Tuesday, 11 March 2014

Conditional Cash Transfers and child protection outcomes: sticks or carrots?

Conditional cash transfers (CCTs) have gained unprecedented popularity as a social protection intervention and are no longer exclusively found in Latin America but being implemented across the globe. Its appeal lies in the combination of poverty reduction through the provision of cash with behavioural change by tying the receipt of cash to specific conditions that aim to improve outcomes in other dimensions of wellbeing, most notably for children. Such conditions frequently include school attendance and health check-ups. Ideological and political considerations also come into play: many hold strong reservations about whether cash is spent on the ‘right’ things or are opposed to the idea of giving ‘something for nothing’. Making cash transfers conditional upon certain behaviour is a means of counteracting such concerns.

There is no doubt that CCTs can help reduce poverty and improve wellbeing outcomes that range from nutrition to education and health. The evidence base about those positive effects is substantial and steadily expanding. However, the current debate around CCTs is in danger of being romanticised. Apart from strong moral and ideological considerations denouncing the conditional element of CCTs, perverse incentives and unintended side-effects of CCTs can negatively influence children’s outcomes. A recently published paper in Child Abuse & Neglect assesses the potential impact of three elements of CCTs – conditions, cash and services – on child protection outcomes in particular.

Conditionality is the defining feature of CCTs, requiring participants to meet certain requirements in order to receive the transfers. It is considered part and parcel of CCTs’ great success: the aspect of conditionality induces behavioural change that leads to positive outcomes in the areas of education, health, amongst others. The extent to which positive impacts of CCTs can be attributed to the aspect of conditionality, however, is far from evident. At the same time, perverse incentives and negative side effects are often overlooked. Experiences in Brazil, Kenya and Nicaragua indicate that children were either kept underweight or being overfed in a bid to meet requirements and guarantee receipt of transfers. Programmes that are conditional upon work – public works programmes – have been found to lead to substitutability with children taking on more domestic work or increasing the numbers of hours spent on rearing livestock at the expense of going to school or enjoying leisure time.

The provision of cash has many positive effects: it reduces poverty, improves wellbeing outcomes and helps lifting barriers to access to services. In terms of child protection, it can improve care relationships due to ameliorated stress levels and support carers in providing better care for their children. The role of cash in supporting care for children is however not without its pitfalls. There is a danger of ‘commodification’ of children when carers are primarily motivated by financial incentives to provide foster care, for example.

Finally, CCTs are predicated on the assumption that services required for participants to meet conditions related to education, health and nutrition are available and that services are of high quality. The importance of this supply-side requirement, and the reality that indeed services may not be available to everyone or may not be of high quality, is often overlooked in ‘theories of change’ of CCTs. This particularly puts the most marginalised and vulnerable groups at a double disadvantage: not only do they experience lack of access to (high quality) services, they are also punished for such lack of access as the consequent inability to comply with conditions means they are no longer eligible for the programme.

This blog post does not aim to discredit the many positive effects of CCTs. That said, the current debate on CCTs and their appropriate role does need a more nuanced perspective and be more recognisant of the potential negative effects, particularly when it comes to children. The substantial evidence base on positive impacts makes it tempting to base future decisions on if, where and how to implement CCTs on assumptions rather than in-depth assessments of what works and doesn’t work for children. Stronger linkages between the social protection and child protection rhetoric could help bridging the divide. Without a more nuanced perspective, programmes risk doing as much harm as they do good.  

Written by Keetie Roelen, IDS Research Fellow