Conditional Cash Transfer (CCT) projects are an increasingly common tool used throughout the developing world to give vulnerable populations cash resources that are conditioned on certain desired behaviors. Often, they condition the transfer of funds on children’s school attendance or visits to the doctor for regular check-ups. This summary reviews a CCT program in Zimbabwe where there was also an unconditional cash transfer (UCT) component. Households with vulnerable children under 18 were targeted and received cash if they made sure that their children had birth certificates, were up to date on vaccination, attended school, and if the parents attended parenting classes. At the one-year post-test, there were statistically significant increases in the percentage of children who had a birth certificate in the CCT group relative to the control but not in the UCT group and both groups saw increases in school attendance (though at a higher rate for the CCT) relative to the control group. There were no significant differences by group in terms of the vaccination rates for young children.
DESCRIPTION OF PROGRAM
Target population: Families with vulnerable children
This program targets vulnerable families in areas of Zimbabwe with high HIV rates; vulnerability is defined as caring for an orphan, caring for a disabled or chronically ill person, being the poorest wealth quintile, or having a head of household who was younger than 18. Families that meet this criteria are eligible to receive cash transfers that are conditional on compliance with a number of program goals: applying for a birth certificate for all children younger than 18, keeping children under five years of age up to date with their vaccinations, making sure that children between the ages of six and 17 attended school 90 percent of the time, and attendance at two-thirds of parenting skills classes that the local diocese conducted. Compliance cards keep track of whether families are meeting the requirements; however, requirements are “soft,” meaning that there is a six-month window to comply. At six months, families are given assistance if they have not complied. After a second check, if families still have not complied, a community volunteer is assigned to help them meet each of the requirements. After four months, if compliance is still not met, their transfer is reduced by 10 percent. If the household ultimately meets requirements, the full transfer is reinstated.
EVALUATION OF PROGRAM
Robertson, L., Mushati, P., Eaton, J. W., Dumba, L, Mavise, G., Makani, J., Schumacher, C., Crea, T., Monash, R., Sherr, L., Garnett, G.P., Nyamukapa, C., & Gregson, S. (2013). Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomized trial. The Lancet, 381, 1283-1292.
Evaluated population: Households with children under 18 who also met other vulnerability criteria (head of household was under 18, they were caring for an orphan, disabled person or chronically ill person, or the household was in the poorest wealth quintile) were eligible to participate. There were 4,043 eligible households participating in the study. At baseline, approximately 40 percent of children aged zero to four had their births registered, approximately two-thirds had a complete vaccination record, 77 to 78 percent of children ages six to 12 attended school at least 80 percent of the time, and 65 to 75 percent of adolescents ages 13 to 17 did so.
Approach: Cluster randomization was used to divide participants into three study groups: a control group that received no services or cash transfer, an unconditional cash transfer (UCT) group, and a conditional cash transfer (CCT) group. Clusters were defined by the type of settlement – agricultural estate, subsistence farming area, small town, or roadside trading settlement – and then within each of these clusters three groups were defined and randomly assigned to one of the intervention groups. Of the 4,043 households in the study population, 1,199 households were assigned to control group, 1,525 to the unconditional cash transfer (UCT) group, and 1,319 to the conditional cash transfer (CCT) group. Linear regression was used to assess impacts. Outcomes measured included whether a baby (ages zero to four) had a birth certificate and was fully vaccinated and whether children ages six to 12 and adolescents ages 13 to 17 attended school regularly. Data were collected at baseline and again approximately one year later. (The intention was for the program to continue for two years but government funding was not renewed after one year as they planned to roll out a national program). At baseline, the three groups were statistically similar, except that in the UCT group there were more girls aged zero to four and that adolescents ages 13 to 17 had less regularly attended school.
Results: At the one-year post-test, there were statistically significant increases in the percentage of children who had a birth certificate in the CCT group relative to the control but not in the UCT group. There were no significant differences by group in terms of the vaccination rates for young children. Both the UCT and CCT groups reported that children ages six to 12 were more likely to report regular school attendance compared to those in the control group. Both the UCT and CCT groups reported that adolescents (ages 13 to 17) went to school more often, and this impact was larger for those in the CCT group compared with those in the UCT group.
SOURCES FOR MORE INFORMATION
Robertson, L., Mushati, P., Eaton, J. W., Dumba, L, Mavise, G., Makani, J., Schumacher, C., Crea, T., Monash, R., Sherr, L., Garnett, G.P., Nyamukapa, C., & Gregson, S. (2013). Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: A cluster-randomized trial. The Lancet, 381, 1283-1292.
KEYWORDS: infants, toddlers, children, adolescents, males and females, community-based, welfare/public assistance, parent or family component, other physical health.
Program information last updated on 8/4/2016.