Publication:
Medium-Term Impacts of Integrated Social Safety Nets: Cash Transfers, Information Meetings, and Home Visits for Child Development

Loading...
Thumbnail Image
Files in English
English PDF (1.63 MB)
46 downloads
English Text (237.71 KB)
20 downloads
Published
2025-12-05
ISSN
Date
2025-12-05
Editor(s)
Abstract
Cash transfers are a cornerstone of social protection. This paper evaluates an integrated program in Burkina Faso that combines cash transfers with parenting interventions delivered through group meetings or home visits. In a randomized experiment across 225 villages, households received cash alone; cash plus information on child health and development; or cash, information, and home visits reinforcing the information. Fifteen months after treatment ended, households receiving all three components had fewer pregnancies, more medically assisted births, improved health behaviors, and better educational outcomes. Adding home visits is essential for enhancing child development. Cash alone or with information produces no lasting effects.
Link to Data Set
Citation
Akresh, Richard; De Walque, Damien; Kazianga, Harounan; Stocker, Abigail. 2025. Medium-Term Impacts of Integrated Social Safety Nets: Cash Transfers, Information Meetings, and Home Visits for Child Development. Policy Research Working Paper; 11270. © World Bank. http://hdl.handle.net/10986/44036 License: CC BY 3.0 IGO.
Digital Object Identifier
Associated URLs
Report Series
Report Series
Other publications in this report series
  • Publication
    The Macroeconomic Implications of Climate Change Impacts and Adaptation Options
    (Washington, DC: World Bank, 2025-05-29) Abalo, Kodzovi; Boehlert, Brent; Bui, Thanh; Burns, Andrew; Castillo, Diego; Chewpreecha, Unnada; Haider, Alexander; Hallegatte, Stephane; Jooste, Charl; McIsaac, Florent; Ruberl, Heather; Smet, Kim; Strzepek, Ken
    Estimating the macroeconomic implications of climate change impacts and adaptation options is a topic of intense research. This paper presents a framework in the World Bank's macrostructural model to assess climate-related damages. This approach has been used in many Country Climate and Development Reports, a World Bank diagnostic that identifies priorities to ensure continued development in spite of climate change and climate policy objectives. The methodology captures a set of impact channels through which climate change affects the economy by (1) connecting a set of biophysical models to the macroeconomic model and (2) exploring a set of development and climate scenarios. The paper summarizes the results for five countries, highlighting the sources and magnitudes of their vulnerability --- with estimated gross domestic product losses in 2050 exceeding 10 percent of gross domestic product in some countries and scenarios, although only a small set of impact channels is included. The paper also presents estimates of the macroeconomic gains from sector-level adaptation interventions, considering their upfront costs and avoided climate impacts and finding significant net gross domestic product gains from adaptation opportunities identified in the Country Climate and Development Reports. Finally, the paper discusses the limits of current modeling approaches, and their complementarity with empirical approaches based on historical data series. The integrated modeling approach proposed in this paper can inform policymakers as they make proactive decisions on climate change adaptation and resilience.
  • Publication
    South Africa’s Fragmented Cities: The Unequal Burden of Labor Market Frictions
    (Washington, DC: World Bank, 2026-01-08) Baez, Javier E.; Kshirsagar, Varun
    Using high-resolution administrative, census, and satellite data, this paper shows that South African cities are characterized by spatial mismatches between where people live and where jobs are located, relative to 20 global peers. Areas within 5 kilometers of commercial centers have 9,300 fewer residents per square kilometer than expected, which is 60 percent below the global median. Poor, dense neighborhoods are most affected. In Johannesburg, a 10-percentile increase in distance from the nearest business hub corresponds to a 3.7-percentile drop in asset wealth (a proxy of household wellbeing) and 4.9-percentile drop in employment. In Cape Town, the declines are 4.0 and 3.7 percentiles, respectively. Employment is 87 percent lower in the poorest decile than the richest in Johannesburg and 61 percent lower in Cape Town. These findings suggest that South Africa’s spatial organization of people and economic activity constrains agglomeration and reinforces inequality. This methodology provides a scalable and standardized data-driven framework to analyze spatial accessibility and agglomeration frictions in complex, data-constrained urban systems.
  • Publication
    The Evolution of Local Participatory Democracy in Nepal
    (Washington, DC: World Bank, 2025-11-05) Bhusal, Thaneshwar; Breen, Michael G; Rao, Vijayendra
    Nepal is, according to its constitution, among the world’s most decentralized countries, with a long and complex tradition of local-level public participation. This paper traces the evolution of Nepal’s modern participatory institutions, examining the extent to which they are “induced” by external interventions versus being “organically” rooted in indigenous practices. The paper identifies three broad phases: an initial focus on participation in project implementation; a subsequent phase that expanded citizen engagement; and a third phase of citizen empowerment, culminating in the 2015 federal constitution, which granted unprecedented local autonomy. The analysis yields five key findings. First, over the past 50 years, successive reforms have progressively expanded opportunities for citizens to influence local decision-making. Second, these reforms have integrated traditional participatory mechanisms into formal institutions of local government. Third, although central-level initiatives exist, most participatory platforms continue to operate at the local level. Fourth, the federal constitution has created a new landscape of local democracy, embedding autonomy and accountability. Fifth, although they are still valued in many ethnic and territorial communities, traditional participatory practices are gradually disappearing. The paper concludes by offering policy recommendations to help donor agencies and governments strengthen Nepal’s democratic trajectory. It argues that effective interventions should build on Nepal’s deep participatory traditions while recognizing the constitutional reality of far-reaching local autonomy.
  • Publication
    Institutional Capacity for Policy Implementation: An Analytical Framework
    (Washington, DC: World Bank, 2026-01-07) Kim, Galileu; Kumar, Tanu; Ramalho, Rita; Russell, Stuart
    State capacity is an important prerequisite for policy implementation, yet at the country level it is difficult to measure, assess, and reform. This paper proposes a focus on institutional capacity: the ability of public institutions to implement the specific policy mandates for which they are responsible. Based on a review of existing literature, the paper defines the different dimensions that compose institutional capacity and groups them into two cross-cutting categories: organizational dimensions (personnel, financial resources, information systems, and management practices) and governance dimensions (transparency, independence, and accountability). The paper proposes measures for organizational and governance dimensions using existing data, shows intra-institutional variation of these measures within countries, and discusses how new data could be collected for better measurement of these concepts. Finally, the paper illustrates how the framework can be used to diagnose the sources of common problems related to weak policy implementation.
  • Publication
    Closing the Gender Gap in Entrepreneurship: Overcoming Challenges in Law and Practice for Female Entrepreneurs
    (Washington, DC: World Bank, 2026-01-07) Behr, Daniela M.; Xi, Yue
    Despite significant strides toward gender equality, women around the world continue to encounter systemic obstacles that hinder their entrepreneurial success. This paper systematically reviews the literature on the barriers female entrepreneurs face and the solutions proposed to overcome these challenges. It discusses institutional factors, financial factors, human capital factors, and social and cultural factors. The literature overview is complemented by a series of stylized facts that illustrate how overcoming some of these existing barriers is correlated with improved women’s entrepreneurship and female labor force participation, drawing on the World Bank’s Women, Business and the Law database as well as the World Bank’s Enterprise Surveys. The findings underscore the need for creating an enabling environment where women can thrive as entrepreneurs.
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Alternative Cash Transfer Delivery Mechanisms : Impacts on Routine Preventative Health Clinic Visits in Burkina Faso
    (2012-01-01) Akresh, Richard; de Walque, Damien; Kazianga, Harounan
    The authors conducted a unique randomized experiment to estimate the impact of two alternative cash transfer delivery mechanisms on household demand for routine preventative health services in rural Burkina Faso. The two-year pilot program randomly distributed cash transfers that were either conditional or unconditional, and the money was given to either mothers or fathers. Families enrolled in the conditional cash transfer schemes were required to obtain quarterly child-growth monitoring at local health clinics for all children under five years old. There was not such a requirement under the unconditional programs. Compared with control group households, conditional cash transfers significantly increased the number of preventative health care visits during the previous year, while unconditional cash transfers did not have such an impact. For the conditional cash transfers, money given to mothers or fathers showed beneficial impacts of similar magnitude in increasing routine visits.
  • Publication
    Cash Transfers and Child Schooling : Evidence from a Randomized Evaluation of the Role of Conditionality
    (World Bank, Washington, DC, 2013-01) Akresh, Richard; de Walque, Damien; Kazianga, Harounan
    The authors conduct a randomized experiment in rural Burkina Faso to estimate the impact of alternative cash transfer delivery mechanisms on education. The two-year pilot program randomly distributed cash transfers that were either conditional or unconditional. Families under the conditional schemes were required to have their children ages 7-15 enrolled in school and attending classes regularly. There were no such requirements under the unconditional programs. The results indicate that unconditional and conditional cash transfer programs have a similar impact increasing the enrollment of children who are traditionally favored by parents for school participation, including boys, older children, and higher ability children. However, the conditional transfers are significantly more effective than the unconditional transfers in improving the enrollment of "marginal children" who are initially less likely to go to school, such as girls, younger children, and lower ability children. Thus, conditionality plays a critical role in benefiting children who are less likely to receive investments from their parents.
  • Publication
    Child Ability and Household Human Capital Investment Decisions in Burkina Faso
    (2010-07-01) Akresh, Richard; Bagby, Emilie; de Walque, Damien; Kazianga, Harounan
    Using data they collected in rural Burkina Faso, the authors examine how children's cognitive abilities influence resource constrained households' decisions to invest in their education. This paper uses a direct measure of child ability for all primary school-aged children, regardless of current school enrollment. The analysis explicitly incorporates direct measures of the ability of each child s siblings (both absolute and relative measures) to show how sibling rivalry exerts an impact on the parents decision of whether and how much to invest in their child s education. The findings indicate that children with one standard deviation higher own ability are 16 percent more likely to be currently enrolled, while having a higher ability sibling lowers current enrollment by 16 percent and having two higher ability siblings lowers enrollment by 30 percent. The results are robust to addressing the potential reverse causality of schooling influencing child ability measures and using alternative cognitive tests to measure ability.
  • Publication
    Evidence from a Randomized Evaluation of the Household Welfare Impacts of Conditional and Unconditional Cash Transfers Given to Mothers or Fathers
    (World Bank, Washington, DC, 2016-06) Akresh, Richard; de Walque, Damien; Kazianga, Harounan
    This study conducted a randomized control trial in rural Burkina Faso to estimate the impact of alternative cash transfer delivery mechanisms on education, health, and household welfare outcomes. The two-year pilot program randomly distributed cash transfers that were either conditional or unconditional and were given to either mothers or fathers. Conditionality was linked to older children enrolling in school and attending regularly and younger children receiving preventive health check-ups. Compared with the control group, cash transfers improve children's education and health and household socioeconomic conditions. For school enrollment and most child health outcomes, conditional cash transfers outperform unconditional cash transfers. Giving cash to mothers does not lead to significantly better child health or education outcomes, and there is evidence that money given to fathers improves young children's health, particularly during years of poor rainfall. Cash transfers to fathers also yield relatively more household investment in livestock, cash crops, and improved housing.
  • Publication
    Child Labor, Schooling, and Child Ability
    (2012-02-01) Akresh, Richard; Bagby, Emilie; de Walque, Damien; Kazianga, Harounan
    Using data collected in rural Burkina Faso, this paper examines how children's cognitive abilities influence households' decisions to invest in their education. To address the endogeneity of child ability measures, the analysis uses rainfall shocks experienced in utero or early childhood to instrument for ability. Negative shocks in utero lead to 0.24 standard deviations lower ability z-scores, corresponding with a 38 percent enrollment drop and a 49 percent increase in child labor hours compared with their siblings. Negative education impacts are largest for in utero shocks, diminished for shocks before age two, and have no impact for shocks after age two. The paper links the fetal origins hypothesis and sibling rivalry literatures by showing that shocks experienced in utero not only have direct negative impacts on the child's cognitive ability (fetal origins hypothesis), but also negatively impact the child through the effects on sibling rivalry resulting from the cognitive differences.

Users also downloaded

Showing related downloaded files

  • Publication
    World Development Report 2025: Standards for Development
    (Washington, DC: World Bank, 2025-12-11) World Bank
    Standards make everyday life run smoothly. You rarely notice them: the credit card that works in any corner of the world, the Wi-Fi signal that connects a remote village to the cloud, or the vaccine vial that fits syringes from Dakar to Delhi. When standards work, they build trust. They free people and firms to focus on creating, trading, and innovating, confident that the systems around them will hold. When standards fail, the effects are immediate and draining. Payments are declined, signals drop, vaccines spoil—and instead of being productive, people spend their energy just meeting their basic needs. Standards, in short, are the hidden infrastructure of modern economies—and they have never been more important. Developing countries today must contend with a thicket of increasingly stringent international standards, a product of globalization and rapid technological change. Using standards—and shaping them—is now a prerequisite for export growth, technology diffusion, and the efficient delivery of public services. Yet standards are too often overlooked by policy makers, especially in developing countries. World Development Report 2025: Standards for Development provides the most comprehensive assessment of the global landscape of standards today and how they can be used to accelerate economic development. It offers a practical framework for countries at all stages of development. Countries at the earliest stage should adapt international standards to suit local conditions when needed, whereas at more advanced stages, they should aim to align domestic markets with international standards. Meanwhile, all countries should author international standards in priority areas.
  • Publication
    Jobs in a Changing Climate: Insights from World Bank Group Country Climate and Development Reports Covering 93 Economies
    (Washington, DC: World Bank, 2025-11-05) World Bank
    The World Bank Group’s Country Climate and Development Reports (CCDRs) provide a crosscutting look at how countries’ development prospects, and the job opportunities they offer to their people, can be threatened by climate impacts and supported by climate policies. Climate change and policies affect jobs through impacts on productivity, energy and material efficiency, and physical, human, and natural capital. They can also transform employment opportunities, especially through complementary measures that help workers and firms adapt to and benefit from new technologies and production practices. Prepared by the World Bank, the International Finance Corporation (IFC), and the Multilateral Investment Guarantee Agency (MIGA), CCDRs integrate country perspectives, climate science and economic modeling, private sector information, and policy analysis to assess how countries can successfully grow and develop their economies and create jobs despite increasing climate risks and while achieving their climate objectives and commitments. Each CCDR starts from the country’s development priorities, opportunities, and challenges, and is developed in close consultation with governments, businesses, and civil society, ensuring the recommendations reflect national priorities. By combining evidence on adaptation, resilience, and emissions pathways, CCDRs highlight where climate action can reinforce development and job creation, and where targeted policies are needed to manage risks and smooth labor market transitions. Taken together, these elements can help create local jobs, ensure economic transitions are just and inclusive, and equip workers and firms to navigate the disruptions and opportunities of a changing climate and changing technologies.
  • Publication
    Business Ready 2024
    (Washington, DC: World Bank, 2024-10-03) World Bank
    Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.
  • Publication
    The World Bank Group Annual Report 2025
    (Washington, DC: World Bank, 2025-10-09) World Bank Group
    The World Bank Group Annual Report 2025 presents on World Bank Group activities in fiscal 2025. The Annual Report is prepared by the Executive Directors of ICSID, IFC, MIGA, and the World Bank (IBRD/IDA) in accordance with the by-laws of the institutions. The President of the World Bank Group and Chairman of the Board of Executive Directors submit the Annual Report, together with the accompanying administrative budgets and audited financial statements, to the Board of Governors.
  • Publication
    Forging Viet Nam's Semiconductor Future: Talent and Innovation Leading the Way
    (Washington, DC: World Bank, 2025-09-10) World Bank
    Vietnam has prioritized semiconductors as one of ten critical technologies and set explicit goals of becoming a global semiconductor talent hub by 2030, moving up the value chain toward higher value-added segments, and developing a complete semiconductor value chain by 2045. Delivering on that pledge hinges on strategic and urgent investment in top talent, science, and innovation. This report concentrates on the most urgent gap – cultivating a cadre of scientists and engineers (S&E). and, to the extent possible, tech entrepreneurs, to support Vietnam’s semiconductor and high-tech ambitions. The analysis and interventions focus on the highly skilled workforce and frontier talent development, and cover research, innovation, and university-industry linkages in relation to the talent challenges. The report recognizes that to unlock its semiconductor potential, Viet Nam must address other binding constraints, notably: weak linkages between FDI and domestic firms, emerging infrastructure gaps (e.g., energy and logistics), and intellectual property rights regulations, amid evolving geoeconomics conditions.