““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