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““Going to Scale”Going to Scale”
Conditional Cash Transfers (CCT) Conditional Cash Transfers (CCT) Potential for Potential for
ECD ProgramsECD Programs
Marito Garcia, Ph DMarito Garcia, Ph DThe World Bank, Washington DCThe World Bank, Washington DC
ECCD ECCD Going to Scale WorkshopGoing to Scale WorkshopZanzibar, October 27, 2009 Zanzibar, October 27, 2009
Model has spread from Mexico Model has spread from Mexico
Turkey Palestine
Kenya Burkina Faso
Swaziland Mozambique
Sri-Lanka Bangladesh Pakistan Cambodia
• Mexico
•Jamaica •Dominican Republic
•Nicaragua Honduras Costa Rica
•Colombia •Ecuador Brazil
•PeruChile Paraguay
Total Countries: 21 since 1997 !
Source: Garcia and Mulaa (World Bank) 2005
Objectives of PresentationObjectives of Presentation
Lessons from Mexico Progresa-Lessons from Mexico Progresa-OportunidadesOportunidades
Lessons as Mexico model applied Lessons as Mexico model applied in 21 countries since 1997: in 21 countries since 1997: Customize!Customize!
Challenges as we think of applying Challenges as we think of applying to ECD programmesto ECD programmes
Progresa-Oportunidades Progresa-Oportunidades “has gone to scale !”“has gone to scale !”
YearYear BeneficiariesBeneficiaries BudgetBudget
(families) (million pesos)(families) (million pesos)
19971997 300,000 363 300,000 363
19981998 1,500,000 3,3981,500,000 3,398
19991999 2,306,600 6,8992,306,600 6,899
20002000 2,476,000 9,5182,476,000 9,518
20012001 3,116,000 12,2963,116,000 12,296
20022002 4,240,000 18,6084,240,000 18,608
20032003 4,300,000 20,0024,300,000 20,002
20042004 5,000,000 24,000 5,000,000 24,000 (US$2.6billion)(US$2.6billion)Source: SEDESOL, Mexico 2005Source: SEDESOL, Mexico 2005
What is CCT?What is CCT?
Monthly Cash Payments to Monthly Cash Payments to WomenWomen in Eligible Families in Eligible Families
IFIF Member of Families Use Member of Families Use Education and Health Education and Health ServicesServices
Mexico CCT---Mexico CCT---what benefits were given?what benefits were given?
$26 per Month for Each Child $26 per Month for Each Child in Grades 3 – 9 in Grades 3 – 9
IFIF Child attends 85% or More Child attends 85% or More of Classesof Classes
What is the CCT Benefit?What is the CCT Benefit?$15 Monthly Cash Transfer per Family $15 Monthly Cash Transfer per Family
IFIF Each Child Receives 2-4 Checkups Each Child Receives 2-4 Checkups annually, Adults Receive One Annual annually, Adults Receive One Annual Checkup, Pregnant Women Receive Checkup, Pregnant Women Receive Seven Pre- and Post-natal CheckupsSeven Pre- and Post-natal CheckupsIfIf mothers attend parenting classes mothers attend parenting classes
Specifically, To Obtain Cash…Specifically, To Obtain Cash…Pregnant women must go to public health clinic forPregnant women must go to public health clinic for– prenatal care beginning in 1prenatal care beginning in 1stst trimester trimester– nutrition monitoring & supplementsnutrition monitoring & supplements
100% of daily required micronutrients & 20% of 100% of daily required micronutrients & 20% of protein protein
Mothers attend parenting education classesMothers attend parenting education classes– nutrition monitoring & supplementsnutrition monitoring & supplements
Children 0-5 must got to public health clinic forChildren 0-5 must got to public health clinic for– Well baby & nutrition monitoring visitsWell baby & nutrition monitoring visits– Given nutritional supplementsGiven nutritional supplements
For age 0-24 months For age 0-24 months For 24-60 months if poor nutrition detectedFor 24-60 months if poor nutrition detected
Four components: Mexico CCT
EducationScholarships (higher for girls than for boys) conditional on
school attendance$25
Average monthly cashtransfer to the mother in
the family
HealthRegular check-ups in health
clinics
In kind
+
NutritionCash transfer
+
Nutritional suplement conditional on women training
$15
$40
+
Total
Assets $8 Savings account, conditional on
graduation
PROGRESA-OportunidadesPROGRESA-Oportunidades Targeting Households Eligible to Targeting Households Eligible to
Receive Benefits through Receive Benefits through a Three-Step Process:a Three-Step Process:
Step One: Geographic TargetingStep One: Geographic Targeting - - Identification of poor villages Identification of poor villages
Step Two: Proxy Means TestingStep Two: Proxy Means Testing – – Identification of poor households in the Identification of poor households in the poor villages, on the basis of Survey poor villages, on the basis of Survey Information about factors related to Information about factors related to incomeincomeStep Three: Local ValidationStep Three: Local Validation
Local meetings to incorporate eligible Local meetings to incorporate eligible families, and resolve disputed casesfamilies, and resolve disputed cases
Vulnerabilities Vary Based on the Stage of the Life Cycle
Risks: Orphanhood, malnutrition, infectious diseases
Risks: low human capital (nutrition, education)
Risks: low human capital, inactivity, substance abuse, early pregnancy
Risks: poverty (unemployment or underemployment), chronic illness
Risks: poverty, illness
Risks for all age groups: disabilities, poor health, poor living conditions (housing, basic infrastructure), conflicts,natural disasters, economic downturns
Risks for all age groups: disabilities, poor health, poor living conditions (housing, basic infrastructure), conflicts,natural disasters, economic downturns
Over 40 Percent of CTs in SSA Address Childhood-Related Risks;Another 30 Percent Focus on the Elderly
n=57
PROGRESA-OportunidadesPROGRESA-Oportunidades Overall Accomplishments:Overall Accomplishments:
Serves Over 20 Million People, Serves Over 20 Million People, Around Around One-Fifth of Mexico’s One-Fifth of Mexico’s PopulationPopulation
Provides 20% of Income of Provides 20% of Income of Participating Participating FamiliesFamilies
Keeps Administrative Expenses Keeps Administrative Expenses under 10% of Total Program Costunder 10% of Total Program Cost
Has Survived a Landmark Shift in Has Survived a Landmark Shift in Power Away from the Political Party Power Away from the Political Party that Established It (Zedillo to Fox)that Established It (Zedillo to Fox)
Assessing PROGRESA’SAssessing PROGRESA’S Targeting and Impact:Targeting and Impact:
Baseline household surveys Baseline household surveys immediately before and two years immediately before and two years after after PROGRESA PROGRESA InitiationInitiation
In 506 Randomly-Selected villages In 506 Randomly-Selected villages qualifying for qualifying for PROGRESAPROGRESA participation, of Whichparticipation, of Which– 206 Began Participating in 206 Began Participating in PROGRESA PROGRESA
Shortly After Baseline SurveyShortly After Baseline Survey– 186 Did Not Begin Participating in 186 Did Not Begin Participating in
PROGRESAPROGRESA until After Follow-Up until After Follow-Up SurveySurvey
PROGRESA PROGRESA Targeting Targeting Accomplishments Accomplishments
Reaching Reaching Bottom Bottom 20%20% of National of National PopulationPopulation
0
10
20
30
40
50
60
70
Bottom 20% ofNational Population
Top 20% of NationalPopulation
Per
cen
t of
Tot
alP
rogr
am B
enef
its
Education Impact !Increase in secondary school
enrollment
25% general enrollment
33% female students
16% male students
Impact on Morbidity is CumulativeImpact on Morbidity is Cumulative
-35.0%
-30.0%
-25.0%
-20.0%
-15.0%
-10.0%
-5.0%
0.0%
5.0%
10.0%
6 Months 12 Months 18 Months 24 Months
Months Receiving PROGRESA Benefits
Ch
ang
e in
Mo
rbid
ity
Du
e to
P
RO
GR
ES
A
Newborn Age 0 at Baseline
Age 1 at Baseline Age 2-3 at Baseline
Health
12% reduction in child morbidity
Morbidity under 2 years of age
Nutrition
16% increase in height and weight
Malnutrition under age 3
Successful, why?
Transparent mechanisms to identify beneficiaries
Before
• No clear rules (discretionary)
• Driven by political demands
Now
• Transparency : Means test to each family
• Systematic procedures to identify eligible households
• Creation of the first beneficiary registry
Before
• Independent actions by each ministry
Successful, why?
Better sectoral coordination and convergence
of services to families
Now
• Coordination of :
Education
Health
Nutrition
Before
• Short term support through assistance
and welfare
Successful, why? Shared responsibility between government and family
Now
• Shared responsibility between govt and family:
• A) change in family behavior to trigger
long-term effects
• B) Self-targeting of the poor
Success factors, as viewed by Mexicans
1) Rigorous evaluation
2) Addressed both short term household needs, and long-term human capital development goals
3) Consolidating disperse budgets
4) International support
5) Central coordination across sectors
6) Building on success
7) Political support (Even with the change in political party, and President from Zedillo to Fox)
Plus----efficiency in delivery to target groups!
PETS—public expenditure tracking surveys in Uganda, in 1994 showed that:
“For every $1 education non-salary budget at Treasury Level----Only 16 cents reached the schools!! “
In Mexico Progresa and Colombia Familias en Accion, for every $1 budget at Treasury Level---about 90 cents received by deserving families !!
Only 10 cents per $1 is cost of administration!
Cash transfers programs: AfricaCash transfers programs: Africa
Source: Garcia and Moore 2009
Countries with Cash Transfers Countries with Cash Transfers Programs in Africa, 2000- 2009Programs in Africa, 2000- 2009
Source: Garcia and Moore 2009
Countries in which cash transfer
programs have been discussed, planned,
or implemented
Countries with no known dialogue
surrounding cash transfer programs
Countries excluded from the study
CCT Programs in Africa: NEW CCT Programs in Africa: NEW programs emerging !!programs emerging !!
Kenya Conditional Cash Transfers for Kenya Conditional Cash Transfers for OVC $180 millionOVC $180 million
Nigeria CCT Program $300 millionNigeria CCT Program $300 million
GHANA LEAP Cash Transfers $30 GHANA LEAP Cash Transfers $30 millionmillion
Ethiopia Productive Safety Nets Ethiopia Productive Safety Nets (Cash transfers) $450 million(Cash transfers) $450 million
South Africa Child Grants $1 billionSouth Africa Child Grants $1 billion