Conditional cash transfers improve birth registration and school attendance amongst orphans and vulnerable children in Manicaland, Zimbabwe Laura Robertson, Phyllis Mushati, Jeff Eaton, Morten Skovdal, Lovemore Dumba, Gideon Mavise, Mr Makoni, Christina Schumacher, Tom Crea, Roeland Monasch, Lorraine Sherr, Geoff Garnett, Constance Nyamukapa, Simon Gregson

Cluster-randomised controlled trial of conditional & unconditional cash transfers in Manicaland, Zimbabwe 30 rural clusters, matched on socio-economic characteristics & randomised to 3 trial arms: UCT, CCT & control Sept 2009: completed baseline census; May 2011: completed follow-up census Eligible households: care for children < 18 years, not in richest quintile of households & meet at least one criteria: – Poorest quintile of households – Cares for one or more orphans (under 18 years) – Household head is under 18 years – Chronically ill or disabled household member (any age) Jan 2010-Jan 2011: eligible households in UCT & CCT arms received US$18 every two months & an extra $4 per child (max 3 children) CCT arm: households monitored for compliance: – Birth certificates for children < 18 years, including newborns within 3 months. – Children < 5 years: up-to-date with vaccinations & attend growth monitoring twice per year. – Children 6-17 years: attend school >= 90% of school days per month. – 1 adult must attend 2/3 parenting skills classes

Flow diagram: clusters & households 30 clusters 4,043 households Baseline UCT arm 10 clusters 1,525 households Baseline control arm 10 clusters 1,199 households Baseline CCT arm 10 clusters 1,319 households Followed CCT arm 10 clusters 1,248 households (95%) Followed UCT arm 10 clusters 1,452 households (95%) Followed control arm 10 clusters 1,118 households (93%) 42 migrated 3 refused 26 unknown 48 migrated 0 refused 25 unknown 46 migrated 1 refused 34 unknown

Primary & secondary endpoints Mean of cluster level percentages Absolute increase in percentage (95% CI) N=30 ControlUCTCCTUCT vs. ControlCCT vs. Control Births registered (children 0-4 years) 45%47%62% 1.5% ( ) 16.4% ( ) Complete vaccination record (children 0-4 years) 75%78%77% 3.1% ( ) 1.8% ( ) School attendance >= 80% (children 6-12 years) 79%86%87% 7.2% ( ) 7.6% ( ) School attendance >= 80% (children years) 80%88%91% 7.9% ( ) 10.4% ( ) Intention-to-treat analysis Effect of interventions: cluster-level linear regression models adjusted for matched study design

Acknowledgments Partnership for Child Development & World Bank Wellcome Trust UNICEF Zimbabwe Manicaland HIV/AIDS Prevention Project team Catholic Relief Services DOMCCP Study participants