The role of CCT programs in social policy is different from place to place, as a consequence of differences in both their design and the context in which they operate. Most obviously, CCT programs vary with respect to the pertinent measures of size. In terms of absolute coverage, they range from 11 million families (Brazil), to 215,000 (Chile), to pilot programs with a few thousand families (Kenya, Nicaragua). In terms of relative coverage, programs cover a range from about 40 percent of the population (Ecuador), to approximately 20 percent (Brazil, Mexico), to 1 percent (Cambodia). In terms of budget, programs cost from about 0.50 percent of gross domestic product (GDP) in countries such as Brazil, Ecuador, and Mexico to 0.08 percent of GDP in Chile. The generosity of benefi ts ranges from 20 per-cent of mean household consumption in Mexico, to 4 perper-cent of mean household consumption in Honduras, and to even less for the programs in Bangladesh, Cambodia, and Pakistan.
CCT programs are expected to fi ll different niches in social policy.
In some countries (Brazil, Jamaica, Mexico), the CCT program offers large-scale social assistance and grew out of a reform and expansion of other social assistance programs.
In Mexico, Oportunidades was established to replace consumption subsidies that were badly targeted and had limited impact on poverty.
By the mid-1990s, the Mexican government had 15 food subsidy programs. Of those programs, 11 were targeted at urban and rural populations and 4 had no explicit targeting mechanism (see Levy and Rodríguez [2004]; Levy [2006]). More than half of social funding was allocated to bread and tortilla subsidies in urban areas—a great deal of which was absorbed by nonpoor urban households. Food subsidies were an ineffi cient way to redistribute welfare to the rural poor, who often lived in small, hard-to-access communities. Approximately 60 percent of poor rural families received no support from the federal government (Rodríguez 2003). There was little coordination across programs, administrative tasks were duplicated, there was a noticeable imbalance in spending that favored urban areas, and there was no systematic evalu-ation to analyze the effectiveness of such programs.
Oportunidades was an innovation in Mexican social policy. In place of ineffi cient subsidies and poorly targeted cash transfers, the program made explicit a commitment to give benefi ciaries the freedom to choose how they used the transfers as long as they committed to certain behav-iors, namely education, health, and nutrition behaviors that were viewed as investments in human capital.
In Brazil, several states began to experiment with new forms of social assistance in the mid-1990s. In 1995, two programs (Bolsa Escola and the Guaranteed Minimum Family Income Program) were initiated in the Distrito Federal (Brasilia) and Campinas, respectively. The federal government started the Programa de Erradicação do Trabalho Infantil (PETI) in 1996. Two years later, the government began to provide transfers to municipalities that were running CCTs.
By 2001, CCTs with education conditions expanded to more than 100 municipalities and provided support to approximately 200,000 families (Lindert et al. 2007). In that same year, the federal government decided to create a national version of the Bolsa Escola program. It also initiated the Bolsa Alimentação (2001), a conditional cash transfer for pregnant women and lactating women with children; the Auxílio Gás (2002), an unconditional cash transfer intended to dampen the effects on poor families as cooking gas subsidies were phased out; and the Cartão Alimentação (2003), a general cash transfer to the extremely poor population to promote food consumption and prevent hunger.
Bolsa Família was created in 2003 by merging Bolsa Escola, Bolsa
Alimentação, Cartão Alimentação, and Auxílio Gás. That consolida-tion of programs signaled an effort to improve the effi ciency of the social safety net and to broaden federal support for poverty-targeted programs.
In other countries, such as Chile, programs are smaller and are meant to fi ll the cracks between and tie together a large number of existing social services. In some countries, CCT programs stand independently (Honduras, Jamaica), in others they provide links to a large and some-times increasing array of other services (Chile, Colombia, Mexico). In several countries, CCT programs are still small pilot efforts (Kenya, Nicaragua). In still other countries, the programs’ roots are in the education sector (Cambodia) or are a hybrid of social assistance and education (Bangladesh, Kenya). Some of the nascent programs will focus more on the nutrition of young children.
Many of the programs in middle-income countries have pursued an integrated approach to poverty reduction, balancing goals of social assistance and human capital formation. They cover children from birth (or prenatally) through their mid-teens, with conditions on health care use for children from birth to ages 5 or 6 and with conditions on school enrollment thereafter. Targeting usually is done with a proxy means test, sometimes combined with geographic targeting. In most cases, programs are administered by ministries of social welfare or freestanding agencies under the presidency. Examples of that type of CCT include Argentina, Brazil, Colombia, El Salvador, Jamaica, Mexico, Panama, and Turkey.
Mexico has one of the iconic programs in this class. The program started early, its evolution has been carried out thoughtfully, and it has been successful. What really makes Mexico’s program iconic is the successive waves of data collected to evaluate its impact, the placement of these data in the public domain, and the hundreds of papers and thousands of refer-ences to them that this easy access has generated.
Brazil’s efforts also have been exemplary. The program started early, has evolved enormously, and is equally large in coverage and impor-tance. Brazil’s CCT provides something of an interesting contrast to the Mexican case in various respects—the issue of federalism is more to the fore in the program; it takes a softer, more gradual tack on conditions;
and it puts a shade more emphasis on redistribution than on human capital formation. Also, unlike the Mexican program, the Brazilian programs did not explicitly incorporate impact evaluations in their design; as a result, much less is known about the impact they have had
on consumption, poverty, health, nutrition, and education than is true of Mexico’s program. Table 1.2 shows some of the more salient similari-ties and differences between the Oportunidades program in Mexico and the Bolsa Família program in Brazil.
There is another branch of the CCT program family that focuses on education in low-income countries. The programs usually cover a
Table 1.2 Implementation of “Similar” Programs: Contrast between Mexico and Brazil
Program feature Mexico Brazil
More-similar features
Program size 5 million families 25% of the population
11 million families 25% of the population Defi nition of conditions Education:
• School enrollment and minimum attendance rate of 85%, both monthly and annually
• Completion of high school (for savings account)
Health:
• Compliance by all household members with the required number of health center visits and mother’s attendance at health and nutrition lectures
Education:
• At least 85% school attendance in a 3-month period for children aged 6–15
Health:
• Children 0–7: vaccination and follow-up of nutritional development
• Pregnant women: pre- and postnatal visits, health and nutrition seminars Less-similar features
Targeting system Geographic targeting used to determine which rural areas participated initially Proxy means test used for household targeting within localities and in urban areas Program itself does targeting and program registration
Geographic targeting used to assign ration of slots in registry of poor households Means test used as household targeting system
Municipalities do program targeting and program registration
Evaluation Explicitly taken into account in program design
No systematic attempt to integrate evaluation of program impact into design Benefi t structure Differentiated by age, grade, gender Differentiated by poverty level
Payment mechanism In cash at program-specifi c payment points Via debit card usable at banks, ATM machines, and lottery points Enforcement of conditions Rigorous, reduction in benefi ts at fi rst
round of noncompliance
Warning system, noncomplying households seen as in need of additional “care” and problem solving
Source: Authors’ compilation.
narrower segment of education—some only secondary (Bangladesh’s Female Secondary School Assistance Program [FSSAP]; Cambodia’s Japan Fund for Poverty Reduction [JFPR] and Education Sector Support Project [CESSP]), some only primary (Bolivia, Kenya, and proposals in Nigeria and Tanzania), and occasionally both (Indonesia’s Jaring Pengamanan Sosial [JPS] program). The genesis of these pro-grams is rather varied. In Bangladesh, the FSSAP was part of a strategy to close the then signifi cant gender gap in education. Doing so was seen as an important policy objective: in 1981, the female literacy rate (approximately 13 percent) was about half the literacy rate among men (26 percent). As a result, a series of stipend and tuition waiver programs was made available to girls as long as they attended school regularly, made passing grades, and remained unmarried. In addition, the Food for Education (FFE) program was initiated in 1995 to provide in-kind food transfers to poor households as long as they sent their children to primary school (Ravallion and Wodon 2000). The FFE in-kind trans-fer was converted to a cash transtrans-fer in 2002, and was renamed as the Primary Education Stipend Program.
In Indonesia, the JPS program was instituted following the East Asian fi nancial crisis in order to prevent children from dropping out.
In Kenya and Tanzania, the programs are geared especially to coping with the crisis of orphans and vulnerable children that has burgeoned in the wake of HIV/AIDS. In many cases, the administrative structure behind these programs is less sophisticated than it is for the big Latin American programs. This is a result of several things. First, because these are primarily education programs and often are run through the education ministry, there are fewer actors to coordinate. Second, daily attendance is not always a condition of receipt of the transfer, and that simplifi es administration. Third, the programs are newer and situated in lower-capacity countries so simpler systems are to be expected. To compensate for the lack of a complex administrative structure, the role of the community in implementing the programs is often greater than it is in the Latin American programs.
Chile Solidario works in a very different way to fi ll a different niche.
The program is targeted to only the extremely poor, about 5 percent of Chile’s population. It differs notably from classic CCT programs by customizing its conditions. Families initially work intensely with social workers to understand actions that could help them get out of extreme poverty, and then they commit to action plans that become
the household-specifi c conditions of the benefi t. The diagnosis covers a total of 53 different so-called minimum conditions grouped along seven dimensions (identifi cation and legal documentation, family dynamics, education, health, housing, employment, and income). Households receive a comparatively small cash transfer, with the amount declining periodically during the two years of active participation, and then a still lower amount for an additional three years following the program.
However, they receive preferential access to the full range of Chilean social assistance programs from the time they join Chile Solidario through the end of the three-year follow-up period. Additional, though small, transfers come from those other social programs; the transfer from Chile Solidario itself is really intended only to motivate clients to avail themselves of the services of the social worker. Chile Solidario is thus far a model unto itself, although other programs are moving to emulate it to a degree.2
The different goals and contexts of the programs suggest that some-what different benchmarks may be pertinent to judge them, and dif-ferent weights should be given to results in difdif-ferent dimensions—for example, reduction in consumption poverty versus improvements in human development outcomes. Primary school enrollment in Colombia and Mexico already exceeded 90 percent before the CCT programs.
Enrollment increased slightly due to the CCTs, but dramatic gains were not possible because the base was already so high. Those programs, however, emphasized their role in social assistance and, with large transfers and well-targeted and extensive coverage, they are successful at it. The Bangladesh stipend for girls in secondary school was designed as a gender-targeted education program. It makes small cash payments, however; and given its focus on increasing girls’ enrollments, it did not contemplate poverty targeting. Thus, without an understanding of the program and its original goals, one could consider it a failure by the standards of social assistance.
Variation can occur not only among countries, but even within a single program over time. For example, in the 10 years of its existence, Mexico’s Oportunidades has undergone continuous evolution of implementation systems in order to respond to changing needs as the program expanded and as administrative systems were built. The role of geographic targeting was reduced as the program achieved national coverage, the role of community targeting was eliminated, and the role of the proxy means test increased accordingly. Carrying out the proxy
means test and eligibility procedures moved from contracted agencies to in-house staff. Both eligibility and compliance monitoring were moved from a paper-based system to computerized systems, and most of the data now fl ows via the Internet. The timeline for bringing people into the program has been reduced from 6–8 months to 4–8 days, and a set of benefi ts held in a savings account was added to the cash payment.
The role and design of CCT programs is evolving in many countries.
Early successes with the basic model are bringing countries to address a second and third round of challenges, including these:
•
Should the emphasis on expanding the supply of services be com-plemented with efforts to improve the quality of those services, in tandem with the demand-increasing action of the CCT?•
Should the range or defi nition of conditions be changed, for example, to reward performance instead of, or in addition to, service use?•
What can be done to ensure that youth who are aging out of the school support provided by the program can attain jobs or receive further training?•
What should be the balance between targeting younger and older children?In some countries, CCT programs themselves are addressing those challenges through adjustment to their basic design; in other cases, they are catalyzing changes in other programs.