Publication: Community-Based Conditional Cash Transfers in Tanzania : Results from a Randomized Trial
Loading...
Files in English
10,829 downloads
Published
2014-03-04
ISSN
Date
2014-03-06
Author(s)
Editor(s)
Abstract
Given the success of conditional cash transfer (CCT) programs elsewhere, in 2010 the Government of Tanzania rolled out a pilot CCT program in three districts. Its aim was to see if, using a model relying on communities to target beneficiaries and deliver payments, the program could improve outcomes for the poor the way centrally-run CCT programs have in other contexts. The program provided cash payments to poor households, but conditioned payments on complying with certain health and education requirements. Given scarce resources, the Government randomly selected 40 out of 80 eligible villages to receive the pilot program. Households in participating and comparison villages were broadly comparable at baseline. This report describes the program and the results of a rigorous, mixed methods impact evaluation. Two and a half years into the program, participating households were healthier and more educated. Health improvements due to the CCT program were greatest for the poorest half of households—the poorest of the poor. They experienced a half a day per month reduction in sick days on average, and poor children age 0-4 in particular had a full day per month reduction in sick days. In education, the program showed clear positive impacts on whether children had ever attended school and on whether they completed Standard 7. Households were also more likely to buy shoes for children, which can promote both health and school attendance. In response to the program, households also made investments to reduce risk: Participating households were much more likely to finance medical care with insurance and much more likely to purchase health insurance than were their comparison counterparts. The program did not significantly affect savings on aeverage, although it did increase non-bank savings amongst the poorest half of households. Participating households also invested in more livestock assets, which they used to create small enterprises. The program did not, however, have significant impacts on food consumption. On the whole, the results suggest that households focused on reducing risk and on improving their livelihoods rather than principally on increasing consumption. There is also evidence that the project had positive effects on community cohesion.
Link to Data Set
Citation
“Hausladen, Stephanie; Evans, David K.; Reese, Natasha; Kosec, Katrina. 2014. Community-Based Conditional Cash Transfers in Tanzania : Results from a Randomized Trial. World Bank Study;. © http://hdl.handle.net/10986/17220 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Cash Transfers, Trust, and Inter-household Transfers(Published by Oxford University Press on behalf of the World Bank, 2023-01-24)Institutionalized conditional cash transfer (CCT) programs may affect pre-existing, informal safety nets such as inter-household transfers and trust among community members. This study reports on a randomized controlled trial used to test the impact of CCTs on various measures of trust and informal safety nets within communities in Tanzania. It provides evidence that the introduction of a CCT program increased program beneficiaries’ trust in other community members and their perceived ability to access support from other households (e.g., childcare). Although CCTs reduced the total size of transfers to beneficiary households in the community in the short run (after 1.75 years of transfers), that reduction had disappeared 2.75 years after transfers began. Taken together, this evidence suggests that formal CCT programs do not necessarily crowd out informal safety nets in the longer term, and they may in fact boost trust and support across households.Publication Cash Transfers and Health(Published by Oxford University Press on behalf of the World Bank, 2019-06)How do cash transfers conditioned on health clinic visits and school attendance impact health-related outcomes? Examining the 2010 randomized introduction of a program in Tanzania, this paper finds nuanced impacts. An initial surge in clinic visits after 1.5 years—due to more visits by those already complying with program health conditions and by non-compliers—disappeared after 2.5 years, largely due to compliers reducing above-minimal visits. The study finds significant increases in take-up of health insurance and the likelihood of seeking treatment when ill. Health improvements were concentrated among children ages 0–5 years rather than the elderly, and took time to materialize; the study finds no improvements after 1.5 years, but 0.76 fewer sick days per month after 2.5 years, suggesting the importance of looking beyond short-term impacts. Reductions in sick days were largest in villages with more baseline health workers per capita, consistent with improvements being sensitive to capacity constraints. These results are robust to adjustments for multiple hypothesis testing.Publication Cash Transfers Increase Trust in Local Government(World Bank, Washington, DC, 2018-02)How does a locally-managed conditional cash transfer program impact trust in government? On the one hand, delivering monetary benefits and increasing interactions with government officials (elected and appointed) may increase trust. On the other hand, imposing paternalistic conditions, leading some to experience feelings of social stigma or guilt, and potentially permitting capture by local elites could reduce trust. This paper answers this question by exploiting the randomized introduction of a locally-managed transfer program in Tanzania in 2010, which included popular election of community management committees to run the program. The analysis reveals that cash transfers can significantly increase trust in leaders. This effect is driven by large increases in trust in elected leaders as opposed to appointed bureaucrats. Perceptions of government responsiveness to citizens' concerns and honesty of leaders also rise; these improvements are largest where there are more village meetings at baseline. One of the central roles of village meetings is to receive and share information with village residents. One indicator that governance may have improved is that records from school and health committees are more readily available in treatment villages. Notably, while the stated willingness of citizens to participate in community development projects rises, actual participation in projects and the likelihood of voting does not. Concerns that local management of a cash transfer program will destroy trust in government or reduce the quality of governance appear unfounded—especially in high-information contexts.Publication The Effects of Home-based HIV Counseling and Testing on HIV/AIDS Stigma among Individuals and Community Leaders in Western Kenya : Evidence from a Cluster-randomized Trial(Taylor and Francis, 2013-06-09)HIV counseling and testing services play an important role in HIV treatment and prevention efforts in developing countries. Community-wide testing campaigns to detect HIV earlier may additionally impact community knowledge and beliefs about HIV. We conducted a cluster-randomized evaluation of a home-based HIV testing campaign in western Kenya and evaluated the effects of the campaign on community leaders’ and members’ stigma toward people living with HIV/AIDS. We find that this type of large-scale HIV testing can be implemented successfully in the presence of stigma, perhaps due to its “whole community” approach. The home-based HIV testing intervention resulted in community leaders reporting lower levels of stigma. However, stigma among community members reacted in mixed ways, and there is little evidence that the program affected beliefs about HIV prevalence and prevention.Publication Cash Transfers and Health(World Bank, Washington, DC, 2016-11)How do conditional cash transfers impact health-related outcomes? This paper examines the 2010 randomized introduction of a program in Tanzania and finds nuanced impacts. An initial surge in clinic visits after 1.5 years -- due to more visits by those already complying with program health conditions and by non-compliers -- disappeared after 2.5 years, largely due to compliers reducing above-minimal visits. The study finds significant increases in take-up of health insurance and the likelihood of seeking treatment when ill. Health improvements were concentrated among children ages 0–5 years rather than the elderly, and took time to materialize; the study finds no improvements after 1.5 years, but 0.76 fewer sick days per month after 2.5 years, suggesting the importance of looking beyond short-term impacts. Reductions in sick days were largest in villages with more baseline health workers per capita, consistent with improvements being sensitive to capacity constraints. These results are robust to adjustments for multiple hypothesis testing.
Users also downloaded
Showing related downloaded files
Publication Design Thinking for Social Innovation(2010-07)Designers have traditionally focused on enchancing the look and functionality of products.Publication Governance Matters IV : Governance Indicators for 1996-2004(World Bank, Washington, DC, 2005-06)The authors present the latest update of their aggregate governance indicators, together with new analysis of several issues related to the use of these measures. The governance indicators measure the following six dimensions of governance: (1) voice and accountability; (2) political instability and violence; (3) government effectiveness; (4) regulatory quality; (5) rule of law, and (6) control of corruption. They cover 209 countries and territories for 1996, 1998, 2000, 2002, and 2004. They are based on several hundred individual variables measuring perceptions of governance, drawn from 37 separate data sources constructed by 31 organizations. The authors present estimates of the six dimensions of governance for each period, as well as margins of error capturing the range of likely values for each country. These margins of error are not unique to perceptions-based measures of governance, but are an important feature of all efforts to measure governance, including objective indicators. In fact, the authors give examples of how individual objective measures provide an incomplete picture of even the quite particular dimensions of governance that they are intended to measure. The authors also analyze in detail changes over time in their estimates of governance; provide a framework for assessing the statistical significance of changes in governance; and suggest a simple rule of thumb for identifying statistically significant changes in country governance over time. The ability to identify significant changes in governance over time is much higher for aggregate indicators than for any individual indicator. While the authors find that the quality of governance in a number of countries has changed significantly (in both directions), they also provide evidence suggesting that there are no trends, for better or worse, in global averages of governance. Finally, they interpret the strong observed correlation between income and governance, and argue against recent efforts to apply a discount to governance performance in low-income countries.Publication Breaking the Conflict Trap : Civil War and Development Policy(Washington, DC: World Bank and Oxford University Press, 2003)Most wars are now civil wars. Even though international wars attract enormous global attention, they have become infrequent and brief. Civil wars usually attract less attention, but they have become increasingly common and typically go on for years. This report argues that civil war is now an important issue for development. War retards development, but conversely, development retards war. This double causation gives rise to virtuous and vicious circles. Where development succeeds, countries become progressively safer from violent conflict, making subsequent development easier. Where development fails, countries are at high risk of becoming caught in a conflict trap in which war wrecks the economy and increases the risk of further war. The global incidence of civil war is high because the international community has done little to avert it. Inertia is rooted in two beliefs: that we can safely 'let them fight it out among themselves' and that 'nothing can be done' because civil war is driven by ancestral ethnic and religious hatreds. The purpose of this report is to challenge these beliefs.Publication Governance Matters VIII : Aggregate and Individual Governance Indicators 1996–2008(2009-06-01)This paper reports on the 2009 update of the Worldwide Governance Indicators (WGI) research project, covering 212 countries and territories and measuring six dimensions of governance between 1996 and 2008: Voice and Accountability, Political Stability and Absence of Violence/Terrorism, Government Effectiveness, Regulatory Quality, Rule of Law, and Control of Corruption. These aggregate indicators are based on hundreds of specific and disaggregated individual variables measuring various dimensions of governance, taken from 35 data sources provided by 33 different organizations. The data reflect the views on governance of public sector, private sector and NGO experts, as well as thousands of citizen and firm survey respondents worldwide. The authors also explicitly report the margins of error accompanying each country estimate. These reflect the inherent difficulties in measuring governance using any kind of data. They find that even after taking margins of error into account, the WGI permit meaningful cross-country comparisons as well as monitoring progress over time. The aggregate indicators, together with the disaggregated underlying indicators, are available at www.govindicators.org.Publication Government Matters III : Governance Indicators for 1996-2002(World Bank, Washington, DC, 2003-08)The authors present estimates of six dimensions of governance covering 199 countries and territories for four time periods: 1996, 1998, 2000, and 2002. These indicators are based on several hundred individual variables measuring perceptions of governance, drawn from 25 separate data sources constructed by 18 different organizations. The authors assign these individual measures of governance to categories capturing key dimensions of governance and use an unobserved components model to construct six aggregate governance indicators in each of the four periods. They present the point estimates of the dimensions of governance as well as the margins of errors for each country for the four periods. The governance indicators reported here are an update and expansion of previous research work on indicators initiated in 1998 (Kaufmann, Kraay, and Zoido-Lobat 1999a,b and 2002). The authors also address various methodological issues, including the interpretation and use of the data given the estimated margins of errors.