“Going to Scale” Conditional Cash Transfers (CCT) Potential for ECD Programs Marito Garcia, Ph D The World Bank, Washington DC ECCD Going to Scale Workshop Zanzibar, October 27, 2009

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 Peru Chile Paraguay Total Countries: 21 since 1997 ! Source: Garcia and Mulaa (World Bank) 2005

Objectives of Presentation Lessons from Mexico Progresa- Oportunidades Lessons as Mexico model applied in 21 countries since 1997: Customize! Challenges as we think of applying to ECD programmes

Progresa-Oportunidades “has gone to scale !” Year Beneficiaries Budget (families) (million pesos) (families) (million pesos) , ,500,000 3, ,306,600 6, ,476,000 9, ,116,000 12, ,240,000 18, ,300,000 20, ,000,000 24,000 (US$2.6billion) Source: SEDESOL, Mexico 2005

What is CCT? Monthly Cash Payments to Women in Eligible Families IF Member of Families Use Education and Health Services

Mexico CCT--- what benefits were given? Mexico CCT--- what benefits were given? $26 per Month for Each Child in Grades 3 – 9 IF Child attends 85% or More of Classes

What is the CCT Benefit? $15 Monthly Cash Transfer per Family IF Each Child Receives 2-4 Checkups annually, Adults Receive One Annual Checkup, Pregnant Women Receive Seven Pre- and Post-natal Checkups If mothers attend parenting classes

Specifically, To Obtain Cash… Pregnant women must go to public health clinic for –prenatal care beginning in 1 st trimester –nutrition monitoring & supplements 100% of daily required micronutrients & 20% of protein Mothers attend parenting education classes –nutrition monitoring & supplements Children 0-5 must got to public health clinic for –Well baby & nutrition monitoring visits –Given nutritional supplements For age 0-24 months For months if poor nutrition detected

Four components: Mexico CCT Education Scholarships (higher for girls than for boys) conditional on school attendance $25 Average monthly cash transfer to the mother in the family Health Regular check-ups in health clinics In kind + Nutrition Cash transfer + Nutritional suplement conditional on women training $15 $40 + Total Assets $8 Savings account, conditional on graduation

PROGRESA-Oportunidades Targeting Households Eligible to Receive Benefits through a Three-Step Process: Step One: Geographic Targeting - Identification of poor villages Step Two: Proxy Means Testing – Identification of poor households in the poor villages, on the basis of Survey Information about factors related to income Step Three: Local Validation Local meetings to incorporate eligible families, and resolve disputed cases Local meetings to incorporate eligible families, 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 Over 40 Percent of CTs in SSA Address Childhood- Related Risks; Another 30 Percent Focus on the Elderly n=57

PROGRESA-Oportunidades Overall Accomplishments: Serves Over 20 Million People, Around One-Fifth of Mexico’s Population Provides 20% of Income of Participating Families Keeps Administrative Expenses under 10% of Total Program Cost Has Survived a Landmark Shift in Power Away from the Political Party that Established It (Zedillo to Fox)

Assessing PROGRESA’S Targeting and Impact: Baseline household surveys immediately before and two years after PROGRESA Initiation In 506 Randomly-Selected villages qualifying for PROGRESA participation, of Which –206 Began Participating in PROGRESA Shortly After Baseline Survey –186 Did Not Begin Participating in PROGRESA until After Follow-Up Survey

PROGRESA Targeting Accomplishments Reaching Bottom 20% of National Population Percent of Total Program Benefits

Education Impact ! Increase in secondary school enrollment 25% general enrollment 33% female students 16% male students

Impact on Morbidity is Cumulative

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: Africa Cash transfers programs: Africa Source: Garcia and Moore 2009

Countries with Cash Transfers Programs in Africa, 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 programs emerging !! Kenya Conditional Cash Transfers for OVC $180 million Nigeria CCT Program $300 million GHANA LEAP Cash Transfers $30 million Ethiopia Productive Safety Nets (Cash transfers) $450 million South Africa Child Grants $1 billion