be that the most vulnerable households received safety nets, and not necessarily that safety nets cause violence”.
Implementation matters, independently of targeting methods! I had already reviewed this paper by Porisky et al when out in a different format, but here it is in a journal version: in 2017, Kenya turned poverty-targeted cash transfers for the elderly into ‘universal’ social pensions. Results? Evidence from Marsabit County revelas that more coverage and transparency are attained; but fast implementation and little registration capacity led to exclusion in poor areas.
From impacts to costs: an interesting article from Niger by Trenouth et al calculates the cost-efficiency of two cash interventions – an unconditional cash transfer that makes 4 rounds of payments versus one that makes 6 distributions. Somewhat unsurprisingly, the admin costs of the former (35% of non-transfer costs) are lower than the latter’s (44%), see table 5, p.6. The article calls for “… considering cost to beneficiaries, the variable implications of programme design on beneficiary costs, and how the cost burden may be differentially shared across the beneficiary population”.
What’s new in high income countries? Neighly et al summarize 15 cash transfer programs or multi-program initiatives that occurred in the US and Canada since the early 1900s, and assess their evidence across 8 dimensions (e.g., education, employment, etc). The review provides plenty of helpful resources and references on historical experiences, although its conclusions seem to paint a slightly overly-positive picture (there is limited discussion of trade-offs and possible negative effects).
UBI is back: a study on Alaska’s annual universal cash dividend by Wyndham-Douds and Cowan found that receiving the payment during pregnancy has no meaningful effect on birth outcomes; and Redmond et al distill global lessons for a UBI in Ireland.
Payments! Madan and Isgut review “the state of G2P transfers” in 8 Asian countries (namely Afghanistan, Bangladesh, Bhutan, Cambodia, Laos, Myanmar, Nepal, and Timor-Leste); Shamsuddin et al have an interesting paper on e-wallets in Malaysia; and in discussing the relationship between mobile money and poverty in Kenya and Uganda, Balasubramanian et al conclude that “… the business case for mobile money degenerates in regions where it, arguably, is needed the most”.
On the current inflation crisis: Ecker et al reflect on responses to “diverging food and energy prices”. And in Pakistan, an analysis by Khalid shows that only 11% of recent generalized fuel subsidies accrued to the poorest 40% of the population (and 55% of subsidies went to the top quintile); he then estimated that under alternative scenarios, cash transfers directed to the bottom two quintiles would have entailed savings for about PKR 74.63B (or $330M). Bonus: Matallah et al offer an overview of the effects of subsidies on inequality in Algeria.
Mix of papers! Cabral and Devereux review the influence of different equity-related fields of study on “food” issues (e.g., food aid, food security, food systems, etc.). They then synthesized and translated the findings into a framework for the analysis of “food equity”, see figure 5.1,p.30. A chapter by Khondker and Kitsios identifies strengths and weaknesses in South Asia’s social protection systems. And in one of his three papers summarized in an overarching piece, Siren argues that “… the expansion of anti-poverty cash transfer schemes can be an important strategy to accelerate the process of ending global poverty”.
And if you’d like a handy selection for the weekend, yours truly laid out his top 10 papers of 2022.
Finally and sadly, these past weeks witnessed the passings of two eminent personalities in social protection: Martin Ravallion and Michael Cichon. Tributes from around the world abound, and we are all infinitely grateful for their inspiring work, exceptional lives, and unparalleled legacies.
Ugo Gentilini is from the World Bank’s Social Protection & Jobs global practice. The Social Protection Links newsletter, issued every Friday, distills and discusses a selection of curated resources on the topic, from academic articles to podcasts. The blog is republished on socialprotection.org each week, offering knowledge on social protection to help you stay on top of it — succinctly, regularly and frequently. Previous editions can be found here.