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1 Cash transfers: what does the evidence say? A rigorous review of programme impact and of the role of design and implementation features Francesca Bastagli, Jessica Hagen-Zanker, Luke Harman, Valentina Barca, Georgina Sturge and Tanja Schmidt, with Luca Pellerano July 2016

2 Overseas Development Institute 203 Blackfriars Road London SE1 8NJ Tel. +44 (0) 20 7922 0300 Fax. +44 (0) 20 7922 0399 E-mail: [email protected] www.odi.org www.odi.org/facebook www.odi.org/twitter Readers are encouraged to reproduce material from ODI Reports for their own publications, as long as they are not being sold commercially. As copyright holder, ODI requests due acknowledgement and a copy of the publication. For online use, we ask readers to link to the original resource on the ODI website. The views presented in this paper are those of the author(s) and do not necessarily represent the views of ODI. © Overseas Development Institute 2016. This work is licensed under a Creative Commons Attribution-NonCommercial Licence (CC BY-NC 4.0). Cover image: Receiving food assistance and cash transfers in Burkina Faso © EC/ECHO/Anouk Delafortrie, Licence: CC BY-NC-ND 2.0

3 Page 3 Cash transfers: what does the evidence say? Contents Acknowledgements 4 Executive summar y 5 16 SECTION I Chapter 1 17 Introduction 1 7 1.1 ackground and objectives of this review B 1 9 S 1.2 tructure of the report 22 Chapter 2 Conceptual framework verarching conceptual framework 2 2 2.1 O 6 ndicator- and outcome-specific theories of change 2.2 I 3 48 Review of cash transfer reviews Chapter 3 verview of systematic reviews 4 9 3.1 O verview of findings from systematic reviews 3.2 5 1 O ole of cash transfer design and implementation features 7 3.3 R 5 62 Methods Chapter 4 4.1 2 Overview 6 riteria for inclusion 6 3 4.2 C earch methods for identification of studies 6 5 4.3 S tudy screening and assessment process 7 6 S 4.4 Ev 7 0 4.5 idence extraction 4.6 imitations of this review 7 3 L 74 Chapter 5 The evidence base S 7 4 5.1 cale of the evidence tudies included in the review 6 5.2 S 7 85 SECTION II The impact of cash transfers on monetar 86 Chapter 6 y poverty ummary of findings 6.1 8 8 S S 8 6.2 ummary of evidence base 9 9 T he impact of cash transfers on poverty 2 6.3 T he impact of cash transfers on poverty indicators for women and girls 9 5 6.4 T he role of cash transfer design and implementation features 9 6 6.5 P olicy implications 9 9 6.6 105 Chapter 7 The impact of cash transfers on education S ummary of findings 1 07 7.1 S 1 08 7.2 ummary of evidence base T 1 11 7.3 he impact of cash transfers on education he impact of cash transfers on education indicators for women and girls 15 1 7.4 T 17 he role of cash transfer design and implementation features 7.5 1 T P olicy implications 1 21 7.6 The impact of cash transfers on health and nutrition 127 Chapter 8 S 8.1 1 29 ummary of findings ummary of evidence base 31 S 8.2 1 1 T he impact of cash transfers on health and nutrition 34 8.3 he impact of cash transfers on health and nutrition indicators for women and girls 1 37 T 8.4 1 39 T 8.5 he role of cash transfer design and implementation features olicy implications 1 P 43 8.6 investment and production 149 Chapter 9 The impact of cash transfers on savings, S ummary of findings 9.1 1 51 1 S 52 9.2 ummary of evidence base T 1 he impact of cash transfers on savings, investment and production 55 9.3 T 1 61 he impact of cash transfers on savings, investment and production indicators for women and girls 9.4 T he role of cash transfer design and implementation features 1 62 9.5 1 P 9.6 66 olicy implications The impact of cash transfers on employment 174 Chapter 10 S ummary of findings 1 77 10.1 S ummary of evidence base 1 78 10.2 he impact of cash transfers on employment 1 82 T 10.3 10.4 1 96 T he role of cash transfer design and implementation features olicy implications 01 10.5 2 P 211 Chapter 11 The impact of cash transfers on empowerment S ummary of findings 2 13 11.1 S 2 13 11.2 ummary of evidence base 16 he overall impact of cash transfers on empowerment T 2 11.3 he role of cash transfer design and implementation features 2 24 11.4 T 27 olicy implications 11.5 2 P 236 SECTION III 237 Summar Chapter 12 y of findings and conclusion Overview 37 2 12.1 he evidence base 38 12.2 2 T he impacts of cash transfers by outcome 12.3 40 2 T 12.4 ummary of the evidence by outcome and indicators 2 45 S he role of design and implementation features 53 12.5 T 2 12.6 Conclusion 66 2 References 271

4 Cash transfers: what does the evidence say? Page 4 Contents Acknowledgements Acknowledgements Executive summary SECTION I Chapter 1 Introduction The authors are grateful to members of the project’s Advisory Group, Michelle Adato, Armando Barrientos, Christina Behrendt, Benjamin Davis, Margaret Grosh, Nicola Jones and Fabio Veras Chapter 2 Soares, for advice over the course of the project and comments on the report. Thanks also to Conceptual Hugh Waddington for comments on the draft report. framework Chapter 3 At DFID, Nathanael Bevan, James Bonner, Ranil Dissanayake, Matthew Greenslade, Heather Review of cash Kindness, Abigail Perry, Jessica Vince, Rachel Yates and Benjamin Zeitlyn provided helpful transfer reviews feedback and detailed comments on earlier versions of the report. Special thanks to Heather Kindness and Jessica Vince who advised on review scope, approach and content throughout. Chapter 4 Methods Dharini Bhuvanendra provided excellent research assistance and John Eyre reviewed the literature Chapter 5 search strategy. Thanks to Calvin Laing and Fiona Lamont for project support, to John Maher The evidence base for copy-editing, to Aaron Griffiths for proofreading and to Garth Stewart and Sean Willmott for design. SECTION II This project was led by ODI and conducted in partnership with Oxford Policy Management Chapter 6 (OPM). This research has been funded by UK aid from the UK government. However, the views The impact of expressed do not necessarily reflect the UK government’s official policies. cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

5 Cash transfers: what does the evidence say? Page 5 Contents Acknowledgements Executive summary Executive summary SECTION I Chapter 1 Introduction Objectives of the review Chapter 2 Conceptual Cash transfers have been increasingly adopted by low- and middle-income countries as central framework elements of their poverty reduction and social protection strategies (Barrientos, 2013; DFID, Chapter 3 2011; Hanlon et al., 2010; Honorati et al., 2015; ILO, 2014). There are some 130 low- and Review of cash middle-income countries that have at least one non-contributory unconditional cash transfer transfer reviews (UCT) programme (including poverty-targeted transfers and old-age social pensions), with growth in programme adoption especially high in Africa, where 40 countries out of 48 in Chapter 4 aharan Africa now have a UCT, double the 2010 total. Similarly, 63 countries have at least - sub S Methods one conditional cash transfer programme, up from two countries in 1997 and 27 countries in Chapter 5 2008 (Honorati et al., 2015). This expansion has been accompanied by a growing number of The evidence base evaluations, resulting in a body of evidence on the effects of different programmes on individual- and household-level outcomes. More recently, closer attention has been paid to the programme design and implementation details that influence the ways in which cash transfers work. SECTION II Chapter 6 This review retrieves, assesses and synthesises the evidence on the effects of cash transfers on The impact of individuals and households through a rigorous review of the literature of 15 years, from 2000 to cash transfers on 2015. Focusing on non-contributory monetary transfers, including conditional and unconditional monetary poverty cash transfers, social pensions and enterprise grants, it addresses three overarching research questions: Chapter 7 The impact of 1. W hat is the evidence of the impact of cash transfers on a range of individual- or household- cash transfers on level outcomes, including intended and unintended outcomes? education hat is the evidence of the links between variations in programme design and implementation W 2. Chapter 8 features and cash transfer outcomes? The impact of cash transfers on health 3. hat is the evidence of the impacts of cash transfers, and of variations in their design and W and nutrition implementation components, on women and girls? Chapter 9 The impact of This review is distinct from previous cash transfer literature reviews in three key features: cash transfers on the methods used (more on this below), the breadth of the evidence retrieved, assessed and savings, investment synthesised, and the particular focus on programme design and implementation features. The six and production outcomes covered by the review are: monetary poverty; education; health and nutrition; savings, investment and production; employment; and empowerment. The cash transfer design and Chapter 10 The impact of implementation features considered are: core design features; conditionality; targeting; payment cash transfers on systems, grievance mechanisms and programme governance; complementary interventions and employment supply-side services. Chapter 11 The impact of cash transfers on Methods empowerment This is a rigorous literature review, which complies with core systematic review principles – breadth, rigour and transparency – while allowing for a more flexible handling of retrieval and SECTION III analysis with the objective of ensuring comprehensiveness and relevance. Having detailed the methodological approach in ‘protocol’ form, the literature was then retrieved through five distinct Chapter 12 Summary of search tracks: (1) bibliographic databases, (2) other electronic sources (i.e. websites and search findings and engines), (3) expert recommendations, (4) past reviews and snowballing, and (5) studies deemed to conclusion be relevant from other outcome areas. The searches were conducted in mid-2015. The more than 38,000 studies retrieved were screened using predefined inclusion criteria, with relevant studies References then subjected to a second-stage screening that considered the risk of bias and methodological

6 Cash transfers: what does the evidence say? Page 6 Contents rigour in the research methods used by each study. The studies that showed no or low concerns Acknowledgements in terms of risk of bias and methodological rigour were included in the review. The final group of 201 studies which passed the search, retrieval and assessment stages are listed in an annotated Executive summary bibliography (Harman et al., 2016), which contains detailed information on each study, including the intervention analysed, methods used and outcomes covered, as a resource for researchers when carrying out future literature reviews and analyses. SECTION I Chapter 1 For each outcome area, evidence was extracted and synthesised for five to seven indicators, Introduction identified on the basis of their policy relevance, coverage in the literature and prevalence of sex- disaggregated results. For quantitative, counterfactual analysis, the magnitude, sign and statistical Chapter 2 significance of coefficients measuring the effects of cash transfers and of variations in their design Conceptual features on individual- and household-level outcomes were extracted, at the highest level of framework aggregation reported. Whenever available, disaggregated results for women and girls were also Chapter 3 extracted and analysed. Review of cash transfer reviews In synthesising the evidence, the review relied on both a vote counting and narrative synthesis approach. The vote counting approach reports the number of studies that show an increase/ Chapter 4 Methods decrease in a specific indicator and provides an indication of the strength of the evidence available for each indicator. While it provides a useful tool to summarise findings, its limitations include Chapter 5 the fact that it does not take sample size or magnitude of effects into account. Furthermore, it The evidence base aggregates findings across different cash transfer programmes, obscuring differences in policy objectives, target population and baseline levels. To at least partly address these shortcomings, the SECTION II review also relies on a narrative synthesis, which includes examples and discussions of the ranges and magnitudes of effects and of results that are not statistically signficant. Chapter 6 The impact of cash transfers on The evidence base monetary poverty Chapter 7 201 studies were included in the annotated bibliography. The scale of the evidence base varies The impact of by outcome and by design and implementation feature. For outcome areas, the evidence cash transfers on base is largest for ‘education’ (99 studies) and ‘health and nutrition’ (89 studies), followed by education ‘employment’ (80 studies) and smallest for ‘savings, investment and production’ (37 studies). On the whole, there are fewer studies explicitly designed to analyse the effects of cash transfer design Chapter 8 The impact of cash and implementation features on outcomes of interest, with no relevant studies found for ‘grievance transfers on health mechanisms and programme governance’, though there is a substantial evidence base of 41 studies and nutrition for ‘core design features’. In total, 165 studies were included in the extraction stage, ranging from 74 studies for ‘employment’ to 27 studies for ‘savings, investment and production’. These are the Chapter 9 studies from which the evidence discussed in this review is drawn. The impact of cash transfers on savings, investment For the studies included in the extraction stage, with the exception of the ‘savings, investment and and production production’ outcome, the majority focused on cash transfer programmes in Latin America; across all search sub-questions, approximately 54% of the studies report on a programme from Latin Chapter 10 America. Around 38% of the studies focused on a programme in sub-Saharan Africa, with studies The impact of cash transfers on looking at East Asia and the Pacific, Europe and Central Asia, and the Middle East and North employment Africa accounting for around 8%. Chapter 11 In total, this review covers 56 different cash transfer programmes, with some studies analysing The impact of more than one programme. The majority were conditional cash transfers (CCTs) (55%), mostly cash transfers on located in Latin America. 25% of the programmes were unconditional cash transfers (UCTs), empowerment mostly implemented in sub-Saharan Africa. Of the remaining programmes, 9% involved a combination of CCTs and UCTs, 7% were social pensions and 4% were enterprise grants. SECTION III Chapter 12 Summary of findings and conclusion References

7 Cash transfers: what does the evidence say? Page 7 Contents The impacts of cash transfers by outcome Acknowledgements Executive summary Monetary poverty There is a comparatively large evidence base linking cash transfers to reductions in monetary SECTION I poverty. The evidence extracted consistently shows an increase in total and food expenditure and Chapter 1 reduction in Foster–Greer–Thorbecke (FGT) poverty measures. Introduction 35 studies report findings on impact on , with 26 of these household total expenditure Chapter 2 demonstrating at least one significant impact and 25 finding an increase in total expenditure. Conceptual framework Among the 31 studies reporting impacts on household food expenditure , 25 show at least one statistically significant effect, with 23 of these being an increase. Two studies report a decrease Chapter 3 owing to a reduction in labour supply and possible prioritisation of savings over consumption. Review of cash transfer reviews Nine studies consider impacts on Foster–Greer–Thorbecke poverty measures (poverty headcount, Chapter 4 poverty gap, squared poverty gap). Among these studies, around two-thirds find a statistically Methods significant impact. While cash transfers are shown to mostly increase total and food expenditure, it appears that in many cases this impact is not big enough to have a subsequent effect on aggregate Chapter 5 poverty levels. However, with one exception, the studies consistently show decreases in poverty. The evidence base Six studies reported sex-disaggregated outcomes for expenditure indicators, but none shows a SECTION II difference between female/male recipients and female/male-headed households. Chapter 6 The impact of Education cash transfers on monetary poverty Overall, the available evidence highlights a clear link between cash transfer receipt and increased school attendance. Less evidence and a less clear-cut pattern of impact is found for learning Chapter 7 The impact of outcomes (as measured by test scores) and cognitive development outcomes (information cash transfers on processing ability, intelligence, reasoning, language development and memory), although, education interestingly, the three studies reporting statistically significant findings on the latter all report improvements in cognitive development associated with cash transfer receipt. Chapter 8 The impact of cash transfers on health attendance , of which 13 report some significant school 20 studies report on the overall effect on and nutrition effect. With the exception of one study, the findings point towards an increase in school attendance and a decrease in school absenteeism. Less evidence and a less clear-cut pattern Chapter 9 of impact is found for links between cash transfer receipt and learning outcomes. Five studies The impact of learning examine overall effects on , as measured through test scores in maths, language or a cash transfers on savings, investment composite test score. Two studies find a statistically significant effect (both for language test and production scores), one being an improvement and one a decrease. Five studies report an effect estimate of cognitive development scores; three of these find a statistically significant improvement. Chapter 10 The impact of 20 studies disaggregate findings by sex (either by sex of the child or head of the household), cash transfers on with statistically significant effects being increases in school attendance for girls and some employment improvements in test scores and cognitive development, with no clear pattern in effects varying by Chapter 11 head of the household. Of 15 studies disaggregating effects on attendance for girls versus boys, 12 The impact of report a statistically significant increase for at least one school attendance measure for girls, while cash transfers on one reports a decrease. Of five studies disaggregating impacts on learning, two find significant empowerment increases in test score results for girls, and for the five studies reporting on cognitive development, three report significant increases for girls. SECTION III Chapter 12 Health and nutrition Summary of findings and Evidence of the impacts of cash transfers across all three indicator areas – use of health services, conclusion dietary diversity and anthropometric measures – was largely consistent in terms of direction of References effect, showing improvements in the indicators. On the whole, the available evidence highlights how, while the cash transfers reviewed have played an important role in increasing the use of

8 Cash transfers: what does the evidence say? Page 8 Contents health services and dietary diversity, changes in design or implementation features, including Acknowledgements complementary actions (e.g. nutritional supplements or behavioural change training), may be required to achieve greater and more consistent impacts on child anthropometric measures. This Executive summary is reflected in the greater proportion of significant results found relating to health service use and dietary diversity and a lower proportion for anthropometric measures. SECTION I The available evidence shows that, on the whole, cash transfers – both CCTs and UCTs – have Chapter 1 increased the uptake of health services. Of the 15 studies reporting overall effects on the use of Introduction , nine report statistically significant increases. For dietary diversity, findings also health facilities , dietary diversity consistently show increases. Among the 12 studies reporting on impacts on Chapter 2 seven show statistically significant changes across a range of dietary diversity measures, all Conceptual is anthropometric outcomes being improvements. Evidence of statistically significant changes in framework limited to five out of 13 studies for stunting, one out of five for wasting and one out of eight for Chapter 3 underweight. All significant overall changes were improvements. Review of cash transfer reviews Evidence on how outcomes vary by sex was available from five studies. The evidence provides mixed results and highlights the importance of disaggregating by sex and age. For instance, one Chapter 4 Methods set of results on child anthropometric outcomes for an Indonesian conditional transfer provides indicative findings as to the importance of the sex of the household head for such impacts, with Chapter 5 a negative impact on child weight-for-height only found among male-headed households (World The evidence base Bank, 2011). SECTION II Savings, investment and production Chapter 6 The impact of Overall, impacts on savings, and on livestock ownership and/or purchase, as well as use and/ cash transfers on or purchase of agricultural inputs, are consistent in their direction of effect, with almost all monetary poverty statistically significant findings highlighting positive effects of cash transfers, though these are not universal to all programmes or to all types of livestock and inputs. This is an important finding Chapter 7 The impact of as, with the exception of one programme, none of the cash transfers analysed focuses explicitly on cash transfers on enhancing productive impacts. Impacts on borrowing, agricultural productive assets and business/ education enterprise are less clear-cut or are drawn from a smaller evidence base. Chapter 8 With regard to specific findings, of the 10 studies that look at the overall effect of cash transfers on The impact of cash transfers on health , half find statistically significant increases in the share of households reporting savings household and nutrition savings (ranging from seven to 24 percentage points) or the amount of savings accumulated. borrowing Impacts on were mixed. Of the 15 studies, four report significant increases, three Chapter 9 report significant reductions, one reports mixed findings and the remainder are not statistically The impact of significant. cash transfers on savings, investment and production Of the eight studies reporting on relevant indicators of households’ accumulation of agricultural for crop production (axes, sickles, hoes and other agricultural tools), three productive assets Chapter 10 find a positive and significant impact on a wide variety of indicators. The remaining five studies The impact of find no significant impacts. Lack of impact is explained in several ways, including behaviour cash transfers on influenced by strong programme labelling (money was to be spent for children) and the low value employment or unpredictability of the transfer. Of the eight studies reporting on agricultural inputs , six report Chapter 11 a significant increase in expenditure or use, primarily for fertiliser and seeds, while one reports a The impact of significant, but small, decrease. 12 out of 17 studies assessing livestock ownership and value show cash transfers on a significant increase. Impacts were particularly concentrated on smaller livestock, such as goats empowerment and chickens. SECTION III Impacts on business and enterprise were mixed: of the nine studies, four find significant increases in the share of households involved in non-farm enterprise or in total expenditure on business- Chapter 12 related assets and stocks, while one finds a significant decrease. Summary of findings and Eight studies report sex-disaggregated outcomes. Interestingly, three studies find significant conclusion impacts for some of the savings, production and investment indicators for female-headed References households, where they do not find any for male-headed households. Two studies find different types of impacts for male versus female household heads or beneficiaries (e.g. different type of

9 Cash transfers: what does the evidence say? Page 9 Contents investment preferred), while another two find no significant differences between men and women. Acknowledgements Overall, these results appear to be driven by different levels of asset ownership at baseline, with women having lower levels and hence showing bigger improvements, and also differing cultural Executive summary roles, with studies showing that women mainly acquired small livestock. SECTION I Employment Chapter 1 Introduction The evidence extracted for this review shows that for just over half of studies on adult work have a statistically significant impact. (participation and intensity), the cash transfer does not Chapter 2 Among those studies reporting a significant effect among adults of working age, the majority Conceptual find an increase in work participation and intensity. In the cases in which a reduction in work framework participation or work intensity is reported, these reflect a reduction in participation among the Chapter 3 elderly, those caring for dependents, or they are the result of reductions in casual work. Review of cash transfer reviews For both adult and child work, three indicators were considered (1) whether an individual works or does not work (adult labour force participation); (2) the time spent working (work intensity); Chapter 4 and (3) the sector/type of employment. 14 studies report on the effect on overall adult labour Methods , four find statistically : among the eight that report on adults of working age force participation Chapter 5 elderly significant impacts: three being increases and one a decrease. Among the two studies on The evidence base adults , one finds a significant effect in terms of reducing pensioners working for pay. 10 studies , with six studies showing statistically significant adult intensity of work report on overall impacts. Three involved reductions in time worked, though one was among the elderly. The SECTION II two interventions resulting in increases in time spent working resulted from enterprise grants Chapter 6 specificially intended to increase employment. The impact of cash transfers on Studies on sector of work show that in over half of the studies cash transfers did not significantly monetary poverty affect overall participation in the specific sectors studied; there is stronger evidence, however, for cash transfers impacting on time allocation towards different activities. A total of 12 studies Chapter 7 The impact of adult labour force participation by sector/type estimate the impact of cash transfers on overall cash transfers on . Of these, five find at least one significant effect, with three finding increases in of employment education self-employment, one an increase in unpaid family work and two showing reductions in casual adult work intensity work outside the household. 10 studies report the impact of cash transfers on Chapter 8 ; of these, seven report a statistically significant effect, in different sectors/types of employment The impact of cash transfers on health showing a mix of impacts. Three studies report on the impact on migration , with findings and nutrition showing that cash transfers can either increase or decrease the probability of migrating internally or internationally. Chapter 9 The impact of The evidence extracted shows some differential effects for men and women for labour force cash transfers on participation and work intensity. One of the main emerging themes around gendered effects relates savings, investment and production to changes in time allocation to different activities, with a few studies finding an increase in time spent on domestic work by women. In particular, out of six papers analysing the impact of cash Chapter 10 transfers on the number of hours worked by women by sector/type of employment, three find at The impact of least one statistically significant result, with two studies from Latin America finding an increase in cash transfers on time spent on domestic work by women (alongside a reduction in time spent on domestic chores by employment younger girls). Chapter 11 The impact of With regard to child labour, over half of the studies on cash transfer–child work participation cash transfers on links find no statistically significant result, while all the studies on child work intensity find empowerment statistically significant reductions in time spent working. Importantly, all the studies reporting a statistically significant result for whether a child is working/not working find a clear reduction SECTION III in child labour associated with cash transfer receipt. Moreover, the vast majority of estimates in studies reporting non-statistically significant results on child work participation rates display a Chapter 12 negative coefficient. It is interesting to note here, too, that the significant reductions in recorded Summary of child labour are driven by programmes in Latin America (with the addition of one programme findings and in Indonesia and one in Morocco), and that none of the studies reporting on a cash transfer conclusion programme in sub-Saharan Africa finds a significant impact. References

10 Cash transfers: what does the evidence say? Page 10 Contents More specifically, a total of 19 studies report cash transfer impacts on child labour force Acknowledgements . Of the eight studies that find any significant impact, all show a decrease in child participation labour. In terms of , of the eight studies, five report sector - child labour participation by sub Executive summary significant results, indicating reductions in various forms of market work, domestic work, own- farm work, and one shift from physical labour to non-physical labour. Five studies report on the intensity of overall child labour impacts on the . All find statistically significant reductions in the SECTION I number of hours spent working, with reductions ranging from 0.3 fewer hours a week to 2.5 Chapter 1 fewer hours a week. Four studies report cash transfer impacts on the number of hours worked Introduction by children by sector/type of work . Three studies report at least one significant result, showing a mixture of increased time on a family enterprise, reductions in time spent on own-farm work, and Chapter 2 reduced time in domestic work outside the household. Conceptual framework A total of 20 studies report effects on child labour participation among girls, of which 12 report Chapter 3 a significant effect with impacts generally showing reduction in child labour for boys and both Review of cash girls. Eight studies report estimates of the impact of cash transfers on girls working by sector. transfer reviews Five report significant effects, of which four show reductions across the board, and one shows an increase in household chores. Seven studies report estimates of the impact of cash transfers Chapter 4 Methods on the number of hours worked by girls in different sectors. Five report at least one statistically significant finding, including four studies showing declines in time spent on domestic work, Chapter 5 however, another does show an increase in time spent on family enterprise work in Indonesia. The evidence base Empowerment SECTION II Chapter 6 The available evidence shows that transfers can reduce physical abuse of women by men, but also The impact of that they may increase non-physical abuse, such as emotional abuse or controlling behaviour. It cash transfers on supports both the theory that increased income lowers stress-related abuse and the theory that monetary poverty increased income enables the woman to bargain out of abuse. The relatively strong evidence that decision-making power increases for women in the beneficiary household also offers substance to Chapter 7 The impact of this latter theory. Other evidence reveals that risky sexual behaviour and early marriage differ by cash transfers on gender, but for both girls/women and boys/men increased income to an extent lifts the constraints education that drive engagement in these behaviours. In the case of women and girls, the evidence that directly or indirectly receiving a transfer reduces the likelihood of having multiple sexual partners Chapter 8 indicates that cash transfers may reduce the incidence of relationships that are transactional. The impact of cash transfers on health Taken together, the evidence in this section points to cash transfers having a positive impact on and nutrition women’s choices as to fertility and engagement in sexual activity. In the case of men and boys, some of the evidence collected here suggests that cash transfers do not have the same effect of Chapter 9 reducing risky sexual activity, and in fact may lead to an increase in this type of behaviour. The impact of cash transfers on abuse by a Coming to the specific findings, eight studies consider the impact of cash transfers on savings, investment and production : six have significant results for physical or sexual abuse, all showing a reduction in male partner abuse. The findings for non-physical (e.g. emotional) abuse are mixed: six studies show significant Chapter 10 results for non-physical abuse, of which two indicate a rise in reports of abuse and four indicate a The impact of decline. Eight studies examine the impact of cash transfers on women’s decision-making power ; cash transfers on all eight look at expenditure-related decisions and four out of five significant results indicate a employment rise in a woman’s likelihood of being the sole or joint decision-maker. Five studies also look at Chapter 11 involvement in non-expenditure decisions, with mixed findings: one shows a significant decrease The impact of in the likelihood of the female being the sole or joint decision-maker and one shows a significant cash transfers on increase (both for decisions relating to contraceptive use). empowerment Six studies look at marriage , with five yielding significant results. Four of these indicate delayed SECTION III marriage for beneficiary women, with one exception. 10 studies report on (pregnancy fertility or giving birth) and of the seven studies yielding significant results, five indicate that the transfer Chapter 12 decreased the likelihood of pregnancy or giving birth, with two studies showing an increase for Summary of Honduras’s PRAF. For this programme, it is argued that the programme design linking transfer findings and levels to the number of children could have affected fertility outcomes (Stecklov, 2006). There conclusion are 10 papers dealing with the impact of a cash transfer on the use of contraception . Five of the References six studies with significant results find unambiguous evidence that the transfer increased the use of contraceptives or reduced the likelihood of unsafe sex for both men and women, with another

11 Cash transfers: what does the evidence say? Page 11 Contents study showing mixed results for men. Of the four studies considering the effect of the transfer on an Acknowledgements , three yielded significant results, all of which indicated multiple sexual partners individual having that the transfer lowered this likelihood – interestingly, the effect was only observed for females. Executive summary The role of design and implementation features SECTION I Chapter 1 The second main research question addressed by this review concerns the evidence as to the role of Introduction variations in cash transfer design and implementation features in influencing cash transfer effects on selected outcome indicators. Compared to the evidence available on impacts on outcome areas, Chapter 2 the evidence base is smaller: we extracted findings from a total of 55 unique studies. Conceptual framework Chapter 3 Core design features Review of cash transfer reviews Core design features were considered by 38 unique studies of cash transfers. The features discussed here are: main recipient, transfer value, frequency and duration of transfer payments. Chapter 4 Methods While one might expect differences in outcomes depending on the gender of the main recipient , Chapter 5 based on the four studies included in this review, for most of the indicators in this review there The evidence base does not appear to be strong support for differences arising from specifically targeting either men or women. One study did suggest that the age of the recipient, as a proxy for the demographic structure of the household, can affect impacts on attending a health clinic, with members of SECTION II households with older heads attending less frequently. Chapter 6 The impact of have significant impacts level of transfer The available evidence highlights how variations in the cash transfers on on a range of indicators. Drawing on 15 studies, higher transfer levels are associated with larger monetary poverty impacts, including higher food expenditure, savings and investment in livestock and improvements in educational and health and nutrition outcomes among beneficiaries of higher transfers Chapter 7 The impact of compared to those receiving lower transfers. Regarding concerns that higher transfer values may cash transfers on generate work disincentives, the only evidence of decreases in working hours among adults linked education to higher transfer levels is among family members taking care of dependents, highlighting that higher transfer values can additionally alleviate the overall work-burden of adult family members. Chapter 8 Finally, one study finds an unintended effect associated with higher transfer values, with a The impact of cash transfers on health larger transfer linked to an increased likelihood of physical abuse by a male partner in Mexico’s and nutrition Oportunidades programme (Angelucci, 2008). Chapter 9 timing and frequency of transfers While drawing on just four studies, the evidence relating to The impact of suggests that these features can have an important bearing on specific indicators. For instance, cash transfers on the evidence for education reminds us that, as school fees are typically due at specific times of the savings, investment and production year, tailoring their timing so that households have sufficient funds available at the right time to pay the fees may help in maximising the impact of a cash transfer on educational outcomes. The Chapter 10 same logic applies to agricultural seasons, when cash is required at specific points of the year in The impact of order to acquire inputs. cash transfers on employment Overall, the evidence extracted from 24 studies on points to a number of duration of exposure Chapter 11 improvements in outcomes arising from increased duration of exposure to cash transfers, including The impact of improvements in health behaviours and child growth outcomes, higher expenditure and food cash transfers on expenditure, lower likelihood of early marriage, pregnancy and greater contraceptive use. Results empowerment are mixed in relation to labour supply. Evidence from one study also highlights that households that stop receiving transfers can experience serious difficulties, even after receiving the transfer for SECTION III a number of years previously. Chapter 12 Summary of findings and conclusion References

12 Cash transfers: what does the evidence say? Page 12 Contents Conditionality Acknowledgements Of the eight studies directly comparing a CCT to a UCT, six find (somewhat) bigger impacts Executive summary for education and health and nutrition outcomes for CCTs and / or significant impacts where they are not significant for UCTs (four of these differences are statistically significant). As such, SECTION I there is some evidence that making transfers conditional on certain behaviours or actions can positively affect the outcomes relating to the conditions on which the transfers are conditioned. Chapter 1 Understanding what it is about conditionalities included in a cash transfer programme (e.g. type Introduction of behavioural requirement, communication of the prescribed behaviour to the public, planned response to non-compliance, implementation in practice) that influences programme outcomes Chapter 2 Conceptual was one of the questions of interest to this review. While it was not possible to disentangle which framework aspect of conditions was driving the results in most studies, a number of studies highlight the role of people’s perceptions of whether a conditionality is in place or not and of the messaging Chapter 3 or communication of desired behaviours in facilitating intended outcomes. Such findings point Review of cash to the potential for clear communication regarding the importance of service use and support in transfer reviews accessing relevant services to contribute to progress towards programme objectives (for instance Chapter 4 in education and health and nutrition), beyond the implementation of additional elements of Methods conditionality such as sanctionary responses to non-compliance associated with potentially high administrative and social costs. Chapter 5 The evidence base Targeting SECTION II The one study in the review that considered variations in targeting mechanisms shows that Chapter 6 transfers targeted through a general vulnerability index, compared to those targeted on the basis The impact of of age categories, had stronger impacts on food expenditure and some productivity and investment cash transfers on indicators. monetary poverty Chapter 7 The impact of Payment mechanisms cash transfers on education Two studies focusing on the same programme show that the way transfers were paid does not affect selected indicators for savings, where theoretically one would predict a shift in behaviour, Chapter 8 but did affect other outcomes, such as types of crops grown and dietary diversity. The impact of cash transfers on health and nutrition Complementary interventions and supply-side services Chapter 9 The impact of The nine studies of complementary interventions show that supplementing cash transfers with cash transfers on appropriate training, grants or products in many cases strengthens the intended impacts of the savings, investment programme. This is seen most clearly for savings, investment and production, and also health and and production nutrition. The evidence also reveals unanticipated impacts from complementary interventions. Chapter 10 Examples include the rise in non-agricultural labour among children in households that received The impact of a productive investment grant in addition to a basic cash transfer, and the rise in controlling cash transfers on behaviour by a male partner who participated in group training but is not the beneficiary of the employment programme. Chapter 11 The impact of cash transfers on Conclusion empowerment Cash transfers can have wide-ranging impacts SECTION III Overall, the evidence reflects how powerful a policy instrument cash transfers can be, and Chapter 12 Summary of highlights the range of potential benefits for beneficiaries. For studies reporting statistically findings and significant results, the vast majority are in the direction policy-makers intend to achieve. This conclusion finding is particularly impressive given its consistency across the critical outcome areas and high number of indicators covered by this review. References

13 Cash transfers: what does the evidence say? Page 13 Contents The review also uncovers a number of studies that find no statistically significant effect of Acknowledgements transfers on the indicators reviewed and some studies which flag unintended effects. The review highlights how these vary depending on the underlying indicator and on factors linked with Executive summary programme design and implementation features. Clear and significant impacts are especially well documented for intended first- and second-order SECTION I outcomes, such as expenditure on food and other household items, access to schooling or use of Chapter 1 health services. Importantly, cash transfers are shown to have impacts on a range of outcomes Introduction simultaneously, for instance greater school attendance is consistently accompanied by a reduction in child labour. There is also robust evidence that cash transfers can affect first- and second- Chapter 2 order outcomes that are generally not the immediate focus of many programmes, such as savings, Conceptual productive investments and diversification of livelihood strategies. Positive impacts on investment framework in livestock and agricultural inputs are consistently found across CCTs in Latin America and Chapter 3 UCTs in sub-Saharan Africa, suggesting that cash transfers can not only play a role in reducing Review of cash poverty by redistributing resources to the poor, but can also foster their economic autonomy and transfer reviews self-sufficiency. Chapter 4 Methods The review highlights how the evidence is more limited in size and less strong for changes in third- order outcomes – that is, medium- to long-term effects – linked to cash transfers. This is partly Chapter 5 due to the nature of these indicators, which may require longer time periods for impacts to become The evidence base manifest, meaning the timescale of the evaluations reviewed here does not enable the capture of such impacts. SECTION II The review also investigates the potential unintended effects of cash transfers. Two results of Chapter 6 particular interest are summarised here, concerning: (1) the potential for cash transfers to generate The impact of work disincentive effects, to be associated with a reduction in labour supply and work effort, and cash transfers on (2) the potential for cash transfers, especially those targeted at households with children, to be monetary poverty associated with an increase in fertility. Interestingly, the evidence reviewed here does not support Chapter 7 these concerns. With regard to work, more than 50% of studies on adult work participation and The impact of intensity rates showed that employment outcomes were unaffected by the transfer. Among those cash transfers on increase in work studies reporting a significant effect among adult workers, the majority find an education participation. Where a reduction in work participation or work intensity is reported, this reflects a reduction in participation among the elderly or is linked to reductions in casual work. With regard Chapter 8 The impact of cash to fertility, the review shows that for five out of seven studies, with the exception of two studies transfers on health on the same programme (PRAF in Honduras in Stecklov et al., 2006), the cash transfer led to a and nutrition statistically significant decrease in the number of pregnancies among beneficiaries, compared to those who did not receive the transfer. Chapter 9 The impact of cash transfers on Impact trajectories can differ for women and girls savings, investment and production One of the key policy questions relating to cash transfers is whether they can play a role in Chapter 10 addressing gender-based inequalities. This review considers: (1) whether impacts differ for women The impact of and girls, compared to men and boys, and (2) whether impacts differ across households according cash transfers on to the sex of the household head or main beneficiary/recipient. employment Chapter 11 In particular, compared with other outcomes examined in the review, there is a strong evidence The impact of base relating to the implications of cash transfers for women and girls in education, employment cash transfers on and empowerment. The studies reviewed show a clear improvement in education indicators for empowerment girls associated with receipt of cash transfers. On the whole, they highlight an increase in school attendance, with weaker but still positive effects for girls associated with cash transfer receipt in SECTION III cognitive development and test scores. Chapter 12 With respect to work indicators, the available evidence mostly reports on cash transfers leading to Summary of a reduction in labour force participation and work intensity for girls. It also finds some differential findings and effects for men and women. In this respect, one of the main emerging themes around gendered conclusion effects concerns changes in time allocation for different activities, with a few studies finding References an increase in time spent on domestic work by women linked to cash transfers, suggesting that mothers may be substituting for their daughters’ reduced work efforts when they start attending

14 Cash transfers: what does the evidence say? Page 14 Contents school more regularly. Such results raise questions about the demands on women’s time, and Acknowledgements time use more generally, especially when there are additional programme-imposed requirements, for instance in the form of attending meetings or participating in complementary interventions Executive summary and supply-side programmes. These trade-offs could be carefully weighed up by policy-makers, especially in light of existing constraints faced by women and common intra-household allocation of responsibilities, with the bulk of care work commonly falling mostly on women. SECTION I Chapter 1 In the field of empowerment, the review found that while transfers tend to increase women’s Introduction decision-making power and reduce physical abuse, in some cases these impacts were accompanied by increased non-physical abuse, such as emotional abuse or controlling behaviour, by male Chapter 2 partners. This suggests that when a transfer is specifically targeted at women, the design, Conceptual implementation and monitoring and evaluation stages could include considerations of context- framework specific gender relations and the underlying drivers of gender-based inequalities. Chapter 3 Review of cash Theory suggests there are several reasons why variations in the impact of cash transfers by sex transfer reviews of the household head and sex of the main beneficiary/recipient might be expected. Studies of the effects of cash transfers on food expenditure find that these do not differ for female-headed Chapter 4 Methods households or female recipients compared with their male couterparts. In terms of investment, a number of studies found greater impacts for female-headed households compared with male- Chapter 5 headed households. This challenges the notion of female recipients focusing their transfers on their The evidence base children, as earlier reviews suggest (e.g. Yoong et al., 2012). This finding may partly be explained by the fact that female-headed households often have lower initial levels of productive assets than SECTION II those headed by men. This means that programme implementers could potentially expect to see greater proportionate improvements in productive investments when targeting female-headed Chapter 6 households. The impact of cash transfers on monetary poverty Research gaps Chapter 7 The impact of The review allows for the identification of a number of areas where further research could usefully cash transfers on contribute to our understanding of how cash transfers work, and help move current policy education discussions forward. Five broad areas are summarised below. Chapter 8 First, the evidence base would benefit from additional rigorous evaluations of cash transfer The impact of cash transfers on health programmes in low- and middle-income countries beyond Latin America and, to a lesser extent, and nutrition sub-Saharan Africa. The majority of the studies in the review were from these two regions, despite a growing number of cash transfer programmes, including several with comparatively high Chapter 9 population coverage, implemented in other regions. The impact of cash transfers on Second, in terms of interventions, the review highlights how much of the available evidence is savings, investment and production drawn from the experience of CCTs. Such information could be usefully complemented with additional evidence arising from UCTs, especially regarding the role of their specific design and Chapter 10 implementation features. In addition, given the growing interest in the use of enterprise grants for The impact of supporting productive inclusion, and the large number of social pensions that now exist, there is cash transfers on scope for a greater focus on evaluations of these types of cash transfer interventions. employment Chapter 11 Third, there is scope in future evaluations for a greater focus on higher order outcomes that The impact of are of ultimate policy interest, such as child growth measures and health status or educational cash transfers on performance. However, given the particular challenge of influencing such outcomes through cash empowerment transfers alone, flexible but rigorous mixed-methods approaches, based on a strong theory of change analysis and conceptual underpinnings, will be crucial moving forward. This would allow SECTION III the question of which factors, relating to programme design and implementation, as well as local context, support or undermine such impacts, to be effectively addressed. Chapter 12 Summary of Fourth, there is a need for disaggregated analysis according to individual- and household-level findings and characteristcs, particularly those dimensions for which high vulnerability and inequality are conclusion observed. The focus in this review on the size and quality of the evidence of the impact of cash References transfers on women and girls has highlighted how, for some outcomes in particular, much more could be done to improve our understanding of the extent to which specific programmes tackle

15 Cash transfers: what does the evidence say? Page 15 Contents gender-related vulnerabilities and inequalities, and of the design and implementation features Acknowledgements which help to ensure such issues are addressed. Executive summary Finally, the review of evidence on the role of programme design and implementation features demonstrates their importance in mediating impacts, but also shows how the evidence base explicitly testing such features remains small. The main knowledge gaps here include the role SECTION I of grievance mechanisms and programme governance, payment mechanisms, as well as specific Chapter 1 design details of cash transfer components, such as variations in the details of conditionality Introduction design and implementation. Chapter 2 Conceptual framework Chapter 3 Review of cash transfer reviews Chapter 4 Methods Chapter 5 The evidence base SECTION II Chapter 6 The impact of cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

16 Cash transfers: what does the evidence say? Page 16 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash transfer reviews SECTION I Chapter 4 Methods Chapter 5 The evidence base SECTION II Chapter 6 The impact of cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

17 Cash transfers: what does the evidence say? Page 17 Contents Acknowledgements Chapter 1 Executive summary SECTION I ntroduction I Chapter 1 Introduction Chapter 2 Conceptual framework 1.1 ackground and objectives of this review B Chapter 3 Review of cash Cash transfers have been increasingly adopted by low- and middle-income countries as central transfer reviews elements of their poverty reduction and social protection strategies (Barrientos, 2013; DFID, Chapter 4 2011; Hanlon et al., 2010; Honorati et al., 2015). One hundred and thirty low- and middle- Methods income countries now have at least one non-contributory unconditional cash transfer programme (including poverty-targeted transfers and old-age social pensions; with growth in programme Chapter 5 adoption especially high in Africa, where 40 countries out of 48 in the region now have a UCT, The evidence base doubling since 2010) and 63 countries have at least one conditional cash transfer programme (up from 2 countries in 1997 and 27 countries in 2008) (Honorati et al., 2015). This expansion SECTION II has been accompanied by evaluations yielding a growing body of evidence on the impact of different programmes. More recently, closer attention has been paid to the programme design and Chapter 6 implementation details that are associated with such results. The impact of cash transfers on monetary poverty While there is now a growing number of literature reviews focusing on specific outcome areas and indicators, few have pulled together findings across a range of broad outcomes, or examined Chapter 7 the role of different cash transfer design and implementation features in a single review. This The impact of review aims to retrieve, assess and synthesise the existing body of evidence on the impacts of cash cash transfers on transfers and their design and implementation features. It covers the cash transfers literature of 15 education years, from 2000 to 2015. Chapter 8 The impact of cash More specifically, the review addresses three overarching research questions: transfers on health and nutrition hat is the evidence of the impact of cash transfers on a wide range of individual- or W 1. household-level outcomes, including unintended outcomes? Chapter 9 The impact of W 2. hat do we know about the links between variations in cash transfer design and cash transfers on implementation features and cash transfer outcomes? savings, investment and production hat is the evidence of the impacts of cash transfers, and of variations in their design and 3. W implementation components, on women and girls? Chapter 10 The impact of The review focuses on cash transfers targeted at individuals or households and delivered by cash transfers on the state or non-governmental organisations (NGOs). The programmes or policies considered employment are generally funded out of general taxation or by donors. As such, social insurance cash Chapter 11 transfers financed through employer and employee contributions are not covered, although non- The impact of contributory pensions such as old-age social pensions are included. In all, four broad types of cash transfers on cash transfer programme are considered: unconditional cash transfers (UCTs), conditional cash empowerment transfers (CCTs), social pensions and enterprise grants. SECTION III It is worth highlighting upfront the range of policies that such cash transfers include, reflecting important differences in terms of policy rationale, objectives and design details. By way of Chapter 12 example, studies reviewed here analyse cash transfer programmes which range from Uganda’s Summary of Women’s Income Generating Support (WINGS) cash transfer, (which identified 1,800 poor findings and people, mostly women, in 120 war-affected villages with the aim of helping them start small but conclusion sustainable retail and trading enterprises), to national programmes such as Brazil’s Bolsa Família References (reaching over 26% of Brazil’s population, or 55 million people, with the objective of providing a minimum income to low-income individuals and families while promoting school and education

18 Cash transfers: what does the evidence say? Page 18 Contents service use), and Mexico’s Adultos Mayores social pension (providing support to individuals aged Acknowledgements 70 and over, covering 2.1 million beneficiaries across Mexico). Executive summary This review examines the impact of cash transfers on six broad outcome areas: • etary poverty mon SECTION I • e ducation • h ealth and nutrition Chapter 1 s avings, investment and production • Introduction e • mployment and Chapter 2 mpowerment. e • Conceptual framework It searches, retrieves, assesses and consolidates evidence on the impact of cash transfers on selected indicators for these broad outcomes. Furthermore, the review examines the evidence of the role Chapter 3 played by variations in cash transfer design and implementation features on the cash transfer Review of cash transfer reviews outcomes considered. Chapter 4 The six cash transfer design and implementation features covered are: Methods c ore cash transfer design features (e.g. transfer levels and duration of participation) • Chapter 5 • onditionality c The evidence base • argeting t p ayment systems • SECTION II g • rievance mechanisms and programme governance c • omplementary interventions and supply-side services. Chapter 6 The impact of For each of the six outcome areas, 5–7 priority indicators were selected, based on their policy cash transfers on relevance, coverage in the literature and prevalence of sex-disaggregated results. For each of these, monetary poverty evidence is extracted at the highest level of aggregation reported by a study and, where available, Chapter 7 for women and girls. Impact estimates for the latter were also extracted by age, when available. The impact of cash transfers on Table 1.1 Cash transfers review: six outcomes and their selected indicators education Empowerment Poverty Education Health and nutrition Employment Savings, investment and production Chapter 8 The impact of cash Attendance Total household Use of health services Household savings Adult labour force Physical abuse by male transfers on health partner participation expenditure and nutrition Borrowing Child work Non-physical abuse by Maths test scores Dietary diversity Food expenditure male partner Chapter 9 The impact of Language test scores Women’s decision- Agricultural productive Child stunting Adult labour intensity Poverty headcount cash transfers on making power assets savings, investment Poverty gap Composite test scores Marriage Child labour intensity Agricultural input Child wasting and production expenditure Chapter 10 Adult labour force Livestock ownership Child underweight Cognitive development Squared poverty gap Fertility participation and The impact of intensity by sector cash transfers on employment Child work and intensity Use of contraception Involvement in business by sector and enterprise Chapter 11 Multiple sexual partners Migration The impact of cash transfers on Source: Authors empowerment SECTION III The report aims to act as an information source for policy practitioners and policy-makers, academics and others to help inform policy processes and debates. It is accompanied by an Chapter 12 annotated bibliography (Harman et al., 2016), which provides a comprehensive source of Summary of information on a wide range of written documents (including papers published in peer-reviewed findings and conclusion journals, working papers, unpublished reports and theses) which satisfy the review’s screening and quality assessment criteria. The annotated bibliography aims to facilitate researchers’ and References practitioners’ direct access to rigorous cash transfer studies and evaluations by outcomes covered, country and cash transfer programme/policy.

19 Cash transfers: what does the evidence say? Page 19 Contents The review represents a unique effort in terms of: Acknowledgements he range of outcomes covered, some of which have not been the subject of a rigorous review t • Executive summary • he focus on both overall cash transfer impacts, and on evidence of the role of programme t design and implementation features in shaping transfer ourcomes SECTION I t • he methodological approach, which combines systematic searches and rigorous analytical approaches to ensure validity of the evidence reported while allowing for a more flexible Chapter 1 handling of retrieval and analysis Introduction • t he breadth of evidence covered, summarising the rigorous evidence published over the course Chapter 2 of 15 years, from 2000 to 2015 (much of it recent and including programmes running at scale Conceptual in sub-Saharan Africa), and covering a range of different types of publication including articles framework from peer-reviewed journals and grey literature. Chapter 3 Review of cash Compared with previous reviews of cash transfers, by reviewing the evidence on a large number transfer reviews of outcomes and indicators, the present review enables the pulling together of information across outcome areas, highlighting links and the range of ways in which cash transfers shape outcomes. Chapter 4 Methods The attention paid to the role of cash transfer design and implementation details addresses one of the limitations of some of the existing reviews: their focus on summarising the evidence on Chapter 5 impacts, providing limited insights into what it is about the cash transfers that affects impacts. The evidence base By retrieving and consolidating evidence on the role of design and implementation features, this review aims to make explicit the policy implications that arise from existing policy analysis SECTION II and evaluations, highlighting policy options and trade-offs and helping to inform policy debate directly. The methodological approach reflects these aims and facilitates the retrieval and analysis Chapter 6 of rigorous evidence that is relevant to uncovering both the impacts of cash transfers and the links The impact of between variations in their design and implementation features and outcomes. Finally, the breadth cash transfers on of evidence covered in terms of number of years and types of publication means that the present monetary poverty review provides an update to previous ones and extends the evidence base to include findings from Chapter 7 a larger range of cash transfer programmes in terms of geographic coverage. The impact of cash transfers on education 1.2 S tructure of the report Chapter 8 The impact of cash The report is structured in three sections, in turn organised in chapters, for a total of 12 chapters. transfers on health It is also accompanied by five annexes, which provide additional detailed information (including and nutrition on the study screening and assessment process and on the evidence retrieved). In addition to reading the report in its entirety, given the length and breadth of the review, readers may consider Chapter 9 consulting specific chapters depending on their area of interest and reasons for consulting the The impact of cash transfers on document. In addition to reporting results from the review in detailed and summarised form, this savings, investment report provides resources and tools for policy analysts and practitioners which can be used as and production stand-alone pieces to inform policy analysis and discussion. These are highlighted below. Chapter 10 The report’s section I sets the context for the review, presents key background information, The impact of cash transfers on outlines the methodological approach adopted and summarises the evidence base (e.g. number of employment studies, type of evidence, geographic and policy coverage) obtained by the review. It is made up of the following chapters: Chapter 11 The impact of cash transfers on Chapter 2: The conceptual framework empowerment This chapter provides an overarching conceptual framework outlining the channels through which cash transfers shape outcomes and summarise the main theories and claims linking cash transfer SECTION III interventions to outcomes. Drawing on a review of existing theories of change for cash transfers, Chapter 12 this overarching framework aims to set the context for the review, clarifying the main terminology Summary of used and priority policy questions concerning the ways in which cash transfers work. The chapter findings and then narrows its attention to the six outcome areas of focus of the review and their selected conclusion indicators. It discusses examples of the potential intended and unintended impacts of cash transfers References and of variations in their design and implementation features across the selected indicators.

20 Cash transfers: what does the evidence say? Page 20 Contents Chapter 3: Review of cash transfer reviews Acknowledgements The review of cash transfer reviews in Chapter 3 takes stock of existing systematic reviews and Executive summary other literature reviews on the impact of cash transfers. With the objectives of positioning the present review in the context of existing cash transfer reviews and of informing the findings of the present review with those of previous ones, it provides an overview of existing reviews (e.g. SECTION I outcome categories covered, years covered, number of studies/evaluations from which evidence Chapter 1 is extracted) and summarises the main findings relevant to this study. Findings from previous Introduction reviews are discussed with respect to the six broad outcome areas selected (i.e. monetary poverty, education, health and nutrition, etc.) and the six design and implementation features of interest Chapter 2 (i.e. core design features, conditionality, targeting, etc.). Conceptual framework Chapter 4: Methods Chapter 3 Review of cash transfer reviews Chapter 4 describes the steps involved in the retrieval and inclusion of studies in the review, as well as those concerning the evidence extraction and synthesis stages. It provides detailed Chapter 4 information on the literature searches, criteria for inclusion, study screening and assessment Methods process and evidence extraction and synthesis stages. Annex 2 of this report provides the tools Chapter 5 employed, including the search protocols and the tools used to assess studies. Annex 3 reports the The evidence base number of studies retrieved from different search tracks and detailed search flow diagrams for each search conducted. SECTION II Chapter 5: The evidence base Chapter 6 The impact of Information on the scale of the evidence across different outcomes and by programme design and cash transfers on implementation feature and the underlying methods, types of publication, types of programme monetary poverty and geographical coverage are presented in Chapter 5. This chapter also discusses the reasons for Chapter 7 exclusion of studies from the review. The impact of cash transfers on education Section II Chapter 8 Section II reports the evidence as retrieved, consolidated and analysed by this review organised by The impact of cash the six outcome areas in six chapters (monetary poverty; education; health and nutrition; savings, transfers on health investment and production; employment and empowerment). All six chapters follow a common and nutrition basic structure, starting with a box summarising the rigorous evidence on the selected indicators Chapter 9 of the respective outcome followed by sections reporting: a summary of findings, a summary of The impact of the evidence base, results on the impact of cash transfers on the selected indicators, results on cash transfers on the impact of cash transfers on women and girls, evidence of links between cash transfer design savings, investment and implementation features and the selected indicators and, finally, a discussion of the policy and production implications arising from the evidence and its analysis. For all outcomes, results on the impacts Chapter 10 of cash transfers measured for women and girls and evidence of the role of programme design The impact of features are reported in annex 5. cash transfers on employment Chapter 6: The impact of cash transfers on monetary poverty Chapter 11 The impact of This chapter provides both summary and detailed results on the evidence of the impact of cash cash transfers on empowerment transfers on total household expenditure, food expenditure and poverty measures (poverty headcount, gap and squared poverty gap). SECTION III Chapter 7: The impact of cash transfers on education Chapter 12 Summary of Evidence of the impact of cash transfers – and of variations in their design and implementation findings and features – is reported for the following indicators: attendance, maths test scores, language test conclusion scores, composite test scores and cognitive development. References

21 Cash transfers: what does the evidence say? Page 21 Contents Chapter 8: The impact of cash transfers on health and nutrition Acknowledgements This chapter reports the results of the review on health and nutrition, covering the following Executive summary indicators: use of health services, dietary diversity, child stunting, child wasting and child underweight. SECTION I Chapter 9: The impact of cash transfers on savings, investment and production Chapter 1 Introduction This chapter reports summary and detailed results on the evidence of cash transfer impacts on: Chapter 2 household savings, borrowing, agricultural productive assets, agricultural input expenditure, Conceptual livestock ownership and involvement in business and enterprise. framework Chapter 3 Chapter 10: The impact of cash transfers on employment Review of cash transfer reviews The review also retrieved, assessed, consolidated and analysed evidence on the impact of cash Chapter 4 transfers on the following indicators reported in this chapter: adult labour force participation, Methods child labour force participation, adult labour intensity, child labour intensity, adult labour force participation by sector, adult labour intensity by sector, child labour by sector, child labour Chapter 5 intensity by sector and migration. The evidence base Chapter 11: The impact of cash transfers on empowerment SECTION II Chapter 11 reports the results regarding the impact of cash transfers on the selected indicators Chapter 6 The impact of relating to empowerment: physical abuse by male partner, non-physical abuse by male partner, cash transfers on women’s decision-making power, marriage, fertility, use of contraception and multiple sexual monetary poverty partners. Chapter 7 The impact of Section III cash transfers on education Section III of the report draws together the main findings of the review in a synthesised form and identifies and discusses the main policy implications arising from the evidence in a single, final Chapter 8 The impact of cash chapter. transfers on health and nutrition Chapter 12: Summary of findings and conclusions Chapter 9 The impact of The conclusion provides a summary of the evidence base on cash transfers by outcome area, cash transfers on design and implementation feature, geographic coverage and type of programme. It then savings, investment summarises the evidence on the impacts of cash transfers on the selected outcomes and indicators and production and discusses results both in term of statistical significance and direction of effects. It also Chapter 10 provides summary information on the evidence of impacts on women and girls. This is followed The impact of by a more detailed discussion of results by outcome area and by variations in programme design cash transfers on and implementation details. The final section draws out overall conclusions, linking these to some employment of the debates in the cash-transfer field, and identifies areas for future research. Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

22 Cash transfers: what does the evidence say? Page 22 Contents Acknowledgements Chapter 2 Executive summary SECTION I C onceptual framework Chapter 1 Introduction Chapter 2 Conceptual framework This chapter is organised in two sections. First, it outlines the overarching conceptual framework for reviewing the evidence on the multiple intended and unintended impacts of cash transfers. Chapter 3 Second, it identifies the six outcome areas of focus of this review, lists the selected indicators for Review of cash which evidence is extracted and discusses the ways in which cash transfers, and variations in transfer reviews their design and implementation features, may affect such indicators. While we do not aim to Chapter 4 provide a comprehensive theory of change for each outcome area and selected indicator, Section Methods 2 provides examples of the channels through which cash transfers and their specific design and implementation features may exert intended and unintended effects on them. Chapter 5 The evidence base The conceptual framework and specific reviews of outcome indicators build on those discussed in DFID (2011) and in Fiszbein and Schady (2009), and on a further review of existing theories SECTION II of change (TOCs) for cash transfers, including those developed for a number of influential cash transfer programmes (Browne, 2013; Tirivayi et al., 2013; Department of Social Development et Chapter 6 1 al., 2012; Pellerano et al., 2012; FAO, 2015; IEG, 2011; and Gaarder et al., 2010 among others). The impact of cash transfers on monetary poverty O verarching conceptual framework 2 .1 Chapter 7 The impact of The core theoretical case in support of cash transfers revolves around a sequence of intended cash transfers on positive impacts. When cash is transferred in a predictable way directly to households or education individuals it is expected to be used in ways that have immediate effects on household expenditure Chapter 8 (food, health and education, as well as other household needs) and saving/investment behaviour. The impact of cash Additionally, it can have longer-term effects on households’ human capital, asset accumulation transfers on health and livelihood strategies, in turn reducing poverty and vulnerability, and increasing resilience. and nutrition A wave of impact evaluations of cash transfer programmes worldwide has explored these Chapter 9 The impact of hypotheses, while drawing attention to other unintended effects or other types of impacts – cash transfers on including changes in bargaining power and gender relations, social relations, psychosocial savings, investment wellbeing. There is also a potential role of cash transfers in affecting community-level dynamics and production – productivity and growth within local economies, local labour markets and existing social networks – as well as macro-level outcomes. Chapter 10 The impact of cash transfers on The objective of this conceptual framework is to provide an overarching logical structure for the employment classification and interpretation of the multiple pathways of change that can originate from cash transfers. It serves as a basis to guide, limit and orient this review throughout all phases, from Chapter 11 the literature search to analysis. A stylised visualisation of the conceptual framework is shown in The impact of cash transfers on Figure 1 below, while the specific ‘theories of change’ for the six outcome areas and the selected empowerment indicators that are object of this review are discussed in the next section. A few elements are worth noting: SECTION III strong focus on individual- and household-level First, the conceptual framework includes a outcomes, since these are the central area of inquiry of this review. Although meso- and macro- Chapter 12 Summary of level outcomes are mentioned and represented in Figure 1, the attention is primarily on micro- findings and level variables and the potential channels of impact on these. Second, although a range of factors conclusion References N ote that some of these are programme theories of change that do not figure in any official literature or documentation. 1

23 Cash transfers: what does the evidence say? Page 23 Contents influencing the ways in which cash transfers operate and affect outcomes are acknowledged and Acknowledgements discussed, attention is concentrated on the role played by their design and implementation details. Since one of the primary motivations of the present review is the consolidation and synthesis of Executive summary the evidence on the impact of cash transfer design and implementation features, the conceptual framework and the outcome/indicator-specific section that follows below include a more detailed overview of the potential ways in which such features can affect outcomes (compared with the SECTION I potential mediating effects of other factors such as local- and country-level constraints and Chapter 1 enablers). Third, in order to graphically represent and organise the large variety of impacts that Introduction can derive from the transfer of cash to individuals or households, outcomes have been organised 2 around three main ‘orders of outcome’. Chapter 2 Conceptual F irst-order outcomes refer to those income and expenditure effects that may be understood to • framework be triggered as a direct consequence of receiving cash through a cash transfer. Chapter 3 , or intermediate outcomes, broadly refer to those behavioural changes S econd-order outcomes • Review of cash that primarily derive as a consequence of some of the immediate income effects discussed transfer reviews above. Chapter 4 refer to medium- to long-term impacts. , or final outcomes ird-order outcomes, Th • Methods Finally, in the conceptual framework, the individual and household-level outcomes are mainly Chapter 5 The evidence base discussed at a high level of aggregation, with only limited specification of particular individual and household groups (e.g. by characteristics such as age, gender, disability, ethnicity). However, a specific area of interest in this review is the evidence of the impacts of cash transfers on women SECTION II and girls. For this reason, this section also includes a brief section motivating the focus in this review on retrieving, extracting and synthesising the evidence of cash transfer impacts on women Chapter 6 The impact of and girls. cash transfers on monetary poverty ndividual, intra-household and household-level outcomes (Micro) I 2.1.1 Chapter 7 The impact of cash transfers on First-order outcomes education The stylised theory of change in Figure 2.1 depicts a simplification of reality by focusing on the Chapter 8 3 three main uses of cash when transferred to an individual or household. Additional resources are The impact of cash transfers on health either: and nutrition : on food, other individual or household goods (soap, clothes, furniture, etc.), or to access • S pent Chapter 9 services (education, transport, health, etc.). Cash may also be spent on other less ‘desirable’ The impact of goods such as alcohol and tobacco (unintended effects). cash transfers on • aved : if liquidity constraints are weakened or no longer binding, a cash transfer recipient may S savings, investment and production increase formal savings (e.g. in banks) and/or participation in formal and informal savings groups, such as merry-go-rounds. With increased creditworthiness and reliable payments Chapter 10 acting as collateral, recipients may also increase their access to credit or use the money to pay The impact of off existing debt. cash transfers on employment nvested I • : The alleviation of credit and liquidity constraints and increased certainty of income can enable cash transfer recipient households to invest in assets or services. There can also Chapter 11 be reduced disinvestment and distress sale of assets as a consequence of cash transfers, as The impact of cash transfers on discussed below. empowerment SECTION III Chapter 12 Summary of findings and conclusion 2 e acknowledge that this ultimately forces reality, but it is a useful categorisation for analytical purposes. W References 3 F or further reference see also: Deaton (1992); DSD, SASSA and UNICEF (2012); Barrientos (2012). Note that, in some cases, additional income could also be transferred to other households, leading to potential spillover effects within a community.

24 Cash transfers: what does the evidence say? Page 24 Contents Figure 2.1 Conceptual framework Acknowledgements HOUSEHOLD-LEVEL CONSTRAINTS AND ENABLERS LOCAL-LEVEL CONSTRAINTS AND ENABLERS COUNTRY-LEVEL CONSTRAINTS AND ENABLERS • Sociocultural norms and context • Household asset base (including land ownership) • Institutional capacity Executive summary • Poverty levels and specic vulnerabilities • Pre-CT income, income sources and livelihood strategies • Role of donors • Infrastructure and supply of services • Household size and composition • Political economy and policy priorities nationally • Labour capacity of household members • Local institutions (formal and informal) • Budget, fiscal space and programme costs • Agro-ecological context • Overall levels of human and social capital • Fragility and conflict • Existing time/risk preferences, intra-household dynamics • Economic opportunities • Idiosyncratic shocks • Local markets and prices SECTION I • Covariate shocks Chapter 1 CASH TRANSFER Introduction Individual, intra-household and household level (MICRO) FIRST ORDER OUTCOMES (examples) Chapter 2 Local/community level (MESO) General Conceptual household Investment Saving • Changes in local Expenditure expenditure Expenditure Expenditure and framework and access labour markets on health (e.g. clothes, on food on education disinvestment to credit • Changes in local soap, economy and goods and CASH TRANSFER furniture) services markets DESIGN FACTORS Chapter 3 • Changes in social • Core design features networks, social (e.g. level of transfer) SECOND ORDER OUTCOMES (examples) Review of cash cohesion and peer-effects • Conditionality CHANGES TO: • Targeting Farm and • Time and risk Food intake, transfer reviews School Labour • Payment system non-farm Self-acceptance, Utilisation preferences dietary Aggregate level (MACRO) enrolment, participation • Grievance mechanisms asset building pride, dignity, of health • Intra-household diversity, attendance and sector and programme and hopefulness services dynamics and food security and retention of work governance diversication • Poverty and inequality decision making Chapter 4 • Complementary and of strategies reduction; productivity • Gender supply side services and growth; social relations and Methods relations and social empowerment cohesion THIRD ORDER OUTCOMES (examples) effects Livelihood Chapter 5 Resilience School strategies Psychosocial (coping with learning, Nutrition Health diversication, wellbeing shocks), performance The evidence base (stunting and status productivity, and social adaptive and wasting) income earning capital capacity progression potential SECTION II Source: Authors Chapter 6 The impact of cash transfers on monetary poverty order outcomes - Second Chapter 7 4 The impact of Health and education cash transfers on education The additional cash provided to households can boost household income and reduce the household liquidity/credit constraints by covering the direct, indirect and opportunity costs associated with Chapter 8 school enrolment, attendance and retention, along with health service access. Direct costs for The impact of cash transfers on health education that cash transfers can help cover include fees (especially for secondary schooling), and nutrition uniforms, school materials and books; for health care, fees and medicines. Indirect costs include travel costs (particularly high for secondary schooling or specialised health care) and bribes paid Chapter 9 to access services. Opportunity costs mainly include foregone earnings, either of the child while The impact of in school (education versus child labour and household chores) or of the patient and carer while cash transfers on savings, investment seeking care. and production Interestingly, these effects can also be strengthened through other channels represented in the Chapter 10 framework. For example: The impact of cash transfers on • can directly lead to labour participation decisions and time allocation decisions hanges in C employment reduced child labour, with effects on school attendance and retention. Chapter 11 , with immediate nutritional status xpenditure on food (quantity and type) increases children’s E • The impact of consequences in terms of health status (morbidity, etc.) and potential impacts on schooling cash transfers on (concentration, absenteeism, etc.). empowerment • E xpenditure on other household goods such as shoes and soap can boost children’s willingness to participate in schooling, as an effect of , and increased self-acceptance, pride and dignity SECTION III reduced stigma. Such effects can also affect access to health care services. Chapter 12 Summary of findings and conclusion References 4 U seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on education can be found in Reimers et al. (2006) and Baird et al. (2012). Similarly, examples for health can be found in Lundberg et al. (2010); Gaarder et al. (2010); Forde et al. (2011) and Pega et al. (2014).

25 Cash transfers: what does the evidence say? Page 25 Contents C • hanges in intra-household bargaining processes and decision-making can also affect access to Acknowledgements health and education services: having an additional source of income that is not ‘earmarked’ in the household budget means that money can be spent beyond the standard spending categories Executive summary 5 of that household (this is based on the idea of ‘mental accounting’). 6 Food intake, dietary diversity, food security SECTION I Chapter 1 Poor households spend large proportions of their income on food. In the case of cash transfers, it Introduction is argued that increased expenditure on food can translate into: Chapter 2 • ncreases in overall quantities of food consumed (food intake). I Conceptual onsumption of a wider selection of food types (e.g. more meat, a wider variety of vegetables, • C framework use of cooking oil, etc.), leading to an improved dietary diversity. Chapter 3 mprovements in overall food security – i.e. prevention of negative responses to food insecurity • I Review of cash transfer reviews such as skipping meals. • P otentially, a shift to lower-effort and higher-fat food types (ready-made food, snacks, etc.). Chapter 4 Methods Such shifts in nutritional behaviour are of course the direct consequence of the increased Chapter 5 cash availability, but in the medium term they can also be linked to other elements within the The evidence base investment in farm assets cash might be spent on seeds to framework. For example, thanks to grow more food, or a goat to provide milk which can be consumed or sold for additional income. SECTION II may also affect who exactly within the household is Intra-household decision-making dynamics benefitting from such improved nutrition (e.g. children versus adults, male versus female). Shifts in Chapter 6 household education levels, as well as increased knowledge and awareness (e.g. through tailored The impact of educational sessions) can also have an impact on feeding and care practices. cash transfers on monetary poverty 7 Farm and non-farm asset building and diversification of strategies Chapter 7 The impact of The literature widely documents how ‘insecurity leads to inefficient use of resources by those in cash transfers on poverty, for example, by forcing rural poor households to opt for low-risk/low-return crops and education production methods’ and to ‘hold liquid but less productive assets’ (Barrientos, 2012). Chapter 8 The impact of cash Households facing reduced credit and liquidity constraints and increased certainty and security transfers on health who invest cash transfer income face a wider set of investment choices, encompassing higher risk and nutrition and higher-yielding strategies. For examples, recipients can: Chapter 9 nvest in on-farm activities and assets. This may include purchasing or renting additional or I • The impact of more productive land, farm inputs, livestock and livestock inputs, as well as hiring additional cash transfers on labour or investing in complementary services (e.g. insurance). Shifts in the use of inputs and savings, investment techniques may also occur (e.g. setting up irrigation system). and production • I nvest in non-farm activities and assets. Given the economic context in which most cash Chapter 10 transfer households live, investments can be directed to purchasing stock for petty trading, but The impact of cash transfers on also for setting up small service businesses and other activities. employment However, these households are likely to be a minority, given the high credit constraints of the Chapter 11 poor. In fact, shifts in access to credit as a consequence of becoming a cash transfer recipient are The impact of possibly the most important mediating factors of such effects. cash transfers on empowerment SECTION III Chapter 12 Summary of findings and F 5 or more details on why this is the case, see Richard T. Thaler’s seminal 1990 article ‘Anomalies: saving, fungibility and mental accounts’. conclusion seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on food intake, dietary diversity and food 6 U security can be found in Leroy et al. (2009); Gaarder et al. (2010); Manley et al. (2012); and Holmes and Bhuvanendra (2013). References 7 seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on farm and non-farm asset building and U diversification of strategies can be found in Asfaw et al. (2012); Barrientos (2012); Tirivayi et al. (2013)

26 Cash transfers: what does the evidence say? Page 26 Contents 8 Labour market participation and employment Acknowledgements As a direct consequence of the changes in household circumstances brought about by cash Executive summary transfers (and consequent investment decisions and shifts in risk/time preferences), households may reallocate household labour and time. In terms of work participation, conventional economic cash transfers generate a labour disincentive effect, particularly when theory predicts that targeted SECTION I the targeting mechanism leads to a high benefit withdrawal rate. At the same time, cash transfers Chapter 1 can be associated with improved health and nutrition outcomes that could lead to increased labour Introduction market participation. The literature highlights a range of potential effects, including the following: Chapter 2 • c hanges in labour market participation (e.g. withdrawing from or joining the labour market) Conceptual • educing or increasing the number of hours worked r framework • sh ifting labour patterns – for example shifts from on-farm to non-farm work, from casual Chapter 3 work to own-farm work/work on own business, or between informal and formal work Review of cash transfer reviews • educing distress sale of labour (low-paid, highly degrading/undesirable labour) – specifically, r households with sufficient labour capacity would be expected to decrease risky income- Chapter 4 Methods generation activities (commercial sex, begging and theft), low-risk yet less profitable activities and distress sale of labour in favour of potentially riskier and more profitable strategies Chapter 5 9 The evidence base • elated to the above, reduction or increases in child labour r • ncreasing investment in searching for a job. i SECTION II 10 Self-acceptance, pride, dignity and hopefulness Chapter 6 The impact of Expenditure by beneficiary households on ‘general household items’ such as clothes, furniture, cash transfers on toiletries and home improvements could be perceived as being non-productive as it does not monetary poverty generate any immediately tangible effects in terms of the most widely cited categories of impact Chapter 7 (e.g. health and nutrition, education). However, such expenditure can have important effects on The impact of individuals’ self-acceptance, self-esteem, pride and dignity. This is due to beneficiaries being able cash transfers on to be better dressed (new clothes, school shoes and uniforms for children), clean (e.g. purchase of education soap) and proud of their home environment (e.g. new furniture or roof). Chapter 8 The impact of cash Increased expenditure is not the only way such dimensions of wellbeing can be triggered. For transfers on health example, thanks to the cash transfer, recipients can become less dependent on others and and nutrition reciprocate the support they receive, re-entering social networks that were excluded to them. More generally, the cash gives them the means to make decisions about their own lives and plan Chapter 9 for the future (linked to the changes in decision-making cited above), triggering hopefulness. The impact of cash transfers on The secondary impacts of such individual-level changes can be wide-ranging, as reiterated in this savings, investment conceptual framework. and production Chapter 10 Third-order outcomes The impact of cash transfers on 11 School learning, performance and progression employment The extent to which increased school enrolment, attendance and retention effectively lead to Chapter 11 The impact of learning, cognitive development and improved performance and progression (as measured by test cash transfers on scores and pass rates) is issue for debate, especially as such a casual linkage is strongly mediated empowerment by the quality of schooling provided. Nevertheless, improved educational outcomes have also been SECTION III 8 U seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on labour market participation and Chapter 12 employment can be found in Moffitt (2002); Alzúa et al. (2010); OEECD (2011); Asfaw et al. (2012); Barrientos (2012); Tirivayi et al. (2013); de Hoop and Rosati (2014) (focus on child labour). Summary of findings and B 9 y modifying the propensity to attend school and by changing the returns to child labour (de Hoop and Rosati, 2014). conclusion 10 U seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on self-acceptance, pride, dignity and hopefulness can be found in Attah et al. (2016); Tirivayi et al. (2013). References 11 F or the second order outcomes on health and nutrition discussed above, relevant literature includes Reimers et al. (2006) and Baird et al. (2012).

27 Cash transfers: what does the evidence say? Page 27 Contents linked to children’s increasing self-acceptance and pride and consequent psychosocial wellbeing Acknowledgements (see below) as well as improved nutrition (better able to concentrate in class and perform in exams), meaning cash transfers can potentially have an impact on these dimensions. Increased Executive summary gains from schooling in terms of cognitive and non-cognitive development can influence in the longer-run employability and earning potential. SECTION I 12 Health status and nutritional outcomes Chapter 1 Introduction Increased access to health care services and expenditure on health care, together with improved nutrition and increased cleanliness (and therefore hygiene) can improve household members’ health Chapter 2 status, especially children and mothers’. This may be manifested in many different ways, including Conceptual a reduction in maternal and child mortality and morbidity, and a reduction in prevalence of framework underweight children and stunting. If cash transfers are also linked to complementary awareness and Chapter 3 training services, such effects can be further enhanced (improved caring practices for children, etc.). Review of cash transfer reviews 13 Psychosocial wellbeing and social capital Chapter 4 Methods ‘Psychosocial wellbeing’ mixes the concept of psychological (or subjective) wellbeing trying to draw more attention to social influences on wellbeing. cash transfers can promote psychosocial Chapter 5 wellbeing thanks to the mutually reinforcing effects on recipients’ self-acceptance, self-esteem, The evidence base pride, dignity and hopefulness (discussed above), on their overall mental health (e.g. reducing stress due to liquidity and credit constraints) and on their ability to engage in meaningful and SECTION II effective relationships with others – including public institutions (re-entering social networks). This last dimension is linked to recipients potentially ‘re-entering’ the social life of their extended Chapter 6 families and communities (not being perceived as a burden anymore; being perceived as ‘clean’, The impact of etc.), and increasing participation in faith-based and traditional events and in contribution-based cash transfers on networks (e.g. community-based savings groups, funeral societies) – all important elements monetary poverty of increased social capital. Social transfers may also promote social capital through regular Chapter 7 interactions between local communities and authorities, for instance at payment points and in The impact of related information-sharing fora. cash transfers on education It should also be noted that beneficiaries who are able to access contribution-based networks and risk-sharing arrangements (reciprocal lending and borrowing, burial societies, etc.) are less Chapter 8 The impact of cash vulnerable to shocks, less marginalised and more likely to mimic the behaviour of the richer transfers on health members of the community (e.g. in terms of accessing services). On the other hand, receipt of the and nutrition transfer can also undermine traditional forms of social protection (see below) and negatively affect households’ decisions in terms of human capital accumulation. Chapter 9 The impact of 14 cash transfers on Safe transition to adulthood savings, investment and production The transition to adulthood is a critical phase when behaviours and events in young people’s lives have lasting impacts on their life trajectories, and when health and wellbeing can be influenced Chapter 10 by economic and social factors. Adolescents are at risk of exposure to violence, HIV infection The impact of cash transfers on and early pregnancy and/or marriage, as well as the potential adoption of so-called ‘risky’ employment sexual behaviours (early debut, multiple partners, substance abuse, transactional sex, etc.). Such behaviours can lead to educational drop-out or underachievement and be linked to depression and Chapter 11 low self-esteem. The impact of cash transfers on To the extent that cash transfers increase the income available to the household, they can affect empowerment these life-course choices of young adults, females especially. For example, the additional cash might reduce female financial dependence on others, meaning marriage choices could be delayed SECTION III Chapter 12 Summary of or the second order outcomes on health and nutrition discussed above, the relevant literature includes: Leroy et al. (2009); Lundberg et al. F 12 findings and (2010); Gaarder et al. (2010); Manley et al. (2012); Forde et al. (2011); Holmes and Bhuvanendra (2013); and Pega et al. (2014). conclusion 13 seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on psychosocial wellbeing and social capital U can be found in Attah et al. (2016); Attanasio et al. (2009); Vigorito et al. (2013); Barca et al. (2015). References 14 R elevant literature includes Hargreaves et al. (2008); Pettifor et al. (2008); Robinson and Yeh (2012); Palermo et al. (2015) and recent publications by the UNICEF Innocenti Office of Research (most notably Palermo, 2015).

28 Cash transfers: what does the evidence say? Page 28 Contents and ‘sugar daddy’ relationships or transactional sex avoided (the same goes for opting out of Acknowledgements certain ‘last resort’ jobs that put women at risk of violence). Impacts on schooling (see above) can also have a role. For example, improvements in school attendance may decrease the likelihood Executive summary that young people will have sex with partners of older age groups (who are more likely to be HIV infected) and expose young people to knowledge relating to HIV and pregnancy prevention, while also giving them aspirations for the future (less likely to marry early). A role may also be played SECTION I by shifts in adolescents’ psychosocial wellbeing and overall mental health and shifts in access to Chapter 1 health care and exposure to health-related training (e.g. educational sessions, etc.). Introduction 15 Livelihood strategies diversification, productivity and income earning potential Chapter 2 Conceptual ‘Third-order outcomes’ of cash transfers also relate to individuals’ and households’ changing framework livelihood strategies (and consequent income earning potential) as a consequence of changes in Chapter 3 intra-household decision-making, labour allocation of household members, investments that Review of cash improve income-generation capacity, and changes in risk-management behaviour. Overall, transfer reviews increased investment in on-farm and non-farm assets and shifting labour allocations can also lead to some level of diversification of livelihood strategies and an increase in productivity, in turn Chapter 4 Methods generating additional sources of income and earnings for the household, if market conditions allow. Chapter 5 16 Resilience and adaptive capacity The evidence base Regular and predictable payments, increased precautionary savings and the ability to access credit SECTION II through formal and informal sharing mechanisms can also help prevent detrimental risk-coping strategies (e.g. distress sale of assets, borrowing, reduced spending and, potentially, eating), Chapter 6 especially in the face of both idiosyncratic and covariate shocks, leading to increased resilience of The impact of recipient households. cash transfers on monetary poverty In the longer term, some of the changes generated by cash transfers can also have an impact on Chapter 7 households’ adaptive capacity, for example by helping the poor respond to climate-related shocks, The impact of helping to engage in investment decisions and innovations to increase their adaptive capacity cash transfers on (e.g. sustainable land management practices), by reducing pressure to engage in strategies which education weaken long-term adaptive capacity, and facilitating livelihood transitions. Chapter 8 The impact of cash 17 Cross-cutting outcomes: preferences and decision-making transfers on health and nutrition The fact that additional cash has been introduced into the household can have additional, Chapter 9 less tangible impacts, linked to individuals’ and households’ preferences and decision-making The impact of processes. These have been visually represented as cutting across the three orders of outcome, as cash transfers on they are not clearly temporally or sequentially bound. savings, investment and production For example, household members receiving cash transfers will face a different set of constraints Chapter 10 and opportunities, leading to shifts in their time use (e.g. labour versus free time), risk preferences The impact of (e.g. potentially increasing risk-taking behaviour) and overall choice-set. cash transfers on employment Moreover, recognising that households are not unitary but collective entities, there may be shifts Chapter 11 in intra-household bargaining power and decision-making, and ultimately in gender relations The impact of within the household. The injection of cash can reinforce traditional gender roles (e.g. the woman cash transfers on as home-keeper and carer) and potentially increase tensions and stress within the household, but empowerment may also lead to female empowerment, enabling a process by which ‘those who have been denied the ability to make strategic choices acquire such ability’ (Kabeer, 1999). This ability to exercise SECTION III Chapter 12 U seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on livelihood strategies diversification, 15 Summary of productivity and income earning potential can be found in Asfaw et al. (2012); Barrientos (2012); Tirivayi et al. (2013). findings and seful examples of the theoretical framework and ‘Theory of Change’ for cash transfers’ impact on resilience and adaptive capacity can be 16 U conclusion found in Sabates-Wheeler and Devereux (2011); Tirivayi et al. (2013); Wood (2011) (adaptive capacity). References 17 U seful examples of the theoretical pathways linking cash transfers and intra-household decision-making processes can be found in: Becker, 1965 (on time allocation more generally); Barrientos (2012); Yoong et al. (2012), Holmes and Jones (2013) (focus on gender); Asfaw et al. (2013) (focus on agriculture).

29 Cash transfers: what does the evidence say? Page 29 Contents choice could have profound implications on a wide range of other outcomes, including ultimate Acknowledgements allocation of resources and labour, reproductive health rights (linked to marriage, pregnancy and sexual behaviour), domestic abuse and social relations/standing among others. Executive summary 2.1. 2 Spillover’ effects and local/community-level outcomes (Meso) ‘ SECTION I The injection of cash into a proportion of households within the community (depending on the Chapter 1 Introduction targeting approach) may have repercussions at the local/community level. In Figure 2.1 we have not visually linked these changes to a specific order of outcome, as these occur as a consequence of Chapter 2 many of the changes at the household level described above and impact these in turn. In analysing Conceptual these ‘spillover’ effects we focus on three main strands: changes in local labour markets, changes in framework the local economy and goods and services markets, and changes in social relations and peer effects. Chapter 3 18 Review of cash Changes in local labour markets transfer reviews As discussed above at the household level, cash transfers can affect labour allocation decisions. In Chapter 4 turn, those decisions can have knock-on effects at the community level, such as: Methods eneficiaries choosing to withdraw from or enter the labour market, reducing/increasing the b • Chapter 5 number of hours worked or shift overall labour patterns could affect local labour supply The evidence base • s imilarly, there may be some marginal effects on labour demand, due to beneficiaries hiring labour (on-farm or off-farm) SECTION II t hese shifts, in turn, could affect local wages. • Chapter 6 The impact of 19 Changes in local economy and goods and services markets cash transfers on monetary poverty Trading activities and economic exchange in local markets can be intensified by cash transfers, Chapter 7 as well as providing a marginal boost to local businesses through income multipliers in local The impact of economies. Beneficiary households spend their transfers on goods and services that are mainly sold cash transfers on or produced by non-beneficiary households. Also, shifting and potentially expanding livelihood education activities of beneficiaries can also increase the overall supply of goods and services in the local Chapter 8 markets. Overall, cash transfers can lead to a diversification of goods on offer in local markets, The impact of cash due to shifts in purchasing patterns of beneficiary households (potentially more bulk purchases of transfers on health goods and wider variety of goods purchased). A possible unintended effect of such changes can be and nutrition price inflation at local level, which is likely to be stronger where there are market constraints to Chapter 9 respond to increased local demand. The impact of cash transfers on 20 Social relations and peer effects savings, investment and production Tight-knit communities, especially in rural areas, generally have a relatively rigid hierarchy of power and social relations, which cash transfers can ‘shake-up’ or undermine. On the positive side, Chapter 10 The impact of cash transfers can decrease the social distance between the poorest households in the community cash transfers on and their families and peers, as well as local institutions. This is partly due to households re- employment entering contribution-based social networks, and to higher levels of respect, social acceptance and recognition of beneficiaries’ role in the community (affected by and affecting beneficiaries’ Chapter 11 psychosocial wellbeing). However, there is also a risk of cash transfers replacing existing reciprocal The impact of cash transfers on arrangements and forms of informal social protection among households, and a risk of generating empowerment jealousy and resentment among non-recipient households. The extent to which such effects are triggered may be strongly linked to cash transfer design and implementation features, such as the effectiveness of the overall communications strategy, the role of local committees, design and SECTION III implementation targeting and the functioning of the programme’s grievance mechanism. Chapter 12 Summary of findings and conclusion 18 T he main theoretical references for this are OECD (2011); Asfaw et al. (2012); Barrientos (2012); Tirivayi et al. (2013). 19 T he main theoretical references for this are Schneider and Gugerty (2011) and Tirivayi et al. (2013). References 20 R elevant literature includes Kumlin and Rothstein (2005); Attanasio et al. (2009); MacAuslan and Riemenschneider (2011); Sacerdote (2011); Vigorito et al. (2013); World Bank (2015).

30 Cash transfers: what does the evidence say? Page 30 Contents Behavioural change within cash transfer recipients, moreover, may trigger peer effects within the Acknowledgements community, such as changes in choices and behaviour compared to those who are physically or socially close. This may be particularly important in the context of education, where peer effects Executive summary have been most widely documented. SECTION I A 2.1. 3 ggregate outcomes (Macro) Chapter 1 Introduction Reduction of poverty and inequality, productivity and growth, social relations and social cohesion Chapter 2 All of the changes discussed in the previous paragraphs – at the individual, intra-household, Conceptual household and local/community level – ultimately have aggregate, macro-level effects. Given framework that most cash transfers are explicitly designed to redistribute income to the poorest and most 21 Chapter 3 the first of such expected effects is a reduction of aggregate poverty and inequality as vulnerable, Review of cash measured by the main indices of monetary poverty (e.g. poverty headcount, poverty gap, poverty transfer reviews 22 depth, poverty severity, Gini index, etc.). Chapter 4 Impacts in terms of aggregate productivity and growth may also be expected as a direct Methods consequence of increases in poor households’ productivity, aggregate demand (e.g. counter- 23 Chapter 5 cyclical spending) and shifts in labour force participation, or as an indirect consequence of The evidence base 24 Nevertheless, the literature concurs that enhanced human capital and enhanced social cohesion. such effects are likely to be limited in low-income contexts because of the relatively low scale of spending on social protection and the marginal share of national income in the hands of the poor. SECTION II Chapter 6 Shifts in social networks of beneficiary households, reductions in economic and social inequalities The impact of and direct programme effects (e.g. where rights-based measures encouraging voice and accountability cash transfers on 25 strengthening the contribute towards greater social inclusion) can also enhance social cohesion, monetary poverty social contract between state and citizen and thus potentially contributing to state-building, state legitimacy and good governance, including pressure for efficient and equitable public policy. Chapter 7 The impact of cash transfers on 26 Mediating factors at household, community and country level education Chapter 8 Individual and household behaviour can be strongly affected by a series of external constraints The impact of cash and mediating factors. These are listed below, distinguishing between three different levels: transfers on health and nutrition household level: At the Chapter 9 , most importantly all agricultural and non-agricultural assets, including asset base ousehold H • The impact of ownership of land and livestock. Asset accumulation and livelihood choices are strongly cash transfers on dependent on initial endowments, with important implications for ultimate distributional savings, investment and production outcomes. Household with a higher asset base may also be more risk-prone. income sources , income re-cash transfer P • . These will affect use of the livelihood strategies and Chapter 10 The impact of transfer and overall livelihood choices (including labour participation and investment). cash transfers on size H • ousehold . Size affects dilution of the transfer (unless this is carefully composition and employment calibrated accordingly), while members’ age and overall dependency ratio affects use of the Chapter 11 transfer and labour/time-use responses. The impact of cash transfers on empowerment 21 n fact, the main driving factor for the spread of cash transfer programmes ‘was the rise in poverty and vulnerability which followed crises and I structural adjustment in the 1980s and 1990s, which then persisted in the recovery phase’ (Barrientos, 2010). SECTION III 22 ee for example Grosh et al. (2008); Barrientos (2010); Fiszbein and Schady (2009); DFID (2011); Piachaud (2013). S Chapter 12 S ee for example Barrientos (2013); Piachaud (2013); Mathers and Slater (2014). 23 Summary of rowth theory suggests that a more stable, cohesive society is more conducive to investment and economic activity. 24 G findings and e define social cohesion in line with Babajanian (2012), as the ‘extent of cooperation and solidarity between different groups and individuals 25 W conclusion in a society, and their interconnectedness with broader economic, social and political outcomes’. For further reading on the links between social protection and social cohesion see Babajanian (2012) and Mathers and Slater (2014). References onstraints and enablers at the household, community and country level are widely discussed in the literature, though not in great depth. The 26 C two key references in which the topic is addressed in relative detail are Sabates-Wheeler and Devereux (2011); Tirivayi et al. (2013).

31 Cash transfers: what does the evidence say? Page 31 Contents • L abour capacity of household members. Labour-constrained households will be much less Acknowledgements likely to achieve any productive investments or modify their labour participation. verall levels of • O human and social capital (years of formal education, kinship and social Executive summary networks, etc.). More highly educated households may be more likely to reinvest in their children’s education. Households with wider and deeper social networks may be more resilient SECTION I to shocks and more capable of negotiating access to services, etc. Chapter 1 • sting Exi . Shifting attitudes to risk and intra- intra-household dynamics , time/risk preferences Introduction household bargaining processes are strongly dependent on the existing household situation. Chapter 2 diosyncratic shocks (e.g. death or illness of household member, etc.). The occurrence of these • I Conceptual shocks at the household level can hinder the wide range of potential impacts of cash transfers. framework At the local level: Chapter 3 Review of cash (religion, gender norms, etc.). Religious and societal norms context and ociocultural norms S • transfer reviews can affect the role of the women within the household (including their bargaining power and labour/time allocation) or affect how money is spent (e.g. setting priorities). Chapter 4 Methods and • specific vulnerabilities overty levels (e.g. HIV-AIDS). The social, productive and labour P participation impacts of cash transfers are likely to vary largely depending on the overall Chapter 5 The evidence base poverty levels and specific vulnerabilities within a given community. I nfrastructure supply of services (electricity, internet, roads, etc.) and • (health and education SECTION II especially). Existing infrastructure affects the possibility and outcomes of productive investments and labour participation (e.g. possibility of travel), ultimately with an impact on Chapter 6 household income. The local supply of services – including their quality – will determine the The impact of extent to which those services are accessed and the extent to which intermediate outcomes cash transfers on can translate into final outcomes (e.g. improved health, school learning, performance and monetary poverty progression). Chapter 7 L • (formal and informal, e.g. micro-finance groups, burial societies, etc.). The ocal institutions The impact of presence of enabling local institutions can enhance some of the impacts of cash transfers, while cash transfers on education concurrently affecting social relations. A gro-ecological context . • Differences in rainfall, seasonal variations, temperatures and soil- Chapter 8 The impact of cash water content all contribute to disparities in agricultural production and the subsequent transfers on health outcomes such as income, consumption and food security, nutrition and poverty. and nutrition E • conomic opportunities . The dynamism of the local labour market and the overall range of Chapter 9 economic opportunities available for cash transfer recipients affects livelihood choices and The impact of ultimately household incomes. cash transfers on savings, investment L The level of integration of local markets with the wider economy, . • ocal markets and prices and production have far-reaching effects on households’ as well as their size, prevailing prices and location livelihood options and on the likely multiplier effects of cash transfers at the community level. Chapter 10 The impact of C ovariate shocks • . Natural disasters (earthquakes, floods, etc.) or slower-onset shocks (drought) cash transfers on affect all households, but particularly expose the poor. In such contexts, the consumption- employment smoothing role of a predictable transfer assumes critical importance. Chapter 11 The impact of , the design and implementation of the cash transfer itself can be affected by At the country level cash transfers on donors institutional capacity ; role of a range of factors: ; political economy and policy priorities empowerment . fragility and conflict ; costs budget, fiscal space and programme nationally; SECTION III Chapter 12 Summary of findings and conclusion References

32 Cash transfers: what does the evidence say? Page 32 Contents T he role of cash transfer design and implementation features 2.1.4 Acknowledgements As discussed in the introduction and visually represented in Figure 2.1, the outcomes and impacts Executive summary discussed in the above paragraphs can be significantly influenced by individual cash transfer programme design and implementation details, as well as by a series of external factors at the SECTION I household, local/community and country level. The following section identifies the main design and implementation features by which cash transfers vary, as well as their potential linkages to Chapter 1 outcomes. Introduction Cash transfer design features include ‘core’ cash transfer parameters such as transfer values, main Chapter 2 Conceptual recipient, frequency and duration of payments, as well as accompanying components and practices framework such as targeting and conditionality elements, communication systems, grievance mechanisms and linkages to complementary interventions and supply-side services. These can vary considerably Chapter 3 by design, while their implementation may depart from official programme design, adding an Review of cash additional dimension of variation. transfer reviews Chapter 4 Core cash transfer design features: level, frequency, duration and main recipient Methods Chapter 5 Four core design features by which cash transfers vary are: The evidence base 27 . evel of the transfer L • Transfer amounts can directly affect monetary (income and consumption) outcomes. They may also influence behavioural decisions around investment SECTION II and labour market participation, as well as school and health service use. For example, larger transfers can trigger investment decisions versus current expenditure, while transfers that Chapter 6 are too small to cover even basic consumption costs not be able to support progress towards The impact of 28 its objectives in terms of poverty reduction and service use. Maintaining the value of the cash transfers on monetary poverty transfer over time (in line with inflation and programme objectives) can be an implementation challenge, faced through tailored uprating practices. Chapter 7 29 The impact of T iming and frequency of the transfer • The established frequency and regularity of payments . cash transfers on may also play a critical role in the effectiveness of a cash transfer. Regular and frequent education 30 payments can help smooth consumption and allow planning for the future. Ad hoc or lump- sum payments at key moments in the agricultural productive cycle or the school year may Chapter 8 trigger critical investment or school enrolment. The impact of cash transfers on health 31 . uration of the transfer D Some cash transfers may include a maximum duration of • and nutrition participation or time limit, linked to a hypothesis of programme ‘graduation’. This can affect the extent to which programme outcomes can be realistically achieved in the time assigned Chapter 9 The impact of (e.g. before completion of a child’s education cycle) and may limit its social protection cash transfers on function. savings, investment 32 and production A thread of literature hypothesises that the characteristics of ain recipient of the transfer . • M the main recipient (especially whether male or female) may also affect a range of outcomes, Chapter 10 including intra-household decision-making and dynamics. For example, women may be more The impact of likely to spend the money on human capital accumulation for their children. cash transfers on employment Chapter 11 The impact of cash transfers on empowerment 27 ee Bastagli (2009); Grosh et al. (2008); Fiszbein and Schady (2009); Barca et al. (forthcoming). S N ote that best practice internationally has been to set the benefit level in relation to desired impacts. For example, the size of the education 28 SECTION III grant for Oportunidades in Mexico was set to cover children’s incomes; and in Honduras it was set to cover both the opportunity and direct costs, the latter including the costs for books, uniforms and the like (Grosh et al. (2008); Fiszbein and Schady). Instead, in many sub-Saharan Chapter 12 African countries, in which desired impacts are mostly focused on food security, transfer size is often set as a percentage of households’ Summary of consumption expenditure or food poverty (World Bank, 2012). findings and 29 F or further reading on the topic see Fiszbein and Schady (2009); Barca et al. (forthcoming). conclusion e discuss the role of predictability of the transfer below, when looking at payment systems. 30 W References 31 or further reading on the topic see Sabates-Wheeler and Devereux (2011); Daidone et al. (forthcoming) F 32 F or further reading on the topic see Fiszbein and Schady (2009); Doepke and Tertilt (2011); Yoong et al. (2012).

33 Cash transfers: what does the evidence say? Page 33 Contents 33 Conditionality Acknowledgements The design of cash transfers can be conditional (CCTs) – i.e. explicitly conditioned on desired Executive summary 34 behaviour – or unconditional (UCTs). Arguments in favour of tying behavioural requirements to transfer receipt emphasise that these counteract ‘impatience’, ‘myopia’ and ‘bounded rationality’, thus promoting behavioural change. Arguments against posit that conditionalities can be SECTION I expensive to administer, ineffective in areas with an insufficient or low-quality supply of services. Chapter 1 In practice, conditionality varies by design depending for instance on the precise behavioural Introduction requirements (e.g. education, health, job-related) and on the regulation of non-compliance (e.g. whether it is punitive or not). Furthermore, the implementation of conditionality may vary Chapter 2 depending on whether behavioural requirements are monitored in practice and whether response Conceptual framework to non-compliance is executed as intended by programme design. Chapter 3 35 Review of cash Targeting transfer reviews A range of different designs and approaches for the identification and selection of beneficiaries are Chapter 4 used in cash transfer programmes, and these have far-reaching implications not only on the cost- Methods effectiveness and fiscal sustainability of cash transfers in a broad sense, but also on their potential Chapter 5 impacts. We analyse: The evidence base T he specific targeting mechanism and related informational requirements (e.g. self-reported • income and simple means test, proxy means test, validation within community, etc.) may be SECTION II linked to a programme’s overall targeting effectiveness (minimising exclusion and inclusion errors) and to its costs, administrative burden, political acceptability and its perception of Chapter 6 fairness within the community – with important impacts on poverty and inequality outcomes The impact of and social relations. cash transfers on monetary poverty affects recipients’ behavioural incentives as well as frequency of recertification/retargeting • he T perceived fairness. Chapter 7 The impact of implemented in practice he way in which the targeting process is • (ease of registration, T cash transfers on transparency, etc.) similarly affects behavioural responses, perceptions of fairness and, education ultimately, social relations within the community. Chapter 8 The impact of cash 36 Payment system transfers on health and nutrition With the rise of modern technologies, there are an increasing number of cash transfer payment Chapter 9 modalities or options available to policy-makers to reach the target population. For example, The impact of it is hypothesised that transferring cash through bank accounts or mobile money (e.g. mobile cash transfers on phone technology such as M-Pesa in Kenya) can trigger saving behaviour and access to formal savings, investment credit, which in turn can affect household investments (both physical and relating to health and production and education). Other aspects that may vary depending on the payment modality include the Chapter 10 direct and indirect costs of collecting the cash (affecting ultimate transfer size and time use) and The impact of potential impacts on stigma and shame (e.g. due to publicly queuing to collect cash). Importantly, cash transfers on though, the use of mobile payment technologies may reduce opportunities for physical interaction employment with beneficiaries, reducing the opportunities for delivery of complementary interventions, Chapter 11 messaging and monitoring. Finally, the practicality of implementing payments may lead to long The impact of delays, meaning transfers are no longer predictable. This undermines much of the ‘protective’ role cash transfers on of cash transfers, as well as their potential capacity to increase access to credit and induce risk- empowerment taking behaviour. SECTION III Chapter 12 or further reading on the topic see de Janvry and Sadoulet (2006); de Brauw and Hoddinott (2007); Fiszbein and Schady (2009); Bastagli F 33 (2009a); Hanlon et al. (2010); Pellerano and Barca (2013) Summary of findings and T 34 he distinction between the two is not always clear-cut, see Pellerano and Barca (2013) for further details. conclusion 35 or further reading on the topic see: Coady et al. (2004); Grosh et al. (2008); Ellis (2008); Fiszbein and Schady (2009); Slater and Farrington F (2009); Barca et al. (forthcoming). References 36 F or further reading on the topic see: DFID (2009); Devereux and Vincent (2010); Barca et al. (2010); DFID (2011); Smith et al. (2011); O’Brien et al. (2013).

34 Cash transfers: what does the evidence say? Page 34 Contents 37 Grievance mechanisms and programme governance Acknowledgements A range of social accountability mechanisms – aimed at guaranteeing citizen feedback and Executive summary independent oversight of programme operations – are available to programme implementers keen to ‘strengthen programme effectiveness and accountability for vulnerable groups and populations, and in turn state-citizen relations’ (Jones et al., 2013). Three examples of such mechanisms are: SECTION I , including the possibility for complaints and appeals. • grievance mechanisms ell-designed W Chapter 1 These may help ensure that transfers reach the intended population, improving their Introduction effectiveness. They can also minimise the possibility of social tensions within a community. Chapter 2 ther feedback mechanisms O • , such as specially-designed community meetings, go-to Conceptual framework committees and suggestions ‘boxes’. • , focused on involving articipatory monitoring and evaluation (M&E) mechanisms P Chapter 3 Review of cash communities in the ongoing assessment of programmes using methodologies such as Citizen transfer reviews Report Cards. Chapter 4 To enhance accountability, moreover, communication strategies can be carried out alongside the Methods roll-out of a cash transfer system to communicate on a wide range of implementation-related issues Chapter 5 (timing and amount of transfer, how and where to collect the cash, etc.), including the suggested The evidence base usage of the cash. Such a tailored communication strategy, combined with a strong (yet not controlling) role assigned to a carefully selected Community Committee, can enhance acceptance of the programme and local buy-in, reduce misunderstandings and resentment linked to targeting, SECTION II and help reinforce the overall programme objectives, affecting how cash is ultimately used. Chapter 6 The impact of 38 Complementary interventions and supply-side services cash transfers on monetary poverty Linking cash transfer interventions to complementary interventions and supply-side services and Chapter 7 efforts can greatly magnify their impact and social protection objectives. For example, this could The impact of be achieved through: cash transfers on education i on a range of topics, including hygiene, nutrition and the • nformation/training sessions importance of schooling Chapter 8 The impact of cash • a llocating additional resources to improve the supply of local services (e.g. health and transfers on health education), given that no demand-side intervention can fully live up to expectations if the and nutrition supply of services is inexistent or of very poor quality Chapter 9 (e.g. health insurance, crop g • ranting preferential or automatic access to other programmes The impact of insurance, school feeding, etc.) cash transfers on savings, investment (e.g. lump sum cash or a large ransferring additional resources together with the cash transfer t • and production asset), as an add-on to enable graduation (often called ‘Cash Plus’) Chapter 10 , designed to satisfy specific needs (e.g. agricultural extension, business ills development sk • The impact of development, etc.). cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 37 F or further reading on the topic see also OPM (2012); Jones et al. (2013). 38 F or further reading on the topic see also Fiszbein and Schady (2009); McCord (2012).

35 Cash transfers: what does the evidence say? Page 35 Contents Table 2.1 Cash transfers: examples of variations in design and implementation features Acknowledgements Dimension Design or Examples of features by which cash transfers vary Implementation Executive summary Design Core cash transfer evel of the transfer L • iming and frequency of payment T • design features D • uration (maximum time limit?) SECTION I • M ain recipient (male or female? age?) Implementation • T ransfer value uprated over time or not Chapter 1 egularity of transfer and duration of participation in practice R • Introduction • U nconditional or conditional Design Conditionality Chapter 2 • ype of behavioural requirements (e.g. education, health, job-related) T Conceptual on-compliance response sanctionable or not N • framework • B ehavioural requirements clearly communicated to the public Implementation ehavioural requirements and non-compliance monitored • B Chapter 3 esponse to non-compliance implemented • R Review of cash transfer reviews Design Targeting argeting design (who is being targeted and proportion within community) • T argeting mechanism and information requirements • T requency of recertification/retargeting • F Chapter 4 Methods • Implementation I n practice, information used to identify beneficiaries Fr • equency of information recertification in practice Chapter 5 Payments • Design ayment modality (e.g. smart-card, phone, paypoint) P The evidence base unctioning of payment modality and its components in practice Implementation • F Design Grievance mechanisms • rievance mechanism, other feedback mechanisms and participatory M&E included in cash G SECTION II and programme transfer design governance • ype of grievance mechanism other feedback mechanisms and participatory M&E included T Chapter 6 • Q uality and extent of the communication strategy The impact of • R ole assigned to community committees responsible for cash transfer processes cash transfers on hether the grievance mechanism, other feedback mechanisms, participatory M&E and W • Implementation monetary poverty communication strategy are implemented • hether grievance, feedback and M&E data are analysed to improve programme design W Chapter 7 • raining and set-up of the community committees responsible for cash transfer processes T The impact of • hether complementary interventions are linked to cash transfers by design Complementary and Design W cash transfers on supply-side interventions • ypes of interventions linked (e.g. informational/training sessions, targeted supply-side T education support, skills development, etc.) Chapter 8 hether accompanying services are implemented and accessible in practice • Implementation W The impact of cash transfers on health Source: Authors. and nutrition Chapter 9 The impact of ash transfer impact: the outcomes for women and girls C 2.1. 5 cash transfers on savings, investment and production Women and girls in many countries face a different set of initial endowments compared to their male peers. This potentially includes: Chapter 10 The impact of ower levels of human capital, because of household preferences for male education • l cash transfers on ower ownership or differing legal entitlement to assets in some countries (home, land, • l employment productive assets, etc.) Chapter 11 ower levels of social capital and opportunities to exercise meaningful voice and agency at • l The impact of community level. cash transfers on empowerment Theory and evidence suggest there are several reasons to expect to see variations in the impact of cash transfers by sex of the household head and gender of the main beneficiary/recipient SECTION III (Quisumbing and Maluccio, 2000; Hoddinott and Haddad, 1995; Holmes and Jones, 2010): Chapter 12 • iffering spending preferences and priorities, with women potentially more prone to spending d Summary of on nutrition, education and health – particularly for children findings and conclusion • onstraints on woman’s time (e.g. child-rearing and caring for elderly), which, among c other things, affects women’s capacity to meet the time-demands of conditionalities or References complementary interventions and supply-side services

36 Cash transfers: what does the evidence say? Page 36 Contents c onstraints on women’s mobility and market participation (due to discrimination, risk of • Acknowledgements gender-based violence, etc.) • d iffering cultural roles and aptitudes, with women engaging in a different set of activities Executive summary compared to men (e.g. agricultural, business, etc.) and purchasing different types of assets d • iffering risk attitudes, with women potentially being more risk averse (Eckel and Grossman, SECTION I 2008). Chapter 1 Introduction 2.2 I ndicator- and outcome-specific theories of change Chapter 2 Conceptual The previous section outlines the overarching conceptual framework within which this review framework is situated, and motivates and informs the structure of this review. Building on this framework Chapter 3 and as explained in the introduction, the review focuses on six outcome areas and on a subset Review of cash of indicators within each outcome (see Table 2.2). In this section, we provide a detailed list of transfer reviews the selected indicators by outcome and discuss the ways in which cash transfers, and variations in their design and implementation features, may influence the indicators under review. The Chapter 4 Methods objective is to review and provide examples of the channels of impact and potential intended and unintended effects of cash transfers (and their specific design features) on the indicators of focus. Chapter 5 The evidence base Table 2.2 Cash transfers review: six outcomes and their selected indicators Poverty Education Employment Health and nutrition Empowerment Savings, investment and production SECTION II Physical abuse by male Total household Attendance Use of health services Household savings Adult labour force Chapter 6 expenditure participation partner The impact of Maths test scores Dietary diversity Food expenditure Borrowing Non-physical abuse by Child work cash transfers on male partner monetary poverty Adult labour intensity Women’s decision- Agricultural productive Child stunting Language test scores Poverty headcount Chapter 7 making power assets The impact of Child wasting Composite test scores Poverty gap Marriage Child labour intensity Agricultural input cash transfers on expenditure education Squared poverty gap Adult labour force Child underweight Cognitive development Fertility Livestock ownership Chapter 8 participation and intensity by sector The impact of cash transfers on health Child work and intensity Involvement in business Use of contraception and nutrition and enterprise by sector Multiple sexual partners Migration Chapter 9 The impact of cash transfers on Source: Authors savings, investment and production Chapter 10 Poverty The impact of cash transfers on The following three indicators were selected to capture the effects of cash transfers on individual employment or household material/financial/monetary wellbeing: Chapter 11 T is measured either at the individual or household level and is otal consumption expenditure • The impact of the sum of all expenses made on goods and services within a particular time period (with own cash transfers on production and rent often imputed). It is seen as a more reliable and useful measure of actual empowerment living standards than income, as it captures consumption smoothing and hence measures income (Deaton, 1997). permanent SECTION III F ood consumption expenditure • is also measured at the individual or household level and Chapter 12 is the sum of all expenses on food (with own production and gifts often imputed), within a Summary of particular time period. Food expenditure is an important measure of wellbeing because it often findings and constitutes the largest expenditure category for households, especially for poorer households. conclusion References

37 Cash transfers: what does the evidence say? Page 37 Contents • T he (1984) measure poverty and three indicators developed by Foster–Greer–Thorbecke (FGT) Acknowledgements inequality. They are measured at the household level but aggregated at the population level and measures the poverty headcount are calculated with either income or expenditure data. The Executive summary proportion of the population that is poor (i.e. their income/expenditure is below the poverty poverty gap line). It gives us an idea of the share of the population that is poor. The measures how poor the extent of poverty, in other words poor households are, by measuring the distance SECTION I between household income/expenditure and the poverty line. The final measure, poverty Chapter 1 or the squared poverty gap, measures inequality among poor households. It takes the severity Introduction average of the squared poverty gaps, hence placing greater value on poorer households. Chapter 2 One of the rationales behind cash transfers is their potential for increasing households’ purchasing Conceptual power, reducing short-term poverty among beneficiary households and potentially affecting framework longer-term poverty, for instance through improved human capital, increased investments, Chapter 3 changing livelihoods and labour allocations. In theory, a cash transfer may also lead to changes in Review of cash individual or household preferences and behaviour, which could work against poverty reduction transfer reviews objectives. For example, a targeted cash transfer may generate an incentive for a household to maintain an income below the eligibility threshold and reduce its work effort, leading to a Chapter 4 Methods reduction in wage income. If the reduction in wage income is the same/larger than the transfer, total expenditure will stay unchanged/be reduced. Chapter 5 The evidence base The following table summarises some of the ways in which variations in cash transfer design and implementation features may influence monetary poverty outcomes. SECTION II Table 2.3 Implications of cash transfer design features on poverty indicators Chapter 6 Potential impacts on poverty indicators Cash transfer features The impact of cash transfers on monetary poverty Core cash Level of the Higher transfer levels may be expected to lead to higher impacts on poverty measures in the immediate instance. transfer They can also be expected to influence second-order outcomes which could in turn increase or decrease poverty. transfer Chapter 7 For example, higher transfer values of means-tested transfers may be expected to pose a higher risk of generating a design The impact of features work disincentive effect. cash transfers on Timing and A one-off or annual payment is arguably more likely to be saved or invested than regular and frequent payments, education which can support beneficiaries in their ongoing consumption expenditures and facilitate consumption smoothing. frequency of payment Chapter 8 A longer duration of receipt may encourage more investment and sustained impacts on expenditure and poverty. Duration The impact of cash transfers on health Can affect the composition of expenditure, with female recipients argued to favour food and other household/child Main recipient and nutrition expenditures. Conditionalities – whether perceived or enforced through regular monitoring and non-compliance response Conditionality Chapter 9 enforcement – can affect expenditure directly (for example, through the perceived requirement that the transfer The impact of should be spent on certain items, e.g. food) and indirectly, through time use (time spent meeting conditionality cash transfers on requirements vs other activities). savings, investment Targeting One rationale for targeting transfers towards the poor is that it may lead to more sizeable short-term impacts, as and production their pre-transfer expenditure levels are lower. However, narrow targeting displays costs and political economy challenges, and can be associated with effects that may work against poverty reduction objectives. Moreover, the Chapter 10 targeting of particular groups, such as poor households with limited or no labour capacity, who are least capable of The impact of investing and diversifying their livelihood activities, may not necessarily maximise potential poverty reduction effects. cash transfers on Payment modalities associated with direct and indirect costs for beneficiaries reduce de facto size of the transfer, Payments employment leading to potentially lower impacts. Payment modality could also affect composition of expenditure. If actual payment frequency is lower than anticipated or payments are not predictable, it could affect how the transfer is Chapter 11 spent – more difficult to use cash transfer to smooth consumption, less likely to be spent on investment or risk- The impact of taking activities. cash transfers on The presence of social accountability mechanisms can improve the effectiveness of transfer delivery (for example, Grievance mechanisms and empowerment programme governance more effective targeting, more predictable payments, payments of the actual level that beneficiaries are entitled to), which could in turn lead to bigger effects on expenditure and poverty. SECTION III Could affect composition of expenditure in the short term and earning potential in the long term, with indirect Complementary interventions impacts on poverty and inequality. Positive effects on livelihoods and productivity – hence more sustainable poverty reduction – are expected to be stronger when cash transfers are provided in combination with other type of Chapter 12 interventions (skills and knowledge development, asset transfers; etc.) Summary of findings and conclusion Source: Authors References

38 Cash transfers: what does the evidence say? Page 38 Contents Education Acknowledgements Indicators that measure education outcomes can be broadly categorised into indicators that Executive summary measure access (second-order outcomes) and learning/performance (third-order outcomes). The three groups of indicator areas selected for this review are: SECTION I S chool attendance , most commonly measured as the proportion of total school days for which • enrolled students are present during a school year. School attendance indicators may also Chapter 1 measure attending an exam at the end of the school year or absenteeism in a given school year/ Introduction school week. Chapter 2 ndicators for I • , which most frequently include learning outcome test scores/performance Conceptual framework as measured by test scores in individual subjects (maths, language, science, cognitive and problem-solving skills) or a composite assessment score from test scores in different subjects or Chapter 3 other measures of skills and learning. Review of cash transfer reviews • I , focused on early childhood development, most ndicators for cognitive development commonly measured through a variety of tests including memory, behavioural or vocabulary Chapter 4 tests among pre-school children. Methods Chapter 5 The main mechanism through which cash transfers are thought to increase access to education in The evidence base the short term is by removing the financial barriers to education: the additional funds available to a household increase overall household income to cover the direct (fees, uniforms, school materials, etc.) and indirect (travel costs, bribes, etc.) costs associated with school participation. SECTION II At the same time, the introduction of additional cash may also reduce the burden on children to contribute to household income (child labour) thus reducing drop-out and increasing enrolment. Chapter 6 The impact of Implicit in the theory of change is the assumption that the cash transfer may replace or cash transfers on compensate for the opportunity cost of sending children to school, and that families, if there is an monetary poverty economic incentive, will make decisions in favour of educating their children. Chapter 7 An increase in service utilisation is of interest mainly insofar as to what extent children who The impact of cash transfers on are enrolled and attend school as a result of the cash transfer are able to complete more years of education schooling and increase learning, a crucial step towards the accumulation of human capital in the long term (Fiszbein and Shady, 2009; Reimers et al., 2006). The underlying theory of change for Chapter 8 these learning indicators assumes that the quality of instruction available to beneficiary children is The impact of cash adequate and that increased years of education will translate into improved education status. transfers on health and nutrition In addition to the main pathways outlined above, other channels may strengthen or weaken the Chapter 9 effects on education outcomes: The impact of cash transfers on • he value that the programme places on education could be transferred to the households and T savings, investment wider community, improving attitudes towards the importance of investing in the schooling of and production children (Reimers et al., 2006). Chapter 10 P • ositive peer influence that children receive as they participate in school may encourage them The impact of to study harder and pursue higher education in the long term (Baez and Camacho, 2011). cash transfers on employment ransfers may trigger increases in household expenditure (food and other household goods), T • resulting in better food security, psychosocial wellbeing and nutritional/health status Chapter 11 . of children (Adelman et al , 2008). These effects could positively affect a child’s school The impact of attendance, cognitive ability and efficiency of learning in the long term. cash transfers on empowerment G • reater enrolment and attendance may change the student–teacher ratio, increase overcrowding and lead to greater competition for limited resources. SECTION III • arginal children who are brought into school by the transfers could have lower expected M returns to school compared to those already enrolled, since they may be, for instance, less Chapter 12 motivated or come from lower socioeconomic background. This can trigger negative peer Summary of findings and effects in learning. conclusion The following table provides examples of the ways in which variations in cash transfer design and References implementation features can affect the education indicators under review.

39 Cash transfers: what does the evidence say? Page 39 Contents Table 2.4 Implications of cash transfer design features for education indicators Acknowledgements Cash transfer features Potential impacts on education indicators Core cash Level of the All else being equal, programmes that make larger transfers may be expected to have larger effects, particularly in Executive summary transfer transfer secondary school and for older children, if transfers are high enough to cover children’s income (opportunity costs) design in addition to the direct costs of schooling. features SECTION I Timing and Some payment schedules may be more successful in inducing incentives for behavioural change in education (e.g. frequency of payments tied to key moments within schooling cycle, differential payment by grade or graduation prizes). Chapter 1 payment Introduction Duration A longer duration of participation could determine whether a child is able to complete a school year or progress from primary to secondary school, as well as have long-term improvements in learning. Chapter 2 The main recipient of the transfer may determine the effect on access to education services, with female recipients Main recipient Conceptual argued to be more likely to focus spending on human capital outcomes for children compared to male recipients. framework One of the arguments underpinning the use of conditions is that households lack full information on the long-term Conditionality Chapter 3 benefits of education. Conditionality (actual and perceived) and messaging may therefore exert an additional effect Review of cash in encouraging access to education. If this is the case, we would expect the effects to be larger for CCTs or ‘labelled transfer reviews UCTs’ (implicitly endorsing schooling) compared to pure UCTs that have no schooling conditions or focus. However, there is also a concern that the imposition of conditions could act as an exclusionary factor, penalising the most vulnerable families. Chapter 4 Methods Targeting Targeting the poorest households (often located in remote areas) may affect the educational impacts of cash transfers, especially when the quality of available schools is inadequate, and disadvantaged students do not receive Chapter 5 the additional support necessary to raise performance levels. Higher impacts on educational outcomes are expected The evidence base from programmes that explicitly target households with school-age children (or even children at critical educational stages) and marginal students (e.g. girls). Payment modality Payment modalities associated with direct and indirect costs for beneficiaries may reduce the size of the transfer, SECTION II leading to potentially lower impacts. Payment modality could also affect composition of expenditure in favour of education (e.g., if transferred through schools and almost perceived as a scholarship). If actual payment frequency is lower than anticipated or payments are not predictable, it could affect longer-term household expenditure decisions Chapter 6 (composition and overall) as to whether to invest in education. The impact of cash transfers on Grievance mechanisms and The presence of social accountability mechanisms can improve the effectiveness of transfer delivery, which may in monetary poverty programme governance turn lead to larger effects on education. Complementary interventions Well-designed information sessions on topics that emphasise the importance of investing in the education as well as Chapter 7 the potential returns to education may induce households to send their children to school. Likewise, supplementary The impact of supply-side interventions aimed at improving school quality and increasing resources for low-performing students cash transfers on are central for taking into account higher utilisation of education services. education Source: Authors Chapter 8 The impact of cash transfers on health Health and nutrition and nutrition This review considers the evidence as to how cash transfers can affect (1) the utilisation of health Chapter 9 The impact of care services, (2) dietary diversity and (3) child anthropometric outcomes (stunting, wasting and cash transfers on being underweight). The measurements of dietary diversity considered are all aggregate measures savings, investment or indices rather than changes in the intake of specific foods or food groups. and production utilisation of health care One channel through which cash transfers can be expected to affect the Chapter 10 The impact of is through the demand side. Theory suggests that demand for health care is mediated services cash transfers on through a wide number of channels (Ensor and Cooper, 2004) and cash transfers may impact on a employment number of these. For example: Chapter 11 b • y alleviating liquidity and credit constraints, thereby increasing the ability of beneficiaries to The impact of 39 cover health-related costs (‘income effect)’ cash transfers on empowerment • b y counteracting impatience and ‘myopia’ and increasing knowledge and understanding of long-term benefits of health care access, either through explicit conditionality (as is the case in CCTs) or through milder forms of conditioning (e.g. labelling) and information-sharing SECTION III (information campaigns, training sessions, etc.). Chapter 12 Summary of Some cash transfers may also impact upon utilisation through the supply of health care services, findings and by simultaneously investing in local health services. Supply may also be affected by increased conclusion References 39 W hether there is an increase in health care use or not will depend upon a range of factors, including the services being available as well as existing health care utilisation levels.

40 Cash transfers: what does the evidence say? Page 40 Contents demand for health care, as described above. If there is no supply response, this may lead to Acknowledgements overcrowding and potential reduction in health care use. Executive summary dietary diversity Theory suggests that cash transfers may also affect by: a • lleviating liquidity and credit constraints, enabling households either to purchase or to SECTION I produce a wider range of foods, depending upon local market conditions (Tirivayi et al., 2013) Chapter 1 s timulating the availability of and demand for a more diverse range of foods, especially where • Introduction programmes involve conditions or messaging relating to nutritional education, or complementary food security/agriculture interventions (e.g. home gardening, agricultural inputs, etc.). Chapter 2 Conceptual , the two immediate child undernutrition According to UNICEF’s conceptual framework relating to framework causes are an inadequate dietary intake and disease (Black et al., 2008). Cash transfers have the Chapter 3 potential to affect both of these, by affecting overall dietary diversity (see above) and the overall level Review of cash of food consumed (because of relaxed budgetary constraints and, potentially, higher self-production). transfer reviews Some cash transfers have also included complementary nutritional supplementation, which in itself is likely to improve the nutritional intake of children besides any effect that cash or conditions may Chapter 4 Methods have on dietary intake. Cash transfers may also help to alleviate the drivers of disease, including improved care practices and hygiene and improvements to the household environment, and to Chapter 5 minimise the negative consequences of disease by enabling more timely access to health services. The evidence base The following table provides examples of the ways in which variations in cash transfer design and SECTION II implementation features may affected the health and nutrition indicators under review. Chapter 6 Table 2.5 Implications of cash transfer design features for health and nutrition indicators The impact of Cash transfer features Potential impacts on health and nutrition indicators cash transfers on monetary poverty Level of the Should the transfers represent a small proportion of the cost of travelling to a clinic, of a diverse food basket, or of Core cash transfer agricultural inputs needed to produce a wider variety of produce, this would clearly limit the size of effects that could transfer Chapter 7 design be expected on these outcomes, restricting any subsequent effect on child health and nutrition outcomes. The impact of features Timing and Irregular and infrequent payments may inhibit the ability of households to be able to smooth their consumption (e.g. cash transfers on frequency of covering health care costs or being consistent in their ability to consume a varied diet), with associated detrimental education payment effects on child health indicators. Chapter 8 It could be expected that receiving cash transfers for longer would allow households to build up a higher level of Duration capital, increasing their capacity to cover health care costs and to consume a more varied diet, with concomitant The impact of cash improvements in child health and nutrition outcomes. Given that changes in anthropometric outcomes may take transfers on health some time to show, benefitting for a longer time may also allow any such effects to be observed. and nutrition Main recipient The main recipient of the transfer may determine the effect on access to health services and on food intake and Chapter 9 diversity, with female recipient argued to be more likely to focus spending on human capital outcomes compared to The impact of male recipients. cash transfers on In principle, explicit conditionality lowers the opportunity cost of the particular health-related behaviour that forms Conditionality savings, investment part of the condition, relative to alternative uses of time or money, resulting in increased adherence to that behaviour and production (e.g. attendance at health clinics). Similar effects could also be the consequence of learning effects arising through programme messaging (labelling and knowledge sharing). When response to non-compliance is punitive, there is a Chapter 10 concern that conditionality may work against programme objectives by additionally penalising the poorest households. The impact of The communication of the importance of the regular use of health services alone, may have an effect on health and nutrition outcomes, and the role of the public’s perceptions may matter. Whether compliance is monitored and/or non- cash transfers on compliance responses are implemented in practice could also either work in favour or against intended objectives. employment The target population and information requirements used to target can help ensure that those groups that are Targeting Chapter 11 excluded from existing health services are reached. Ensuring that pregnant women, young children, older persons, The impact of people with disabilities, people with chronic illnesses are examples. cash transfers on Payment modalities associated with direct and indirect costs for beneficiaries may reduce de facto size of the Payment modality empowerment transfer, leading to potentially lower impacts on health and nutrition outcomes. If actual payment frequency is lower than anticipated or payments are not predictable, it could affect longer-term household expenditure decisions (composition and overall) whether to invest in health. SECTION III The presence of social accountability mechanisms can improve the effectiveness of transfer delivery, which could in Grievance mechanisms and turn lead to bigger effects on health. governance Chapter 12 Summary of Complementary interventions Complementary interventions, including supply-side investments in health care provision and health training and awareness, may play a positive mediating role in improving health and nutrition outcomes. Supplementary nutrition findings and and livelihoods interventions in particular may be especially effective in improving dietary diversity measures and conclusion child anthropometric measures. References Source: Authors

41 Cash transfers: what does the evidence say? Page 41 Contents Savings, investment, production Acknowledgements The indicators for this outcome area are grouped into three broad categories: saving and Executive summary ; borrowing purchase and ownership of productive assets (agricultural assets, agricultural inputs business and enterprise and livestock); and . SECTION I Within the category for saving and borrowing, we focus on indicators on the share of households Chapter 1 that hold any savings/loan and the total value of these savings/loans. Within the productive assets Introduction category we focus on indicators on the share of households that own any or spent any money on that asset, monetary value of the asset and the total number owned of that asset. For the business Chapter 2 and enterprise category we include indicators on the share of households who operated non-farm Conceptual framework enterprises or who owned business assets, monetary value of the assets and total expenditure on business assets over reference period. Chapter 3 Review of cash The theoretical and empirical literature confirms that liquidity, credit and insurance constraints transfer reviews are among the main factors limiting poor households from investing optimally (Asfaw et al., Chapter 4 2012; Barrientos, 2012; Tirivayi et al., 2013). For example, households in poverty face binding Methods credit constraints as they have no access to collateral to secure loans, while also being more likely to default because of the urgency of their consumption needs (Banerjee, 2005, Barrientos, 2012). Chapter 5 More generally, insurance markets seldom reach those in poverty, leaving households insufficiently The evidence base protected (Dercon, 2005; Siegel and Alwang, 1999; Barrientos, 2012). Insecurity, in turn, leads to , either in production inefficient use of resources and the adoption of low-risk/low-return strategies SECTION II or the diversification of income sources (Morduch, 1995; Siegel and Alwang, 1999; Dercon, 2003; Asfaw et al., 2012; Barrientos, 2012). This could include: Chapter 6 The impact of h • olding assets that are liquid but less productive cash transfers on 40 • ocusing on current consumption (having enough to eat) in preference to investment f monetary poverty isinvestment and negative coping, depleting the household asset base. d • Chapter 7 The impact of cash transfers on Further constraints to investment in poor households are also linked to lack of knowledge (e.g. education farming techniques, markets) and lack of adequate inputs and factors of production (in turn affected by credit constraints). The literature on assets and poverty traps, for example, emphasises Chapter 8 the importance of assets in preventing households from being locked into a low-level equilibrium The impact of cash (Carter and Barrett, 2006). transfers on health and nutrition Given this context, receiving a guaranteed and predictable source of income at regular intervals Chapter 9 could affect our selected outcome indicators in the ways set out below (Barrientos, 2012; Asfaw et The impact of al., 2012; Tirivayi et al., 2013). cash transfers on savings, investment Households’ saving and borrowing behaviour could be affected in several ways: and production i • ncreased capacity for saving because of (a) increased income, (b) increased access to formal Chapter 10 and informal financial institutions The impact of cash transfers on • ecreased saving because of (a) increased expenditure on cash transfer ‘desirable goods’ (health, d employment education, etc.), (b) increased expenditure on productive assets and inputs (also used as stock of Chapter 11 value) The impact of • ncrease in borrowing because of (a) shifts in livelihood activities (i.e. more investment), (b) i cash transfers on empowerment increased access to formal and informal financial institutions (increased creditworthiness, increased collateral, reduced information asymmetries on household financial situation, etc.), and (c) increased financial security and risk-taking SECTION III • ecreased borrowing/outstanding debt because of (a) focus on repaying existing debts using d Chapter 12 cash transfer money (reduced stigma), (b) reduced need to borrow at adverse interest rates (cash Summary of transfer cash available). findings and conclusion References 40 I n the face of such constraints, the production and consumption decisions of agricultural households can be viewed as ‘non-separable’, in the sense that they are jointly determined (Singh et al., 1986).

42 Cash transfers: what does the evidence say? Page 42 Contents A household’s decision to spend a portion of its cash transfer on productive investment – and, more Acknowledgements widely, livelihood diversification – greatly depends on the existing asset stock, livelihood strategies, human capital endowment and other similar factors. Generally, theory suggests that additional Executive summary income can enable households to (Barrientos, 2012; Asfaw et al., 2012; Tirivayi et al., 2013): dopt riskier strategies with a higher rate of return (because they have a definite source of basic • a SECTION I income) Chapter 1 • h ave sufficient liquidity and/or access to credit for productive investment (e.g. new assets, use Introduction of new inputs, diversification of activity) Chapter 2 • i mprove their ability to manage risk and shocks, avoiding detrimental risk-coping strategies Conceptual (e.g. distress sales of productive assets) framework • mprove their human capital in the medium-long term, affecting their investment decisions (and i Chapter 3 potentially enhancing productivity) Review of cash transfer reviews a • ctively participate in reciprocity-based social networks, with potential effects on their insurance and livelihood strategies. Chapter 4 Methods At the same time, ‘injecting a significant amount of cash into the local economy can stimulate local product and labour markets and create multiplier effects’ (Asfaw et al., 2012). Nevertheless, Chapter 5 The evidence base it is unlikely that a large proportion of households invest in such assets/inputs or that a large 41 proportion of cash transfer cash within a household is used for this purpose. This is mainly due to the fact that the explicit and implicit objectives of existing cash transfer programmes rarely SECTION II encompass a focus on productive investment, but also because: Chapter 6 t • he demographic characteristics of beneficiary households and their assets endowment may not The impact of be conducive to significant increases in productivity (e.g. labour constrained) cash transfers on monetary poverty l • ack of investment can be entirely rational (e.g. lower soil quality households have less reason 42 etc.) to invest in fertiliser, Chapter 7 The impact of ifferent characteristics of assets make them ‘valuable’ to households, meaning that their d • cash transfers on monetary value and capacity to increase productivity are not the only variables that affect education 43 investment decisions Chapter 8 s • evere market failures in the communities where beneficiaries live may affect their choices The impact of cash transfers on health • rogramme design may not be conducive to productive investment (e.g. amount too little, p and nutrition unpredictable payments, conditionality on human capital outcomes, etc.) – as discussed below. Chapter 9 Finally, it is important to clarify that, even if households were to invest in productive assets and The impact of cash transfers on activities as measured by the selected indicators for this study, the ultimate impact on productivity savings, investment and income is not guaranteed. This is because such outcomes are ‘mediated by factors beyond and production the control of the programme and the producer – such as prices, weather and access to input and output markets’ (Asfaw et al., 2012). It is obvious, for example, that in rural areas characterised Chapter 10 by ‘low population density, illiquid markets, and inadequate public infrastructure’ constraints on The impact of cash transfers on production are particularly severe (FAO, 2015). employment Chapter 11 The impact of cash transfers on empowerment SECTION III urther methodological issues are likely to arise when analysing such indicators. For example, money metrics fail to account for depreciation F 41 Chapter 12 of assets; such indicators are hard to turn into scalar measure, presenting aggregation problems and different units; asset ownership is slow Summary of changing, meaning evaluation timing may affect findings. findings and S 42 ee Marenya and Barrett (2009). conclusion A ccording to Siegel and Alwang (1999), this includes security of access, use and transfer rights, and insurability of the asset; rate of return 43 References and sustainability of returns from the asset; interactions between assets in generating returns (e.g. complementarity); store of wealth and basis for claims on other assets (e.g. collateral); liquidity, lumpiness and mobility (e.g. goat vs cow); ability to satisfy household to provide basic consumption needs (e.g. milk from livestock); externalities related to holding or use (e.g. social status).

43 Cash transfers: what does the evidence say? Page 43 Contents Table 2.6 Implications of cash transfer design features on savings, investment and production indicators Acknowledgements Cash transfer features Potential impacts on savings, investment and production indicators Core cash Level of the Higher levels expected to increase productive impact (production/saving rather than consumption smoothing). The Executive summary transfer size of the transfer may also affect the choice of investment: higher amounts may be used for bulkier investments transfer design (e.g. cow) and smaller amounts for smaller investments (e.g. chickens and goats). features SECTION I Less frequent ‘lumpy’ payment could have higher impact on ‘lumpy’ investments vs consumption smoothing. Timing and frequency of Potentially more impact if timing linked to seasonal changes (i.e. to key agricultural moments). payment Chapter 1 Introduction Duration It might be expected that receiving cash transfers for longer would allow households to build up a higher level of capital. Chapter 2 Main recipient Can affect extent of livelihood diversification, overall productive choices and ultimate level of risk taking (see section Conceptual on gender). framework Conditionality If conditional (or strongly labelled) on human capital accumulation, less likely to have productive impacts in the short Chapter 3 term, but potentially more impacts in the long term due to increases in productivity. If conditional on investment, likely to have strong impacts. If low compliance/monitoring/enforcement of human capital-related conditionality, Review of cash potentially higher productive impact. Higher supervision of investment-related conditionality, on the other hand, is transfer reviews likely to increase impacts. Chapter 4 Potentially lower productive impacts if targeted at poorest, elderly, labour-constrained or land/asset-constrained Targeting Methods households, or households in areas with absence of markets or lack of agricultural activity. Payment modalities associated with direct and indirect costs for beneficiaries reduce the size of the transfer, leading Payment modality Chapter 5 to potentially lower impacts. Potentially higher impact on savings/credit if delivered through banking system or The evidence base mobile money system. Regularity and predictability of payment essential for creditworthiness and risk management, while also increasing the time horizon of beneficiary households. Community monitoring can play a function in creating social pressure and ensuring cash transfer resources are Grievance mechanisms and SECTION II governance spent ‘productively’. Chapter 6 Coupling cash transfers with business and vocational training initiatives, extension services, and productive grants Complementary interventions or asset transfers can significantly improve productive impact. Coupling with micro-credit initiatives or support to The impact of formal banking can enhance saving/credit outcomes. cash transfers on monetary poverty Source: Authors Chapter 7 The impact of cash transfers on education Employment Chapter 8 The selected indicators of focus in this review distinguish between participation in a labour The impact of cash activity and the amount of time spent participating in that activity . Beyond this, we are also transfers on health interested in how cash transfers might affect participation in, and the time allocated to, different and nutrition activities or types of work across different sub-sectors . Chapter 9 The impact of In this review we consider a large combination of employment outcomes, disaggregated by age and cash transfers on gender. These are summarised under five core indicators for which evidence is extracted: savings, investment and production – measured in a range of ways, such as whether verall labour participation (adult and child) O • the individual is working, has engaged in any labour activity in a given period or whose main Chapter 10 activity is productive work. The impact of cash transfers on – measured • abour participation in a particular sub-sector or type of work (adult and child) L employment in much the same way as overall labour participation, this indicator provides an insight into Chapter 11 changes in participation in specific sub-sectors or types of work (e.g. agricultural, non-farm, The impact of paid, unpaid, etc.). cash transfers on empowerment – generally measured as the number of hours worked verall labour intensity (adult and child) • O in a given reference period, this indicator tells us about the amount of time spent in work overall. SECTION III measured in a abour intensity in a particular sub-sector or type of work (adult and child) – • L Chapter 12 similar way to overall labour intensity, this indicator tells us about any impacts on the time Summary of spent on specific types of work or in specific sub-sectors. findings and conclusion • igration – measures covered here include the decision to migrate, either domestically or M internationally. References

44 Cash transfers: what does the evidence say? Page 44 Contents : a cash transfer may have a positive income effect at the household level, increasing Child labour Acknowledgements the ability of a household to send their child to school, and therefore lowering their time spent on labour activities (Basu and Van, 1998; Baland and Robinson, 2000). Where transfers are Executive summary linked to, or are conditional upon, specific children attending school, a cash transfer might also be expected to lead to a reduction in the time spent on labour activities by those children, arising from a reduction in the opportunity cost of attending school. This could even lead to a SECTION I substitution effect, with other non-eligible children increasing their own time spent on labour Chapter 1 activities. However, where cash transfers can have a positive effect on productive activities (e.g. on Introduction farm), there may also be an increase in the utilisation of children in related activities. Chapter 2 Among households with children, if transfers do lead to a reduction in child labour, this may Conceptual represent a reduction in income from child work (or a reduction in time spent on household chores). framework If the size of the transfer does not adequately cover that loss and any additional costs of attending Chapter 3 within the household are incentivised to increase their time spent in adults school, it could mean that Review of cash income-generating activities, or else experience a drop in household consumption levels. transfer reviews Independently of impacts on child labour, the standard economics literature suggests that, if Chapter 4 Methods leisure is a normal good (that is, demand for it increases as income increases), then a cash transfer may lead to an increase in the time spent by on leisure, with a concomitant reduction in adults Chapter 5 time spent working (Fiszbein and Schady, 2009). However, given that recipients of cash transfers The evidence base are typically poor, they may not reduce their labour supply in response to an increase in household income (meaning the income elasticity of demand for leisure time may in fact be quite low). SECTION II Indeed, an alternative theory, drawn from the literature on institutional economics, would posit that injections of cash can in fact help to address credit and liquidity constraints, thereby allowing Chapter 6 households to engage more fully in certain types of – more productive or better remunerated – The impact of labour activity (Kirsten et al., 2009). This might be combined with a reduction in time spent on cash transfers on other labour activities, such as unpredictable or casual labour, where people are employed on more monetary poverty adverse terms. Chapter 7 The impact of Finally, thinking about , access to social protection may increase or decrease the migration cash transfers on likelihood of migration (see Hagen-Zanker and Himmelstine, 2013). On the one hand, access education to a social protection programme may render the need to migrate obsolete, if remittances and social protection benefits are viewed as substitutes by potential migrants (ibid). On the other Chapter 8 The impact of cash hand, migration and social protection could be seen as complementary strategies by prospective transfers on health migrants, with the cash obtained from receiving a social protection transfer being used to finance and nutrition migration (ibid). Chapter 9 As mentioned above, the design of a cash transfer programme is likely to have important The impact of cash transfers on implications for the impacts it has on employment outcomes. The table below summarises some of savings, investment these considerations. and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

45 Cash transfers: what does the evidence say? Page 45 Contents Table 2.7 Implications of cash transfer design features for employment indicators Acknowledgements Cash transfer features Potential impacts on employment indicators Level of the Low transfer levels may limit reductions in child labour (and, relatedly, in schooling). Also, if transfers are insufficient Core cash Executive summary transfer transfer to cover any loss in income from reductions in child labour plus any additional costs of attending school, it may lead design to adults having to increase their time spent on labour activities (potentially in low-paid casual work). However, high transfers attached to means-tested benefits could generate an incentive for households to appear to remain poor features SECTION I (e.g. reducing labour income). At the same time, higher transfer levels could instead provide households with greater resources to be able to invest and increase involvement in more profitable income-generating employment activities. Chapter 1 The size of the transfer might also lead to greater or smaller effects on migration, depending on whether transfers Introduction are seen as substitutes or complements to migration. If transfers are received infrequently this can mean recipients having to maintain or take on certain forms of Timing and Chapter 2 frequency of employment (including informal and casual work) to smooth consumption. It may also limit their ability to plan Conceptual payment and invest part of the transfer in alternative employment activities. The timing of transfers can also be crucial. For framework example, tying transfers to certain points in the school year can lead to greater improvements in school participation and, in turn, less child labour. Chapter 3 Duration If transfers are fixed for a limited duration (and are large enough), this could provide incentives for individuals Review of cash to invest part of their transfer in more profitable employment activities to prepare for when they will no longer transfer reviews receive the transfer. By contrast, if transfers are not provided for long enough, they may not allow sufficient time for households to keep children in school or shift to more profitable employment options, limiting impacts on child Chapter 4 labour and on opportunities for improving their employment options. Methods Main recipient Who receives the transfer can have important implications for the employment decisions of others within the household. For example, if the transfer is received by elderly individuals as a pension, this may reduce the burden on Chapter 5 other household members and even allow some members to migrate to seek better employment opportunities. The evidence base Conditionality If transfers that are conditional upon school enrolment lead to increases in participation, this could in turn lead to reductions in child labour. By imposing particular behaviours on women in the household or by increasing particular responsibilities on women, conditionalities (e.g. participating in information sessions, ensuring children comply, etc.) SECTION II may reinforce a woman’s domestic role and may have implications for shifts across sectors of work for women and girls. Specific forms of conditionality (access to pre-school) may contribute to reduced caring duties and facilitate Chapter 6 women’s engagement with the labour market. The communication of the advantages and benefits of school The impact of participation may promote school attendance and contribute to a reduction in the time children spend on work. cash transfers on However, children may continue to combine the two. If conditionalities are punitive in practice, they risk additionally monetary poverty penalising vulnerable children and reinforcing their work patterns. Targeting The type of individual or household targeted, depending on age, gender, ability to work, current sector of Chapter 7 employment and labour market factors, will have critical implications for the expected effects on the selected The impact of indicators. In terms of migration, greater impacts are more likely to be seen where labour migration opportunities cash transfers on are available and known to recipients. Ineffective targeting (e.g. transfers reaching wealthier households that education are already engaged in better remunerated employment) could be expected to exert weaker employment effects. Similarly, weak or infrequent recertification could have a similar effect. Chapter 8 Payment modality Reducing the time spent on collecting the transfer (e.g. through electronic payment mechanisms) could increase The impact of cash the time available to engage in productive employment activities and, where transfers are received through bank transfers on health accounts, may even support the establishment of small enterprises. If payments are irregular and unpredictable, and nutrition this could lead to recipients having to engage in casual or informal labour to smooth consumption. It may also limit their ability to plan and invest part of the transfer in alternative employment activities. It may also affect decisions Chapter 9 around investment in education, which could limit reductions in child labour. The impact of The presence of grievance mechanisms that allow for recipients to raise concerns over the implementation of cash Grievance mechanisms and cash transfers on governance transfers could, if effective, lead to improved delivery. This may affect employment and migration outcomes through savings, investment other channels above, e.g. in so far as it leads to larger and/or more regular transfers. and production Complementary interventions Transfers that are also combined with supervision or business grants might be expected to lead to greater shifts Chapter 10 towards self-employment and/or the establishment of small enterprises, which may even limit migration in so far The impact of as it increases the returns from employment in the recipients’ current location. Complementary sessions may also, however, involve time commitments that reduce time spent on certain labour activities. cash transfers on employment Source: Authors Chapter 11 The impact of cash transfers on Empowerment empowerment In this review, empowerment is measured using six indicators: domestic abuse, women’s decision- SECTION III making power, marriage, pregnancy, use of contraception and having multiple sexual partners. Chapter 12 In the literature, these indicators are discussed with respect to two distinct groups: (1) marriage, Summary of pregnancy, use of contraception and having multiple sexual partners relate to school age and findings and unmarried young adults, male and female, (2) domestic abuse, women’s decision-making and, to conclusion an extent, contraceptive use, mostly relate to married or cohabiting women. For this reason, we References discuss the potential impacts on these indicators for the two groups separately below, although they display overlaps in part.

46 Cash transfers: what does the evidence say? Page 46 Contents Unmarried school-age girls and young women Acknowledgements Underpinning some of the arguments on the ways in which a cash transfer may impact the Executive summary empowerment indicators for this group of girls and young women is the assumption of a binary distinction or trade-off between the state of being in school and the state of being married. A related condition is that limited or even no livelihood options are available for women outside SECTION I marriage. Therefore, for girls who are able and willing to attend school, the primary mechanism Chapter 1 by which a cash transfer can delay marriage, pregnancy and risky sexual behaviour is through Introduction incentivising enrolment and attendance (Hargreaves et al., 2008; Pettifor et al., 2008; Palermo, 2015). As discussed in the overarching conceptual framework, school attendance also exposes Chapter 2 young people to knowledge related to safe sex (e.g. use of condoms) and pregnancy prevention, Conceptual while also giving them aspirations for the future (less likely to marry early, get pregnant). framework Chapter 3 Additional cash could similarly reduce female financial dependence on others, meaning marriage Review of cash choices could be delayed and ‘sugar daddy’ relationships or transactional sex and multiple transfer reviews partners avoided (the same goes for opting out of certain ‘last resort’ jobs that put women at risk of violence) (see, for example, Robinson and Yeh, 2012). This holds true regardless of whether Chapter 4 Methods women are in school or not. In a context which affords some livelihood opportunities and purchasing autonomy to women, this means that women have a way besides marriage to extract Chapter 5 themselves financially from their families (delayed marriage). The evidence base Married or cohabiting adult women SECTION II For this group, an increase in a woman’s individual liquidity resulting from a cash transfer could Chapter 6 have an impact on the balance of power within a household. An increase in household liquidity The impact of may also affect household bargaining patterns and, in many cases, poverty-related stress. cash transfers on Complementary or compulsory information programmes that may accompany a cash transfer monetary poverty might also increase a woman’s ability to manage her own budget and boost her social capital Chapter 7 through expanding social networks, with associated impacts on bargaining power. The impact of cash transfers on The link between a rise in a woman’s individual income and the likelihood of her being abused education by a male partner is not likely to be consistent across all cases. In the context that many cash transfers operate in, women are financially dependent on their partner. According to some Chapter 8 The impact of cash theories, this financial dependence increases the risk of domestic violence or rather reduces a transfers on health woman’s ability to escape from it (Vyas and Watts, 2009). Reducing financial dependence should and nutrition therefore reduce vulnerability to abuse. However it is unclear from the theoretical literature whether a cash transfer is an effective instrument for doing so. The two competing sets of theories Chapter 9 are as follows: The impact of cash transfers on abusive behaviour, through ash transfers • decrease two principal channels: (a) female C savings, investment bargaining power increases, and with it a woman’s ability to bargain out of violence thanks to and production ‘out of marriage options’ (Tauchen et al., 1991) (although this only applies where a separated Chapter 10 has the option to marry again), or or unmarried woman can participate fully in economic life The impact of (b) transfers may reduce poverty-related stress and, as a consequence, abusive behaviour cash transfers on (Farmer and Tiefenthaler 1997). employment • ash transfers through two mechanisms: (a) female bargaining , abusive behaviour increase C Chapter 11 power increases so the partner/spouse increases his level of non-physical abuse as an The impact of instrument to align expenditure more closely with his preferences (Eswaran and Malhotra, cash transfers on 2011) or as a means to extract rents (Bloch and Rao, 2002), (b) increased female earnings empowerment result in ‘male backlash’ or the use of violence to reassert control where it is perceived to have 44 been lost (Castro et al., 2006; Castro and Casique, 2008, cited in Bobonis et al., 2013). SECTION III On the basis of this, it also stands to reason that increases in a woman’s personal income may not Chapter 12 have obvious or consistent effects on a woman’s decision-making power. Adato et al. (2000) in a Summary of findings and conclusion References 44 B acklash may result from any combination of simple resentment, fear of accusations of unmanliness, a perceived threat to the man’s employment prospects (i.e. if the woman starts an enterprise using the transfer), and the fear that the woman’s attention will be diverted away from household responsibilities.

47 Cash transfers: what does the evidence say? Page 47 Contents paper reviewed here, offer a good overview of the different determinants of bargaining power: 1) Acknowledgements control over resources, 2) other influences that can alter the bargaining process, 3) interpersonal networks, and 4) attitudinal norms. The cash transfer is likely to most affect empowerment Executive summary outcomes through mechanisms 1 and 3 in this framework. Table 2.8 Implications of cash transfer design features on empowerment indicators SECTION I Potential impacts on empowerment indicators Cash transfer features Chapter 1 Introduction Higher levels are expected to increase financial independence and hence decision-making power, reduction/delay Core cash Level of the transfer transfer in marriage and pregnancy, increase in contraceptive use and reduction in risky sexual behaviour. Violence may Chapter 2 increase or decrease. design Conceptual features framework Timing and Timing payment at crucial ages could increase impact on marriage and pregnancy. Frequency of payment could affect impact, particularly where school enrolment is a desired outcome and means to empowerment. frequency of Chapter 3 payment Review of cash It might be expected that receiving cash transfers for longer would allow women to build up a higher level of capital, Duration transfer reviews increasing their capacity to find gainful employment as an alternative to marriage. Extended duration could also increase out-of-marriage options and therefore decrease violence. Chapter 4 Methods Transfers targeted to (young) women clearly have stronger potential to empower women. Transfers to men could Main recipient reduce incentives to engage in domestic abuse. Chapter 5 A school enrolment condition could delay marriage and pregnancy and reduce risky sexual behaviour. Other Conditionality The evidence base conditions could increase human capital accumulation which could improve out-of-marriage options. Targeting Could have an impact on poverty-related stress and subsequently decrease domestic abuse. Enforcement of gender targeting could reduce the unintended inclusion of men in specific cases. SECTION II Potentially higher impacts on autonomy in decision-making if transferred through a mechanism where funds can be Payment modality Chapter 6 hidden from other family members. The impact of More predictable payments may increase female financial security and as a result reduce dependence on a partner. cash transfers on Domestic violence may decrease as a result. Regular payment could also ensure school attendance and thus delay monetary poverty marriage and pregnancy. Grievance mechanisms and The presence of social accountability mechanisms can improve the effectiveness of transfer delivery, which might in Chapter 7 programme governance turn lead to bigger effects on empowerment. The impact of cash transfers on Coupling cash transfers with business and vocational training initiatives, extension services, and productive grants Complementary interventions education or asset transfers could significantly improve productive impact. These complementary interventions have been often been directed explicitly towards women with a view to fostering their economic hence social empowerment. Education campaigns could especially improve contraception outcomes. Chapter 8 The impact of cash transfers on health Source: Authors and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

48 Cash transfers: what does the evidence say? Page 48 Contents Acknowledgements Chapter 3 Executive summary SECTION I R eview of cash transfer Chapter 1 Introduction reviews Chapter 2 Conceptual framework Chapter 3 Review of cash transfer reviews This section summarises the key features and findings of the large number of systematic reviews and other literature reviews on the impacts of cash transfers. After briefly discussing some issues Chapter 4 of definition, the section first looks at the body of systematic reviews and asks what they tell us Methods about the evidence on the impacts of cash transfers and the role of design and implementation Chapter 5 choices. The remainder of the section then looks at other forms of literature review and asks what The evidence base additional insights they offer. For the purpose of distinguishing between systematic reviews and other forms of evidence SECTION II synthesis, it is helpful to clarify the distinction between them. As noted by Hagen-Zanker and Chapter 6 Mallet (2013), standard literature reviews can often suffer from a bias resulting from the literature The impact of that is included or omitted. This means that the reviews may draw conclusions from what is cash transfers on effectively a ‘non-representative sample’ (Petticrew and Roberts, 2006). Another shortcoming of monetary poverty such reviews can arise where data extraction and analysis is non-transparent – for example, when it does not adopt a predefined approach for assessing or grading evidence (Hagen-Zanker and Chapter 7 The impact of Mallet, 2013). cash transfers on education To help deal with some of the shortcomings of standard literature reviews, many approaches have emerged for systematising the process of research synthesis. Berrang-Ford et al. (2015) discuss a Chapter 8 number of key examples and define a systematic review in broad terms as ‘a focused review of the The impact of cash literature that seeks to answer a specific research question using predefined eligibility criteria for transfers on health and nutrition documents and explicitly outlined and reproducible methods’. As the authors point out, systematic reviews have traditionally been used for analysis of quantitative data in the health sciences, with Chapter 9 particular emphasis on randomised control trials. However, more recently a large number of The impact of systematic reviews, incorporating international development issues, have been commissioned and cash transfers on carried out across the social sciences, supported by various networks and organisations, such as savings, investment and production 3ie, the Campbell Collaboration and the EPPI-Centre. Chapter 10 While the specific requirements of a systematic review can vary depending on the particular The impact of institution through which they are commissioned, published and disseminated, the general cash transfers on definitions by the Cochrane Collaboration, Campbell Collaboration, the EPPI-Centre and the employment Centre for Reviews and Dissemination all suggest a number of core features. These include: Chapter 11 • roviding a comprehensive coverage of the available empirical literature relevant to a particular p The impact of cash transfers on research question empowerment aving an explicit pre-specified search strategy with clear inclusion and exclusion criteria • h a ssessing the validity of findings in included studies through quality assessment • SECTION III m eta-analysis (where possible). • Chapter 12 Summary of Another common requirement is the use of two reviewers, either for the screening process or data findings and extraction processes, with results compared to reduce subjectivity and mistakes. conclusion References Short of favouring one particular set of criteria to define what a systematic review is, some element of judgement is required and for the purpose of distinguishing between reviews in this paper, each

49 Cash transfers: what does the evidence say? Page 49 Contents one was checked against the four core bulleted features above. As meta-analyses are not always Acknowledgements of the four core features is not categorised two possible, any review that did not fully meet at least below as a systematic review, even if it refers to itself as one. Executive summary Finally, we focus here on systematic reviews that explicitly consider cash transfer interventions, which in some cases include reviews that also look at other types of intervention. However, the SECTION I discussion here only concerns evidence on cash transfers. A summary of non-systematic reviews is Chapter 1 provided in Annex A1.3. Introduction Chapter 2 3.1 O verview of systematic reviews Conceptual framework A large number of systematic reviews have been carried out investigating the impacts of cash Chapter 3 45 Reviews of CCTs are more common than those transfers, of which 11 are reviewed below. Review of cash covering UCTs, reflecting the emergence of a large number of CCTs in Latin America during the transfer reviews late 1990s, often with the integration of experimental evaluations in their implementation plans. The spread of UCTs, by contrast, has taken place more recently, including many examples across Chapter 4 Methods sub-Saharan Africa. The majority of reviews also appear to cover evaluation studies up until 2010 or early 2011. In some cases, a fairly small number of studies are included in the final analysis, Chapter 5 which partly reflects the inclusion and exclusion criteria used as well as the outcomes studied, The evidence base sources searched and year of the review. SECTION II Looking at the various outcomes and indicators studied within the 11 systematic reviews (see Annex A1.1), it becomes clear that those relating to health are by far the most commonly Chapter 6 investigated. This is perhaps not surprising when considering that systematic reviews have been The impact of primarily used within the health sciences (Berrang-Ford et al., 2015). The next group of outcomes cash transfers on covered most frequently are those relating to education, and then economic impacts (e.g. labour monetary poverty supply, household investments). Finally, a range of other less commonly reviewed outcomes in the Chapter 7 systematic reviews include household expenditure, poverty, empowerment, political participation The impact of and domestic violence. Some of these outcomes are explored more in the other non-systematic cash transfers on reviews, particularly consumption and poverty (these studies are summarised in the table in education Annex A1.3). Chapter 8 The impact of cash The study designs and methods accepted for inclusion within the systematic reviews (see Annex transfers on health A1.2) reveal a distinction between those that adopted a more prescriptive set of exclusion criteria and nutrition from the outset (e.g. including only experimental, or a list of specific quasi-experimental, designs) and those that were more inclusive in terms of the evidence they were willing to consider. While Chapter 9 most reviews also explicitly assessed the quality of included studies or, ‘risk of bias’, a few did not. The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 45 A n umber of reviews also touch upon cash transfers as a part of reviewing a broader range of interventions. Those in which many or most interventions were not cash transfers are not included here. Examples include Petrosino et al. (2013), Dickson and Bangpan (2012) and Cooper and Stewart (2013). The latter investigate the effect of household ‘financial resources’, but focus on OECD countries.

50 Cash transfers: what does the evidence say? Page 50 Contents Table 3.1 Key features of past systematic reviews on cash transfers 46 47 48 49 Acknowledgements Population Broad outcome Study start and end Evaluations in Types of cash Reference 46 47 final analysis categories reported on dates for searches transfer Executive summary School enrolment and UCTs and CCTs (with Baird et al. (2013) LICs and MICs (World Start 1997. Searches 75 Bank). Outcome attendance, enrolment and completed by April specific condition relating to schooling) test scores (comparison 2012. Updated April indicators for those SECTION I 2013 between CCTs and UCTs) aged 5–22 41 CCTs (with a specific LICs and MICs Health and nutrition Gaarder et al. (2010) Not stated Chapter 1 condition relating to Introduction health or nutrition) Chapter 2 14 Not stated No restrictions Maternal and newborn CC Ts Glassman and Duran Conceptual (2013) health and fertility framework No start limits. Kabeer et al. (2012) 46 Unclear (studies CC Ts Economic impacts (household and community Searched April 2010 reviewed were LICs Chapter 3 or MICs) level) Review of cash Lagarde et al. (2009) 10 No start limits. LICs and MICs CC Ts Use of health services and transfer reviews Searched November (World Bank) health outcomes 2005 to April 2006. Chapter 4 Updated search in Methods MEDLINE May 2009 No restrictions Anthropometric 24 Manley et al. (2012) Cash transfers Restricted to after 1990 Chapter 5 when more than 1,000 The evidence base references. Searched July and September 2010 SECTION II 42 Early 2010 ‘Developing countries’ Saavedra and Garcia Education CC Ts (2012) Chapter 6 The impact of Reviews reporting on effects of a broader range of interventions, including cash transfers cash transfers on Broad outcome Population Reference Types of cash Study start and end Evaluations in monetary poverty 49 48 categories reported on transfer dates for searches final analysis Chapter 7 15 1990 or after (search Banks et al. (2016) Poverty, employment, LICs and MICs Publicly provided social The impact of assistance (as well as health complete in December (12 non-contributory social insurance) cash transfers or 2014) cash transfers on grants) education No start limits. Cash transfers: Hagen-Zanker et al. 37 Money-metric poverty UCTs, CCTs and Chapter 8 employment guarantee outcomes Searched October Participants in all (2 011) The impact of cash schemes (EGSs) 2010. LICs and MICs transfers on health (World Bank definition). EGSs: selected and nutrition countries including USA in 1930s Chapter 9 The impact of Wide range of sex- IEG (2014) 145 (110 UCTs or Projects approved Relevant World Bank CCTs, UCTs (including cash transfers on CC Ts) during the financial disaggregated or gender- projects from all regions income support), non- savings, investment years 2002–2013. specific outcomes contributory pensions, in-kind (food) transfers, and production and public work programmes (PWPs) Chapter 10 The impact of 15 Gendered differences in Unearned transfers of LICs and MICs (or low- Start 1990. Searched Yoong et al. (2012) cash transfers on economic resources June 2010 to January (7 for UCTs or CCTs) income communities family wellbeing (material employment in developed country and physical, human 2 011. (cash or in-kind) including micro-credit capital and social relations) settings) Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 s there can often be an embargo on online journal articles, database searches may not always pick up all studies published in the year the 46 A Summary of search was carried out. findings and conclusion 47 S ome studies report on the same interventions. A 48 s there can often be an embargo on online journal articles, database searches may not always pick up all studies published in the year the References search was carried out. S 49 ome studies report on the same interventions.

51 Cash transfers: what does the evidence say? Page 51 Contents 3.2 O verview of findings from systematic reviews Acknowledgements This section provides an overview of the findings of the systematic reviews. It does this first by Executive summary summarising the main conclusions of each study in Table 3.2, and then draws out the findings across reviews by outcome area. It should be noted that reviews often draw on the same studies, SECTION I though this is generally noted in the discussion below where applicable. Chapter 1 Table 3.2 Summary of headline conclusions on impacts from systematic reviews 50 Introduction Summary of review’s main conclusions regarding impacts Reference Chapter 2 Baird et al. (2013) articipation in UCTs and CCTs improve odds of being enrolled in and attending school compared to no participation. P • Conceptual ffect sizes always larger (but not significant) for CCT programmes than UCT programmes. However, when categorised on strength of E • conditions and enforcement, is a significant difference. framework ffectiveness on improving test scores ‘small at best’. E • Chapter 3 Banks et al. (2016) • B enefits from participation are mostly limited to maintaining minimum living standards and do not appear to fulfil the potential of long- Review of cash term individual and societal social and economic development. transfer reviews C CTs increase utilisation of services upon which the transfer is conditioned, as long as beneficiaries have knowledge about the Gaarder et al. • programme requirements. (2010) Chapter 4 here is a more mixed picture with regard to final health and nutrition outcomes (e.g. nutritional status and morbidity and mortality). • T Methods • L imited evidence from Mexico suggests CCTs may affect health in other ways than through increased service utilisation and beyond improved food consumption. Specifically, poverty alleviation may affect mental health and lifestyle choices. Chapter 5 C CTs have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers, Glassman and • The evidence base and reduced the incidence of low birthweight. Duran (2013) N o significant impact on fertility or caesarean sections was found. • • mpact on maternal and newborn mortality has not been well documented. I • Hagen-Zanker et ransfers have a predominantly, but not exclusively, positive impact in reducing poverty for the three money-metric indicators covered. T SECTION II al. (2 011) 50 Chapter 6 • O utcomes for the household and its members differ depending on sex of recipient. IEG (2014) • omen receiving CCTs are on average less likely to experience domestic violence. W The impact of ittle or no evidence of increased fertility or ability of women to decide on contraception. • L cash transfers on • CTs generally effective in increasing likelihood of having more prenatal visits and giving birth in an institutional facility with larger positive C monetary poverty impacts tended to be found where baseline levels were low, though UCTs were not similarly effective (unclear whether due to conditionality). • ransfers can support investments in productive assets even if they were not designed to do so, with women found to invest in livestock T Chapter 7 and agricultural tools as much or more than men, but invest in different types of assets. The impact of ash transfers have not caused a reduction in labour supply for men or women in most countries. • c cash transfers on • mpacts on enrolment and attendance are higher in secondary school (where attendance is lower) and in several cases the most I disadvantaged group at baseline experienced the largest gains. education • here is very little evidence on the impacts on quality of education and learning. T Chapter 8 trong evidence that CCTs can lead to a rise in overall household consumption and investment in productive assets, increase in school S • Kabeer et al. attendance and reduction in child labour. (2012) The impact of cash • ixed evidence on the impacts of adult labour; increases in market work in some contexts and increases in leisure and domestic work M transfers on health in others. and nutrition • Persuasive evidence’ that CCTs protect household consumption and educational patterns during times of crisis. ‘ Limited evidence that CCTs have spillover effects within communities in terms of poverty reduction, increased loans and transfers and • ‘ Chapter 9 household behaviour.’ The impact of No evidence that CCTs lead to inflationary pressure in the local economy.’ • ‘ cash transfers on CT programmes appear to be effective in increasing the uptake of preventative health services and encourage some preventative • Lagarde et al. C savings, investment behaviours. In some cases programmes have noted improvement of health and nutrition outcomes (e.g. positive impact on mother’s (2009) and production reports of children’s ill health, child height, and mixed evidence on height-for-age and anaemia). • t is unclear what components lead to this positive effect. I Chapter 10 verall, no significant effect of cash transfers on height-for-age but impacts differ considerably by programme. O Manley et al. • The impact of • CTs achieve statistically similar results to UCTs when conditions relate to health and education, but conditions relating to work or saving C (2012) cash transfers on are associated with worse outcomes. • G irls benefit more than boys in height-for-age measures. employment igher marginal effects in most disadvantaged areas and countries with poorer health care systems. H • Chapter 11 • verage effect sizes for enrolment, attendance and drop-out in both primary and secondary schooling are statistically different from zero. Saavedra and A Garcia (2012) verage effect sizes for secondary enrolment, attendance and drop-out are larger than those for primary. • A The impact of • rogrammes with more generous transfers have larger primary and secondary enrolment effects. P cash transfers on rogrammes that condition benefit receipt on achievement and pay transfers less frequently than monthly show larger enrolment and • P empowerment attendance effects. ind evidence in support of publication bias and selective reporting. • F onsiderable heterogeneity in effect sizes for all outcomes and schooling levels. • C SECTION III Yoong et al. (2012) • ender of the transfer recipient affects outcomes of some programmes but increasing female control of transfers does not guarantee G positive outcomes. Chapter 12 argeting transfers to women can improve children’s wellbeing (particularly through investments in health and education). • T Summary of • utcomes may be dependent on the type of programme. O findings and conclusion References 50 U nless stated, conclusions for this study cover all types of safety nets covered, where UCTs and CCTs represented 110 of the 145 studies. Conclusions specific to other safety nets are not reported.

52 Cash transfers: what does the evidence say? Page 52 Contents Monetary poverty Acknowledgements There has been relatively little direct attention to reviewing poverty-related outcomes in the Executive summary systematic reviews, aside from Hagen-Zanker et al. (2011), which looked exclusively at impacts on money-metric indicators of poverty. However, some other reviews do refer to a number of studies that report on poverty-related indicators (e.g. consumption, expenditure and negative coping SECTION I strategies). Overall, the evidence is fairly consistent in finding that providing cash in the form Chapter 1 of regular transfers or social pensions leads to higher household overall and food expenditure. Introduction Despite a similar story for studies looking at income, the review of evidence here suffers from a lack of studies reporting statistical significance, and evidence of cash transfers supporting a move Chapter 2 above the poverty line is also much weaker. Conceptual framework Hagen-Zanker et al. (2011) covered 14 studies reporting Household consumption/expenditure – Chapter 3 on household expenditure, mostly looking at traditional cash transfers with a few covering Review of cash pensions. Most were from Latin America, with four from Africa and two from Europe. Overall, transfer reviews an increase was found in 10 studies, nine of which were statistically significant. Kabeer et al. (2012) report on six studies that examined the impact of cash transfers on household consumption Chapter 4 from Latin America, all of which point to total and food consumption increasing due to the Methods transfer, though statistical significance is not reported. In a meta-regression of seven studies they Chapter 5 find an overall effect of CCTs increasing consumption by 7% and highly statistically significant. The evidence base Yoong et al. (2012) also refer to five studies reporting on expenditure, mostly from Latin America, where a number of significant impacts were reported on total expenditure and expenditure on food and education. Several studies reviewed by Manley et al. (2012) also found significant SECTION II impacts on improvements in food consumption. Chapter 6 The impact of Hagen-Zanker et al. (2011) reviewed eight studies that looked at the impact of CCTs, Income – cash transfers on UCTs and pensions on income, all except one were on programmes from sub-Saharan Africa. All monetary poverty studies showed an increase, except two from Zambia, one of which was the only study to measure statistical significance. A range of methodological approaches were used with varying robustness Chapter 7 in terms of allowing for causal interpretation. The impact of cash transfers on education The review by Hagen-Zanker et al. (2011) looked at 15 studies reporting on Poverty indices – poverty indices, all but one using a measure from the Foster–Greer–Thorbecke (FGT) index, Chapter 8 which is a money-metric based measure. The studies cover a wide range of programmes across The impact of cash Latin America, Europe, Africa and Asia, and in all but one poverty decreased. However, there was transfers on health wide variation in the robustness of methods used in terms of allowing for a causal interpretation, and nutrition and only four studies measured statistical significance. Chapter 9 The impact of cash transfers on Education savings, investment and production As set out in the conceptual framework, education outcomes can be distinguished in terms of direct impacts (e.g. school enrolment, attendance and drop-out) and final outcomes (e.g. test Chapter 10 scores). There is fairly clear and consistent evidence across the reviews that CCTs and UCTs have The impact of had a positive impact on enrolment, attendance and drop-out rates (Baird et al., 2013; IEG, 2014; cash transfers on employment Kabeer et al., 2012; Saavedra and Garcia, 2012; Yoong et al., 2012). There is an overall weaker evidence base, however, on improvements in final outcomes, such as increasing test scores and Chapter 11 improving the quality of education and learning, although the evidence that is available indicates The impact of small positive effect sizes (Baird et al., 2013; IEG, 2014). cash transfers on empowerment Enrolment – There is clear and consistent evidence of positive impacts on enrolment across the 32 studies that report on enrolment reviewed by Baird et al. (2013), including eight UCTs and 27 SECTION III CCTs. The pooled effect size for all studies gives an odds ratio of 1.36, indicating that the odds of children being enrolled in school is 36% higher in households receiving cash transfers. Impacts on Chapter 12 enrolment in secondary schools were higher than those for primary. Yoong et al. (2012) reported Summary of on a study excluded by Baird et al. (2013), which also found positive and statistically significant findings and results on enrolment for boys and girls in Nicaragua’s Red de Protección Social (RPS). The conclusion Independent Evaluation Group review (IEG, 2014) and Saavedra and Garcia (2012) report mostly References on the same studies as Baird et al. (2013). The IEG (2014) review notes how in several cases the gender group that was most disadvantaged at baseline showed the highest gains.

53 Cash transfers: what does the evidence say? Page 53 Contents In the 17 studies reporting on school attendance in Baird et al. (2013) all UCTs and Attendance – Acknowledgements CCTs showed positive Odds Ratios, indicating better odds of attending school due to transfers, though impacts in CCT programmes were both far more significant and higher in their level of Executive summary impact. Positive and significant results on attendance were also found in the review by IEG (2014) which, as well as covering many of the same studies as Baird et al. (2013) included a number of additional studies, including a number from Africa. Again, Saavedra and Garcia (2012) report SECTION I mostly the same studies. The one study reporting attendance from the review by Yoong et al. Chapter 1 (2012) for a microenterprise grant did not find statistically significant results. Introduction Drop-out – Impacts on drop-out rates were reported in Saavedra and Garcia (2012) from Chapter 2 nine studies for primary level and six studies for secondary level. In both, effects were mostly Conceptual statistically significant reductions in drop-out rates though the overall effect was higher at framework secondary level. Chapter 3 Review of cash From the systematic reviews there was very little evidence on the effects on final Test scores – transfer reviews educational outcomes. Baird et al. (2013) review findings from 10 studies that report impacts on tests. It is noted, however, that where test scores are from those in school there may be danger Chapter 4 Methods of selection bias given that tests are only administered to those in school. Their meta-analysis therefore only uses findings from the five studies that used standardised scores administered in Chapter 5 children’s homes. While the overall effect size is significant at the 5% significance level, the effect The evidence base is very small at 0.06 standard deviations and UCTs do not have a statistically significant effect. SECTION II Health and nutrition Chapter 6 The impact of As set out in the conceptual framework, outcomes in health can be considered in terms of first- cash transfers on order outcomes (e.g. health expenditure), second-order outcomes (e.g. changes in health-seeking monetary poverty behaviour) and third outcomes (e.g. morbidity, anthropometric and nutritional measures or mortality). Most of the evidence on health reported in the systematic reviews focuses on second- Chapter 7 and third-order outcomes and comes from the experience of CCTs. The impact of cash transfers on education – there is consistent evidence that CCTs have increased the uptake Health service utilisation of health services, including antenatal visits and giving birth at health facilities (Gaarder et al., Chapter 8 2010; Glassman and Duran, 2013; IEG, 2014; Lagarde et al., 2009). However, many such CCTs The impact of cash involved conditions of using health services and there is evidence to suggest that awareness of transfers on health conditionalities was important and that UCTs might not have been similarly effective (Gaarder et and nutrition al., 2010; IEG, 2014). Gaarder et al. (2010) distinguish between impacts on health care services Chapter 9 that were and were not subject to conditionality. They note a difference between the two, with The impact of limited or no effect on services to which no conditionality was attached. The authors also cite cash transfers on evidence from one study on Mexico’s Oportunidades programme of possible substitution effects savings, investment away from private health services to public health services (Gutierrez et al., 2004). and production Chapter 10 Immunisation coverage – Evidence on immunisation coverage suggests limited and patchy effects. The impact of Of the four evaluations reviewed by Lagarde et al. (2009) of Latin American CCTs that reported cash transfers on immunisation coverage, there were some small positive impacts for certain child immunisations employment but not for others. Of the seven studies of CCTs reviewed by Gaarder et al. (2010) that reported Chapter 11 immunisation results, only two found large programme impacts on full vaccination coverage, with The impact of no significant effect found in any other programme, except for some increased coverage in single cash transfers on vaccinations. Impacts on tetanus toxoid vaccinations for mothers were reported in two Latin empowerment American CCTs in Glassman and Duran (2013), but neither was statistically significant. Morbidity (e.g. diarrhoea, illness and self-reported health) – There is a particular challenge in SECTION III understanding the impacts on poor health as noted by Gaarder et al. (2010), which is that some Chapter 12 measures may increase due to more frequent visits to health centres and more frequent or accurate Summary of diagnosis of illness. These effects can be difficult to disentangle. Of the three CCTs that the findings and same authors find reporting on reported illness, diarrhoea and respiratory disease, only Mexico’s conclusion Oportunidades (also when it was called PROGRESA) showed clear reductions in a range of References reported illness indicators from six separate studies covering 1997 to 2004. They also report a study by Fernald et al. (2004) which found that participation significantly reduced the prevalence of

54 Cash transfers: what does the evidence say? Page 54 Contents obesity and hypertension in the same programme. In Colombia’s Familias en Acción there was only Acknowledgements a significant reduction in diarrhoea for children under 48 months. Changes were not significant for those older than that or for respiratory disease. In Honduras’s Programa de Asignación Familiar, Executive summary diarrhoea actually increased in the intervention group, more than the control group. All of the studies covering morbidity (child illness) in Lagarde et al. (2009) report the same studies as Gaarder et al. (2010). One other study looking at morbidity was reviewed in Glassman and Duran (2013), SECTION I citing a study that found that participants of a CCT programme in Malawi that involved conditions Chapter 1 attached to school enrolment were less likely to have HIV (Baird et al., 2012). Introduction – There is some evidence of positive and significant impacts on Nutritional/anthropometric Chapter 2 anthropometric measures such as child weight-for-age, height-for-age and birthweight, though Conceptual it is not consistent across programmes (Gaarder et al., 2010; IEG, 2014; Lagarde et al., 2009; framework Manley et al., 2012). Six studies in Lagarde et al. (2009) report positive significant impacts on Chapter 3 anthropometric and nutritional measures. However, impacts were not significant in all cases (e.g. Review of cash in older children). In one study of a CCT in Brazil – Bolsa Alimentação – the authors found that transfer reviews there was no effect on height-for-age measures and even a significant negative effect on weight-for- 51 age among young children from participating families (Morris et al., 2004). The authors argue Chapter 4 Methods that, as previous studies had shown, the programme increased the availability of nutritious food among beneficiary households, the small negative impact on child weight may have been due to an Chapter 5 incentive effect, in that mothers may have believed their continued participation depended upon The evidence base their child being underweight. One study by Gitter et al. (2011) reviewed in the IEG (2014) review also found a statistically significant negative impact on height-for-age z-scores in Honduras’s SECTION II Programa de Asignación Familiar (PRAF) and Nicaragua’s Red de Protección Social CCTs, but only among younger siblings of school-going children in the poorest households at baseline. The Chapter 6 evaluators suggest that these may have arisen from parents reallocating resources to school-age The impact of children to comply with the school attendance requirements of the CCTs, as older children may cash transfers on require a higher food intake and more money for school clothes and other expenses. However, the monetary poverty authors found the opposite effect in the case of Mexico’s PROGRESA/Oportunidades. Chapter 7 The impact of Of the other relevant studies reviewed (e.g. covering South Africa’s Old-Age Pension and some cash transfers on cash transfers in Latin America), found positive significant impacts were found on weight-for- education height and height-for-age z-scores, but not universally so when disaggregated by sex of recipient 52 Gaarder et al. (2010) report on a number of additional studies and outcomes for boys and girls. Chapter 8 The impact of cash covering CCTs in Latin America and find mixed results, with many studies reporting some transfers on health positive impact on height-for-age or weight-for-age, but others not finding significant impacts on and nutrition these indicators or finding significant effects for some groups and not others. Manley et al. (2012) present mean impacts on height-for-age from 18 studies, but do not report individual statistical Chapter 9 significance as it averages across estimates within each study. With the exception of five studies The impact of cash transfers on (including the one by Morris et al. (2004) on Brazil mentioned above), mean impacts were positive savings, investment to varying degrees. Impacts on weight-for-age reported in six studies are positive for half of and production them, and seven studies reporting impacts on child height all show positive effects, though again, statistical significance is not reported. There are mixed results among studies reporting weight- Chapter 10 for-height and BMI. In the seven studies that reported changes in dietary diversity, all but one The impact of cash transfers on found significant increases in the consumption of particular food groups (e.g. protein, fruit and employment vegetables or meat) or a dietary diversity index (Manley et al., 2012). Chapter 11 Finally, small but statistically significant reductions in low birthweight were found by both CCT The impact of studies reporting this outcome reviewed in Glassman and Duran (2013). One additional study cash transfers on covered by Gaarder et al. (2010) from Colombia’s Familias en Acción found no effect in rural empowerment areas, but a statistically significant increase in urban areas. SECTION III Mental health – There were few studies exploring impacts on mental health. Three studies reviewed by Gaarder et al. (2010) investigate the impact on mental health. One finds a large and Chapter 12 significant effect on lowering cortisol (a stress-related hormone) in children of mothers with high Summary of findings and conclusion 51 T he differential effect compared to children from non-beneficiary households was most notable at around 12 months of age but not observed References in children aged 30 months and above. 52 Y oong et al. (2012) also report on the same South African pension programme.

55 Cash transfers: what does the evidence say? Page 55 Contents depressive symptoms. Another finds a decrease in aggressive symptoms, but no significant effect Acknowledgements on anxiety or depressive symptoms or problem behaviours, and the third also finds a significant negative association between higher cash transfers and children’s behaviour problems. One study Executive summary reviewed by Glassman et al. (2013) on Mexico found participation associated with a decrease in depression, but it was not statistically significant. SECTION I – Impacts on mortality have generally not been well documented. Some studies on Mortality Chapter 1 Mexico’s Oportunidades programme indicate positive impacts on maternal and infant mortality, Introduction with impacts on the latter increasing relative to the proportion of population incorporated into the programme (Gaarder et al., 2010). The three studies reviewed by Glassman and Duran (2013) Chapter 2 include the same evaluation on Oportunidades, with one on India’s Janani Suraksha Yojana Conceptual programme finding large and significant declines in perinatal and neonatal deaths (though this is framework contested by other studies and criticisms of the evaluation). The third study found a small but Chapter 3 non-significant decline in neonatal mortality in Nepal’s Safe Delivery Incentive Programme. Review of cash transfer reviews – While more of a behavioural impact, the relatively limited evidence on Health-related behaviour fertility also suggests a mix of impacts (Gaarder et al., 2010; Glassman and Duran, 2013; IEG, Chapter 4 Methods 2014). Of the seven country cases for which fertility-related outcomes were reported in Glassman and Duran (2013), three appeared to be statistically significant. Of these, one in Malawi with Chapter 5 educational conditions involved a decrease in teenage pregnancies and two CCTs from Latin The evidence base America (Honduras and Uruguay) suggested very small increases. It was noted how increases in the Honduran programme could have partly been due to the design, as women were provided 53 SECTION II Though it was also the case that this effect was identified against with benefits per child. declining fertility rates overall. Studies covered in the IEG review (2014) found evidence of small Chapter 6 but significant increases in fertility in two studies, one being on the same Honduran programme The impact of as above (from a later study) and the other from Panama. As with Honduras, the authors of the cash transfers on Panama study interpret the finding to relate to inaccurate perceptions among beneficiaries about monetary poverty having to be pregnant. Chapter 7 The impact of Regarding use of contraception, a review of four Bangladeshi programmes cited in the IEG review cash transfers on found no evidence of positive impacts. Gaarder et al. (2010) report results on contraceptive use education from three studies and find positive effects on family planning and contraceptive use, particularly in rural areas and among the poorest, though no statistical significance is reported. Two of the Chapter 8 The impact of cash same studies are reported in Glassman et al. (2013), clarifying that one was not statistically transfers on health significant. Two additional studies on transfers in Mexico and Nepal find positive and statistically and nutrition significant increases in contraceptive use. Chapter 9 The impact of Productive investments and savings cash transfers on savings, investment Investments in business, agriculture and assets – There is a clear body of evidence that shows and production cash transfers, even when they were not designed to increase productive investments, can lead to Chapter 10 them. Yoong et al. (2012) report increases in investment and agricultural investment from three The impact of studies, two of which covered Mexico’s PROGRESA and PROCAMPO and one a Sri Lankan cash transfers on microenterprise grant. There were mixed gendered differences. For example, significant increases employment were not found for male recipients in PROGRESA, but increases for capital stock investments Chapter 11 were not significant among women in the Sri Lankan programme. The impact of cash transfers on Kabeer et al. (2012) review five studies on PROGRESA/Oportunidades, all of which demonstrate empowerment some positive impact on productive investments, especially in agriculture, including increases in livestock ownership. Statistical significance is not discussed. IEG (2014) also review access to productive resources and to a study covered elsewhere, finding positive impacts on agricultural SECTION III investments from a UCT in Malawi and a non-contributory pension in Bolivia. Again, statistical Chapter 12 significance was not explicitly discussed. Summary of findings and conclusion References 53 T his was recognised by programme implementers who subsequently adjusted rules accordingly (IEG, 2014: 31).

56 Cash transfers: what does the evidence say? Page 56 Contents Employment Acknowledgements Regarding adult labour, the results are very mixed depending on the study and gender. The Executive summary reviews overall do not find strong evidence of people becoming dependent on cash transfers by withdrawing from the labour force, but instead show mixed effects with some increases and decreases in market work and some increases in domestic work and leisure in others (IEG, 2014; SECTION I Kabeer et al., 2012; Yoong et al., 2012). It is important to note that there are likely to be quite Chapter 1 different impacts depending on the characteristics of the beneficiary households, including their Introduction livelihoods and local labour markets and one must look carefully at the full range of impacts, including on migration, before making judgements on individual labour impacts. Chapter 2 Conceptual framework (the ‘extensive margin’) – The studies reviewed by Kabeer et al. – Labour force participation (2012) generally did not find any effect on likelihood of labour participation, except for one of the Chapter 3 studies on Brazil’s Bolsa Família, which found a higher proportion of adults in the programme Review of cash were likely to have worked in the previous month compared to those not receiving a transfer. The transfer reviews review by IEG (2014) reports on a large number of CCTs as well as three UCTs and three non- Chapter 4 contributory pensions. Overall, they do not find evidence of cash transfers having reduced labour Methods supply in most countries, with the exception of non-contributory pensions, where studies tended to show a reduction in the labour supply of recipients and in some cases that of prime-age adults Chapter 5 living with them. There was very little evidence among CCTs or UCTs of any significant effects in The evidence base reducing employment among beneficiaries, with some programmes showing significant increases (e.g. in Mexico and Uruguay and South Africa). The main exception was among mothers in two SECTION II CCTs from Latin America. There was also evidence of shifting employment patters, for example from agricultural to non-agricultural activities (Mexico) or low-paid wage labour to own-farm Chapter 6 activity (Malawi). The impact of cash transfers on Hours/days worked – (the ‘intensive margin’) – The review by Kabeer et al. (2012) mostly covered monetary poverty studies from Latin America, many of which appeared to show some significant reductions in the Chapter 7 working hours of women and men, with reductions for women generally being higher. Two studies The impact of on pensions covered by Yoong et al. (2012) found, on the one hand, a significant reduction in cash transfers on hours worked among prime-age adults living with eligible recipients, and (in a different study) a education large number of non-significant impacts on labour, except for some decrease in housework hours for women, both positive and negative impacts on their leisure time, and a significant increase in Chapter 8 The impact of cash their work hours. The study also reported a positive statistically significant impact on housework transfers on health hours for men aged 60 to 69 and a significant decrease in reports of ‘any work’. The review by IEG and nutrition (2014) reports mainly on labour supply and participation in general. Where it does report changes in hours worked, among CCTs from Brazil, Nicaragua and Honduras and one from Paraguay, Chapter 9 there was only a marginally significant decrease of 5.5 hours per week among men for one of these The impact of cash transfers on programmes. Among UCTs, there was a decrease of five days of wage work per month in Malawi’s savings, investment Social Cash Transfer Programme (thought to be replaced by increasing own-account work) and and production no effect on hours worked a week or weeks worked among men but fewer hours worked per week and fewer weeks per year among women for a UCT in Albania. Two non-contributory pensions Chapter 10 were also associated with a reduction in hours worked among participants (South Africa) and The impact of cash transfers on prime-age adults living with beneficiaries (Mexico). employment A study reported in the IEG (2014) review highlights the importance of not taking Migration – Chapter 11 individual impacts in isolation. It showed how, in the same old-age pension programme evaluated The impact of in a study reviewed by Yoong et al. (2012), rather than there being a negative impact on labour cash transfers on empowerment supply, the programme ‘relaxed financial and childcare constraints, allowing prime-age adults to migrate for work’ (IEG, 2014: 40). The impact on migration was larger for women than men (7.9% compared to 5.2%). The four studies reporting on migration in Kabeer et al. (2012) cover SECTION III Mexico’s PROGRESA/Oportunidades and offer contradictory findings. Two find the programme to have been associated with increased migration and two find that it reduced it. Chapter 12 Summary of findings and Child labour – Consistent with findings of increased school enrolment, the evidence also indicates conclusion that cash transfer programmes have generally had the effect of reducing child labour (IEG, 2014; Kabeer et al., 2012). However, the findings were not universal, with transfers increasing the References number of children combining work and school in Brazil (Kabeer et al., 2012). Some studies also reported greater reductions among boys than girls, generally in those studies that defined child

57 Cash transfers: what does the evidence say? Page 57 Contents labour as working for pay (IEG, 2014). Another review noted that studies found greater reductions Acknowledgements among older rather than younger children, thought to result from the fact that it is older children who are more likely to be working, and in rural rather than urban locations, thought to be due to Executive summary lower wages, and hence opportunity cost, of going to school in rural areas (Kabeer et al., 2012). SECTION I Women’s empowerment Chapter 1 Empowerment, voice and agency – The review by IEG (2014) discusses the issue of empowerment Introduction in relation to whether giving transfers to women makes a difference for the household, children Chapter 2 and women. It refers to three categories of impact evaluation: (1) studies that infer the woman’s Conceptual decision-making power indirectly from the analysis of patterns of consumption or expenditure, framework (2) studies of programmes that provide transfers to men and women, and see whether they make different choices, and (3) studies that directly ask women about their ability to make decisions Chapter 3 independently or jointly with their husbands. The focus here is on the third set of studies, within Review of cash transfer reviews which there were four studies covering transfer programmes from Latin America and Bangladesh. Three did not seem to have any notable effect on women’s empowerment, but the study of Chapter 4 Brazil’s Bolsa Família did report significant effects on the autonomy of women in making various Methods household decisions independently or jointly with their husbands, especially on the issue of using contraception. The effect was only seen in urban areas, however, and in rural areas effects were Chapter 5 The evidence base either absent or negative. Of five studies reviewed by IEG (2014) covering CCTs reporting on domestic Domestic violence – SECTION II violence, four showed strong evidence of a reduction in domestic violence (at least three being statistically significant), with little change identified in the fourth. Education levels appeared to Chapter 6 The impact of be an important mediating factor, in that better-educated women were generally more likely to cash transfers on experience the reduction in physical violence. monetary poverty Chapter 7 Community-wide effects The impact of cash transfers on Finally, the evidence on community-wide effects is considerably smaller than that for impacts at education the household level among the reviews. However, evidence from two studies covering PROGRESA/ Oportunidades reviewed by Kabeer et al. (2012) indicates a number of positive spillover effects Chapter 8 The impact of cash to non-recipients living in the same areas as beneficiaries, though statistical significance is not transfers on health discussed. The effects included higher food consumption, lower poverty increases, improved health and nutrition care behaviour and school attendance among certain age groups compared to non-beneficiaries outside programme areas. No evidence of local inflationary effects was found, thought to be due Chapter 9 to many recipients spending money outside the local area, especially when receiving their transfers The impact of cash transfers on outside their communities. A study was also referred to in IEG (2014) which found that, in Mexico, savings, investment non-beneficiary women in areas in which PROGRESA was operating increased their frequency and production cervical cancer tests, thought to be due to a change in social norms. Chapter 10 The impact of cash transfers on 3.3 ole of cash transfer design and implementation features R employment While most of the reviews pay close attention to the question of internal validity (the extent to Chapter 11 which causal conclusions can be drawn from the included studies) they are generally weaker when The impact of it comes to the question of external validity and the extent to which results may be generalised, cash transfers on including the importance of particular design and implementation features. This weakness in part empowerment reflects the nature of traditional systematic reviews (Hagen-Zanker et al., 2012; van der Knaap et al., 2008). However, there is a growing attempt among reviews in other areas of international SECTION III development to try and incorporate a wider range of evidence, as shown by a number of recent theory-based mixed-methods reviews (e.g. Brody et al., 2015; Carr-Hill et al., 2015; Lawry et al., Chapter 12 2014; Waddington and White, 2014). Summary of findings and conclusion A range of approaches have been used in the systematic reviews above to explore the role of mediating factors. Some reviews adopt a ‘light touch’ approach whereby the role of different References design and implementation features of cash transfer programmes is not explicitly discussed or where discussion is limited with readers being left to explore the differences for themselves based

58 Cash transfers: what does the evidence say? Page 58 Contents on the results and description of the different programmes (Glassman and Duran, 2013; Hagen- 54 Acknowledgements Zanker et al., 2011; Lagarde et al., 2009). A second approach has been to provide a more detailed discussion of the results of individual studies and to highlight emerging findings relating Executive summary to mediating factors (Gaarder et al., 2010; IEG, 2014; Kabeer et al., 2012). A third approach, adopted by Yoong et al. (2012), involved explicitly searching for studies that reported outcomes of transfers made to men as opposed to women, with findings brought out in the discussion. Finally, SECTION I a number of reviews did explicitly seek to explore the role of certain design, implementation and Chapter 1 contextual factors (Baird et al., 2013; Manley et al., 2012; Saavedra and Garcia, 2012), some Introduction 55 using meta-regression to assist. Chapter 2 Overall, although the above reviews provide some insights into the role of various ‘effect Conceptual modifiers’ (particularly the issue of conditionality, transfer size and frequency, and sex of framework recipient), the findings are somewhat limited, particularly for certain types of design and Chapter 3 implementation features. Further insights are therefore sought from other sources, including Review of cash a large number of non-systematic reviews and synthesis studies covering the impacts of cash transfer reviews transfers (see Annex A1.3). As only a few of these reviews set out pre-specified search strategies with inclusion and exclusion criteria, there is a greater danger of bias in terms of which studies Chapter 4 Methods are included or excluded, and critical quality assessments of included studies are almost entirely absent, with the exception of a review on social safety nets by the Independent Evaluation Group Chapter 5 of the World Bank (IEG, 2011). For this reason, caution is needed when interpreting findings The evidence base from these reviews, though they can still contribute to our understanding of mediating factors. In addition to this body of literature, the wider literature on specific design and implementation SECTION II issues in development programmes (e.g. beneficiary selection mechanisms) can also be drawn on. A summary is provided below of the main related findings from the systematic reviews, Chapter 6 supplemented by the wider literature just mentioned. The impact of cash transfers on monetary poverty Transfer values and frequency Chapter 7 One of the first sets of design features that could be expected to modify the impacts of a The impact of particular cash transfer programme is the size of the transfer or its relative value to the beneficiary cash transfers on education households. Looking beyond a single payment, the issues of transfer frequency, duration, graduation rules or time limits and arrangements for increasing payments over time also become Chapter 8 important. Clearly, if transfer values remain low relative to existing average household incomes in The impact of cash the area, this will limit the scope for impacts on various outcomes. It is likely there may also be transfers on health threshold effects, in that certain impacts would tend to be observed only beyond certain values, and nutrition depending on local prices. A summary of some of the key results is provided below: Chapter 9 • B aird et al. (2013) carried out a meta-regression of studies looking at impacts on education The impact of cash transfers on and found that neither the transfer size (as a percentage of baseline average household income) savings, investment nor the transfer frequency had a significant effect in changing the pooled effect size for school and production enrolment. Transfer sizes in the programmes covered by the studies included were highly diverse, ranging from 1.5% to 100% of average household income. Chapter 10 The impact of aavedra and Garcia (2012) constructed a monthly equivalent average transfer for each S • cash transfers on programme relative to GDP per capita for the country, using information on the transfer employment size, and then used bivariate random effects models to calculate the effect of transfer sizes on 56 Chapter 11 They found that in general more generous transfers were positively educational outcomes. The impact of and significantly associated with larger primary and secondary school enrolment effects. cash transfers on Payments made less frequently (e.g. bi-monthly or quarterly) were associated with larger empowerment enrolment effect sizes, especially for secondary school attendance. SECTION III Chapter 12 Summary of P art of the reason for this in the review by Hagen-Zanker et al. (2013) is that its underlying research question was concerned with comparing 54 findings and the evidence on employment guarantee schemes with cash transfer in terms of their poverty-reduction effects. conclusion 55 K abeer et al. (2012) also carried out meta-analysis, though not to explore the role of mediating factors. References 56 I t is important to note that the authors used bivariate models due to high collinearity between programme characteristics. Therefore, findings should be interpreted with some caution as there are many factors that are not controlled for, and it may be, for example, that other characteristics associated with a given design feature were equally or more important in explaining any modification of effect sizes.

59 Cash transfers: what does the evidence say? Page 59 Contents anley et al. (2012), using bivariate meta-regression, do not find a statistical relationship M • Acknowledgements between payment size and impacts on height-for-age outcomes. However, as with Saavedra and Garcia (2012) the relationship is bivariate, and an important caveat noted by the authors Executive summary is that the finding of no relationship could be due to a bias resulting from a correlation found between local health conditions and payment size. The authors use the same bivariate approach to investigate the effect of programme duration (the number of months the average household SECTION I had received payments) on height-for-age and find a positive but not statistically significant Chapter 1 relationship. Introduction K abeer et al. (2012) noted in discussions of some specific studies that the size of the transfer • Chapter 2 in some programmes appeared to affect the likelihood of labour participation and impacts on Conceptual migration. framework Looking at the wider literature, a review by Arnold et al. (2011) cites studies on CCTs in which Chapter 3 low transfer values were associated with limited or no impacts on nutrition. It also cites a study Review of cash transfer reviews on Ethiopia’s PSNP which found a limited impact due to low levels of transfers, but that those that received at least half of the intended transfers were significantly more likely to be food secure, Chapter 4 according to some measures (Gilligan et al., 2008). Methods Chapter 5 Targeting (e.g. eligibility, beneficiary selection mechanism) The evidence base Eligibility criteria and beneficiary selection mechanisms may both have an important mediating SECTION II effect on the impacts of cash transfers. With regard to eligibility, one key dimension explored in the literature is whether transfers are targeted to women or to men. In terms of selection Chapter 6 mechanisms, as Coady et al. (2004) have shown, there is a wide range of approaches that can The impact of be used to target transfers to particular groups. However, while their analysis suggests certain cash transfers on mechanisms may be more likely to perform particularly well, in terms of targeting performance, monetary poverty the authors also highlight that choice of mechanism may be less important than implementation. Chapter 7 Y • oong et al. (2012) explicitly sought to evaluate studies that compare outcomes by sex The impact of of the recipient. Their findings are wide and varied, but are not reported by outcome in cash transfers on education their results. However, in general they find that targeting transfers to women can improve children’s wellbeing (especially through investments in health and education) and that the sex Chapter 8 of the recipient does affect outcomes of some programmes. At the same time, they note that The impact of cash increasing female control of transfers does not guarantee positive outcomes. transfers on health and nutrition • EG (2014) aimed to review the impact of social safety nets on ‘gender-related results’ and, I as part of that, looked at how outcomes differed according to the gender of the person that Chapter 9 received the transfer. More details on findings for the wide range of outcomes can be found The impact of cash transfers on in the review, though in general it was found that men and women do respond differently to savings, investment safety nets and benefit from them in different ways. For example, consumption decisions were and production often found to be more focused on children when women receive transfers. When it came to productive investments, women were also found to invest in different types of assets compared Chapter 10 to men. The impact of cash transfers on employment In terms of different targeting mechanisms, Bastagli (2010) has argued that different beneficiary selection mechanisms may work equally well in terms of ensuring that resources are concentrated Chapter 11 on the target population, based on analysis that compared Brazil’s Bolsa Família (which targeted The impact of through self-declared income) with Chile’s Programa Puente which used a proxy means test. cash transfers on empowerment Diepeveen and van Stolk (2012) find very few studies linking programme design to outcomes from a ‘rapid evidence assessment’ of the literature on three CCTs in Nicaragua and Honduras, SECTION III but refer to one study on Nicaragua’s RPS which appeared to find unanticipated effects arising from perceptions about eligibility criteria, leading to household dissolution, e.g. single mothers Chapter 12 separating from the extended family. They also cite a qualitative study which linked perceptions of Summary of findings and errors of exclusion in targeting with a rise in social tensions in the same programme. conclusion References

60 Cash transfers: what does the evidence say? Page 60 Contents Conditionality Acknowledgements One of the biggest debates that has emerged alongside the growth of cash transfers concerns the Executive summary role of conditions attached to transfer receipt. Key questions include whether transfers without conditions perform just as well as those with conditions, how the type and enforcement of conditions might matter and whether they may have unintended consequences. A summary of key SECTION I insights is provided below: Chapter 1 aird et al. (2013) explore the role of education-related conditionalities in CCTs, which they B • Introduction disaggregate in terms of the strength of monitoring and enforcement. Using meta-regression Chapter 2 analysis they found that the effect on enrolment from CCTs with strong monitoring and Conceptual enforcement were larger and significantly different to those with no conditions. framework aavedra and Garcia (2012) also look at the role of conditionality strength. Consistent with S • Chapter 3 the findings of Baird et al. (2013), using bivariate meta-regression they find that stronger Review of cash conditions (beyond simply attendance) were positively associated with larger secondary transfer reviews enrolment and attendance effects. Chapter 4 anley et al. (2012) find, using bivariate meta-regression analysis, that where programmes had M • Methods conditions attached relating to health and education they do not have a significantly different Chapter 5 impact to unconditional programmes, in contrast to the above findings. However, the study The evidence base did not measure the strength of conditions as the other two reviews did. Interestingly, they also find that programmes with conditions relating to work or savings appeared to be negatively and significantly related to height-for-age scores. SECTION II EG (2014) makes some reference to differences in outcomes based on whether the programmes I • Chapter 6 discussed were CCTs or UCTs. One related finding was that UCTs did not appear to be as The impact of effective at increasing prenatal visits and births at institutions, though they could not say cash transfers on whether this was due to the conditionality or other design features. monetary poverty Chapter 7 Fiszbein and Schady (2009) discuss a number of studies that give insights into the role of The impact of conditions, some of which are covered in this review. Their overall conclusion is that there is some cash transfers on evidence to suggest conditions matter in terms of increasing service use, sometimes even if it is just education awareness of the conditions without enforcement. Chapter 8 The impact of cash Complementary and supply-side services transfers on health and nutrition It has been recognised that, although cash transfers may have significant effects on a range of Chapter 9 outcomes, their impacts may also be limited in the absence of additional interventions, either to The impact of support beneficiaries (e.g. training or access to markets) or to improve the supply side of delivery cash transfers on of services (e.g. investing in schools or health care provision). However, limited attention appears savings, investment to have been devoted to these issues as examples of mediating factors within the systematic and production reviews. Chapter 10 • S aavedra and Garcia (2012) find, using bivariate random effects models, that those The impact of cash transfers on programmes that complemented transfers with additional supply-side interventions (e.g. grants employment or other resources for schools) had statistically larger effects on primary enrolment (but not for secondary). Chapter 11 The impact of In the wider literature, a seminal review of CCTs by Fiszbein and Schady (2009) infers from cash transfers on empowerment findings of the studies reviewed that CCTs are likely to be more effective in achieving educational and health and nutrition outcomes when they are combined with additional initiatives to improve the quality of the supply of services. SECTION III On complementary services, a study by Gilligan et al. (2008) on Ethiopia’s PSNP found that when Chapter 12 cash transfers were combined with the provision of agricultural support, beneficiaries were more Summary of findings and likely to demonstrate food security as well as borrow for productive investments, use improved conclusion agricultural inputs and operate their own non-farm businesses. References

61 Cash transfers: what does the evidence say? Page 61 Contents Payment systems and grievance mechanisms Acknowledgements A number of other design and implementation features are considered potentially important effect Executive summary modifiers. These include payment systems (i.e. methods of payment) and grievance mechanisms for any complaints regarding the transfer process. However, very little is mentioned in the reviews on the possible effects of these in modifying programme impacts. SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash transfer reviews Chapter 4 Methods Chapter 5 The evidence base SECTION II Chapter 6 The impact of cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

62 Cash transfers: what does the evidence say? Page 62 Contents Acknowledgements Chapter 4 Executive summary SECTION I M ethods Chapter 1 Introduction Chapter 2 Conceptual framework 4.1 verview O Chapter 3 Review of cash This section describes the different steps involved in the retrieval and inclusion of studies in the transfer reviews review, as well as data extraction and synthesis. A summary of the main stages involved from initial Chapter 4 searches through to the extraction of evidence from final studies is presented in Figure 4.1. The Methods stages and decisions outlined in this figure will be discussed in detail in the remainder of this chapter. Chapter 5 Figure 4.1: Flow diagram of main stages involved in the search, retrieval, screening and extraction stages The evidence base of the review for each research sub-question SECTION II Searches and retrieval: Searches and retrieval: Chapter 6 searching of bibliographic Studies screened at retrieval The impact of by inclusion criteria: databases using search cash transfers on strings • Websites monetary poverty • Past reviews and snowballing Chapter 7 The impact of • Expert suggestions Screening 1: screening cash transfers on Exclusion of studies not of studies retrieved by title education meeting inclusion criteria and abstract Chapter 8 The impact of cash transfers on health screening of Screening 1: and nutrition studies retrieved at full text Chapter 9 The impact of cash transfers on studies Screening 2: savings, investment from all sources satisfying and production inclusion criteria undergo risk of bias/quality assessment Chapter 10 The impact of cash transfers on employment Annotated bibliography (full list of studies) Chapter 11 The impact of cash transfers on empowerment evidence Extraction: Additional studies extracted from studies identifi ed as relevant from reporting on selected SECTION III other sub-questions indicators Chapter 12 Summary of findings and Source: Authors. conclusion References

63 Cash transfers: what does the evidence say? Page 63 Contents As outlined in the introduction, this review focuses on two overarching research questions – the Acknowledgements first around the impact of cash transfers on outcomes (question one) and the second around the links between specific cash transfer design and implementation features and outcomes (question Executive summary two) – each of which has six sub-questions (see below). A consistent methodological approach was applied to all 12 sub-questions, with slight variations in the inclusion and screening criteria for question two due to the different nature of the question. SECTION I Chapter 1 The methodological approach was written up in ‘protocol’ form prior to the commencement of Introduction the search process. This protocol was shared widely with cash transfer experts and an information specialist and the approach was tested, before revising the approach. Throughout the process Chapter 2 we followed an iterative approach and adjusted our methods, where necessary, while always Conceptual documenting changes made. The searches were conducted in mid-2015 and they cover the cash framework transfer literature from 2000–2015. Chapter 3 Review of cash transfer reviews 4.2 riteria for inclusion C Chapter 4 A set of inclusion criteria was applied to studies retrieved in the search process. Only studies that Methods all met inclusion criteria were included in the review. A full list of inclusion criteria can be found Chapter 5 within the search protocols in Annex 2. The evidence base Types of studies SECTION II This review included studies reporting original analysis using primary or secondary data. While Chapter 6 for the first question, only studies using some form of counterfactual analysis were included (more The impact of below), for the second question, exploring the links between design and implementation features cash transfers on and outcomes, descriptive and institutional analyses were also considered. monetary poverty Chapter 7 All studies included under question one – examining the effects of cash transfers on the selected The impact of outcomes – had to use either an experimental design (i.e. randomised control trial (RCT) or cash transfers on 57 or a quasi-experimental design that relies on a credible control group. For quasi- cluster-RCT) education experimental research we included studies that used one of the following methods of analysis: Chapter 8 r • egression discontinuity design The impact of cash atching technique (e.g. propensity score matching) • m transfers on health • ifference-in-difference d and nutrition i nterrupted time series • Chapter 9 o ther form of multivariate regression. • The impact of cash transfers on As such, for question one, studies relying on anecdotal, descriptive or qualitative evidence were savings, investment excluded. Furthermore, studies relying on any form of simulation methods were excluded. and production For question two, studies had to either use an experimental or quasi-experimental approach, or Chapter 10 The impact of be a study with a sound descriptive or institutional analysis. In order to assess the latter, separate cash transfers on criteria for qualitative studies were developed (see section 4.1.3). Studies for question two had employment links between design and implementation explicit to meet an additional criterion of making features and outcomes. In other words, studies that considered design and implementation features Chapter 11 without saying how these affect cash transfer outcomes were excluded. For example, studies that The impact of cash transfers on considered targeting effectiveness were excluded, as were those that looked at the costs of different empowerment payment systems. The review only included studies published in English because of the composition of the search SECTION III team. Only studies published in 2000–2015 were considered. This period corresponds with an expansion of both cash transfer programmes in developing countries as well as high-quality Chapter 12 impact evaluations. We included both peer-reviewed and grey literature (see section below on Summary of findings and search methods) in order to avoid a publication bias, as none or negative findings are less likely to conclusion be published (Waddington et al., 2012). References 57 O ur definition of RCTs is thus rather broad. Furthermore, studies were considered RCTs in our review if stated to be so by the authors.

64 Cash transfers: what does the evidence say? Page 64 Contents Geographic coverage and types of population Acknowledgements This review is restricted to low- and middle-income countries, as defined by the World Bank and Executive summary restricted to their status in 2015. This means that some studies of countries that were a LMIC at the time of data collection are not included (e.g. Argentina, Chile). The population of focus includes recipients of cash transfer programmes, as well as control households. We are interested SECTION I in individual and household-level impacts, and thus excluded studies that measured impacts at the Chapter 1 community or country level. Introduction Chapter 2 Types of interventions Conceptual framework The review covered all studies that considered CCTs or UCTs targeted at individuals or households, delivered by the state or NGOs. All programmes or policies considered include a cash payment Chapter 3 Review of cash component. They are also all generally either funded out of general taxation or donor-funded. As transfer reviews such, social insurance cash transfers financed through employer and employee contributions are not did not covered in this review. However, non-contributory social pensions are included. The review Chapter 4 consider contributory social security transfers, contributory pensions, and private transfers such as Methods remittances and religious donations (e.g. zakat). We also excluded social funds and public works Chapter 5 programmes, as these typically have different objectives to the transfers being considered and, The evidence base particularly in the case of public works, would involve a different theory of change. Even within this category of non-contributory cash transfers, there is considerable variation in SECTION II the types of transfer, reflecting, in part, differences in policy or programme rationale and main objectives. Important differences are observed across a range of policy/programme features, Chapter 6 The impact of including primary aims, target population, transfer levels, duration, behavioural requirements and cash transfers on complementary services. We group programmes into four main broad types: monetary poverty • nconditional cash transfer u Chapter 7 onditional cash transfer • c The impact of • ocial pension s cash transfers on nterprise grant. • e education It is worth highlighting here the wide range of programmes and policies covered by this review. Chapter 8 The impact of cash Studies cover programmes and policies which range from Uganda’s WINGS cash transfer, which transfers on health identified 1,800 poor people, mostly women, in 120 war-affected villages with the aim of helping and nutrition them start small, but sustainable, retail and trading enterprises, to national programmes such as Brazil’s Bolsa Família, reaching over 26% of Brazil’s population, around 55 million people, with the Chapter 9 objective of providing a minimum income to low-income individuals and families while promoting The impact of cash transfers on school and education service use, and Mexico’s Adultos Mayores social pension, providing support savings, investment to individuals aged 70 and over, covering 2.1 million beneficiaries across Mexico. Section 5.2.5 and production gives a detailed discussion of the types of programme covered. For a full list of the programmes and policies for which evidence was extracted in this review, see Table 5.2 below. Chapter 10 The impact of cash transfers on Types of outcomes (Question one) employment Chapter 11 The six outcome areas and sub-questions around which the searches were structured under The impact of question one are: cash transfers on empowerment a – Monetary poverty • 1 b – Education 1 • • 1 c – Health and nutrition SECTION III d – Savings, investment and production • 1 • e – Employment 1 Chapter 12 1 f – Empowerment • Summary of findings and conclusion For each outcome area we included a broad range of possible outcomes in the searches. Search protocols are available in Annex 2. These included both first-order as well as second- or third- References order outcomes. Only studies that considered the impact of the cash transfer on one of the specific outcomes were included in the review under question one.

65 Cash transfers: what does the evidence say? Page 65 Contents Types of programme design and implementation features (Question two) Acknowledgements The review also searched and retrieved evidence on the effects of alternative cash transfer design Executive summary and implementation features on the outcome areas identified above. Question two focused on six design and implementation features, including: SECTION I a – Core cash transfer design features 2 • • b – Conditionality 2 Chapter 1 • 2 c – Targeting Introduction 2 • d – Payment systems Chapter 2 2 • e – Grievance mechanisms and programme governance Conceptual 2 • f – Complementary interventions and supply-side services framework For each design/implementation features we included a broad range of possible synonyms in the Chapter 3 Review of cash searches (see search protocols in Annex 2). As stated above, only studies that considered the effect transfer reviews of a design/implementation features on the six cash transfer outcome areas above were included in the review. Chapter 4 Methods Chapter 5 earch methods for identification of studies 4.3 S The evidence base The retrieval stage consisted of five distinct tracks: (1) bibliographic databases, (2) other electronic sources (i.e. websites and search engines), (3) expert recommendations, (4) past reviews and SECTION II snowballing, and, as this review followed an iterative process, during the extraction stage another retrieval method was identified and added to this review as (5) studies from other sub-questions. Chapter 6 The impact of As explained above, the review was structured around 12 sub-questions. Any studies that were cash transfers on identified as being relevant for another sub-question, but not already under that sub-question, monetary poverty were added to it. This happened at two main points during the review: during the search and retrieval process (meaning that any studies added in this way went through the same screening Chapter 7 processes described in this methods section) and later on during the extraction of information for The impact of cash transfers on the annotated bibliography (once all studies had gone through the risk of bias/quality screening education described below). Chapter 8 A detailed overview of the number of studies retrieved from different tracks, as well as search flow The impact of cash diagrams showing number of studies at different stages, by sub-question, can be found in Annex 3. transfers on health and nutrition Bibliographic databases Chapter 9 The impact of cash transfers on The first retrieval stage consisted of searching bibliographic databases. For all sub-questions we savings, investment conducted a title, abstract and keyword search in the comprehensive multi-disciplinary Elsevier and production Scopus database, which includes over 20,000 peer-reviewed journals, including key journals in which cash transfer impact evaluations have been published. For some sub-questions we searched Chapter 10 additional databases, see Tables 4.1 and 4.2. We restricted the searches to studies published since The impact of cash transfers on 2000. employment Databases were searched using a consistent set of search strings, with one specific search string per Chapter 11 sub-question. These search strings consisted of a number of components (for full search strings see The impact of protocols in Annex 2) and were structured according to the following pattern: cash transfers on empowerment Cash transfer (including variations thereof) AND outcome (including variations thereof) AND low- and middle-income country (including a list of all of these, as SECTION III defined by the World Bank). Chapter 12 This means that included studies had to include the term ‘cash transfer’, as well as a relevant Summary of findings and outcome and a low- or middle-income country in the title, abstract or keywords. The latter conclusion component was included to exclude the huge literature on high-income countries. Search strings included both US and UK spelling, where required, and abbreviated terms using an asterisk (*) to References take account of variations in terminology and singular and plural use of terms.

66 Cash transfers: what does the evidence say? Page 66 Contents The searches were conducted between May and June 2015. Acknowledgements Table 4.1 Databases searched Executive summary Database searched Sub-question 1a–1f; 2a–2f Scopus SECTION I 1a; 1d; 1e Econlit Chapter 1 CAB Abstracts 1d Introduction 1c CAB Global Health 1c POPLINE Chapter 2 Conceptual Global Health 1c framework Chapter 3 Review of cash Other electronic sources transfer reviews Focusing on bibliographic databases alone risks resulting in a ‘publication bias’ for included Chapter 4 studies. Hence, we also conducted extensive sources of websites/search engines in order to also Methods capture the grey, policy and unpublished literature. 13 websites were searched for all sub-questions Chapter 5 and two additional websites were searched for a subset of sub-questions (see Table 4.2). The evidence base As website structure and functionality varies considerably, the searches had to be tailored to the specific websites. Where possible, we searched the publications area of websites. In most SECTION II cases it was not possible to use the full set of search strings to search these websites. Instead we Chapter 6 used a simplified search string consisting of cash transfer and a limited number of outcomes The impact of (see Annex 2). In some cases, we did not search a website using search strings, but just clicked cash transfers on through different tabs looking at all publications. monetary poverty Studies were screened ‘on the spot’. This means that abstracts and full papers were skimmed and Chapter 7 The impact of if they met the inclusion criteria they were included in the review. If searches returned an excessive cash transfers on number of hits, we sorted findings by relevance and only screened the first 50–100 studies. education The searches were conducted in May–June 2015. Chapter 8 The impact of cash Table 4.2 Other electronic sources searched transfers on health and nutrition Sub-question Search engine/website searched Chapter 9 1a–1f; 2a–2f Google The impact of 1a–1f; 2a–2f World Bank Publications cash transfers on 1a–1f; 2a–2f R4D DFID savings, investment and production International Policy Centre for Inclusive Growth (IPC-IG) 1a–1f; 2a–2f International Food Policy Research Institute (IFPRI) website 1a–1f; 2a–2f Chapter 10 The impact of Poverty Action Research Lab 1a–1f; 2a–2f cash transfers on FAO From Protection to Production website 11a–1f; 2a–2f employment 1a–1f; 2a–2f Transfer Project (UNC Chapel Hill) Chapter 11 1a–1f; 2a–2f ECLAC/CEPAL The impact of 1a–1f; 2a–2f Inter-American Development Bank (IADB) website cash transfers on empowerment 1a–1f; 2a–2f Asian Development Bank (ADB) website 1a–1f; 2a–2f Social Science Research Network SECTION III 1a–1f; 2a–2f 3ie evaluations database UNICEF website 1b; 1c Chapter 12 Cochrane Collaboration 1c Summary of findings and conclusion References

67 Cash transfers: what does the evidence say? Page 67 Contents Expert recommendations Acknowledgements For this track we contacted experts in the cash transfer field and asked them to recommend Executive summary unpublished or other relevant and rigorous studies on that particular sub-question. We approached from three to five experts per sub-question. These included academics, practitioners and experts from international organisations, and we ensured institutional and geographic variation of SECTION I experts. This track helped find unpublished or hard-to-find studies, and also helped to get a sense Chapter 1 of which studies in the field are particularly important and/or influential. Introduction Chapter 2 Past reviews and snowballing Conceptual framework For this track we reviewed all major cash transfer literature and systematic reviews published in the past decade. In the end, nine studies were reviewed. We reviewed the bibliographies of these Chapter 3 Review of cash reviews and included any studies that met our inclusion criteria and had not yet been included in transfer reviews the review. Chapter 4 Methods Studies identified as relevant during the data extraction stage Chapter 5 Our review is much broader than other reviews, covering six outcomes and six sets of design The evidence base and implementation features. The breadth of the review enabled us to add another track to the retrieval stage. At two stages in the review, we marked studies within each sub-question as SECTION II relevant to other sub-questions when they met the inclusion criteria for that sub-question. The first stage was during the screening stage, when reviewers ticked a box when a study was relevant Chapter 6 to other sub-questions. The second time was during the data extraction stage: when extracting The impact of information from studies for the annotated bibliography, including on outcomes and indicators, cash transfers on we marked studies as relevant to other sub-questions. These were studies that were not picked up monetary poverty for that particular sub-question through the other four tracks, often because these studies covered Chapter 7 a long list of outcomes and indicators, not necessarily all listed in the abstract or keywords. As The impact of such, we were able to include more relevant studies to each sub-question, including ‘hard-to-find’ cash transfers on studies, meaning that we covered a greater extent of the relevant literature. education We believe this retrieval track is unique to our review. The uncovering of additional studies in this Chapter 8 The impact of cash way is considered by the authors to represent a key advantage of this review – greatly expanding transfers on health the body of evidence from which evidence is extracted – which would not be possible in reviews and nutrition that focus on a single outcome area. Chapter 9 The impact of cash transfers on tudy screening and assessment process S 4.4 savings, investment and production Screening process Chapter 10 The impact of We used the EPPI Reviewer 4 software for data management and analysis. Each sub-question was cash transfers on included in a separate ‘review’. Searches from bibliographic databases were downloaded into EPPI employment Reviewer and then screened according to the inclusion criteria. Studies collected through other Chapter 11 tracks were screened ‘on the spot’ according to the same inclusion criteria and uploaded into EPPI The impact of Reviewer if deemed relevant and not already included in the databases. When uploading studies cash transfers on we noted the track through which they had been retrieved. The number of studies excluded at empowerment various stages, as well as the reasons for exclusion, can be found in the detailed tables and flow diagrams in Annex 3. SECTION III Screening of studies from bibliographic databases Chapter 12 Summary of findings and All search results from bibliographic databases were uploaded into EPPI Reviewer, where they conclusion were then checked for duplicates. Once duplicates had been removed, we screened studies according to the inclusion criteria in two stages. In the first stage, one research assistant screened References all studies according to title and abstract of the study. All studies that were either considered relevant, or where there was not enough information to make a decision, were included in the

68 Cash transfers: what does the evidence say? Page 68 Contents second stage. In the second stage, a different research assistant screened the full text of these Acknowledgements studies according to the same inclusion criteria, resulting in a list of studies to undergo the risk of bias assessment. Executive summary The research assistants worked closely with the core researchers of the review, and queries or ambiguities were immediately resolved. In order to reduce subjectivity involved in the first SECTION I screening stage, the first 50 studies of each question were double-screened against inclusion Chapter 1 criteria, with the research team discussing differences in coding at length. Introduction For four sub-questions the bibliographic database searches resulted in a very high number of hits Chapter 2 (more than 1,000 and up to 10,000). In order to make the first screening stage more manageable Conceptual for these sub-questions, we used an EPPI Reviewer tool called ‘text mining’. A recent systematic framework review has concluded that text mining is a safe tool to prioritise the order in which to screen Chapter 3 (O’Mara-Eves et al., 2015). Using this, we first screened and coded a randomly selected sub- Review of cash sample of 1,000 studies against the inclusion criteria. EPPI Reviewer then extracted common transfer reviews keywords and phrases from these (around 50–100), which were reviewed by the research team and then used within EPPI to rank the remaining studies according to whether or not they feature Chapter 4 Methods in their title or abstract. We then proceeded to screen in the usual way the list of studies that were identified as relevant by the text mining (generally around 200 studies). If the list of relevant Chapter 5 studies was still too long, we only screened the first 200 and then conducted keyword searches to The evidence base double-check that the text mining tool did not exclude any studies that should have been included. The studies screened out by the text mining were marked as having been excluded on this basis, SECTION II see Annex 3 for further details and flow diagrams. Chapter 6 The impact of Study quality asssessment cash transfers on monetary poverty Study design and methods in themselves indicate a necessary, but not sufficient condition, for us to have confidence in the results of a given study. As pointed out by DFID (2013), it is important Chapter 7 to also consider the quality of individual studies, both in terms of the research design and the The impact of actual implementation of the research. However, as argued in detail in Hagen-Zanker and Mallett cash transfers on education (2013), we are cautious about assigning quality scores to individual studies as recent research has shown how the choice of quality appraisal tool and ‘human handling’ will inevitably shape Chapter 8 the findings (Pieper et al., 2014; Voss and Rehfuess, 2013). Others also warn against score-based The impact of cash weighting schemes (Deeks et al., (2003) cited in Waddington et al., (2012)). Instead of assigning transfers on health a ‘quality score’ to studies, the review considered the ‘risk of bias’ for each study. All studies that and nutrition were deemed relevant after the first screening stage against inclusion criteria were included in a Chapter 9 risk of bias assessment. The impact of cash transfers on According to The Cochrane Collaboration, a bias refers to ‘a systematic error, or deviation from savings, investment the truth, in results or inferences’ (Higgins et al., 2011). This can lead to both underestimation and production and overestimation of the true effect of a given intervention. As it is often impossible to know the Chapter 10 extent to which any biases have actually affected the results of a study, and because results may be The impact of unbiased despite methodological flaws, there is a preference in the evaluation literature to consider cash transfers on risk of bias. the employment Chapter 11 The degree of this risk can be considered across a number of different types of bias. For example, The impact of for RCTs this typically involves looking at selection bias, performance bias, attrition bias and cash transfers on detection bias. In this review, given the breadth of studies considered and the number of different empowerment study designs, we considered the risk of bias primarily by assessing whether a study is prone to selection bias, attrition bias or bias associated with interpretation of statistical significance (Type I or Type II errors). An ‘other’ option was also allowed to capture risks arising from other types of SECTION III bias. Below we explain in more detail the assessment tool that was used in this review. Chapter 12 Summary of This assessment, also done in EPPI Reviewer, was conducted by two researchers using the criteria findings and as set out below. In order to reduce subjectivity involved in the risk of bias assessment, the first conclusion 30 studies of each question were assessed simultaneously by two researchers. The entire research References team then discussed any inconsistencies in coding with the agreements reached informing future coding.

69 Cash transfers: what does the evidence say? Page 69 Contents Assessment of risk of bias for all quantitative studies retrieved Acknowledgements Despite the existence of a large number of tools to assess the risk of bias, it has been argued that Executive summary there are few which enable appropriate evaluation of quasi-experimental designs (Waddington et al., 2012). This review used a risk of bias tool which draws from that developed by the Cochrane Collaboration (Higgins et al., 2011), criteria developed by Hombrados and Waddington (2012) and SECTION I the appraisal tool used by Yoong et al. (2012) in a previous systematic review on cash transfers. Chapter 1 Introduction Table A2.1 in Annex 2 gives an overview of the tool that was used to assess each study. The assessment involved a judgement over whether the study demonstrates a ‘high risk’ of bias or ‘low Chapter 2 risk’ of bias for each of the four domains. It is recognised that some forms of bias (e.g. attrition Conceptual framework bias) may only be relevant to certain study designs. Where a domain was ‘not applicable’ it was marked as such and was not included in the final decision. In a small number of cases, the risk of Chapter 3 bias was marked as ‘unclear’ if assessment against a domain was borderline and it was felt that Review of cash greater information was required to make a decision. transfer reviews Chapter 4 After assessing specific domains within each study, a summary assessment of the risk of bias was Methods made for the study as a whole across all domains. It is important that assessments of the overall risk of bias take the relative importance of the different domains into account, depending on Chapter 5 the focus of the review and specific outcomes being considered ( Higgins et al., 2011). As such, The evidence base summary assessments were based on a judgement by the reviewers about the relative importance of each domain. SECTION II Following summary assessments of individual studies, the research team jointly reviewed with Chapter 6 DFID whether and how to include studies that suggest a high risk of bias. Given the danger The impact of presented by drawing conclusions from studies at high risk of bias, a decision was made to exclude cash transfers on studies with a high risk of bias from the final analysis. It was agreed that studies that included a monetary poverty domain marked as unclear could be included, provided all other domains were coded as low risk. Chapter 7 Table 5.1 in the section describing the evidence base shows how many studies were excluded due The impact of to a high risk of bias. As can be seen from the table, on average around 40% of the studies were cash transfers on excluded for this reason. education Chapter 8 Assessment of quality for qualitative studies The impact of cash transfers on health For quantitative studies returned under searches for research question two, on the links between and nutrition cash transfer design and implementation features and outcomes, the same assessment tool as Chapter 9 described above was used. For qualitative studies and institutional analysis, an alternative The impact of assessment tool was used as presented in Table A2.2 in Annex 2. This tool is based on an cash transfers on assessment of methodological rigour derived from the literature around evaluating qualitative savings, investment studies. and production Chapter 10 There is divided opinion over the value of a formal quality assessment for qualitative studies, with The impact of Noyes et al. (2008) suggesting there is ‘insufficient evidence to inform a judgement on the rigour cash transfers on or added value of various approaches’. While the same authors note the existence of over 100 employment tools and frameworks for aiding the appraisal of qualitative research, they make the important Chapter 11 point that ‘formal appraisal processes and standards of evidence presented as rigid checklists The impact of informing an “in or out” decision can be argued to be inappropriate for qualitative research’. cash transfers on Nevertheless, it is helpful to have a sense of how studies fare against certain core markers of empowerment qualitative research quality. The appraisal in this review draws from DFID’s ‘Analysis of Qualitative Data in Evaluation and SECTION III Research “How to” note’ (2014) as well as the framework for assessing qualitative studies by Chapter 12 Spencer et al. (2003), who undertook a review of appraisal frameworks and checklists. The tool Summary of used for the appraisal facilitates judgements in a number of domains considered important for findings and qualitative research (see Table A2.2 in Annex 2). For each domain a number of questions help to conclusion guide the assessment. In implementing this screening, the reviewer made a brief comment against References each, leading to a judgement for the domain overall as to whether there are ‘no concerns’, ‘some concerns’ or ‘major concerns’ for that domain.

70 Cash transfers: what does the evidence say? Page 70 Contents As with the impact evaluation studies, a summary assessment was carried out for each study. Acknowledgements The assessment involved deciding whether there were ‘no concerns’, ‘some concerns’ or ‘major concerns’, this time for the study as a whole. The following rules were used: Executive summary A s • tudy is considered to have ‘no concerns’ if there are ‘no concerns’ in any of the domains tudy is considered to have ‘some concerns’ if there are ‘some concerns’ in up to two domains • A s SECTION I • A s tudy is considered to have ‘major concerns’ if there is one ‘major concern’ in any domain, or Chapter 1 more than three domains with ‘some concerns’. Introduction Chapter 2 As with the risk of bias assessment for quantitative studies, this summary assessment was used Conceptual to narrow down the ‘full list of studies reviewed’ that is outlined above. Studies that showed framework either ‘no concerns’ or ‘no concerns’ with ‘some concerns’ were included in the ‘full list of studies reviewed’ for the final analysis and, as in the case of quantitative impact evaluations, Chapter 3 were included in the ‘annotated bibliography’. As shown in the summary table of studies passing Review of cash transfer reviews through the various stages through to evidence extraction (Table 5.1 below), among the studies reaching assessment, on average 44% of studies were excluded at this stage (this average does not Chapter 4 account for the two studies on grievance mechanisms and programme governance for which both Methods studies, i.e. 100%, were excluded). A total of four qualitative studies were included in the full list of studies to be reviewed. Chapter 5 The evidence base An initial pilot was carried out using the assessment tool in order to ensure consistency between researchers. As with the risk of bias assessments for the quantitative studies, an initial number SECTION II of studies undergoing the qualitative assessment were reviewed by two researchers, with any discrepancies discussed and agreed by consensus with the involvement of the wider team. Chapter 6 The impact of One of the main issues during this screening was that, on a closer reading, many studies did not in cash transfers on monetary poverty fact explicitly link design or implementation features with the outcomes being considered. As such, a number of studies were excluded on the basis of not fully meeting the initial inclusion criteria. Chapter 7 The impact of cash transfers on 4.5 vidence extraction E education Chapter 8 Overview The impact of cash transfers on health The evidence reviewed in the subsequent analysis of this report has been extracted from those studies and nutrition which passed either the risk of bias assessment or the qualitative assessment, and were therefore Chapter 9 included in the ‘final list of studies reviewed’ and annotated bibliography. From all of these studies, The impact of key information was extracted covering the study design, details of the cash transfer intervention(s), cash transfers on overall findings and indicators reported in order to develop an annotated bibliography. savings, investment and production As mentioned above, at this stage a number of studies were identified as reporting on indicators Chapter 10 under sub-questions to which they had not initially been allocated through the search and The impact of screening process. For example, where a study that was predominantly focused on education cash transfers on outcomes also happened to include at least one estimate of an impact on household poverty, or employment a measure of empowerment. Where this was the case, the study was marked as being relevant to that additional outcome area. In the small number of cases where studies were identified as Chapter 11 The impact of being potentially relevant under question two (design and implementation features), the study was cash transfers on checked against the previously discussed inclusion and screening criteria for that question. empowerment Indicator selection for each outcome SECTION III Given the substantial breadth of evidence included across these studies, covering a wide range of Chapter 12 different indicators and measures, it was agreed that the review of evidence would focus on five to Summary of findings and seven key indicators within each of the six outcome areas (i.e. within poverty, education, health, conclusion savings, investment and production, employment, and empowerment), hence potentially including other potentially relevant indicators. The final list of selected indicators is provided in the findings References chapters. The following set of criteria were used in order to help identify which indicators the review would focus on:

71 Cash transfers: what does the evidence say? Page 71 Contents mportance of individual indicator and set of indicators – drawing on the conceptual • I Acknowledgements framework for the review and discussions with DFID, a key consideration was to ensure that the set of indicators selected would help explain some of the main impact areas of interest Executive summary within debates around the impact of cash transfers. In this regard, where relevant, an emphasis was put on ensuring that the indicators were chosen to cover both short-term impacts as well as longer-term impacts. SECTION I ontribution to the literature – a second criterion was that the indicators selected should help C • Chapter 1 contribute something new to the literature, which in some cases meant placing greater weight Introduction on indicators around which past reviews had identified limited evidence or a need for further Chapter 2 research. Conceptual • F requency of occurrence – a further consideration informing the selection of indicators was framework the extent of evidence available on particular indicators. Care was taken to ensure this did Chapter 3 not mean focusing solely on those indicators for which there was a lot of evidence (thereby Review of cash potentially missing important, but less frequently reported, indicators), though frequency was transfer reviews one of the considerations to ensure that the review had sufficient information to be able to provide a useful and informative synthesis of the evidence. Chapter 4 Methods R • eporting of the indicators in studies that look at the effect of design or implementation features – given that part of the focus of the review was on the effect of design and Chapter 5 The evidence base implementation features, one consideration was to cover indicators included in studies assessing the impact of these features. SECTION II T he prevalence of sex-disaggregated results – a final consideration was to ensure that the • indicators selected would, where possible, allow for a discussion of sex-disaggregated impacts. Chapter 6 The impact of cash transfers on Evidence extraction and reporting monetary poverty Once the indicators were identified, an evidence extraction tool was designed in Microsoft Excel Chapter 7 to collate all relevant evidence on the selected indicators from the final list of studies. Evidence was The impact of extracted on: cash transfers on education • he effect of the cash transfer on the selected indicators at the highest level of aggregation t reported Chapter 8 The impact of cash • he effect of variations in cash transfer design and implementation features on the selected t transfers on health indicators and nutrition • t he effect of the cash transfer and of variations in design and implementation features on the Chapter 9 selected indicators reported for women and girls (and by age for these groups) The impact of cash transfers on e • vidence of links between cash transfer design and implantation features and outcomes for the savings, investment selected indicators (i.e. not just results from counterfactual impact analysis). and production Chapter 10 A number of studies using regression analysis reported multiple results from multiple models, The impact of including results used as robustness checks or sensitivity analysis. Where this was the case, the cash transfers on researcher extracting the evidence was required to choose the models with the most reliable employment estimates, based on the information provided in the study and the strengths and weaknesses of Chapter 11 different methodological approaches. For example, in cases where difference-in-difference results The impact of were presented with and without the use of covariates, results derived from the models using cash transfers on covariates were always preferred. empowerment When extracting evidence, a very small number of studies did not report p-values or clearly demonstrate levels of statistical significance, instead presenting t-statistics or standard errors. In such SECTION III cases, critical values were used to identify the level of statistical significance, or the rule of thumb Chapter 12 was used whereby coefficients greater than twice the standard error were considered significant at Summary of the 5% significance level. In this review, results are considered statistically significant up to the 10% findings and significance level. Most studies typically reported statistical significance up to this level. conclusion References

72 Cash transfers: what does the evidence say? Page 72 Contents As a general rule, coefficients were extracted directly in their original form and were not, for Acknowledgements example, converted to percentage changes based on baseline information within the studies. The convention used for reporting percentage point changes is to keep them in their original form, Executive summary meaning the coefficients reported need to be multiplied by 100 in order to get the full value. In the very small number of cases where percentage point changes were already reported in this way, they have been divided back in order to ensure consistency with the rest of the studies. We also SECTION I tried to achieve consistency in terms of units of measurement, so if a choice of measurements was Chapter 1 available (e.g. continuous form and log form), the measurement that was most common across Introduction studies was chosen. Chapter 2 Given the large volume of evidence (even after narrowing down to a subset of specific indicators) Conceptual when reporting on overall effects, results at the most aggregate level were chosen. So, for example, framework if studies reported on overall effects as well as effects disaggregated at urban and rural levels, it Chapter 3 58 is the overall effect that is reported here. Where findings were reported for a number of time Review of cash periods, the overall effect reported here is for the longest exposure, with any effects reported transfer reviews for earlier follow-ups included in the results under duration of exposure in the section on design and implementation features. In some cases, the variable used to identify participation as a Chapter 4 Methods beneficiary of a cash transfer was the level of transfer. Where this was the case, it is included under transfer value in the design and implementation features section, except if noted otherwise. When Chapter 5 extracting design and implementation findings, all effects on different design and implementation The evidence base variations were extracted, even if the authors did not test for statistically significant differences between these variations. SECTION II For sex-disaggregated results, evidence was extracted for both male and female beneficiaries, but Chapter 6 the discussion focuses on women and girls, including any age-related effects among them. The impact of cash transfers on systematically Finally, due to the scale of the review, we were unable to verify findings and monetary poverty interpretations. Findings and interpretations were mostly included exactly as stated in papers. Chapter 7 When results and/or measurement units were unclear, the research team contacted authors for The impact of clarifications and the findings reported reflect these clarifications, when they were received. cash transfers on education Analysis and synthesis Chapter 8 The impact of cash For the synthesis and analysis of the evidence extracted, the review looks separately at overall transfers on health 59 and impacts on women and impacts of cash transfers at the highest level of aggregation reported, and nutrition girls by age. It also reports and analyses evidence of the effect of variations in cash transfer design Chapter 9 and implementation features on the selected indicators (as arising from counterfactual analyses The impact of testing such links) and of links between such features and outcomes based on descriptive and cash transfers on qualitative studies/approaches. savings, investment and production As this review covered a large number of outcome areas and indicators, we chose to aggregate Chapter 10 the results to give a clear overview of findings. Given the wide range of different indicators and The impact of measures reported, as well as missing information in some studies, e.g. on sample size, a meta- cash transfers on analysis was not feasible. Instead, for each indicator a vote count was carried out, reporting the employment number of studies on a specific indicator, the number of studies showing at least one statistically 60 Chapter 11 and the number of statistically significant findings that show increases or significant result The impact of decreases in the underlying indicator (more on this approach, and its advantages and limitation, cash transfers on below). These vote counts provide a good initial of overall findings in the studies overview empowerment reviewed, for example whether cash transfers tend to have a statistically significant effect on a particular outcome area, and to give the reader an idea of general trends in the findings. However, vote counts lack nuance and a discussion of the causal processes underlying the impacts. SECTION III Chapter 12 Summary of n some cases, the most aggregated result was already disaggregated in some way (e.g. urban or rural). Where this applies it is recorded as 58 I findings and such in the table. conclusion 59 W hen findings were reported for the same dataset or programme, they were only excluded if they reported exactly the same findings. References 60 I f a study considered more than one sub-indicator for a group of indicators (e.g. investment in chicken and goats), for the vote count we looked at whether there was a significant result for at least one indicator. In other words, we considered findings by study, not by result, as to not give more weight to studies looking at a variety of indicators.

73 Cash transfers: what does the evidence say? Page 73 Contents Therefore, the vote-counting exercise was complemented with a narrative synthesis approach. Acknowledgements describes Such an approach studies and findings included in the review (Waddington et al., 2012). The narrative synthesis in this review includes a discussion of the range of direction and Executive summary magnitude of effect, as well as consideration of specific examples. Where available, explanations of underlying causal processes from the studies are included, particularly any discussion of design and implementation features. Hence, while the vote count approach is useful in giving an initial SECTION I overview, the narrative synthesis adds nuance and detail to the broad brush vote count findings. Chapter 1 Introduction L 4.6 imitations of this review Chapter 2 Conceptual This review has three main limitations. The first is linked to the inclusion criteria which, by framework definition, determine that a set of potential sources of relevant evidence are excluded from the Chapter 3 review. While for most criteria, the review made a special effort to ensure that the coverage of the Review of cash evidence base was as comprehensive as possible, on others this was not possible given the available transfer reviews resources. For example, while this review took a comprehensive approach to methodological approaches, considering studies with a variety of different methods, it only considered studies Chapter 4 Methods in the English language. This means that studies published in languages such as Spanish and Portuguese, which have recorded a growing number with the expansion of cash transfers across Chapter 5 Spanish- and Portuguese-speaking countries over the past two decades, are not captured by the The evidence base present review, potentially affecting its findings. SECTION II - l evel A second limitation of the review is related to its scope and focus on individual and household outcomes. As above, partly in response to necessity, the review does not consider community- or Chapter 6 national-level impacts of cash transfers (though acknowledging them in the conceptual framework). The impact of Furthermore, while the findings on the impacts of cash transfers are reported for women and cash transfers on girls (and age) wherever possible, they are not systematically reported and analysed for other monetary poverty levels of disaggregation. As explained above, the evidence extracted focuses on the highest level of Chapter 7 aggregation reported by a paper. While this may reflect some level of disaggregation (e.g. urban/ The impact of rural), and we ensure that this is specified in the extraction and write-up, the report does not cash transfers on explicitly address these types of disaggregation; only sex-disaggregated results are systematically education discussed. Chapter 8 The impact of cash The third main limitation concerns the approach adopted in the synthesis of the evidence transfers on health extracted. As a result of the high number of outcomes and related indicators covered, it was not and nutrition possible to implement a meta-analysis approach to synthesise the rigorous evidence retrieved. Instead, for quantitative counterfactual analyses, regression coefficients and statistical significance Chapter 9 are systematically extracted and reported and used to conduct an unweighted vote count. This The impact of cash transfers on in turn, is used to inform the discussion of the findings in the report using a narrative synthesis savings, investment approach. and production The vote-counting approach has its limitations (see Waddington et al., 2012). However, it Chapter 10 presents a valuable way forward in summarising the results of a review of the evidence such as The impact of cash transfers on this one, with its breadth of coverage of indicators. Readers are encouraged to bear in mind that employment vote counts do not take study sample sizes or magnitude of effects into account and indeed, the discussion of the results reflects on this limitation. To partially overcome this issue, throughout Chapter 11 the report, examples and ranges of magnitude of effects are provided, showing these as percentage The impact of changes or comparing them to baseline values wherever this information is provided by authors. cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

74 Cash transfers: what does the evidence say? Page 74 Contents Acknowledgements Chapter 5 Executive summary SECTION I T he evidence base Chapter 1 Introduction Chapter 2 Conceptual framework This chapter presents results on the scale of the evidence across different outcomes and cash transfer design and implementation features retrieved at various stages of the review. It also lists Chapter 3 the reasons why studies were excluded at different stages. The chapter then takes a closer look at Review of cash those studies that passed the quality assessment stage and from which evidence was extracted. transfer reviews Studies are described in terms of geographical coverage, type of programme studied, methods and Chapter 4 type of publication. Methods Chapter 5 cale of the evidence S 5.1 The evidence base As outlined in section 4.1, evidence was retrieved through five different tracks. Annex 3 shows SECTION II the number of studies retrieved through different tracks by sub-question. The flow-charts in the same Annex give a more detailed picture and show the number of studies at different stages of the Chapter 6 review after exclusion criteria and risk of bias assessments were applied. The impact of cash transfers on monetary poverty A large number of studies were retrieved – more than 38,000 studies across all sub-questions. As shown in Table 5.1 below, the total number retrieved from all tracks by sub-question ranged from Chapter 7 313 studies for grievance mechanisms and programme governance to 10,607 studies for savings, The impact of investments and production. cash transfers on education Annex 3 shows that the majority of studies were retrieved from bibliographic databases (ranging Chapter 8 from 305 to 10,559 post-duplication). However, the vast majority proved to be irrelevant during The impact of cash the screening stage (see more on the reasons for exclusion below). The studies retrieved from other transfers on health sub-questions (as described above) proved to be the second-biggest source of studies for the sub- and nutrition questions overall (ranging from three to 161 studies), with these themselves originally coming from either one of the other four tracks described earlier. Websites provided the next biggest source of Chapter 9 The impact of studies (ranging from seven to 79 studies post-screening). The number retrieved through experts’ cash transfers on suggestion and other review studies was fairly low (around 10 unique studies). We conducted this savings, investment process once the other retrieval stages had been completed, so this is an indication that the other and production search stages were very thorough, as most of the important studies had been included already. Chapter 10 The impact of All studies retrieved were assessed against the inclusion criteria, but this was only done in EPPI cash transfers on for studies retrieved through bibliographic databases. For those studies we show the reasons employment for exclusion at the title and abstract and full-text stage, see Annex 3. For the sub-questions on outcome impacts (1a-1f), the most frequent reason for exclusion at the title and abstract stage Chapter 11 (64%) was that they did not consider a cash transfer intervention, followed by studies that did The impact of 61 cash transfers on At the full-text stage the not consider outcomes we were looking at within this review (16%). empowerment most common exclusion reason was study design (59%), followed by the reason that the study was a review study (19%). For the sub-questions on design and implementation features (2a-2f), intervention was also the most common exclusion reason at the title and abstract stage (86%), SECTION III but at the full-text stage studies were mostly excluded because they were relevant for other sub- questions (42%), in which case they were moved across to that sub-question, and due to study Chapter 12 Summary of design (18%). findings and conclusion References 61 T hese numbers need to be interpreted with caution, as reviewers only selected one reason. Of course some studies could have been disqualified on a number of these indicators.

75 Cash transfers: what does the evidence say? Page 75 Contents A total of 617 studies entered the risk of bias assessment, see Table 5.1 below. The number Acknowledgements of studies included in this stage varied greatly by sub-question (ranging from two to 125, for grievance mechanisms and programme governance and health respectively) and tended to be Executive summary higher for the studies that considered impacts on outcome areas (1a-1f). Studies that were judged to have either all ‘low risk of bias’ or ‘low risk’ and ‘unclear’ for quantitative studies, or for qualitative studies, ‘no concerns’ or ‘no concerns’ and ‘some concerns’, made it through to the SECTION I final list of studies identified as relevant for the outcome area/design and implementation features. Chapter 1 These studies were included within the annotated bibliography. The final number of unique Introduction studies to pass in this way is 201. Four of these were of a qualitative nature. Chapter 2 On average, around 53% of studies made it through to the final list (see Table 5.1 for a breakdown Conceptual by sub-question). For the sub-question on grievance systems and programme governance, the framework application of the risk of bias assessment meant that no studies made it to the final list. For studies Chapter 3 looking at design and implementation features we also considered qualitative studies and two Review of cash studies made it through to the risk of bias assessment, however none of these considered indicators transfer reviews that we focused on and were hence not included in the data extraction stage. Chapter 4 Methods The final list of studies identified as relevant for each sub-question was compiled from the studies that passed the risk of bias assessment and studies that were identified as relevant for the outcome Chapter 5 area while compiling the annotated bibliography. The scale of the evidence base varies greatly by The evidence base outcome, ranging from zero studies for grievance mechanisms to 98 studies for education. On the whole, there are fewer studies on design and implementation features, though there is a substantial SECTION II evidence base of 41 studies on core design features. As such, the ‘power’ of findings for some design and implementation features is somewhat limited. For the outcome areas, the evidence base Chapter 6 is largest for education (99 studies) and health (89 studies), followed by employment (80 studies). The impact of The evidence base is smallest for savings, investment and production (37 studies). cash transfers on monetary poverty Figure 5.1 Number of studies identified as relevant for the outcome area/set of design and implementation features Chapter 7 The impact of cash transfers on Monetary poverty (1a) education Education (1b) Chapter 8 The impact of cash Health and nutrition (1c) transfers on health Savings, investment and nutrition and production (1d) Chapter 9 Employment (1e) The impact of Empowerment (1f) cash transfers on savings, investment Core design features (2a) and production Conditionality (2b) Chapter 10 The impact of Targeting (2c) cash transfers on Payment systems (2d) employment Grievance Chapter 11 mechanisms (2e) The impact of Complementary programmes (2f) cash transfers on empowerment 20 40 0 50 60 70 80 90 100 10 30 Number of studies SECTION III Source: Authors Chapter 12 Summary of findings and Further details of the number of studies passing from retrieval through each of the stages of conclusion screening to the final list are provided by sub-question in the flow diagrams in Annex 3. References

76 Cash transfers: what does the evidence say? Page 76 Contents Table 5.1 Summary of studies retrieved, screened, included in final list and from which evidence extracted Acknowledgements Final number Additional Studies judged Total studies Total studies Total studies identified as retrieved (all either ‘low studies undergoing risk of studies from Executive summary sources) of bias/quality risk of bias’ which evidence relevant for the identified as or ‘low risk’ outcome area assessment was extracted relevant from and ‘unclear’ on the selected other sub- SECTION I (quantitative) or questions indicators (during ‘no concerns’ or ‘no concerns’ compilation Chapter 1 and ‘some of annotated Introduction concerns’ bibliography) (qualitative) Chapter 2 Conceptual Cash transfer impact on outcomes framework 27 34 75 4,975 Monetary poverty 61 44 42 25 74 120 1,16 4 Education 99 Chapter 3 Review of cash 89 25 64 125 4,245 Health and nutrition 41 transfer reviews 10,608 37 5 32 42 27 Savings, investment and production Chapter 4 Methods 19 Employment 61 93 74 80 5,965 54 31 Empowerment 4,206 56 36 18 Chapter 5 The evidence base Impact of cash transfer design and implementation features on outcomes 40 Core design features 634 41 25 16 41 1,681 Conditionality 11 21 2 19 25 SECTION II 1 7 1 6 10 770 Targeting Chapter 6 2 3 0 3 14 1,920 Payment systems The impact of cash transfers on 0 0 2 313 Grievance mechanisms 0 0 monetary poverty and programme governance Chapter 7 1,5 81 Complementary 14 8 3 11 21 The impact of interventions and supply- cash transfers on side services education Chapter 8 The impact of cash tudies included in the review 5.2 S transfers on health and nutrition This section takes a closer look at the studies that are at the heart of the review. We extracted Chapter 9 information on five to eight indicators for each outcome area under question one. Evidence was The impact of only extracted from studies reporting on design and implementation features (Sub-questions 2a-2f) cash transfers on if they reported the effect on these five to eight indicators. As not all studies contained results on savings, investment and production these specific indicators, for the actual review and discussion of findings we focus on a sub-sample of studies from the full list that reached the annotated bibliography, i.e. the ‘final list of studies Chapter 10 from which evidence was extracted on the selected indicators’. The total number of unique The impact of studies from which evidence was extracted on the selected indicators is 165. The total number cash transfers on of studies from which evidence was extracted by sub-question is summarised in the final column employment of Table 5.1 above. In this section, we provide a summary of the number of studies by source of Chapter 11 retrieval, type of study, study design, geographic coverage and cash transfer programmes covered. The impact of cash transfers on empowerment 5.2.1 S ource of retrieval First of all, from a methodological point of view we are interested in the source of retrieval for SECTION III all of the studies that reached the annotated bibliography and the studies from which evidence Chapter 12 was extracted. Table A4.1 in Annex 4 shows the source of retrieval for studies included in the Summary of annotated bibliography. findings and conclusion The way the review was structured around 12 separate sub-questions allowed for studies to be identified as relevant for a particular sub-question from another sub-question. Quite a number References of studies were primarily designed around a particular outcome area or areas, but then included

77 Cash transfers: what does the evidence say? Page 77 Contents results of relevance to other outcomes. In some cases, such studies were also relevant for the sub- Acknowledgements question through which the study was originally identified and in other cases they were not. This makes it challenging to summarise the source of retrieval for all studies from which evidence Executive summary was extracted. For example, if a study was identified through a website but also found to be relevant for another study, then, if the sources of retrieval are considered for the body of evidence as a whole across all sub-questions, this will involve some double counting of studies (e.g. being SECTION I retrieved through a website and also from ‘other sub-questions’). For this reason, the summary of Chapter 1 evidence by source of retrieval in Figure 5.2 is broken down by sub-question in order to avoid any Introduction double counting of studies. Chapter 2 Figure 5.2 shows that studies retrieved from ‘other sub-questions’ provided an important source Conceptual of retrieval for most sub-questions, contributing between 14% and 86% of studies among sub- framework questions that retrieved any studies in this way. For questions 2d (payment mechanisms) and Chapter 3 2e (grievance mechanisms and programme governance) no studies were added from other sub- Review of cash questions. It is worth noting that, without the broad scope of this review, the evidence retrieved transfer reviews through this track would not have not been included and it therefore represents one of the key advantages of the review – greatly expanding the body of evidence from which evidence is Chapter 4 Methods extracted. This would not be possible in reviews that focus on a single outcome area. Chapter 5 The second most important source of retrieval was bibliographic databases. This provided The evidence base between 6% of studies (for empowerment and education) and 81% of studies (for conditionality). Note that studies gained from other sub-questions may also have originally been sourced through SECTION II bibliographic databases, or indeed, from one of the other study sources (i.e. websites, reviews or expert suggestions). Chapter 6 The impact of Figure 5.2 Source of retrieval for studies from which evidence was extracted cash transfers on monetary poverty Pover ty (1a) Chapter 7 The impact of cash transfers on Education (1b) education Health and nutrition (1c) Chapter 8 Savings, investment The impact of cash and production (1d) transfers on health and nutrition Employment (1e) Chapter 9 Empowerment (1f) The impact of cash transfers on Core design features (2a) savings, investment and production Conditionality (2b) Chapter 10 The impact of Targeting (2c) cash transfers on employment Payment mechanisms (2d) Grievance mechanisms and Chapter 11 programme governance (2e) The impact of cash transfers on Complementary and empowerment supply-side services (2f) 30 60 20 10 0 40 80 90 100 50 70 Number of studies SECTION III Websites Review studies Bibliographic databases Chapter 12 Other-sub-questions Expert recommendations Summary of findings and Source: Authors conclusion References

78 Cash transfers: what does the evidence say? Page 78 Contents ype of study 5.2.2 T Acknowledgements This review had a wide and rigorous retrieval strategy in order to also capture evidence that is Executive summary outside the peer-reviewed journal channels, for example, reports from institutional websites. Nevertheless, the majority of studies that we extracted evidence from were published in a peer- SECTION I reviewed journals (Figure 5.3). In total, 42% of studies across all outcomes were a peer-reviewed journal article and this holds for all sub-questions bar two: targeting and payment systems (see Chapter 1 Table A4.2 in Annex 4 for a detailed breakdown). The second most frequent studies were working Introduction papers (25%) and unpublished papers and PhD theses (23%). Only 10% of studies were reports (e.g. official impact evaluation reports) or book chapters. This tells us that much of the rigorous Chapter 2 Conceptual evidence on cash transfers with a low risk of bias is published in peer-reviewed journals. framework Figure 5.3 Type of studies from which evidence was extracted Chapter 3 Review of cash transfer reviews Chapter 4 Methods Chapter 5 23% The evidence base SECTION II 42% Chapter 6 The impact of 10% cash transfers on monetary poverty Chapter 7 The impact of 25% cash transfers on education Chapter 8 The impact of cash Peer reviewed journal articles Working papers Reports and Book chapters PhD theses and unpublished papers transfers on health and nutrition Source: Authors Chapter 9 The impact of cash transfers on savings, investment 5.2.3 tudy design S and production In this review, we included studies with an RCT or quasi-experimental research design, as well as Chapter 10 The impact of qualitative studies (when considering design and implementation features), however none of the cash transfers on qualitative studies were included in the extraction stage for the reasons discussed above. Among the employment studies from which evidence was extracted, a greater share used an RCT approach than a quasi- experimental approach. On average, 58% of the studies relied on an RCT research approach. This Chapter 11 varied by outcome, with 51% of the studies for the poverty sub-question using an RCT approach, The impact of cash transfers on to 78% of the studies for savings, investment and production doing so (Figure 5.3). empowerment SECTION III Chapter 12 Summary of findings and conclusion References

79 Cash transfers: what does the evidence say? Page 79 Contents Figure 5.3 Study design of studies from which evidence was extracted (by outcome) Acknowledgements Executive summary Monetary Poverty (1a) 49% 51% SECTION I Education (1b) 45% 55% Chapter 1 Introduction Health and nutrition (1c) 44% 56% Chapter 2 Conceptual framework Savings, investment 22% 78% and production (1d) Chapter 3 Review of cash transfer reviews Employment (1e) 41% 59% Chapter 4 Methods Empowerment (1f) 40% 60% Chapter 5 100% 70% 60% 50% 40% 30% 20% 10% 0% 90% 80% The evidence base Randomised Control Trials Quasi-experimental SECTION II Source: Authors Chapter 6 The impact of cash transfers on monetary poverty 5.2.4 G eographical coverage Chapter 7 The impact of Also of interest is the geographical coverage of studies from which evidence was extracted. This cash transfers on 62 can give us some sense of how representative the findings are that are synthesised in this review. education Figure 5.4 shows geographical coverage by sub-question. For most outcomes, the majority of Chapter 8 studies focused on a cash transfer in Latin America; across all sub-questions, approximately 54% The impact of cash of the studies report on a programme from Latin America. The exception is for the sub-question transfers on health on savings, investment and production, where more studies focused on sub-Saharan Africa. and nutrition Around 38% of the studies focused on a country in sub-Saharan Africa, with studies looking at East Asia and the Pacific, Europe and Central Asia, and the Middle East and North Africa Chapter 9 The impact of accounting for around just 8%. cash transfers on savings, investment To some extent, the geographical focus of studies included in this review reflects programme and production coverage, yet there are also large-scale cash transfer programmes in Europe and Central Asia, South Asia and South East Asia that have not made it into this review. This could be for a number Chapter 10 of reasons, possibly because they have not been subject to (published) evaluations or because the The impact of cash transfers on studies were of a high risk of bias. As such, while we are confident that this review reflects the employment knowledge base global fairly well, having included most of the low risk of bias, published studies of cash transfers, it does not necessarily mean that the findings are broadly generalisable. The Chapter 11 findings are clearly focused on Latin America and specific programmes. The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 62 N ote that external validity of the findings will also depend crucially on the individual studies and their research design.

80 Cash transfers: what does the evidence say? Page 80 Contents Figure 5.4 Geographical coverage of studies from which evidence was extracted Acknowledgements Executive summary Poverty (1a) SECTION I Education (1b) Chapter 1 Introduction Health and Chapter 2 nutrition (1c) Conceptual framework Savings, investment, production (1d) Chapter 3 Review of cash transfer reviews Employment (1e) Chapter 4 Methods Empowerment (1f) Chapter 5 50 40 30 20 10 0 80 70 60 The evidence base Number of studies SECTION II Europe & Central Asia East Asia & Pacific Sub-Saharan Africa Middle East & North Africa Latin America & Caribbean South Asia Chapter 6 The impact of cash transfers on Source: Authors monetary poverty Chapter 7 The impact of C 5.2.5 ash transfer programmes included in this review cash transfers on education This review covers non-contributory cash transfer programmes, generally tax- or donor-financed, Chapter 8 and delivered by the state or NGOs to individuals and households. The four main broad types of The impact of cash programmes covered by the review are: transfers on health and nutrition u nconditional cash transfers (UCTs) • • c onditional cash transfers (CCTs) Chapter 9 ocial pensions s • The impact of e • nterprise grants. cash transfers on savings, investment and production In total, this review extracted evidence on 56 different cash transfer programmes, including: 31 CCTs, 14 UCTs, 4 social pension programmes, 2 enterprise grants and 5 programmes that Chapter 10 included both conditional and unconditional components. Table 5.2 below lists the cash transfer The impact of programmes on which evience is reported in this review and for each programme lists the country cash transfers on of operation, years of implementation, population coverge and the number of studies from which employment evidence was extracted. Chapter 11 The impact of Of the programmes covered in this review, the majority are CCTs (55%) and most of these are cash transfers on located in Latin America. 25% of the programmes were UCTs, mostly located in Africa. Of the empowerment remaining programmes, 9% involve a combination of CCTs and UCTs (most of these were part of a trial or experiment), 4% were enterprise grants and 7% were social pensions. SECTION III The remainder of this section discusses the four broad types of cash transfer programme and Chapter 12 provides detailed information on one example of each type. Summary of findings and CCTs are cash transfers with an element of conditionality, commonly set in terms of beneficiary conclusion behavioural requirements. CCTs may pursue a combination of objectives including the provision References of a minimum income/income support to specific target groups and promoting human capital accumulation, for instance in terms of education and health. Depending on their underlying

81 Cash transfers: what does the evidence say? Page 81 Contents rationale, CCTs can vary considerably, such as by transfer level, target population and Acknowledgements conditionality. CCTs with a strong human capital accumulation focus may target households with children and include behavioural requirements in the form of regular school attendance Executive summary and health care visits. Other CCTs may be more broadly targeted, for instance to all those with an income or assets below a specific threshold, independently of demographic characteristics. As outlined in Chapter 2, conditionalities can vary considerably depending on the precise behavioural SECTION I requirements, their centrality to CCT operation (e.g. whether compliance is monitored in advance Chapter 1 of benefit receipt), the treatment of non-compliance (e.g. punitive versus non-punitive) and Introduction implementation. CCTs for which evidence is reported in this review include: Brazil’s Bolsa Família, Mexico’s PROGRESA/Oportunidades, Malawi’s Zomba CCT and Tanzania’s Social Action Fund. Chapter 2 Indonesia’s Program Keluarga Harapan (PKH) is described in more detail in Box 5.1. Conceptual framework Box 5.1 PKH (Indonesia) Chapter 3 Indonesia’s Program Keluarga Harapan (PKH) is a CCT programme which began in 2007 to address shortfalls in human Review of cash development outcomes. Targeting is poverty-based (means tested) and only households with a pregnant or lactating transfer reviews woman or child of a certain age (0–15 or 16–18) are eligible. Initial roll-out was to 432,000 households, gradually expanding to several million. Transfer size is determined by number of children and pregnant or lactating women in the Chapter 4 Methods household, with a minimum transfer in 2007 of 600,000 Indonesian rupiahs (~US$62) and a maximum of 2,200,000 Indonesian rupiahs (~$US228) per year. Payments are made quarterly. A large number of conditions are attached to Chapter 5 receiving the transfers, covering use of specific health care services and children being enrolled in school and having The evidence base at least 85% attendance. Compliance is monitored using an online system, with data entered by programme officials. Non-compliance results in a warning and then, if not rectified, a 10% cut to transfer size and, finally, exclusion from the programme. By design, recertification of eligibility is conducted every three years. SECTION II Chapter 6 In contrast to CCTs, UCTs do not include a conditionality component. UCTs typically have The impact of a core poverty reduction objective. Like CCTs, they may also seek to promote human capital cash transfers on accumulation. UCTs can vary widely in terms of their target group and core design features (e.g. monetary poverty size and frequency of payment). For example, the Kenya cash transfer-OVC is targeted at poor Chapter 7 orphaned or vulnerable children, whereas Albania’s Ndhima Ekonomike is targeted at all poor The impact of households, yet both provide a transfer equivalent to about US$20 per month. UCTs covered here cash transfers on include a number of experimental programmes in sub-Saharan Africa, such as the Lesotho Child education Grant, and Malawi’s Social Cash Transfer Programme, described in more detail in Box 5.2. Chapter 8 Box 5.2 SCTP (Malawi) The impact of cash transfers on health Malawi’s Social Cash Transfer Programme started as a pilot UCT in Mchinji district in 2006, aiming to improve and nutrition food security among the poorest households by providing bi-monthly transfers to ultra-poor and labour-constrained households. Households are targeted using a combination of community-based targeting and a proxy-means test. As of Chapter 9 July 2015 the programme was operational in 18 of Malawi’s 28 districts, covering 150,341 households. Monthly transfer The impact of values vary by size of household and, at the time of the pilot, were around 600 Malawi kwacha (US$4.30) for a single- cash transfers on headed household, up to 1,800 kwacha (US$12.85) for four or more people. An additional educational bonus is available savings, investment for each school-going child (200 kwacha for primary and 400 kwacha for secondary school). While transfer levels have and production increased over time, they have lost significant value due to rising prices. Re-targeting is supposed to take place every Chapter 10 four years. The impact of cash transfers on employment Social pensions are non-contributory – transfers are paid without regard to past participation in the labour market. They are age targeted and may also be means-targeted. Their core objective is Chapter 11 to reduce poverty among the elderly, though they may also have (implicit) labour supply objectives, The impact of for instance making it possible for beneficiaries to reduce work effort upon receiving a guaranteed cash transfers on income. Social pensions vary by transfer level and frequency of payment, among other dimensions. empowerment For example, by design, Bolivia’s Bonosol beneficiaries receive one annual payment, whereas recipients of South Africa’s Old-Age Grant receive monthly transfers. The review covers four social SECTION III pensions: Bolivia’s Bonosol/Bolivida pension, Brazil’s BPC, Mexico’s Programa de Atención a Adultos Mayores en Zonas Rurales (described in Box 5.3) and South Africa’s Old-Age Pension. Chapter 12 Summary of findings and conclusion References

82 Cash transfers: what does the evidence say? Page 82 Contents Box 5.3 PAAMZR (Mexico) Acknowledgements Mexico’s Programa de Atención a Adultos Mayores en Zonas Rurales (Assistance for Older Rural Adults Programme, Executive summary PAAMZR) was a non-contributory pension providing support to rural adults at least 70 years old, giving priority to those living in communities with high marginality or who lived in poverty conditions. Starting in 2007, initial roll-out of the programme was to half of Mexico’s states, with the intention of going nationwide. Adults were eligible for the pension if SECTION I they were over 70 years old and lived in communities with fewer than 2,500 inhabitants. Over time coverage extended to 2.1 million beneficiaries. The transfer was 1,000 Mexican pesos (US$90) every two months. The beneficiaries of the Chapter 1 programme were also invited to take part in workshops and social development activities. Since 2013 the programme Introduction has been absorbed by one which is open to adults over 65, with no restriction according to community size. Chapter 2 Conceptual The final type of cash transfer included in this review are enterprise grants. These are framework fundamentally different to other types of cash transfer programme covered by this review, both in terms of objectives and design features. These programmes have the objective of enabling Chapter 3 Review of cash beneficiaries to start or expand a small enterprise through a cash injection and other support transfer reviews not provided. As such, they are often targeted at the poorest households, but instead they are targeted at individuals with labour capacity and some human capital. They often involve a number Chapter 4 of requirements (e.g. writing a business plan) and can be heavily monitored; as such they are Methods effectively conditional. Unlike other cash transfers, transfers are often one-off. Two enterprise Chapter 5 grants are covered in the review, both operating in Uganda: the Youth Opportunities Programme The evidence base (YOP) and Women’s Income Generating Support (WINGS), described in Box 5.4. Box 5.4 WINGS (Uganda) SECTION II Uganda’s WINGS programme has the objective of helping beneficiaries very small but sustainable retail and trading Chapter 6 enterprises. Targeting is conducted by the Association of Volunteers in International Service (AVSI), who identified The impact of 1800 poor people, mostly women, in 120 war-affected villages. Once an enterprise plan was approved, the participant cash transfers on received a grant of 300,000 Ugandan shillings or US$150 at 2009 market exchange rates. The grant was framed as monetary poverty funds to implement the business plan. AVSI’s Women’s Income Generating Support (WINGS) program provided people grants of US$150 (about US$375 in purchasing power parity, or PPP, terms), along with five days of business skills Chapter 7 training and planning, plus ongoing supervision to help implement the plan. The grant was 30 times larger than the The impact of beneficiaries’ baseline monthly earnings. Cash was delivered by AVSI in two equal instalments about 2 and 6 weeks cash transfers on after training. education Chapter 8 Table 5.2 below provides basic information on programmes covered in this review, including The impact of cash the most recent data available on coverage, with more detailed information on each programme transfers on health and nutrition included in the annotated bibliography (Harman et al., 2016). Chapter 9 The table shows that some of programmes assessed were short-term/pilot programmes that ran The impact of for just a few years and that some have relatively low coverage. PROGRESA/Oportunidades is cash transfers on the most analysed programme (being covered in 48 studies across all sub-questions). Being one savings, investment and production of the oldest CCTs, originally evaluated with an RCT design, its delivery involved the collection of a number of high-quality and large N datasets that have been used to analyse various short- Chapter 10 and long-term impacts. A number of other Latin American programmes are also the subject of The impact of a high number of studies, including the Red de Protección Social in Nicaragua (18 studies) and cash transfers on Colombia’s Familias en Acción (10 studies). Outside Latin America, most programmes are covered employment in just a handful of studies. In sub-Saharan Africa, the most frequently covered programme is Chapter 11 Malawi’s Zomba Cash Transfer Programme (5 studies). The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

83 Cash transfers: what does the evidence say? Page 83 Contents 63 64 65 66 67 68 Table 5.2 Cash transfer programmes covered in the evidence extraction of this review Acknowledgements Number Type of Country Programme Coverage at latest count Years of operation programme of studies Executive summary Latin America & Caribbean 63 Bonosol/Bolivida pension Bolivia 2 800,000 individuals (2010) 1997-present Social pension SECTION I 2001–2003 CCT Bolsa Alimentação Brazil 2 million households (2003) 1 Chapter 1 CCT Brazil 1 5 million households (2003) 2001–2003 Bolsa Escola Introduction 2003–present 13.8 million households (2013) 3 CCT Bolsa Família Brazil 1996–present 1 Social pension Brazil Benefício de Prestação Continuada (BPC) 3.7 million individuals (2014) Chapter 2 Conceptual 64 Colombia Familias en Acción CCT 2000–present 2.5 million households (2016) 10 framework CCT Subsidios Condicionados a la Asistencia Colombia 2 46,000 children (2010) 2005–present Escolar (SCAE) Chapter 3 Review of cash Dominican Solidarity Programme 2005–2012 755,683 households (2011) 1 CCT transfer reviews Republic 9 443,803 households (2015) 2003–present Bono de Desarrollo Humano (BDH) CCT Ecuador Chapter 4 Ecuador WFP Colombian refugee RCT (WFP cash CCT April–Sept 2011 3,642 individuals (2011) 3 Methods transfer) Chapter 5 2005–present CCT 2 El Salvador Comunidades Solidarias Rurales (CSR) 80,222 households (2013) The evidence base CCT Programa de Asignación Familiar (PRAF) Honduras 8 660,790 households 1990–present (2010 expected) 65 SECTION II Honduras Bono 10,000 2010–present 1 CCT 600,000 households (2012 expected) Chapter 6 1 Jamaica Programme of Advancement Through Health CCT 2001–present 307,000 individuals (2009) The impact of and Education (PATH) cash transfers on 66 PROGRESA/Oportunidades Mexico CCT 6.1 million households (2015) 48 1997–present monetary poverty 67 PROCAMPO Mexico 1994–present 2.6 million producers (2014) 2 CCT Chapter 7 68 Mexico Programa Apoyo Alimentario (PAL) 2003–2016 CCT 2 1.5 million households (2015) The impact of 2007–present Mexico Programa de Atención a Adultos Mayores en Social pension 2.1 million beneficiaries (2014) 1 cash transfers on Zonas Rurales education 10,000 households (2002) RPS1 1999–2001 18 Nicaragua Red de Protección Social (RPS) CCT Chapter 8 RPS2 2002–2006 The impact of cash Nicaragua 2005–2006 CCT Atención a Crisis 3,000 households (2006) 8 transfers on health and nutrition 1 131,159 households (2015) 2005–present Tekoporã Paraguay CCT Peru 2 769,158 households (2015) 2005–present CCT Juntos Chapter 9 Sub-Saharan Africa The impact of cash transfers on 2 Nahouri Cash Transfers Pilot Project CCT, UCT 2008–2010 2,160 households (2008) Burkina savings, investment Faso and production 2 8200 households (2009) 2008–2011 UCT Innovation for poverty randomised trial Ghana Chapter 10 90,785 beneficiaries (2016) planned Ghana Livelihood empowerment against poverty UCT/CCT 2008–present 3 The impact of (LEAP) to expand to 200,000 by late 2016 cash transfers on 2011–2013 Kenya Give Directly experiment UCT 471 households (2013) 2 employment 2008–present 1 Kenya Hunger Safety Net Programme (HSNP) UCT 100,000 households (2015 target) Chapter 11 240,000 households (2016) UCT Orphans and Vulnerable Children Cash Transfer Kenya 2004–present 3 The impact of (OVC-cash transfer) cash transfers on 2 19,800 households (2014) Lesotho Child Grant Programme (LCGP) UCT 2009–present empowerment continued on next page SECTION III T he programme is now called Renta Dignidad and the latest coverage figure given is for this programme. 63 Chapter 12 Summary of T 64 he programme is now called Más Familias en Acción. findings and T he programme is now called Bono vida Mejor. 65 conclusion 66 T he programme is now called Prospera. References T 67 he programme is now called PROAGRO. T 68 o be merged in 2016 with PROSPERA.

84 Cash transfers: what does the evidence say? Page 84 Contents Table 5.2 Cash transfer programmes covered in the evidence extraction of this review continued Acknowledgements Country Programme Type of Number Years of Coverage at latest count operation programme of studies Executive summary 150,341 households (2015) 2006–present UCT Social Cash Transfer Programme (SCTP) Malawi 3 Malawi 2008–2009 CCT/UCT The Zomba Cash Transfer Programme 3,796 girls (2009) 5 SECTION I Sexual health incentive study CCT 2006–2007 1,307 individuals (2007) 1 Malawi CCT, UCT Prospective study with Forum Santé Niger and Niger 1 3,524 children (2011) 2 011 Chapter 1 Médecins Sans Frontières Introduction Niger 10,000 households (2010) 2 Concern Worldwide drought-response UCT 2010–2011 Chapter 2 unconditional transfer Conceptual 1944–present 3 South Africa Old-Age Pension Social pension 3.1 million individuals (2015) framework UCT Child Support Grant 1 11.9 million and 533,000 South Africa Child Support Grant and Foster Grant Chapter 3 1998–present beneficiaries respectively (2015) Foster Grant Review of cash 1996–present transfer reviews Tanzania Social Action Fund (TSAF) Tanzania 2010–present 1 259,716 households (2015) CCT Chapter 4 2,972 children (2011) 2011–2012 CCT WFP Karamoja cash transfer Uganda 1 Methods Enterprise Youth Opportunities Programme (YOP) Uganda 2008 2,675 individuals (2008) 2 Chapter 5 grant The evidence base 64,113 households (2014) UCT Social Assistance Grants for Empowerment 2011–present Uganda 1 (SAGE) Uganda 2 Women’s Income Generating Support (WINGS) Enterprise 2009 1,800 individuals (2009) SECTION II grant Chapter 6 1 2,069 households (2010 expected) 2007–2010 Monze Cash Transfer Pilot (CTP) Zambia UCT The impact of 2010–2013 Zambia Child Grant Programme UCT 20,000 households (2013) 2 cash transfers on monetary poverty Middle East and North Africa UCT/CCT 1 3,595 households (2008) 2008–2010 Morocco Tayssir Chapter 7 Europe and Central Asia The impact of cash transfers on 1993–present UCT * Albania Ndhima Ekonomike 1 80,000 households (2016) education 1 95,000 households (2014) 2009–2014 CCT BOTA programme Kazakhstan Chapter 8 Turkey Social Risk Mitigation Project CCT 2004–2007 2.6 million children (2007) 1 The impact of cash South Asia transfers on health and nutrition Bangladesh Shombhob CCT 14,125 households (2012) 1 2012–2013 393,000 girls (2014) 2003–present CCT The Punjab Female School Stipend Programme Pakistan 1 Chapter 9 2008–present 1 4.7 million households (2014) UCT Benazir Income Support Programme (BISP) Pakistan The impact of cash transfers on East Asia and Pacific savings, investment unknown 2005–2011 CCT CESSP Scholarship Programme (CSP) Cambodia 2 and production Cambodia Japan Fund for Poverty Reduction (JFPR) CCT 2004–2006 ~4,185 girls (2004) 1 Chapter 10 scholarship program The impact of 142 children (2009) 2009–2010 CCT Junior High School Randomised Controlled Trial China 1 cash transfers on CCT Indonesia Program Keluarga Harapan (PKH) 2007–present 3.2 million households (2014) 1 employment 2 UCT 19 million households (2005) Indonesia Temporary UCT 2005–2006 Chapter 11 1 Indonesia 2008–present CCT Bantuan Siswa Miskin (BSM) cash transfer for 11.1 million children (2013) The impact of poor students cash transfers on empowerment Note: some studies report on more than one programme and so the sum of studies in Table 5.2 does not give the full number of independent studies from which evidence was extracted. * Transfers could technically be SECTION III made conditional on participation in community projects by local councils. Chapter 12 Summary of findings and conclusion References

85 Cash transfers: what does the evidence say? Page 85 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash transfer reviews SECTION II Chapter 4 Methods Chapter 5 Section II reports the evidence retrieved, consolidated and analysed by the review organised by The evidence base outcome in six chapters: monetary poverty; education; health and nutrition; savings, investment and production; employment and empowerment. All six chapters follow a common basic SECTION II structure, starting with a box summarising the rigorous evidence available on the selected indicators of the respective outcome, followed by sections reporting: Chapter 6 The impact of a s • ummary of main findings cash transfers on t • he evidence base monetary poverty r esults on the impact of cash transfers on the selected indicators • r esults on the impact of cash transfers on women and girls • Chapter 7 e • vidence of links between cash transfer design and implementation features and the selected The impact of cash transfers on indicators and education fi nally, a discussion of the policy implications arising from the evidence. • Chapter 8 The chapters include tables reporting estimates of the effects of cash transfers on specific The impact of cash indicators at the highest level of aggregation reported. Detailed tables of the findings on the transfers on health and nutrition impacts of cash transfers measured for women and girls (by age) and evidence of the role of programme design features are provided in Annex 5. Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

86 Cash transfers: what does the evidence say? Page 86 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 6 transfer reviews Chapter 4 Methods T he impact of cash Chapter 5 The evidence base transfers on monetary SECTION II Chapter 6 The impact of cash transfers on poverty monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

87 Cash transfers: what does the evidence say? Page 87 Contents Box 6.1. Summary of evidence for monetary poverty outcomes Acknowledgements Overall effects of cash transfers on selected poverty indicators: Executive summary • E vidence on the impact of cash transfers on monetary poverty was extracted from 44 studies. • largely find an increase. 26 studies T he 35 studies considering the impact of cash transfers on total expenditure SECTION I show a statistically significant effect. The vast majority of these (25 out of 26) find an increase in total expenditure. The increases range from 2.8 percentage point change in total per capita expenditure for Colombia’s Atención a Chapter 1 Crisis (Macours et al., 2012) to 33 percentage point change in total expenditure for Peru’s Juntos (Perova and Vakis, Introduction 2012). One study considering Albania’s Ndhima Ekonomike programme found a significant reduction in total per capita household expenditure, due to drop in labour supply of beneficiaries (Dabalen et al., 2008). Studies with Chapter 2 non-significant findings point towards design and implementation features as explanations, e.g. low level of transfer Conceptual and delays in disbursement, as well as changes in household behaviour. framework • food expenditure T and they largely find an increase. Of the 31 studies, here are 31 studies reporting on impacts on Chapter 3 25 studies show at least one statistically significant effect, with 23 of these being an increase in food expenditure. Review of cash Two studies report a decrease owing to a decrease in labour supply and possible prioritisation of savings over transfer reviews consumption (Dabalen et al., 2008; Ribas et al., 2010). Chapter 4 • FGT poverty measures ine studies consider impacts on N and (poverty headcount, poverty gap, squared poverty gap) Methods while only around two thirds find a statistically significant impact, with the exception of one they show a reduction in poverty. While cash transfers were shown to lead to an increase total and food expenditure for most programmes, it Chapter 5 appears that in many cases this impact is not big enough to have an effect on aggregate poverty levels. Findings on The evidence base the reduction of the poverty headcount range from a reduction of four percentage points (AIR, 2014) to almost nine percentage points (Skoufias et al., 2013). The poverty gap ranges from about a reduction of four percentage points for PROGRESA (Skoufias and di Maro, 2008) to about eight percentage points for Zambia’s Child Grant (AIR, 2014). SECTION II Variation in outcomes by gender: Chapter 6 ix studies reported sex-disaggregated outcomes. The low number of studies is probably due to the nature of the S • The impact of indicators considered under this outcome. Expenditure and poverty rates are mostly measured at the household cash transfers on level, which – by definition – cannot be disaggregated. None of the six studies finds a statistically significant monetary poverty difference between women/men or girls/boys. Two studies found a statistically significant increase in individual Chapter 7 expenditure for female recipients (Blattman et al., 2013; Green et al., 2015). The impact of cash transfers on Role of design and implementation features: education 9 studies report findings on the effects of design and implementation features on poverty. Almost all of these 1 • have at least one statistically significant finding, showing the importance of design and implementation features in Chapter 8 mediating poverty impacts. The impact of cash transfers on health • on non-durable expenditure, finding no significant difference between O ne study considered the main recipient and nutrition male and female recipients (Haushofer and Shapiro, 2013). and they find that a larger transfer is associated with bigger impacts on • our studies considered the transfer level F Chapter 9 expenditure and poverty reduction (three of these are significant). The impact of cash transfers on • transfer frequency wo studies considering T on household expenditure with contradictory findings (one of these is savings, investment statistically significant). and production duration of exposure ine studies considered • and seven of these are able to report statistically significant findings. N Chapter 10 The studies with statistically significant findings suggest that on the whole longer exposure to the programme is The impact of linked to higher expenditure levels. cash transfers on (Merttens et al., 2015). It found that the treatment arm targeted • ne study considered the targeting mechanism O employment towards a specific age category (the elderly) did not have a significant impact for food expenditure unlike for those targeted on the basis of a more general demographic vulnerability index; possibly because recipients saw the Chapter 11 transfer as a personal transfer not to be spent on food for the household as a whole. The impact of cash transfers on F complementary interventions and supply-side servicess ive studies considered . Participation in a • empowerment complementary intervention is statistically significant in four of the studies. In three of the studies participation in complementary interventions and supply-side programmes leads to an increase in expenditure, though mostly similar in magnitude as increases also experienced by cash transfer beneficiaries who did not participate in SECTION III complementary interventions and supply-side programmes. Chapter 12 Summary of findings and conclusion References

88 Cash transfers: what does the evidence say? Page 88 Contents S 6.1 ummary of findings Acknowledgements This section reports on the impacts of cash transfers on household poverty. The specific indicators Executive summary for which estimates are reported are: total expenditure, household food expenditure and the Foster–Greer–Thorbecke (FGT) poverty indicators, which include the poverty headcount, poverty SECTION I gap and squared poverty gap. A summary of the overall effects, how they vary by design and implementation features, and by gender is provided in Box 6.1. Chapter 1 Introduction As discussed in the conceptual framework in Chapter 2, cash transfers potentially affect household expenditure in the short and longer-term, when a cash transfer is spent or invested. Chapter 2 Conceptual When a cash transfer is spent (e.g. on food, household essentials, clothes, accessing basic services framework or on ‘desirable’ goods), by definition household expenditure increases – this subsequently affects the likelihood of being poor (if the poverty line is measured in terms of household expenditure). Chapter 3 When a cash transfer is invested (e.g. on agricultural assets, education a new family business), Review of cash this can raise future earnings and future spending potential and hence longer-term household transfer reviews expenditure. Hence, cash transfers can lead to an increase in expenditure (and decrease in poverty) Chapter 4 in the short and longer term. Methods As such, the rationale behind cash transfer is that they increase households’ purchasing power Chapter 5 and reduce poverty among beneficiary households. However, a transfer may also lead to changes The evidence base in individual or household behaviour and time use, which in turn affect expenditure and poverty. For example, a means-tested transfer of large value as a share of beneficiary income may generate SECTION II an incentive for recipients to reduce their work effort, leading to a reduction in wage income, offsetting progress in poverty reduction. Furthermore, depending on a household’s starting point Chapter 6 on the income distribution, among other factors, a household may choose to prioritise savings The impact of and investment over consumption, which could be an optimal outcome for the household, even if cash transfers on short-term expenditure is reduced. monetary poverty Chapter 7 Impacts across all three indicator areas were consistent in their direction of effect. The The impact of findings point largely towards an increase in total and food expenditure and a decrease in cash transfers on FGT poverty indicators. 35 studies reported findings on impact on total expenditure, with 26 education of these demonstrating at least one significant impact. Of these, 25 show an increase in total expenditure, with one decrease. Studies with non-insignificant findings point towards design Chapter 8 The impact of cash and implementation features as explanations, e.g. low level of transfers, infrequent transfers, as transfers on health well as changes in household behaviour, e.g. a labour supply effect. For food expenditure, of the and nutrition 31 studies, 25 found at least one significant impact. Again, the vast majority find an increase in food expenditure: 23. Seven studies find no significant impact on food expenditure, possibly due Chapter 9 to changes in household behaviour or due to programme design and implementation features. The impact of cash transfers on Giving just one example, Cheema et al. (2014) relate the lack of impact of Pakistan’s BISP to savings, investment the irregularity of transfer, with households spending the transfer – when it comes – on other and production expenditure items instead. Chapter 10 The main exception across both indicators is Albania’s Ndhima Ekonomike programme. Dabalen The impact of et al. (2008) argue that programme participation led to a decrease in household labour supply cash transfers on employment (strongly driven by cultural preferences) and subsequently household food and total expenditure. Ribas et al. (2010) found that beneficiary household participating in Paraguay’s Tekoporã Chapter 11 programme prioritised savings over consumption (possibly as a result of the attached family The impact of support programme), resulting in a decrease in food expenditure. cash transfers on empowerment With regard to FGT poverty indicators, the evidence base is smaller, with nine studies, and with about one third of the studies not finding a significant effect. This suggests that in many cases SECTION III the cash transfer may not be large enough, or beneficiaries may not have received the transfer long enough, to have an impact on aggregate poverty levels. The findings that are statistically Chapter 12 significant consistently point to a reduction in poverty. Nine studies report findings on the poverty Summary of headcount. For the poverty headcount, six show a significant effect, with five of these showing a findings and decrease in the poverty headcount. For the poverty gap, seven studies have statistically significant conclusion findings (of nine studies assessing this outcome) and six of these show a decrease in the poverty References gap. For the seven studies reporting findings on the squared poverty gap, five have a significant result and four of these show a reduction in the indicator. The one exception is again the Ndhima

89 Cash transfers: what does the evidence say? Page 89 Contents Ekonomike programme in Albania. Acknowledgements Executive summary S 6.2 ummary of evidence base In total, there were 44 studies from which evidence was extracted for the specific poverty SECTION I indicators reported in this study, covering 19 countries and 31 cash transfer programmes. Chapter 1 There was an even split between conditional and unconditional cash transfers, but with strong Introduction geographical biases. The vast majority of the Latin American cash transfers were conditional, whereas almost all African cash transfers were unconditional. Chapter 2 Conceptual Table 6.1 provides an overview of the countries and programmes the studies reported on. As framework can be seen, more than half of studies (24 out of 44) cover cash transfer programmes in Latin Chapter 3 America, with a disproportionate number of those (six) focusing on Mexico’s PROGRESA/ Review of cash Oportunidades programme and Nicaragua’s Red de Protección Social (four). Meanwhile, just 13 transfer reviews studies cover sub-Saharan Africa, four cover Asia and two look at an intervention in Europe or 69 Central Asia. Chapter 4 Methods Most studies were of programmes that had been operating at a large scale over a number of Chapter 5 years. However, a number of studies (particularly from sub-Saharan Africa and Asia) report on The evidence base findings from small experimental studies or pilots that were limited in scale. As such, the findings from these studies may be more limited in their external validity and applicability to other SECTION II settings. Chapter 6 A range of different study designs and estimation methods were used in order to estimate the The impact of effect of cash transfers or their design and implementation features on the selected poverty cash transfers on indicators. Table 6.2 provides a summary of these. As can be seen, about half were based on monetary poverty an RCT design, with the remainder using observational data and employing some form of Chapter 7 difference-in-differences (DID), regression discontinuity design (RDD), instrumental variables The impact of (IV) or ordinary least squares (OLS) regression. cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 69 N ote: The totals in the final column of Table 5.1 do not add to the total number of studies as two studies report results for more than one programme.

90 Cash transfers: what does the evidence say? Page 90 Contents Table 6.1: Summary of countries and programmes reported on for the poverty indicators (all studies) Acknowledgements Details if pilot or experimental study* Type of cash # studies Country Programme transfer Executive summary Total number of studies: 44 Latin America : 24 studies SECTION I Bonosol pension UCT 1 Bolivia Bolsa Alimentação CCT 1 Brazil Chapter 1 Introduction CCT Familias en Acción Colombia 2 Bono de Desarrollo Humano Ecuador 2 CCT Chapter 2 Conceptual WFP Colombian refugee RCT Two provinces near Colombian border 1 Ecuador CCT framework 6 Mexico CCT PROGRESA/Oportunidades PROCAMPO CCT 1 Mexico Chapter 3 Review of cash 2 Mexico Programa Apoyo Alimentario (PAL) CCT transfer reviews Nicaragua CCT Red de Protección Social 4 Chapter 4 Experiment 2 CCT Atención a Crisis Nicaragua Methods CCT Tekoporã Paraguay 1 1 Peru Juntos CCT Chapter 5 The evidence base Africa: 14 studies 1 Ghana Innovation for poverty randomised trial UCT Three-year field trial SECTION II UCT/CCT Ghana Livelihood Empowerment Against Poverty (LEAP) 1 Give Directly experiment UCT Kenya 1 Two-year experiment run by Give Directly Chapter 6 Kenya Hunger Safety Net Programme (HSNP) Kenya Phase 1 of programme roll-out 1 UCT The impact of cash transfers on 1 UCT Kenya cash transfer-OVC Kenya monetary poverty 1 Lesotho Child Grant Programme UCT Chapter 7 Malawi UCT Pilot phase (one district) 1 Social Cash Transfer Programme The impact of Uganda Youth Opportunities Program (YOP), CCT 1 Part of Northern Uganda Social Action Fund cash transfers on UCT Two pilots 1 Social Assistance Grants for Empowerment (SAGE) Uganda education 2 Not for profit short-term programme, two Enterprise grant Women’s Income Generating Support (WINGS) Uganda Chapter 8 districts The impact of cash 1 CCT WFP Karamoja Cash Transfer Pilot Uganda Three districts transfers on health Pilot (one district) 1 UCT Monze Cash Transfer Pilot Zambia and nutrition Child Grant Cash Transfer Zambia 1 UCT Chapter 9 East Asia and Pacific: 2 studies The impact of cash transfers on CCT Program Keluarga Harapan Indonesia 1 savings, investment One year compensation for removal of fuel 1 UCT Temporar y UCT Indonesia and production subsidies South Asia: 2 studies Chapter 10 The impact of Shombhob CCT 10 unions from two rural Upazilas and one Bangladesh 1 urban slum cash transfers on employment 1 Pakistan BISP UCT Europe and Central Asia: 2 studies Chapter 11 The impact of Ndhima Ekonomike UCT Albania 1 cash transfers on Kazakhstan 1 Programme operated between 2009–2014 CCT BOTA programme empowerment * This information, for papers that report results from a pilot/experimental implementation, helps distinguish such papers from those that cover cash transfer policies/programmes that are operational at a larger scale SECTION III and/or are long-term/permanent. It provides a ‘flag’ for findings which may have more limited external validity or where it has not been shown that the evidence would necessarily hold at a larger scale. Chapter 12 Summary of findings and conclusion References

91 Cash transfers: what does the evidence say? Page 91 Contents Table 6.2: Summary of study methods used for poverty indicators Acknowledgements Study design and methods used for reported results Reports Study Reports effect Reports sex- of design and total effect disaggregated Executive summary implementation outcomes features? Yes QE (DID, PSM) A IR (2014) Yes SECTION I Yes QE (DID, PSM) Angelucci et al. (2012) QE (OLS, panel data) Yes Attanasio et al. (2012) Chapter 1 Introduction Attanasio and Mesnard (2005) Yes QE (DID, controlling for observable household and community differences) Chapter 2 Yes QE (DID, with some use of PSM) Bazzi (2013) Conceptual Yes Yes Yes RCT (DID, complier average causal effect) Blattman et al. (2013) framework Yes RCT (DID) Yes Blattman et al. (2015) Chapter 3 Braido et al. (2012) Yes QE (OLS, cross-sectional data) Review of cash Buser et al. (2014) Yes QE (RDD, cross-sectional data) transfer reviews Yes QE (RDD, panel data) Cheema et al. (2014) Chapter 4 QE (PSM, panel data) Yes Dabalen et al. (2008) Methods Davis et al. (2002) Yes Yes QE (OLS, panel data) Chapter 5 QE (DID, IV) Yes Yes Edmonds and Schady (2012) The evidence base Yes QE (DID, RDD) Ferré and Sharif (2014) Galiani et al. (2014) QE (DID, controlling for individual and locality characteristics) Yes SECTION II Gertler et al. (2012) RCT (DID, OLS) Yes Yes Gilligan et al. (2013) Yes RCT (ANCOVA, panel data) Chapter 6 RCT (DID, controlling for time-invariant characteristics) Yes Gitter and Caldes (2010) The impact of RCT (DID) Yes Yes Yes Green et al. (2015) cash transfers on monetary poverty Yes Yes QE (DID, PSM) Handa et al. (2014) Handa et al. (2009) QE (OLS, panel data) Yes Yes Chapter 7 Yes Yes Haushofer and Shapiro (2013) Yes RCT (DID, OLS) The impact of cash transfers on Hidrobo et al. (2012) RCT (ANCOVA, panel data) Yes education RCT (IV, cross-sectional data) Karlan et al. (2014) Yes Yes Yes RCT (2SLS, panel data) Macours et al. (2012) Chapter 8 The impact of cash Yes Yes RCT (Seemingly unrelated regression, panel data) Macours et al. (2012) transfers on health RCT (DID, controlling for fixed effects) Yes Maluccio (2005) and nutrition Yes RCT (DID, unknown estimation method) Maluccio and Flores (2005) Chapter 9 RCT (DID, controlling for household characteristics) Maluccio (2010) Yes The impact of QE (DID, controlling for household and community characteristics) Martinez (2004) Yes Yes cash transfers on Merttens et al. (2013) Yes RCT (DID, controlling for household and community savings, investment characteristics) and production Yes Merttens et al. (2015) QE (DID, PSM) Yes Chapter 10 Miller et al. (2011) Yes RCT (DID, with controls) The impact of O’Brien et al. (2013) Yes RCT (IV, panel data) cash transfers on Yes Palermo et al. (2012) RCT (DID, with controls) employment Yes RCT (DID, OLS) Pellerano et al. (2014) Chapter 11 Perova and Vakis (2012) (IV, cross-sectional data) Yes Yes The impact of QE (PSM, longitudinal data) Yes Ribas et al. (2010) cash transfers on empowerment Ruiz-Arranz et al. (2002) RCT (OLS and IV, cross-sectional data) Yes Seidenfeld and Handa (2011) QE (DID, PSM) Yes Skoufias et al. (2013) RCT (DID, controlling for household and village characteristics) Yes SECTION III RCT (DID, with controls) Yes Skoufias and di Maro (2008) Chapter 12 Skoufias et al. (2008) RCT (DID, with controls) Yes Summary of World Bank (2011) QE (IV, cross-sectional data) Yes findings and conclusion QE=Quasi-experimental approach, RDD = Regression Discontinuity Design, RCT = randomised controlled trial, DID = difference-in-difference, PSM = propensity score matching, IV = instrumental variables, References ANCOVA = analysis of covariance.

92 Cash transfers: what does the evidence say? Page 92 Contents T he impact of cash transfers on poverty 6.3 Acknowledgements Tables 6.3 to 6.7 below summarise the effects of cash transfers on the indicators under Executive summary consideration. Where any effects associated with design or implementation features were found, these are not reported in the tables, but are discussed in section 6.5. Similarly, all sex- SECTION I disaggregated results are discussed in section 6.4. Chapter 1 Introduction Total expenditure Chapter 2 Total expenditure – also called consumption – measures all expenditure by a household within a Conceptual specified unit of time, including expenditure on food, household essentials, clothes, services and framework investment. From the 35 studies that looked at the overall effect on total expenditure, 38 findings Chapter 3 were extracted for this review (Table 6.3). Of the 35 studies, 26 found statistically significant Review of cash effects (these coefficients are reported in bold in Table 6.3). transfer reviews As cash transfers increase households’ purchasing power, households are likely to expand their Chapter 4 expenditure (depending on savings patterns and possible labour supply effects). Of the 26 studies Methods significant with impacts, 25 were associated with an increase in total household expenditure, with Chapter 5 one significant . Increases in expenditure are found for both conditional and unconditional decrease The evidence base transfers. In Table 5.3 we give the impact coefficient, as reported by the authors. To give two examples, participation in Zambia’s Child Grant, a UCT, resulted in an increase in per capita monthly total expenditure of 10.44 Zambian kwacha (AIR, 2014), compared to a baseline mean SECTION II of 40.48 Zambian kwacha. Attanasio et al. (2005) found participation in Colombia’s Familias en Chapter 6 Acción to increase total monthly consumption expenditure by 52,576 Colombian pesos for urban The impact of households – this represents a 15% increase compared to mean baseline consumption. Of those cash transfers on studies reporting change in percentage points, the increases range from a 5.3 percentage point monetary poverty change in total per capita expenditure for Brazil’s Bolsa Alimentação (Braido et al., 2012) to a 33 percentage point change in total expenditure for Juntos (Perova and Vakis, 2012). Chapter 7 The impact of cash transfers on Cash transfers can also reduce household expenditure by changing individual or household education behaviour and time use. One study reported a significant decrease in total expenditure: Dabalen et al. (2008) found that receipt of Ndhima Ekonomike, a UCT, led to a decrease of 1,037 leks Chapter 8 in monthly real per capita expenditure, compared to a mean baseline value of 8,762 leks. The The impact of cash transfers on health authors argue that this decrease is driven by a decrease in labour force supply among work-eligible and nutrition individuals, with particularly large decreases in labour force participation among urban residents and women. Chapter 9 The impact of It is difficult to compare the size of the effects due to the different methods applied (particularly cash transfers on savings, investment different units of measurement). Ideally, we would have compared these to baseline values of and production household expenditure, but this information is not available in all studies. Of the studies that report on the same interventions, impacts are broadly similar. For example, Angelucci et al. Chapter 10 (2012), Davis et al. (2002) and Gertler et al. (2012) respectively report effects of 5.49 pesos The impact of (monthly), 14.294 (monthly) and 10.836 pesos (per capita) for Oportunidades/PROGRESA. cash transfers on employment Eight studies found a non-significant impact on total expenditure. Five of these were UCTs and Chapter 11 three were cash transfers. Explanations given by authors for non-significant impacts include: The impact of cash transfers on T • he low level of the transfer : cited for Kazakhstan’s BOTA CCT (O’Brien et al., 2003) and empowerment Ghana’s LEAP UCT (Handa et al., 2014). D • : cited for Indonesia’s temporary UCT (Bazzi, 2013), elays in the disbursement of transfers SECTION III Ghana’s LEAP UCT (Handa et al., 2014) and Lesotho’s Child Grant (Pellerano et al., 2014). I • nfrequent transfers : cited for Lesotho’s Child Grant (Pellerano et al., 2014). Chapter 12 Summary of T • he prioritisation of savings over consumption : Ribas et al. (2010) found that ‘family guides’, findings and tasked with helping recipients of Paraguay’s Tekoporã’s CCT plan their budgets, were very conclusion effective in pushing recipients towards precautionary savings at the expense of consumption References expenditures. As such, even though saving was not an explicit condition of the programme, beneficiary households felt that they should be saving part of the transfer.

93 Cash transfers: what does the evidence say? Page 93 Contents a l • abour supply effect : Edmonds and Schady (2012) found that in Ecuador the additional Acknowledgements income from the Bono de Desarrollo Humano, a CCT conditional on school attendance, was not big enough to replace foregone child labour income Executive summary • : cited for Ghana’s Innovation for poverty n incomplete capture of all expenditure categories a randomised trial (Karlan et al., 2014). SECTION I In other words, design and implementation features (as well as contextual factors) mediate Chapter 1 impacts. These features will be considered in more detail in section 6.5. We also see that Introduction household behavioural changes can potentially affect impact. Chapter 2 Conceptual Food expenditure framework Chapter 3 Food expenditure, measuring expenditure on food and with imputed values for own production, Review of cash is an important poverty measure, as food expenditure tends to be the biggest expenditure item for transfer reviews poor households. In this review, we extract findings on absolute food expenditure (not as a share of total household expenditure, types of food consumed or adequacy of food consumed). Of the Chapter 4 Methods 31 studies that looked at the overall effect on food expenditure, 35 impacts were extracted for this review (Table 6.4). Of these 31 studies, 25 found at least one statistically significant effect (these Chapter 5 coefficients are reported in bold in Table 6.4). The evidence base Depending on programme design and the beneficiary household’s circumstances (e.g. in terms SECTION II of poverty status), food expenditure is likely to increase as a result of cash transfers. Of the 25 studies with statistically significant effects, 23 showed an increase in food expenditure. Of those Chapter 6 absolute finding increases in food expenditure, some impacts were quite small in terms, for The impact of example AIR (2014) find that Zambia’s Child Grant Programme has an impact of 7.56 Zambian cash transfers on kwacha (about US$0.60) on food expenditure, compared, however, to a baseline mean of 30 monetary poverty kwacha. Buser et al. (2014), on the other hand, find that Ecuador’s Bono Desarrollo Humano had Chapter 7 an impact of US$21 on monthly food expenditure (with transfer ranging from US$15–US$35). The impact of For those studies that measured the effects in percentage changes of food expenditure, the change cash transfers on ranges from 4.9% point change for Nicaragua’s Atención a Crisis (Macours et al., 2012) to a 26% education point change for Nicaragua’s Red de Protección Social (Maluccio, 2005). Chapter 8 The impact of cash Two studies found a statistically significant decrease on food expenditure: one is for the transfers on health unconditional Ndhima Ekonomike transfer in Albania and the other one is for the conditional and nutrition cash transfer Tekoporã in Paraguay. As seen above, Dabalen et al. (2008) explain the decrease household total and food expenditure in Albania with the decrease in labour force supply Chapter 9 among beneficiaries. Ribas et al. (2010) found that beneficiary household participating in The impact of cash transfers on Paraguay’s Tekoporã programme prioritised savings over consumption as a result of the powerful savings, investment precautionary savings message transmitted by family budget guides (see above), despite this not and production being an official condition, resulting in a decrease of food expenditure. Chapter 10 Eight studies found a non-significant impact on food expenditure. Six of these showed an increase The impact of cash transfers on in food expenditure and two showed a decrease. Six of the studies evaluated a UCT and one employment evaluated a cash transfer. However, none of the authors link the lack of impact to the fact that the transfers are conditional. Merttens et al. (2015) argue that – in the treatment arm where Chapter 11 the programme is delivered as an old-age grant – Uganda’s SAGE transfer has not influenced The impact of household food expenditure because beneficiaries perceive this to be a personal rather than cash transfers on household transfer. Palermo et al. (2012) explain the non-significant decrease of Kenya’s Cash empowerment Transfer for Orphans and Vulnerable Children by a shift in the beneficiary household’s Engel curves. In other words, the share of income households tend to spend on food changed as a SECTION III result of the cash transfer. Cheema et al. (2014) relate the lack of impact of Pakistan’s BISP to the irregularity of transfer, with households spending the transfer – when it comes – on other Chapter 12 expenditure items instead. Summary of findings and conclusion References

94 Cash transfers: what does the evidence say? Page 94 Contents Poverty headcount Acknowledgements Apart from looking at the effects of cash transfers on expenditure, it is valuable to consider Executive summary whether cash transfers affect the poverty levels of beneficiaries. Depending on the level of the poverty line and the magnitude of the impact of the cash transfer on expenditure, the cash transfer may move households above the poverty line. SECTION I Chapter 1 We use the three indicators developed by Foster–Greer–Thorbecke (1984) which measure Introduction poverty and inequality. The FGT indicators are measured at the household level, but aggregated at the population level and are calculated with either income or expenditure data. The poverty Chapter 2 headcount measures the proportion of the population that is poor (i.e. their income/expenditure is Conceptual framework below the poverty line). It gives us an idea of the share of the population that is poor. The poverty poor households are, by measuring how poor gap measures the extent of poverty, in other words Chapter 3 the distance between household income/expenditure and the poverty line. The final measure, Review of cash poverty severity or the squared poverty gap, measures inequality among poor households. It takes transfer reviews the average of the squared poverty gaps, hence placing greater value on poorer households. Chapter 4 Methods poverty headcount found a statistically Six of the nine studies that included impacts on the significant effect (Table 6.5). Five of these found a decrease in the poverty headcount. For example Chapter 5 AIR (2014) found that the poverty headcount among beneficiaries of Zambia’s Child Grant had The evidence base decreased by 4.1 percentage points after 36 months, compared to non-beneficiaries. Skoufias et al. (2013) found that the poverty head count for beneficiaries of the Programa Apoyo Alimentario SECTION II (PAL) in Mexico decreased by 8.8 percentage points. The biggest effect was found for the BISP Programme in Pakistan: Cheema et al. (2014) found that participation in the programme led Chapter 6 to a decrease in the headcount of 22 percentage points; however this impact may be slightly The impact of 70 The only increase in the share of poor, was found for Albania’s Ndhima overestimated. cash transfers on Ekonomike, as study discussed above (Dabalen et al., 2008). monetary poverty Chapter 7 About a third of the studies looking at poverty, do not find a significant effect on poverty The impact of levels of beneficiary households, yet these all had a negative coefficient for poverty levels (i.e. a cash transfers on reduction in the poverty headcount), as to be expected in theory. That is an important finding education in itself. While the previous section showed that cash transfers largely increase total and to impact on food expenditure, it appears that in many cases this impact is not large enough Chapter 8 The impact of cash aggregate poverty levels. Poverty levels may also be slower to respond and may only change when transfers on health beneficiaries have been exposed for a longer time. For example, Merttens et al. (2015) explain and nutrition that at the time of the evaluation SAGE beneficiaries had just received three monthly payments and that impacts on poverty may become more pronounced once a programme has been running Chapter 9 over a longer period. The impact of cash transfers on savings, investment Poverty gap and production Chapter 10 The poverty gap measures how far an average household is below the poverty line, hence giving The impact of a better idea of how poor poor households are. Nine studies reported findings on this indicator, cash transfers on and seven of these have at least one statistically significant effect (Table 6.6). As for the poverty employment headcount, about one third of studies do not find a significant impact. With the exception of the Chapter 11 decrease study looking at the Ndhima Ekonomike programme, the studies find a in the poverty The impact of gap. For example, Perova and Vakis (2012) find that participation in Juntos leads to a reduction cash transfers on in the poverty gap of almost 14 Peruvian soles. Merttens et al. (2013) find that participation empowerment in Kenya’s Hunger Safety Net Programme led to a reduction of seven percentage points in the poverty gap among beneficiaries, compared to control households. SECTION III Coefficients for these studies are not comparable, as some measure the absolute poverty gap, Chapter 12 whereas others measure the poverty gap index as a share of the poverty line. Summary of findings and conclusion References 70 T hey use RDD to estimate the local average treatment effect. This means that they measure ‘the impact of the BISP for households in the extremely close neighbourhood of the BISP eligibility threshold, which given correlation between poverty rates and the BISP poverty score are likely to be over-represented by households closest to the national poverty line’ (Cheema et al., 2014).

95 Cash transfers: what does the evidence say? Page 95 Contents Squared poverty gap Acknowledgements The squared poverty gap is also known as poverty severity, and is a measure of the inequality Executive summary among poor households, giving greater weight to those households further away from the poverty line. Of the seven studies, five have statistically significant findings. Of these, four find a reduction in the squared poverty gap, with the exception again being the Dabalen et al. (2008) study on SECTION I Albania (Table 6.7). For example, Merttens et al. (2013) find that participation in the Hunger Chapter 1 Safety Net Programme led to a reduction of seven percentage points in the squared poverty gap Introduction among beneficiaries, compared to control households. Chapter 2 Coefficients for these studies are not comparable, as some measure the absolute squared poverty Conceptual framework gap, whereas others take the squared poverty gap index as a share of the poverty line. Chapter 3 Review of cash 6.4 T he impact of cash transfers on poverty indicators for women transfer reviews and girls Chapter 4 Methods Six studies report sex-disaggregated outcomes, likely reflecting the nature of the indicators considered Chapter 5 for this outcome. Expenditure and poverty rates are mostly measured at the household level, which The evidence base – by definition – cannot be disaggregated. Two studies report individual expenditure , and compares the programmes’ impacts on female versus male recipients. The four remaining studies either consider the impact on household-level expenditure by sex of the household head, oldest household member SECTION II or recipient. As such, these studies are testing the hypothesis that women have different expenditure patterns, for instance that women are more likely to spend the transfer on food. Chapter 6 The impact of cash transfers on did not find a statistically significant impact for women , be these female Four of the studies monetary poverty beneficiaries, female-headed households or households where the eldest member is female (Table A.5.1.1). The two studies that do find a statistically significant effect of the transfer for women, Chapter 7 showing an increase in expenditure compared to non-recipients (Blattman et al., 2013; Green The impact of cash transfers on et al., 2015), find no statistically significant difference between the impact for men and women. education As such, this review finds no evidence that female-headed households or households with female beneficiaries have different impacts for total and food expenditure to male-headed households or Chapter 8 households with male beneficiaries. The impact of cash transfers on health The six studies found the following impacts: and nutrition • lattman et al. (2013) consider the impact of a Ugandan experimental cash transfer on B Chapter 9 non-durable expenditure. They look at both male and female recipients and find individual The impact of cash transfers on significant increases in expenditure for both, in comparison to non-beneficiaries. The impact savings, investment of programme participation on short-term expenditure is seven Ugandan shillings males (a and production 13% increase compared to controls, p<0.01) and eight shillings for females (a 16% increase; p<0.05). While effects are bigger in absolute and relative terms for women (possibly hinting at Chapter 10 credit constraints for females in the control group), the difference between women and men is The impact of cash transfers on not statistically significant. employment G • reen et al. (2015) also report impacts on individual-level non-durable expenditure, but for Chapter 11 Uganda’s WINGS programme. They compare the impact for male and female beneficiaries The impact of combined (0.46 z-score units) to the impact for just female beneficiaries (0.41 z-score units); cash transfers on both are statistically significant at the 1% level. While both impacts are positive, the coefficient empowerment for only female beneficiaries is somewhat lower in magnitude. The authors do not report whether this difference is statistically significant. SECTION III • dmond and Schady (2012) considered the sex of the recipient in the evaluation of the CCT E Bono de Desarrollo Humano programme in Ecuador, comparing total annual household Chapter 12 expenditure for households with only female beneficiaries to non-beneficiaries and those with Summary of findings and only male beneficiaries to non-beneficiaries. The programme does not have a significant impact conclusion on household expenditure for households with children of either gender. However, for boys there is an increase, while for girls the coefficient has a negative sign and is much bigger in References magnitude. The authors hypothesise that this is the case because girls experienced much larger declines in work for pay, which resulted in large losses of income for these households.

96 Cash transfers: what does the evidence say? Page 96 Contents aushofer and Shapiro (2013) considered the sex of the recipient in the evaluation of the two- H • Acknowledgements year experiment run by Give Directly in Kenya. They compare the impact of the beneficiary being female to that of the beneficiary being male. While being a female recipient leads to a Executive summary significant. The authors not decrease of total household non-durable expenditure, the effect is hypothesise that the effect is non-significant because transfers did not affect the bargaining power of the different household members as transfers were explicitly temporary. SECTION I H • anda et al. (2014) consider the impact of Ghana’s LEAP programme and disaggregate the Chapter 1 findings by male- and female-headed household, comparing each group to non-beneficiaries. Introduction For both female and male-headed households the effect of the cash transfer has a negative and Chapter 2 non-significant coefficient, though the magnitude of the impact is somewhat larger for male- Conceptual headed households. The authors find a small increase in food expenditure for female-headed framework households (1.87 Ghc) and, for households with male heads, a decrease in food expenditure that is somewhat bigger in magnitude (-7.51 Ghc); however neither coefficient for sex of the Chapter 3 household head is significant. Review of cash transfer reviews inally, the study by Martinez (2004) explores a gender component in addition to the overall F • cash transfer impact of Bolivia’s Bonosol pension. The author considers the impact of the Chapter 4 Methods interaction of being eligible for the programme and the oldest person in the household being female on monthly household food expenditure, compared to those in which the oldest member Chapter 5 is male. The effect shows a decrease (-14 bolivianos), yet one that is not significant and is also The evidence base smaller in magnitude compared to the overall impact of the cash transfer (68 bolivianos). SECTION II 6.5 T he role of cash transfer design and implementation features Chapter 6 The impact of A total of 19 studies reported 27 specific findings on the effect of cash transfer design and cash transfers on implementation features on poverty measures (see Table A.5.1.2 for the detailed findings). There monetary poverty is more evidence on variations in core design features (main recipient, transfer level and transfer Chapter 7 frequency) and complementary interventions and supply-side services than on other aspects. The impact of There is no evidence on conditionality, payment systems or grievance channels. Of the 19 studies, cash transfers on 16 report at least one statistically significant effect. This means that variations in design and education implementation features do mostly affect poverty outcomes. Chapter 8 The impact of cash Findings on core design features are reported by 14 studies. One study considered the effect of transfers on health the identity of the main recipient on expenditure, finding no significant difference between male and nutrition and female recipients (Haushofer and Shapiro, 2013). Four studies consider transfer level and they find that a larger transfer is associated with bigger impacts on expenditure and poverty Chapter 9 reduction (three of these are significant). Two studies, considering the effect of transfer frequency The impact of cash transfers on on expenditure, had contradictory findings. One found that more frequent transfers led to a savings, investment decrease in monthly durable expenditure (Haushofer and Shapiro, 2013) and the other found that and production more frequent transfer within the first year led to higher expenditure growth (Bazzi, 2013). A total of nine studies considered duration of exposure and seven of these report statistically significant Chapter 10 findings. The studies with statistically significant findings suggest that, on the whole longer, The impact of cash transfers on exposure to the programme is associated with higher expenditure levels. employment There is only one study that deals with targeting (Merttens et al., 2015). It found that the Chapter 11 treatment arm targeted towards a specific age category (the elderly) did not have a significant The impact of impact on food expenditure, unlike those targeted according to a more general demographic cash transfers on vulnerability index, possibly because recipients saw the transfer as a personal transfer not to be empowerment spent on food for the household as a whole. SECTION III Finally, there are five studies that consider the effects of different complementary interventions and supply-side services. On the whole, the evidence that participation in complementary interventions Chapter 12 leads to an increase in expenditure, as compared to those that do not participate in the Summary of findings and complementary intervention, is weak. For instance, two studies considered these complementary conclusion interventions: a voucher for participation in vocational training and a lump sum to start a business. Households receiving complementary interventions had slightly bigger impacts on total References expenditure after one year, but not significantly so, possibly because the effects of complementary interventions take time to affect household expenditure.

97 Cash transfers: what does the evidence say? Page 97 Contents The studies showing design and implementation impacts are now discussed in more detail. Acknowledgements Main recipient Executive summary H • aushofer and Shapiro (2013) evaluated different designs as part of the two-year experiment run by Give Directly in Kenya, including having male and female beneficiaries. Targeting a SECTION I female recipient, compared to a male recipient, was associated with a small and non-significant decrease in monthly non-durable expenditure of -US$2.74. Chapter 1 Introduction Transfer levels Chapter 2 • D avis et al. (2002) consider the effect of the level of Mexico’s PROGRESA and PROCAMPO, Conceptual both for beneficiaries and non-beneficiaries. This means they capture both the effect of framework . being a beneficiary and the transfer level Since the transfer levels for both programmes vary Chapter 3 considerably, this analysis gives us a useful picture of variations in transfer size. The authors Review of cash find a positive coefficient for transfer level for both programmes, significant at the 1% level. transfer reviews More specifically, an additional PROGRESA peso leads to a 0.355 peso increase in per capita food expenditure and an additional PROCAMPO peso leads to a per capita 0.386 peso Chapter 4 Methods increase in food expenditure. Similar increases, also significant, are found for total expenditure (a per capita increase of 0.406 pesos and 0.702 pesos for PROGRESA/PROCAMPO Chapter 5 respectively). The evidence base • H anda et al. (2009), also reporting on PROGRESA, likewise capture the hybrid effect of programme participation and transfer level. They also find an increase in total and food SECTION II expenditure for increases in transfer level. An additional PROGRESA peso leads to an impact on total household expenditure of 0.034 log points, with similar findings for food expenditure, Chapter 6 The impact of both of which are significant. cash transfers on B lattman et al. (2013) evaluate the impact of variations in grant size of Uganda’s Youth • monetary poverty Opportunities Programme. A 1% increase in grant size is associated with a 4% increase in Chapter 7 short-term expenditure. However, the effect is not statistically significant. The impact of H • two-year experiment run by Give aushofer and Shapiro (2013) consider the impact of a cash transfers on education on non-durable expenditure. They directly compare the impacts of transfers of Directly different sizes. Those that received large transfers (compared to small transfers) had an increase Chapter 8 in monthly non-durable expenditure of US$20.37. The impact of cash transfers on health Transfer frequency and nutrition B temporary Indonesian UCT azzi (2013) considers transfer frequency of a • . One year after the Chapter 9 programme started, beneficiaries that only received the transfer once had significantly lower The impact of cash transfers on growth in log total household expenditure per capita than those that had already received the savings, investment transfer twice (-0.091 and 0.074 respectively). Yet the effect of differential transfer frequency and production in the first year had no long-term effects: two years after the programme, when all beneficiaries had received full four quarterly transfers, there was no longer a statistically significant Chapter 10 difference between the two groups. The impact of cash transfers on H aushofer and Shapiro (2013) consider the impact of a • two-year experiment run by Give employment on non-durable expenditure. Those that received the transfer more frequently Directly Chapter 11 (monthly instead of one lump sum) had a small, non-significant decrease in monthly non- The impact of durable expenditure of -US$4.4. cash transfers on empowerment Duration of exposure T he study conducted by AIR (2014) considered duration of exposure to Zambia’s Child Grant • SECTION III Cash Transfer Programme. More specifically, they measured the difference between the impact after 24 months and the impacts after 36 months. The difference is negative – the impact on Chapter 12 total household per capita monthly expenditure is four Zambian kwacha less than after 24 Summary of findings and months – but not significant. Effects on poverty measures are also not significant. conclusion A • ngelucci et al. (2012) consider the duration of exposure to Oportunidades on total and References food expenditure. They find bigger impacts for longer duration on food expenditure but not total expenditure. Households participating for one year had an increase in monthly total

98 Cash transfers: what does the evidence say? Page 98 Contents expenditure of 5.82 pesos and those participating for two years had an increase in monthly Acknowledgements food expenditure total expenditure of 5.49 pesos. For food expenditure the impacts on annual are 168.54 pesos and 282.85 pesos respectively. Executive summary W hile most studies consider impacts after fairly short periods of time, Gertler et al. (2012) • consider Oportunidades’ impacts on total household per capita consumption for households SECTION I that have just joined in the past year, compared to those that joined four years earlier. They find that expenditure for the latter group is 10.836 pesos higher, indicating that participation Chapter 1 in the programme leads to long-term improvements in living standards (especially given that Introduction beneficiaries are granted a minimum of nine years in programme participation). Chapter 2 user et al. (2014) evaluate duration of exposure for Ecuador’s Bono Desarrollo Humano B • Conceptual programme. Those beneficiaries that still receive the transfer (compared to those that lost framework access two years ago) have monthly household food expenditure that is US$16.383 higher; Chapter 3 however the effect is not significant. The authors highlight the benefits of continuing to receive Review of cash the programme, yet this finding also suggests that the effects of programme participation may transfer reviews not be sustained. Chapter 4 • P erova and Vakis (2013) consider the impacts of Juntos in Peru after participation for 12–23 Methods months, 24–36 months and more than 36 months. The impacts on overall expenditure are all greater than zero, statistically significant and increasing in magnitude (0.009, 0.11 and Chapter 5 The evidence base 0.15 respectively). The impacts on the poverty headcount are also bigger for beneficiaries with longer treatment spells and significant (findings for the poverty gap are not significant). The authors argue that while impacts on expenditure and poverty reduction are bigger for SECTION II those that participated longer in the programme, the differences between coefficients are not statistically significant, so there is no evidence that ‘impacts on poverty accumulate’ or become Chapter 6 The impact of stronger over time. cash transfers on M on nominal annual aluccio and Flores (2005) report the impact of Red de Protección Social • monetary poverty total per capita expenditure and nominal annual food per capita expenditure after one and two Chapter 7 years. The impact of the programme has a positive coefficient and is statistically significant The impact of after both one and two years, but the magnitude of the impact is smaller after two years. cash transfers on However, the authors do not test if the difference between years is statistically significant. education Maluccio (2010) reports very similar findings for the same programme and exposure. Chapter 8 M • iller et al. (2011) consider the impact of the Social Cash Transfer Programme in Malawi The impact of cash on weekly per capita total expenditures and on weekly per capita food expenditures after six transfers on health months and after one year. They find a statistically significant increase for both time periods, and nutrition though larger after one year. However, the authors do not test if the difference between Chapter 9 exposures is statistically significant. The impact of cash transfers on Targeting mechanism savings, investment and production M erttens et al. (2015) compare two different targeting designs for the SAGE programme • for Uganda. One treatment arm uses age to determine eligibility with over 60s/65s targeted, Chapter 10 depending on the region. Another treatment arm targeted on the basis of a composite The impact of cash transfers on index based on demographic indicators of vulnerability. They find a significant increase in employment monthly food expenditure for the latter group (of 8,500 Ugandan shillings) but the impact for the former group (of 1,500 shillings) is not significant. For total household expenditure a Chapter 11 significant increase for both groups is found. The authors account for the lack of significance The impact of on food expenditure for the age-targeted households with the hypothesis that this transfer cash transfers on is seen as a personal transfer by recipients, which is spent on personal items (e.g. clothing). empowerment Effects on poverty measures are all not significant. SECTION III Complementary interventions and supply-side services Chapter 12 B • lattman et al. (2015) consider design variations for the WINGS programme in Uganda; they Summary of measure the effect of a five-day business training course that some beneficiaries attended and findings and the effect of supervision visits. Only participation in the business training has a statistically conclusion significant impact on expenditure. Households where the beneficiary received the training have References higher monthly non-durable expenditure than non-beneficiaries (the impact is 33,439 shillings), and the impact is slightly higher than that for non-training participants (31,031 shillings), with

99 Cash transfers: what does the evidence say? Page 99 Contents both significant at the 1% level. However, the difference between the training and no-training Acknowledgements impacts are not statistically significant. There is no statistically significant effect for having had two or five supervision visits. Executive summary G reen et al. (2015) also consider the WINGS programme in Uganda, but test whether women • attended the training alone or with their husbands (in Phase 2 of the programme) affected SECTION I individual non-durable expenditure. For both groups we see a decrease in expenditure, compared to beneficiaries from Phase 1, though only the impact for women attending with Chapter 1 husbands is statistically significant, and it is also bigger in magnitude (-0.28 z-score units). Introduction K • arlan et al. (2014) look at the Innovation for Poverty Action randomised trial (Ghana). They Chapter 2 report the impact on total household expenditures for beneficiaries receiving both the cash Conceptual transfer, as well as agricultural insurance. The impact shows an increase, but non-significant framework and lower in magnitude than cash-only beneficiaries (though that impact is also non- Chapter 3 significant). Review of cash 71 transfer reviews considered the impact of complementary interventions associated with • M acours et al. (2012) Atención a Crisis in Nicaragua. They compared households that received the basic treatment Chapter 4 received a scholarship to participate in a in addition (a bi-monthly CCT) to those that Methods in addition received a lump-sum payment to start vocational training course and to those that a small non-agricultural activity. Impacts on log total per capita expenditure have a positive Chapter 5 The evidence base coefficient and statistically significant for all three treatment arms, but while the coefficients for the scholarship and lump-sum group are only slightly bigger (0.281 log points for the basic treatment group, 0.285 log points for the scholarship treatment group and 0.331 log points SECTION II for the lump-sum group). A similar pattern is found after two years, but with mostly non- significant effects. The authors argue that not much of an effect on short-term expenditure Chapter 6 The impact of should be expected for the lump-sum group as the additional transfer is conditional on being cash transfers on invested in a business. Likewise, participation in vocational training is unlikely to affect monetary poverty expenditure in the short term. Chapter 7 The impact of olicy implications 6.6 P cash transfers on education The evidence on the impact of cash transfers on poverty outcomes shows an overwhelmingly Chapter 8 positive picture. Cash transfers are mostly having a statistically significant effect on beneficiary’s The impact of cash expenditure and poverty levels and when they do, they increase expenditure and reduce FGT transfers on health poverty indicators. As such, the evidence shows that cash transfers are effective in terms of and nutrition achieving one of their core objectives. Chapter 9 The impact of While the impact on total and food expenditure is statistically significant in the majority of cases, cash transfers on for FGT poverty indicators this is true for about two thirds of the studies. More specifically, with savings, investment a few minor exceptions, the impact of cash transfer leads to a reduction in FGT poverty measures, and production but in about one third of the cases the impact is not statistically significant. What this is telling Chapter 10 us is that while in many cases cash transfers are successful in raising beneficiary households’ The impact of expenditure, these changes are not big enough to have substantial effects on poverty. Some of the cash transfers on findings considering variations in design and implementation features provide an indication as to employment why this is the case. Chapter 11 The impact of The evidence base on the effect of design and implementation features on poverty impacts consists cash transfers on of 19 studies. There is relatively more evidence on core design features, compared to other empowerment indicators and no evidence on conditionality, payment systems and grievance mechanisms and programme governance. The majority of studies find at least one statistically significant effect, suggesting that design and implementation features matter in shaping poverty impacts. SECTION III Chapter 12 Why do cash transfers not always have the expected impact on poverty? The analysis of design Summary of and implementation features suggest that two are potentially important: findings and conclusion • W hile the evidence is relatively limited, a higher transfer level is associated with stronger and References 71 T he publication by Macours et al. (2012) has very similar findings which are not reported here.

100 Cash transfers: what does the evidence say? Page 100 Contents bigger impacts on expenditure and poverty levels (e.g. Haushofer and Shapiro, 2013). This Acknowledgements means that, in some cases, while a transfer is sufficient to increase expenditure, it is not enough to lift households above the poverty line (or reduce their poverty gap substantially). The policy Executive summary implication is that transfer levels need to be meaningful in order to reduce poverty rates. S • tudies also show that longer duration of exposure to the transfer leads, on the whole, to SECTION I bigger impacts on expenditure (e.g. Angeluccio et al., 2012). The studies that do not find statistically significant results on poverty levels also suggest that poverty rates are only affected Chapter 1 after prolonged exposure (see for example, Merttens et al., 2015). This suggests that impacts Introduction may accumulate over time. For example, when households receive a transfer over longer Chapter 2 periods, they may be able to make livelihood decisions that then increase their income from Conceptual other sources. In terms of policy this means that receiving a transfer for short periods may framework not always have the desired impact, nor be an impact that is sustained beyond participation in the programme. The policy implication is that for the transfer to have a bigger and more Chapter 3 sustainable impact, beneficiaries should be receiving the transfer for longer periods of time. Review of cash transfer reviews The evidence base on complementary interventions relies on six studies. These show that Chapter 4 complementary interventions and supply-side services in many cases do not seem to have a Methods statistically significant effect on poverty measures, nor an effect that is fundamentally different than that found for beneficiaries receiving just a cash transfer. Two of these studies suggest that Chapter 5 The evidence base complementary interventions (such as training programmes) only affect cash transfers in the medium to long term (Macours et al., 2012; Macours et al., 2012a). This makes sense, given that behavioural changes will not happen overnight. It means that we cannot expect complementary SECTION II interventions and supply-side services to have an immediate impact, and that for such programmes to be most effective, the timeframe of cash transfer receipt should be extended. Chapter 6 The impact of cash transfers on Six studies consider the effects of cash transfer on poverty outcomes for women or female- monetary poverty headed households. Most of these do not find a statistically significant effect. Two studies find a significant positive increase in expenditure for female recipients, but no difference compared to Chapter 7 male recipients (Blattman et al., 2015; Green et al., 2015). As such, this review finds no evidence The impact of that female-headed households, or households with female beneficiaries, experience different cash transfers on education impacts for total and food expenditure, than male-headed households or households with male beneficiaries. The available evidence suggests that future research disaggregating poverty Chapter 8 outcomes by gender is needed. The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

101 Cash transfers: what does the evidence say? Page 101 Contents Table 6.3: Summary of results for overall cash transfer effect on total household expenditure Acknowledgements Programme Study Significance # Indicator Additional details Effect Measure of change Executive summary Change in 1 A IR (2014) ZCGP (Zambia) Per capital monthly total expenditure 10.44 5% Zambian kwacha Angelucci et al. 2 After 2 years 5% Change in Mexican 5.49 Total monthly household expenditure Oportunidades SECTION I (2012) (Mexico) pesos Chapter 1 52576 Total monthly consumption expenditure 1% Urban households Attanasio et al. 3 Familias en Acción Change in Introduction (Colombia) Colombian pesos (2005) 53831.1 Total monthly consumption expenditure Familias en Acción Rural household 1% Change in Chapter 2 (Colombia) Colombian pesos Conceptual Attanasio et al. 0.13 3 Log monthly total consumption 4 Familias en Acción Percentage point 1% framework (Colombia) change (2012) Growth in log 5 -0.056 Temporar y UCT Growth in log total household After 2 years NS Bazzi (2013) Chapter 3 points (Indonesia) expenditures per capita 2005–2007 Review of cash 7. 2 7 7 Change in shillings 1% Individual short-term total expenditure YOP (Uganda) Blattmann et 6 transfer reviews al. (2013) Chapter 4 1% Change in 1000s 32.227 Household monthly non-durable WINGS (Uganda) Blattman et al. 7 of shillings expenditure (2015) Methods 8 Log monthly total expenditure 0.053 Bolsa Alimentação Percentage point 10% Braido et al. Chapter 5 change (2012) (Brazil) The evidence base BISP (Pakistan) Cheema et al. 9 Monthly per adult equivalent expenditure 318 Change in 10% (2014) Pakistani rupees -10 3 6.61 Ndihma Ekonomike 10 1% Monthly real per capita expenditure Dabalen et al. Change in Albanian SECTION II lekë (NE) (Albania) (2008) 1% Change in pesos 14.294 Total monthly consumption expenditure PROGRESA (Mexico) Davis et al. 11 Chapter 6 (2002) The impact of Total monthly consumption expenditure PROCAMPO 5% Change in pesos 12.031 cash transfers on (Mexico) monetary poverty 12 Total annual household expenditure BDH (Ecuador) NS Change in US$ -16 8.5 Edmonds and Schady (2012) Chapter 7 10% Ferré and Shombhob Total monthly household expenditure 378.8 Change in 13 The impact of (Bangladesh) Bangladeshi takas Sharif (2014) cash transfers on 63.342 1% Change in pesos Total consumption per adult equivalent PAAMZR (Mexico) Galiani et al. 14 education (2014) Gertler et al. 5% 10.836 Compared to 15 Change in pesos Oportunidades Household per capita consumption Chapter 8 households that (Mexico) (2012) The impact of cash joined 4 years later transfers on health 16 1% KWFP-cash transfer 0.187 Log per capita total consumption Percentage point Gilligan et al. and nutrition (Uganda) change (2013) Chapter 9 17 Z-score Individual monthly non-durable 1% 0.46 WINGS (Uganda) Green et al. The impact of consumption (2015) cash transfers on 18 Handa et al. Effect of per capita 0.034 1% Change in log PROGRESA (Mexico) Log total monthly household expenditure savings, investment (2009) transfer points and production Per equivalent adult consumption Handa et al. NS LEAP (Ghana) 19 -4.37 Change in Ghanaian cedi (2014) Chapter 10 Haushofer and 1% Change in US$ 3 6.18 20 Total monthly non-durable expenditure Give Directly The impact of Shapiro (2013) experiment (Kenya) cash transfers on NS Change in US$ 21 7.14 Total expenditure in 12 months IPA RCT (Ghana) Karlan et al. employment (2014) Chapter 11 Atención a Crisis Macours et al. Change in log In 2006 1% 0.0281 Log total per capita expenditure 22 The impact of points (2012) (Nicaragua) cash transfers on Macours et al. Percentage change 23 For the basic transfer 0.0221 Atención a Crisis Log total household per capita NS empowerment (Nicaragua) (2012a) 686 Change in Nominal annual total per capita 24 Maluccio and RPS (Nicaragua) 1% After 2 years expenditure Flores (2005) Nicaraguan SECTION III córdobas After 2 years 1% 25 Maluccio Percentage point RPS (Nicaragua) Log per capita total annual expenditure 0.174 9 Chapter 12 (2005) change Summary of After 2 years 26 Maluccio Change in 5% Per capital annual total expenditure 676 RPS(Nicaragua) findings and (2010) córdobas conclusion 27 Merttens et al. HSNP (Kenya) Mean monthly consumption expenditure 224.8 Change in Kenyan 5% (2013) shillings References continued on next page

102 Cash transfers: what does the evidence say? Page 102 Contents Table 6.3: Summary of results for overall cash transfer effect on total household expenditure continued Acknowledgements Study Effect Additional details Programme Significance # Measure of Indicator change Executive summary 28 Senior Citizen Grant 10% Change in shillings 10,000 Monthly total expenditure per equivalent SAGE (Uganda) Merttens et al. (SCG) adult (2015) SAGE (Uganda) Vulnerable Family 10% Change in shillings 11,000 Monthly total expenditure per equivalent SECTION I adult Support Grant (VFSG) Chapter 1 29 Change in kwacha 274 Weekly per capita total expenditures SCTP (Malawi) 1% Miller et al. After 1 year (2 011) Introduction 30 NS Change in tenge Not reported O’Brien et al. Per adult equivalent monthly BOTA (Kazakhstan) Chapter 2 (2013) consumption Conceptual Pellerano et al. Change in maloti NS 31 Real monthly total consumption LCGP (Lesotho) 6.594 framework (2014) expenditure per capita Juntos (Peru) Percentage point 0.33 1% Perova and 32 Overall consumption (in log?) Chapter 3 Vakis (2012) change Review of cash 33 NS Ribas et al. -0.08659 Log per capita total consumption Tekoporã (Paraguay) Percentage point transfer reviews (2010) change Chapter 4 0.17 34 Log nominal value of per capita monthly PAL (Mexico) 1% Skoufias et al. Percentage point change total consumption (2008) Methods -4835 35 Change in rupiahs Total monthly expenditure per capita PKH (Indonesia) NS World Bank Chapter 5 (2 011) The evidence base Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS = not SECTION II significant at 10% significance level or below Chapter 6 Table 6.4: Summary of results for overall cash transfer effect on food expenditure The impact of cash transfers on Indicator Programme Study # Additional Significance Measure of Effect monetary poverty details change Monthly food expenditure per capita 1 Change in 5% A IR (2014) ZCGP (Zambia) 7. 5 6 Chapter 7 kwacha The impact of Change in pesos 2 282.85 After 2 years 1% Monthly food expenditure Oportunidades Angelucci et al. (2012) cash transfers on (Mexico) education 1% Change in Urban 37018.1 Monthly food expenditure Familias en Acción Attanasio and Mesnard 3 (Colombia) Colombian pesos (2005) Chapter 8 The impact of cash Familias en Acción Monthly food expenditure Change in pesos 41956.6 1% Rural transfers on health (Colombia) and nutrition 0.159 Percentage point 1% 4 Attanasio et al. (2012) Familias en Acción Log monthly food consumption (Colombia) change Chapter 9 5 NS Effect of per YOP (Uganda) Percentage point 0.043 Blattmann et al. (2013) Log of individual short-term food The impact of capita transfer expenditure change cash transfers on Bolsa Alimentação 6 Braido et al. (2012) 1% Percentage point 0.099 Log of monthly food expenditure savings, investment change (Brasil) and production 7 Buser et al. (2014) BDH (Ecuador) Monthly food expenditure 20.808 Change in US$ 1% Chapter 10 Change in Monthly per adult equivalent food 115 8 NS Cheema et al. (2014) BISP (Pakistan) The impact of Pakistani rupees expenditure cash transfers on 9 1% -157 9.3 Dabalen et al. (2008) NE (Albania) Monthly real food expenditure per Change in lekë employment capita 1% Davis et al. (2002) 10 Change in pesos 13.218 Monthly food expenditure per capita PROGRESA (Mexico) Chapter 11 The impact of PROCAMPO (Mexico) Monthly food expenditure per capita 8.033 Change in pesos 5% cash transfers on 11 Change in taka Ferré and Sharif (2014) Shombhob 337 Monthly food expenditure 1% empowerment (Bangladesh) 1% RPS (Nicaragua) Change in 12 Gitter and Caldes (2010) 652 Annual food expenditure per capita córdobas SECTION III 1% Change in log 13 Handa et al. (2009) Effect of per Log monthly food expenditure 0.035 PROGRESA (Mexico) capita transfer points Chapter 12 Summary of 14 Handa et al. (2014) LEAP (Ghana) Monthly food consumption per capita -1.8 4 Change in cedi NS findings and 1% 15 Hidrobo et al. (2012) WFP cash transfer Percentage point Log of monthly food expenditure per 0.12 conclusion capita (Ecuador) change continued on next page References

103 Cash transfers: what does the evidence say? Page 103 Contents Table 6.4: Summary of results for overall cash transfer effect on food expenditure continued Acknowledgements Programme Additional Measure of Indicator Significance Study # Effect change details Executive summary 16 Basic transfer 1% Percentage point 0.0449 Log of total food consumption per Atención a Crisis Macours et al. (2012) capita change (Nicaragua) 1% Change in 640 RPS (Nicaragua) Maluccio and Flores 17 Nominal annual food expenditure After 2 years SECTION I per capita (2005) córdobas Chapter 1 Log annual food expenditure per Maluccio (2005) RPS (Nicaragua) 1% Percentage point 18 0.2618 After 2 years change capita Introduction Annual food expenditure per capita After 2 years 1% 19 Maluccio (2010) Change in 621 RPS (Nicaragua) Chapter 2 córdobas Conceptual Martinez (2004) 20 5% Change in 6 7. 9 9 2 Monthly food expenditure Bonosol (Bolivia) framework bolivianos Merttens et al. (2015) 1500 NS Monthly food expenditure per Change in 21 SCG SAGE (Uganda) Chapter 3 shillings equivalent adult Review of cash SAGE (Uganda) Change in 8500 VFSG Monthly food expenditure per 5% transfer reviews shillings equivalent adult Chapter 4 1% Weekly food expenditure per capita SGTP (Malawi) Miller et al. (2011) 22 After 1 year Change in 203 kwacha Methods cash transfer-OVC 23 Monthly food expenditure 145.394 Change in Palermo et al. (2012) 1% (?) Chapter 5 (Kenya) shillings The evidence base Change in 31.0 6 Real monthly food expenditure LCGP (Lesotho) Pellerano et al. (2014) 24 NS 5% Percentage point 0.15 Log (?) of food expenditure Juntos (Peru) Perova and Vakis (2012) 25 change SECTION II 5% Percentage point - 0.1216 Log of food expenditure per capita Tekoporã (Paraguay) 26 Ribas et al. (2010) change Chapter 6 The impact of Ruiz-Arranz et al. (2002) 1% Change in US$ 0.307 27 Monthly food expenditure per capita PROGRESA (Mexico) cash transfers on 1% 0.332 Change in US$ PROCAMPO (Mexico) Monthly food expenditure per capita monetary poverty CTP (Zambia) Monthly food expenditure per capita 2 13 3 .18 Change in 28 NS Seidenfeld and Handa (2 011) kwacha Chapter 7 The impact of 1% 29 Percentage point 0.179 Log nominal of monthly food PAL (Mexico) Skoufias et al. (2008) consumption per capita change cash transfers on education Skoufias et al. (2013) 30 1% PAL (Mexico) Monthly food expenditure per capita 45.818 Change in pesos PKH (Indonesia) NS 1556 Monthly food expenditure per capita World Bank (2011) 31 Change in Chapter 8 rupiahs The impact of cash transfers on health Notes: results represent all overall results reported and do not include those disaggregated by gender or and nutrition showing the effect of variations in design features. Figures in bold indicate statistically significant. NS = not significant at 10% significance level or below. Chapter 9 The impact of cash transfers on Table 6.5: Summary of results for overall cash transfer effect on poverty head count savings, investment and production Significance Measure of change Effect Programme # Study Additional Indicator details Chapter 10 -0.041 1 A IR (2014) ZCGP (Zambia) Poverty head count Percentage point change 5% The impact of 10% Percentage point change 2 Cheema et al. (2014) BISP (Pakistan) Poverty head count -0.2191 cash transfers on employment Poverty head count NE (Albania) 1% Percentage point change 0.076 3 Dabalen et al. (2008) Percentage point change 4 Merttens et al. (2013) HSNP (Kenya) Poverty head count -0.048 5% Chapter 11 SCG Merttens et al. (2015) 5 Percentage point change SAGE (Uganda) Poverty head count -0.022 NS The impact of cash transfers on VFSG SAGE (Uganda) Poverty head count -0.042 Percentage point change NS empowerment LCGP (Lesotho) Poverty head count -0.0181 Percentage point change NS Pellerano et al. (2014) 6 7 Perova and Vakis (2012) Juntos (Peru) Poverty head count - 0.14 Percentage point change 1% SECTION III 8 Skoufias and Di Maro (2008) PROGRESA (Mexico) Poverty head count -0.06 Percentage point change NS After one year Percentage point change 1% 9 Skoufias et al. (2013) PAL (Mexico) Poverty head count -0.089 Chapter 12 Summary of Notes: results represent all overall results reported and do not include those disaggregated by gender or findings and showing the effect of variations in design features. Figures in bold indicate statistically significant coefficient. conclusion NS = not significant at 10% significance level or below. References

104 Cash transfers: what does the evidence say? Page 104 Contents Table 6.6: Summary of results for overall cash transfer effect on poverty gap Acknowledgements Measure of Programme Indicator Effect # Study Additional Significance change details Executive summary A IR (2014) 1 Child Grant (Zambia) Poverty gap in relation to extreme poverty 5% -0.084 Percentage line point change Percentage -0.06983 BISP (Pakistan) 2 Poverty gap as proportion of national Cheema et al. (2014) 5% SECTION I point change poverty line Chapter 1 NE (Albania) Poverty gap as proportion of national 0.017 Percentage 5% Dabalen et al. (2008) 3 Introduction point change poverty line -0.06806 Percentage 5% Poverty gap as proportion of national HSNP (Kenya) Merttens et al. (2013) 4 Chapter 2 poverty line point change Conceptual 5 SAGE (Uganda) Poverty gap as proportion of poverty line NS -0.73 Percentage SCG Merttens et al. (2015) framework point change Chapter 3 NS VFSG SAGE (Uganda) Percentage -1.8 Poverty gap as proportion of poverty line point change Review of cash transfer reviews Percentage 6 NS Pellerano et al. (2014) LCGP (Lesotho) Poverty gap as proportion of poverty line -0.01406 point change Chapter 4 Poverty gap (level – in Soles) Juntos (Peru) Perova and Vakis 7 1% Change in -14.52 Methods (2012) Peruvian soles 8 Percentage Skoufias and di Maro -0.0445 Poverty gap as proportion of poverty After one 1% PROGRESA (Mexico) Chapter 5 point change? (2008) line (?) year The evidence base -5.5 Skoufias et al. (2013) PAL (Mexico) Poverty gap as proportion of poverty 1% 9 Percentage point change? line (?) SECTION II Notes: Poverty gap either measured as continuous variable (level effect) or with the gap expressed as the Chapter 6 share of the poverty line (percentage change). In some cases, authors did not specify how the poverty gap was The impact of measured. Results represent all overall results reported and do not include those disaggregated by gender or cash transfers on showing the effect of variations in design features. Figures in bold indicate statistically significant coefficient. monetary poverty NS = not significant at 10% significance level or below. Chapter 7 The impact of Table 6.7: Summary of results for overall cash transfer effect on squared poverty gap cash transfers on education Significance Additional Study Programme Indicator Effect Measure of # change details Chapter 8 1 Squared poverty gap in relation ZCGP (Zambia) A IR (2014) 5% Percentage -0.076 The impact of cash point change to extreme poverty line transfers on health and nutrition 2 Squared poverty gap as NE (Albania) Dabalen et al. (2008) 1% Percentage 0.005 proportion of absolute poverty point change line Chapter 9 The impact of Merttens et al. (2013) HSNP (Kenya) Squared poverty gap as 3 Percentage 5% -6.521 cash transfers on proportion of absolute poverty point change line savings, investment and production Merttens et al. (2015) 4 SCG NS Percentage -7 Poverty gap as proportion of SAGE (Uganda) poverty line point change Chapter 10 NS Percentage VFSG SAGE (Uganda) Poverty gap as proportion of -6.7 The impact of poverty line point change cash transfers on 5 NS ? -0.765 Squared poverty gap (not clear LCGP (Lesotho) Pellerano et al. (2014) employment how measured) Chapter 11 After one year 1% ? -0.0616 Skoufias and Di Maro (2008) PROGRESA (Mexico) Squared poverty gap (not clear 6 how measured) The impact of cash transfers on 7 5% Percentage Squared poverty gap as PAL (Mexico) -0.038 Skoufias et al. (2013) empowerment point change? proportion of poverty line (?) Notes: Squared poverty gap either measured as continuous variable (level effect) or with the squared poverty SECTION III gap expressed as the share of the poverty line (percentage change). In many cases, authors did not specify how the squared poverty gap was measured. Results represent all overall results reported and do not include Chapter 12 those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate Summary of statistically significant. NS = coefficient not significant at 10% significance level or below. findings and conclusion References

105 Cash transfers: what does the evidence say? Page 105 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 7 transfer reviews Chapter 4 Methods T he impact of cash Chapter 5 The evidence base transfers on education SECTION II Chapter 6 The impact of cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

106 Cash transfers: what does the evidence say? Page 106 Contents Box 7.1: Summary of evidence for education outcomes Acknowledgements In total, 42 studies were reviewed reporting on any one of the education indicators covered, either with an overall effect, Executive summary gender-disaggregated effect or on the role of a design and implementation feature. Overall effects of cash transfers on selected education indicators: SECTION I O • verall, the evidence extracted shows that cash transfers lead to an increase school attendance in the short term. 20 studies reported on the overall effect of cash transfers on school attendance, of which 13 reported some Chapter 1 significant impact. Of the studies reporting on a measure of school absenteeism (n=9), all that found significant Introduction effects (n=4) involved reductions. Among studies reporting on attendance (n=16), all but one (n=9) of the 10 significant impacts were positive. Chapter 2 Conceptual H • owever, a less clear-cut pattern of impact was found for learning outcomes (as measured by test scores) and framework cognitive development outcomes (information processing ability, intelligence, reasoning, language development and memory), partly as these result from a dynamic interaction between biological, social and environmental factors, Chapter 3 test scores including the quality of services provided. Five studies examined the overall effect of cash transfers on . Review of cash though none of the results were significant, three reported on language test scores (with maths Four reported on transfer reviews composite test score but found no significant two significant but mixed results), and one study reported on a result. Five studies provided an overall effect estimate on . Of these, three studies found a cognitive development Chapter 4 statistically significant positive effect on cognitive development tests. Methods Variation in outcomes by gender: Chapter 5 The evidence base The evidence on gender is extensive, compared to other outcome areas: of the 42 studies included, 20 studies reported on some variation in outcomes by gender (either girls versus boys or the head of household). Those with statistically significant effects show increases in school attendance for girls and some improvements in test scores and cognitive SECTION II development, with no clear pattern for head of the household. • 1 5 studies looked at disaggregated impacts on school attendance for girls versus boys or girls only. Of these, 12 Chapter 6 studies reported a statistically significant impact for at least one school attendance measure for girls either at the The impact of primary or secondary school level. For all but one study the impact was positive (negative in the case of measures cash transfers on of school absenteeism). Two studies reported on differences by household head, with one finding no differences monetary poverty (Dammert, 2009) and the other only finding significant effects (improvements) among male-headed households (World Bank, 2011). Chapter 7 The impact of • F ive studies looked at disaggregated impacts on test scores by gender. Of these, only the two studies evaluating cash transfers on Malawi’s Zomba Cash Transfer Programme found a significant impact on test scores (maths and English), both of education them positive (Baird et al., 2011; Baird et al., 2013). F • our studies assessed disaggregated impacts on cognitive development by gender. Of these, three were positive and Chapter 8 statistically significant (Baird et al., 2011; Baird et al., 2013; Paxson and Schady, 2010). The impact of cash transfers on health Role of design and implementation features: and nutrition 15 studies shed light on the role of design and implementation features on the education indicators: Chapter 9 • O ne study on Morocco’s Tayssir programme explicitly tested the impact of transferring money to women versus men The impact of as main recipients but found no significant difference between the two in terms of children’s school attendance or cash transfers on performance in a standardised maths test (or enrolment) (Benhassine et al., 2013). savings, investment • our studies explicitly test the impact of varying F , finding mixed evidence, with one of two studies on transfer amounts and production PROGRESA/Oportunidades (Mexico) finding higher transfer levels to be associated with improvements in cognitive and verbal tests (Manley et al., 2015), little evidence of any effect of higher transfers in Cambodia’s CESSP on attendance Chapter 10 The impact of (Filmer and Schady, 2011), and significant effects in the unconditional, but not the conditional, arm of Malawi’s ZCTP cash transfers on on enrolment, and an apparent decline in test scores (Baird et al., 2011). employment • , with some evidence that tying the transfer schedule to timing of transfers wo studies offer insights into the role of T critical moments of the school year decision cycle can have an impact on enrolment especially. Chapter 11 hree experiments in sub-Saharan Africa compare , two of which find conditional vs unconditional cash transfers T • The impact of higher impacts on educational outcomes for CCTs compared to UCTs and one of which finds no differential impact cash transfers on (justified partly by the ‘labelled’ nature of the UCT being compared in Morocco’s Tayssir programme). A fourth study empowerment in Colombia tests the differential impact of different types of conditionality, finding that incentives for graduation and matriculation were more effective than conditionality on attendance in increasing enrolment and attendance. SECTION III ine studies offer insights into the role of increasing • length of exposure for beneficiary households, though few N explicitly test the differential impact of longer exposure to the programme. Overall, evidence is mixed for impacts Chapter 12 on attendance and weak or unsubstantial for impacts on cognitive development, though one study finds that longer Summary of exposure leads to more years of education (Villa, 2014). findings and wo studies assess the role of complementary interventions and supply-side services , both in the context of T • conclusion Nicaragua’s Atención a Crisis programme. In general, largely similar impacts were observed among households that received a basic transfer or one combined with vocational training or a lump-sum payment to start a non-agricultural business. References

107 Cash transfers: what does the evidence say? Page 107 Contents 7.1 S ummary of findings Acknowledgements The following section reports on the impacts of cash transfers on education. The specific Executive summary indicators selected for the purpose of this review were attendance, test scores in different subjects (maths, language and composite assessment scores), and cognitive and problem-solving skills. A SECTION I summary of the overall effects, how they vary by gender and design and implementation feature, is provided in Box 7.1. Chapter 1 Introduction Overall, the evidence reviewed confirms that cash transfers can affect access to education in the short term by removing the direct and indirect financial barriers to education. However, a less Chapter 2 Conceptual clear-cut pattern of impact was found for learning outcomes (as measured by test scores) and framework cognitive development outcomes (information processing ability, intelligence, reasoning, language development and memory), partly as these result from a dynamic interaction between biological, Chapter 3 social and environmental factors, including the quality of services provided. Review of cash transfer reviews , of which 13 report some significant attendance 20 studies reported on the overall effect on school Chapter 4 effect. The direction of effect is mostly in accordance with what we expect in theory (increase in Methods school attendance and a decrease in school absenteeism). Of the studies reporting on a measure of school absenteeism all significant effects were negative; for all but one study reporting on a Chapter 5 measure of attendance, all the significant impacts were positive. The evidence base design and implementation From a perspective, conditionality appears to have had an important SECTION II role in mediating impact for educational ‘access’ (increasing marginal effects for enrolment and attendance), but only to the extent that it is perceived as such by recipients. For example, cash Chapter 6 transfers where conditionality was applied on paper but not monitored, enforced or understood by The impact of recipients ultimately had lower marginal effects than equivalent UCTs that were strongly labelled cash transfers on monetary poverty as being aimed at human development outcomes (through the name of the programme, associated messaging and potential transfer modality). Moreover, marginal effects were often highest where Chapter 7 overall rates at baseline were lowest (more room for improvement), with implications for targeting The impact of design. No conclusive evidence, however, was found on the role of increasing transfer size, cash transfers on transferring the cash to women versus men as main recipients, and increasing length of exposure education to the programme. Chapter 8 The impact of cash Only five studies examined overall effects on , as measured through test scores in maths, learning transfers on health 72 language or a composite test score (n= 5). Four studies reported overall impacts on maths, and nutrition three studies reported on language test scores, and one on a composite score. Two studies found Chapter 9 a statistically significant effect, both of these referred to language test scores, one being an The impact of improvement and one a decrease relative to appropriate control groups. Five studies provided cash transfers on cognitive development scores. Of these, three studies found a an overall effect estimate of savings, investment statistically significant positive effect. and production The fact that the evidence base is not sufficient to make any generalisations on the impacts of Chapter 10 The impact of cash transfers on these ultimate outcomes (or on the role of design and implementation features, cash transfers on for that matter) is a finding in itself. This is partly due to the nature of the selected indicators, employment which have been measured in a wide variety of different ways, making it impossible to compare effect sizes conclusively. It is also partly due to the causal mechanisms underpinning these Chapter 11 outcome areas, which are affected by such a wide variety of mediating factors (e.g. children’s The impact of cash transfers on nutrition, rearing practices, parents’ human capital, quality of service delivery, etc.) that being empowerment able to identify a linear impact of additional cash is extremely difficult. Further research is certainly welcome in this area, especially on the role of complementary initiatives to cash transfers (e.g. nutritional support, educational sessions focused on child-rearing/nutrition, and SECTION III supply-side grants for schools). Chapter 12 Summary of Importantly, given that education indicators mostly refer to individuals and not households, of findings and the 42 studies included, 20 reported variation in outcomes by gender (either by girls versus boys conclusion References 72 S everal studies assessed the impact of cash transfer programmes separately for girls or boys instead of reporting an overall effect. These are discussed in the section on impacts by gender.

108 Cash transfers: what does the evidence say? Page 108 Contents or sex of the head of household). Those with statistically significant effects show increases in Acknowledgements school attendance for girls and some improvements in test scores and cognitive development. Of 15 studies disaggregating effects on attendance for girls versus boys, 12 reported a statistically Executive summary significant increase for at least one school attendance measure for girls either at primary or secondary school level (while one reported a decrease). Of five studies disaggregating impacts on learning, two found significant increases in test score results for girls. Similarly, of five studies SECTION I reporting on cognitive development, three reported significant increases for girls. Chapter 1 Introduction 7. 2 ummary of evidence base S Chapter 2 Conceptual In total, we included 42 studies that evaluated the effect of cash transfer programmes on the framework specific education indicators included in this study. These refer to 27 unique programmes, covering Chapter 3 20 countries in East Asia and the Pacific, Latin America and the Caribbean, Middle East and Review of cash North Africa, sub-Saharan Africa and South Asia. In many cases we included several studies of transfer reviews the same programme, with authors reporting on different education indicators, participants and time periods. Chapter 4 Methods The programmes included differ, quite widely in some cases, in terms of their design features. One Chapter 5 dimension of this variation is around the intensity of conditionality, ranging from unconditional, The evidence base labelled transfers, to conditional transfers with different degrees of monitoring and enforcement mechanisms. Some programmes also had both a conditional and an unconditional treatment arm. SECTION II A second crucial dimension is that some studies were more focused than others on specifically improving educational outcomes. For example, while the Japan Fund for Poverty Reduction Chapter 6 scholarship programme was explicitly aimed at increasing the transition of girls from primary to The impact of lower secondary school, the BPC from Brazil is a social pension, and the senior citizen grant in cash transfers on Uganda’s SAGE programme was also targeted at the elderly. monetary poverty Chapter 7 In terms of geographic distribution, CCTs were most prevalent in East Asia and the Pacific and The impact of included the majority of the Latin American programmes. In contrast, the African cash transfer cash transfers on programmes were almost all unconditional or included both a conditional and unconditional education element. Chapter 8 The impact of cash Table 7.1 provides an overview of the countries and programmes on which the studies reported. By transfers on health far the largest number of studies (21 out of 42) cover cash transfer programmes in Latin America and nutrition and the Caribbean, with a disproportionate number of those focusing on Mexico’s PROGRESA/ Oportunidades programme (7). Meanwhile, 15 studies cover sub-Saharan Africa, one study covers Chapter 9 73 the Middle East and North Africa, four for East Asia Pacific, two for South Asia. The impact of cash transfers on savings, investment Most studies were of programmes that had been operating at a large scale over a number and production of years. However, a number of studies from Africa and Asia report on findings from small experimental studies or pilots that were limited in scale. As such, the findings from these studies Chapter 10 may be more limited in their external validity and applicability to other settings. The impact of cash transfers on employment A range of different study designs and estimation methods were used in order to estimate the effect of cash transfers or their design and implementation features on the selected education Chapter 11 indicators. As can be seen in Table 7.2, a significant majority were based on experimental studies, The impact of with the remainder using observational data and employing some form of DID, RDD, IV or OLS cash transfers on regression. empowerment SECTION III Chapter 12 Summary of findings and conclusion References 73 N ote: The totals in the final column of Table 7.1 do not add up to the total number of studies as two studies report results for more than one programme.

109 Cash transfers: what does the evidence say? Page 109 Contents Table 7.1: Summary of countries and programmes reported on for the education indicators Acknowledgements Type of cash Programme Country # studies Details if pilot or experimental study* transfer Executive summary Latin America and the Caribbean = 21 studies Social Pension Brazil 1 Benefício de Prestação Continuada (BPC) SECTION I 2 Colombia Familias en Acción CCT Chapter 1 Introduction Subsidios Condicionados a la Asistencia Escolar (SCAE) 2 CCT Colombia Chapter 2 2 UCT Bono de Desarrollo Humano (BDH) Ecuador Conceptual CCT 7 PROGRESA/Oportunidades Mexico framework CCT 3 Nicaragua Red de Protección Social (RPS) Pilot in 21 communities Chapter 3 3 One year pilot in six municipalities Nicaragua Atención a Crisis CCT Review of cash 1 CCT Juntos Peru transfer reviews Middle East and North Africa = 1 study Chapter 4 Tayssir Morocco Pilot in the five poorest regions UCT, CCT 1 Methods Sub-Saharan Africa = 14 studies Chapter 5 Nahouri Cash Transfers Pilot Project (NCTPP) Two-year pilot limited to one province 1 CCT, UCT Burkina Faso The evidence base Livelihood Empowerment Against Poverty (LEAP) UCT/CCT 2 Ghana Kenya Kenya Hunger Safety Net Programme (HSNP) UCT 1 SECTION II 1 UCT Child Grant Programme (LCGP) Lesotho Chapter 6 Malawi Mchinji Pilot 2 UCT Social Cash Transfer Programme (SCTP) The impact of cash transfers on Malawi The Zomba Cash Transfer Programme (ZCTP) CCT/UCT 2 monetary poverty Uganda UCT 1 Social Assistance Grants for Empowerment (SAGE) WFP Karamoja Cash Transfer Pilot (KWFP-cash transfer) Uganda Three districts 1 CCT Chapter 7 The impact of Tanzania CCT Tanzania Social Action Fund (TSAF) Pilot in three districts 1 cash transfers on UCT 1 Monze Cash Transfer Pilot (CTP) Zambia Pilot in one district education Zambia 1 UCT Child Grant Cash Transfer (ZCGP) Chapter 8 East Asia and Pacific = 4 studies The impact of cash 1 Cambodia CCT CESSP Scholarship Programme (CSP) transfers on health and nutrition Japan Fund for Poverty Reduction (JFPR) scholarship CCT 1 Cambodia program Chapter 9 1 CCT Junior High School Randomised Controlled Trial (JHS-RCT) Trial in one county in northwest China China The impact of Indonesia Program Keluarga Harapan (PKH) CCT 1 cash transfers on savings, investment South Asia = 2 studies and production 1 Two counties (rural Upazilas) and one urban CCT Shombhob Bangladesh slum Chapter 10 UCT The Benazir Income Support Programme (BISP) Pakistan 1 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

110 Cash transfers: what does the evidence say? Page 110 Contents Table 7.2: Summary of study methods used of included studies reporting on education indicators Acknowledgements Study Study design and methods used for reported results Reports Reports effect Reports sex- total effect of design and disaggregated Executive summary implementation outcomes features? A IR (2014) RCT (DID) Yes SECTION I Yes Yes RCT (DID) Akresh et al. (2013) Yes Chapter 1 Single difference (OLS with matching and fuzzy RDD) Yes Yes Baez and Camacho (2011) Introduction QE (OLS linear and logistic regression with baseline levels Yes – Female only Yes Baird et al. (2011) characteristics as controls) Chapter 2 Baird et al. (2013) RCT (OLS) Yes – Female only Conceptual framework QE (IV) Yes Yes Barrera-Osorio, et al. (2008) Yes Barrera-Osorio, et al. (2011) SD estimator using a regression model with a binary outcome Yes Chapter 3 Review of cash Behrman et al. (2009) Yes RCT (DID) Yes transfer reviews QE (OLS linear and logistic regression) Yes Yes Yes Benhassine et al. (2013) Cheema et al. (2014) QE Fuzzy RDD using cross-sectional and panel data Yes Chapter 4 Methods Covarrubias et al. (2012) RCT (DID; DID w PSM) Yes Yes Dammert (2008) Yes QE (Quantiles of treatment effect) Chapter 5 The evidence base Yes DID w/PSM de Groot et al. (2015) Yes Esteva (2012) RCT (DID, RDD) Yes Yes Yes Evans et al. (2014) RCT (DID) Yes SECTION II Fernald et al. (2008) QE (multivariate regression) Yes Chapter 6 Fernald et al. (2009) QE (multivariate linear regression) Yes The impact of cash transfers on RCT (OLS, Probit) Fernald and Hidrobo (2011) Yes monetary poverty Ferré and Sharif (2014) QE (DID) Yes Yes – Female only QE (PSM) Filmer and Schady (2008) Chapter 7 The impact of Yes Filmer and Schady (2011) QE (RDD) Yes cash transfers on Yes Gertler and Fernald (2004) RCT (PSM) Yes education Yes RCT (ANCOVA) Gilligan et al. (2013) Chapter 8 QE (PSM, multivariate regression) Handa et al. (2014) Yes The impact of cash Yes RDD, PSM Kassouf and de Oliveira (2012) transfers on health and nutrition DID Yes Lincove and Parker (2015) Yes Yes RCT (multiple regression) Macours et al. (2009) Chapter 9 The impact of Yes Yes OLS linear and logistic regression Macours et al. (2012) Yes cash transfers on Yes Yes Maluccio and Flores (2005) RCT (DID) savings, investment Yes Manley et al. (2015) QE (IV) and production RCT (DID) Merttens et al. (2013) Yes Yes Chapter 10 Merttens et al. (2015) Yes Yes QE (RDD; DID with PSM) The impact of Yes RCT (DID) Miller and Tsoka (2012) Yes cash transfers on employment Yes Mo et al. (2013) RCT (DID) RCT (SUR) Yes Yes Paxson and Schady (2010) Chapter 11 The impact of Yes RCT (DID) Pellerano et al. (2014) cash transfers on Perova and Vakis (2012) QE (IV) Yes Yes empowerment QE (DID with PSM) Seidenfeld and Handa (2011) Yes Skoufias and Parker (2001) QE (DID, cross-sectional difference estimator) Yes Yes SECTION III Tommasi (2015) Yes Yes RCT Chapter 12 Villa (2014) QE (multivariate dose-response regression using panel data) Yes Summary of Yes World Bank (2011) QE (IV) findings and conclusion QE=Quasi-experimental approach, RDD = Regression Discontinuity Design, RCT = randomised controlled trial, DID = difference-in-difference, PSM = propensity score matching, IV = instrumental variables, References ANCOVA = analysis of covariance; SD= standard deviation estimator.

111 Cash transfers: what does the evidence say? Page 111 Contents T 7. 3 he impact of cash transfers on education Acknowledgements Tables 7.3 to 7.7 below summarise the overall effects of cash transfers on the indicators under Executive summary consideration. Where any effects associated with design or implementation features were found, these are not reported in the tables, but are discussed in section 7.5. Similarly, all sex- SECTION I disaggregated results are discussed in section 7.4. Chapter 1 Introduction School attendance Chapter 2 Enrolment does not guarantee that a child will attend school regularly throughout the school Conceptual year nor does it mean that he or she completes a grade, progresses to the next grade or transitions framework from primary to secondary school. CCT conditions therefore often include mandatory attendance Chapter 3 requirements in addition to school enrolment. For example, the RPS programme in Nicaragua Review of cash required that enrolled students have fewer than six unjustified absences in a two-month period transfer reviews (Maluccio and Flores, 2005). It is therefore valuable to consider school attendance as one of the key school participation indicators. Chapter 4 Methods Measures of attendance are based either on self-reported data from household surveys asking Chapter 5 parents or children retrospectively about the level of attendance in a given time period, or more The evidence base objective data from school surveys or surprise school visits that measure whether a child is present on that day. In some cases, it is not specified what approach the authors have applied. In addition, measures of attendance varied across studies ranging from whether a child ever attended SECTION II school, attended school over a given time period (i.e. past week, past month or by the end of the Chapter 6 school year) to the number of hours or days a child is attending school in a given time period. The impact of Several studies (n=9) also report a measure of absenteeism rather than attendance, including cash transfers on whether a child missed any days of school or the number of days absent in a given time period. monetary poverty For these measures of absenteeism, a negative coefficient is the desired effect. Given the variety of attendance measures reported in the studies, the coefficients are not comparable and one should be Chapter 7 The impact of cautious when interpreting the results. cash transfers on education Of the 20 studies that reported on the overall effect on school attendance, 13 reported at least significant impact (see Table 7.3). The direction of effect is mostly in accordance with what we Chapter 8 expect in theory (increase in school attendance and a decrease in school absenteeism). Of the The impact of cash transfers on health studies reporting on a measure of school absenteeism, all significant effects were negative (n=4); and nutrition among all studies reporting on a measure of attendance (n=16), all but one of the significant impacts were positive (n=9). Chapter 9 The impact of One study found a negative statistically significant impact (10% significance, 3.4 percentage cash transfers on savings, investment points) on the proportion of children currently attending formal education after one year of 74 and production the Social Assistance Grants for Empowerment (SAGE) programme in programme operations: Uganda (and specifically its Vulnerable Family Support Grant). Impacts on the other reported Chapter 10 overall attendance or attainment indicators for both the Senior Citizen Grant (SCG) and the The impact of Vulnerable Family Support Grant were not significant (mean number of days missed in previous cash transfers on 30 days scheduled school days; class progression rate) (Merttens et al., 2015). The authors point employment out that the lack of impact on school attendance might not be surprising given the fact that, at Chapter 11 baseline, the main reason that children were not attending school was the belief that they were The impact of too young. In addition, particularly among SCG households, the need for the child to help at cash transfers on home was a significant reason, much more than the ability to pay for schooling. The authors also empowerment found that SAGE is not shown to be increasing education expenditure. SECTION III Seven studies found non-significant impacts on any school attendance measure reported. There is limited explanation provided for these non-significant impacts, but suggestions given by authors Chapter 12 generally refer to design and implementation features or contextual factors. Reported barriers Summary of that may have mediated the overall effect include: findings and conclusion References 74 T he second follow-up evaluation was not complete at time of write-up.

112 Cash transfers: what does the evidence say? Page 112 Contents L • ack of compliance monitoring cited for the CCT Shombhob programme in Bangladesh due to Acknowledgements a lack of project personnel to monitor school attendance (conditionality to receive the transfer) in project schools. Authors also report that, due to flooding, the transfers were made regardless Executive summary of the attendance rate (Ferré and Sharif, 2014). • ontextual factors, including baseline enrolment, cited for the Benefício de Prestação Continuada C SECTION I social pension programme in Brazil (Kassouf and de Oliveira, 2012). Programmes in countries with lower baseline enrolment/attendance may deliver larger impacts compared to countries in Chapter 1 which baseline enrolment is high. For example, Kassouf and de Oliveira (2012) report that, since Introduction 97% of children are already in school in Brazil, there is not much room for improvement. Chapter 2 T • ransfer size cited for the Lesotho Child Grant Programme (Pellerano et al., 2014). Based on Conceptual qualitative evidence, the authors note that for secondary education the transfer was too small framework to have any likely impact unless households were already able to meet most of their food Chapter 3 requirements. Review of cash transfer reviews Test scores Chapter 4 Methods Learning (measured through tests) is an important indicator to examine as it is essential to the long-term prospects of children, including human capital formation and empowerment. In theory, Chapter 5 The evidence base we might expect to see positive impacts of cash transfers on learning, especially since some cash transfers may be conditional and have the specific objective of increasing school attendance. If students attend school more regularly and attain higher levels of schooling, they may score SECTION II higher in academic test scores than non-recipient children who are out of school or attend less regularly. This assumes that additional years of schooling increase test scores. Transfers may Chapter 6 The impact of also trigger increases in household expenditure resulting in better food security and nutritional cash transfers on status of children, which in turn may also positively affect a child’s cognitive ability and a child’s monetary poverty efficiency of learning while in school in the long term. However, the ultimate impact of a cash transfer programme on learning outcomes will depend on a number of moderating factors relating Chapter 7 to design and implementation (discussed below in more detail) and contextual factors, including The impact of baseline enrolment rate or additional supply-side interventions that improve the quality of cash transfers on education schooling provided. Chapter 8 Reported learning indicators include tests that were specifically designed for the purpose of the The impact of cash evaluation, and administered at home by the study team or school-based tests, such as end of year transfers on health exams. They also measured different individual subjects or an index measure combining different and nutrition sets of subjects or tests. We therefore divided the test score indicators by test types: maths, Chapter 9 language and composite test scores that are administered to school-age children. The impact of cash transfers on A large number of the included studies assessed the impacts of cash transfer programmes on savings, investment 75 school participation, but only a few examined overall effects on learning outcomes (n=5). Four and production studies reported overall impacts on maths, three studies reported on language test scores, and Chapter 10 one on a composite score (see Table 7.4 to 7.6 at end of chapter for full summary results). The impact of cash transfers on Two studies found a statistically significant effect on test scores, both of which referred to employment language test scores, one representing an improvement and one a decrease relative to non- Chapter 11 beneficiaries. Akresh et al. (2013), evaluating the impacts of two different types of cash transfers The impact of on the Nahouri Cash Transfers Pilot Project in Burkina Faso, find no significant impact on cash transfers on achievement tests, except for a positive impact of CCTs on the reading section of the French test. empowerment The authors also report that in the sub-group analyses by gender, age and ability level, most coefficients are not significant. SECTION III One study found a negative statistically significant impact on test scores: Baez and Camacho (2011) Chapter 12 find the overall impact of Colombia’s Familias en Acción CCT programme on maths test scores to Summary of be statistically non-significant, while that of Spanish was negative and significant at the 10% level findings and conclusion References 75 S everal studies assessed the impact of cash transfer programmes separately for girls or boys instead of reporting an overall effect. These are discussed in the section on impacts by gender.

113 Cash transfers: what does the evidence say? Page 113 Contents (-0.05 standard deviation). The authors also found there to be no significant effect of differential Acknowledgements performance between participant and non-participant children based on the composite test score. The authors, however, provide no explanation as to why they observe the lack of effect. Executive summary The three remaining studies only found non-significant impacts on test scores. SECTION I • n the study by Mo et al. (2013), evaluating the impact of the JHS-RCT (China) on maths test I scores of students in grade seven in rural China, they find the point estimate to be very small Chapter 1 and statistically non-significant. Introduction • enhassine et al. (2013) study the Tayssir pilot programme in Morocco and find a positive B Chapter 2 impact of the labelled cash transfer provided to fathers on standardised test scores (0.08), but Conceptual this effect is not statistically significant in the overall sample (it is larger and significant for framework students already enrolled at baseline and for those from satellite school units). Chapter 3 • I n the case of the Tanzanian Social Action Fund Programme, Evans et al. (2014) find that Review of cash transfer reviews receiving transfers made children four percentage points more likely to be literate after 18–21 months. However, by the second follow-up survey (31–34 months) the impact is smaller (two Chapter 4 percentage points) and becomes non-significant. Methods Chapter 5 Cognitive development The evidence base Cognitive development outcomes in our review refer to indicators of information processing SECTION II ability, intelligence, reasoning, language development and memory among pre-school and school- age children. There are a number of pathways through which cash transfers may impact child Chapter 6 development. As in the case of the previous indicators, improvements may be explained by an The impact of income effect: the additional cash disposable to the household may allow parents to invest in a cash transfers on better home environment or to purchase goods that directly influence child development (i.e. more monetary poverty nutritious food, health care, books). A second mechanism may be that accompanying information Chapter 7 campaigns or conditions that often form part of cash transfer programmes may induce behaviour The impact of change on the part of parents towards their children that could result in better child-rearing cash transfers on practices. Improved child development might be due to improved preferences of parents on how to education raise a child. Chapter 8 The impact of cash Improvements in the cognitive abilities of children of pre-school age as a result of these transfers on health investments may in turn have large effects on school entry, completion and achievement. At and nutrition the same time, it is important to bear in mind that child development results from a dynamic interaction between biological, social and environmental factors, which makes it difficult to isolate Chapter 9 the mechanisms through which cash transfers ultimately influence these outcomes. The impact of cash transfers on savings, investment The issue of whether and to what extent cash transfers improve child development has been and production studied only fairly recently and, therefore, as in the case of test scores, fewer evaluations report on this indicator. Most of the studies included did not report on just one overall effect; many reported Chapter 10 on a diverse range of cognitive development outcomes, in several cases broken down subtests or The impact of cash transfers on by exposure to cash transfer treatments at different stages of development. For all outcomes, if not employment stated otherwise, positive and higher values correspond to better outcomes. Chapter 11 Of the eight studies that reported on cognitive development outcomes, five studies provided an The impact of 76 Out of these, three studies found a overall effect estimate (as opposed to gender disaggregated). cash transfers on statistically significant effect, all of which were improvements (these are reported in bold in Table empowerment 7.7). It is difficult to make comparisons of effect sizes, as such a wide variety of indicators are used, for different age groups of children, however, we do so where possible below. SECTION III For example, Macours et al. (2012) report on the effects of the Atención a Crisis conditional Chapter 12 cash transfer randomised experiment in Nicaragua on an index of five cognitive and socio- Summary of findings and emotional outcomes. As part of the programme, payments were made to mothers who were also conclusion subject to repeated information on the importance of health and education. Children in this References 76 I f an overall index measure was provided, this was extracted over individual tests.

114 Cash transfers: what does the evidence say? Page 114 Contents group were aged six and under when they started receiving the transfers. After nine months in Acknowledgements the programme, and two years after the programme had finished, the authors find a significant positive effect on the index of outcomes for beneficiary children of 0.12 standard deviations Executive summary and 0.08 standard deviations respectively, suggesting that the programme effect did not fade over time. The authors argue that the programme appears to have resulted in behaviour change: beneficiary households increased expenditures on critical inputs into child development such as SECTION I more nutrient-rich foods, provided more early stimulation to their children and made more use of Chapter 1 preventative health care. Introduction Tomassi et al. (2015) referred to the same dataset as Macours et al. (2012), but restricted the Chapter 2 sample to household with only two ‘natural’ decision makers. Similarly to Macours et al. (2012), Conceptual the authors find positive statistically significant results at both follow-ups for an index measure framework of five cognitive and behavioural outcomes. However, point estimates of the original paper Chapter 3 are on average larger, which might be explained by the fact that larger and extended families Review of cash benefited more from the programme than smaller families. Investigating the mechanisms which transfer reviews are more likely to explain the observed improvements in child development, the authors find that the results are largely explained by an income effect and changes in knowledge and child- Chapter 4 Methods rearing practices. Although not presented here, the authors find strong evidence that AAC had heterogeneous programme impacts with respect to the bargaining power of the mother at Chapter 5 baseline (using a proxy, which is education difference). Stronger mothers at baseline were better The evidence base able to use the new resources available and to invest them in their children. The authors therefore argue that CCTs may be effective as long as some initial conditions are satisfied, like a balancing SECTION II power at the baseline favouring mothers. Chapter 6 Within Gilligan et al.’s (2013) evaluation of the WFP Karamoja cash transfer pilot in Uganda The impact of that provided food and cash transfers to households with children aged from 3–5 participating cash transfers on in Early Childhood Development (ECD) centres, the authors find differential impacts for monetary poverty different age groups and depending on the type of cognitive test administered. For children Chapter 7 between 60–83 months of age, authors found almost no significant impacts of either the food The impact of - I or cash transfers on measures of cognitive outcomes, including the KABC I, the sticker test cash transfers on r - of delayed gratification and the HTKS test of self egulation. The authors conclude that either education the transfers generally have no effects in this age range or that the instruments used for this age range were not sufficiently sensitive to detect changes. Conversely, for children aged 54–71 Chapter 8 The impact of cash months, cash transfers caused significant increases in Mullen item and overall scores: in visual transfers on health reception, in receptive language, in expressive language and in the total Mullen raw score (see and nutrition Table 7.7). These findings are consistent with the authors’ findings of significant positive impacts on children’s food consumption, prevalence of anaemia and ECD participation, as well as on Chapter 9 households’ experience with ECD. As regards explanations for the fact that improvements were The impact of cash transfers on concentrated in age range of BICs 54–71 months at endline and not in older BICs, the authors savings, investment note that it may be that the improvements in diet, anaemia status or stimulation from ECD and production centres have larger impacts on younger targeted children. Chapter 10 There were two studies in which no significant effect sizes were found for any measure of The impact of cash transfers on cognitive development, both of which evaluated the impact of the Bono de Desarrollo Humano employment unconditional cash transfer programme in Ecuador (Fernald and Hidrobo, 2011; Paxson and Schady, 2010). Chapter 11 The impact of Although not presented here, Fernald and Hidrobo (2011) find that while there were no cash transfers on significant effects of the programme on combining words and the IDHC-B language development empowerment test of the full sample, there was a statistically significant effect for infants and toddlers in rural areas on language development and ability to combine words. The authors suggest that this may SECTION III be because of higher take-up in rural areas, or greater potential for impact of the educational elements of the programme due to lower initial schooling levels of mothers. Parents of children in Chapter 12 rural areas were also more likely to have ensured that their children received vitamin A or iron Summary of findings and supplementation and were more likely to have bought their child a toy, all potential mechanisms conclusion that could explain the positive effect. Finally, households in rural areas began receiving the transfers five months before urban areas and perhaps had more time to adjust or adapt to the References programme. The authors also comment on the design and implementation features of the BDH compared to other cash transfer programmes in Latin America when trying to explain their

115 Cash transfers: what does the evidence say? Page 115 Contents findings. For example, the BDH had the lowest cash transfer amount when compared with Acknowledgements Mexico’s Oportunidades or Nicaragua’s Red de Protecion Social, and the BDH was considered to be conditional on health care and education requirements by only one quarter of the participants, Executive summary and unconditional by the remainder of the participants. Overall, the results on a positive impact of cash transfers on cognitive development outcomes SECTION I are far from conclusive, which is perhaps to be expected. As described in the theory of change Chapter 1 section, it is harder theoretically to link cash transfers to cognitive outcomes. Introduction Chapter 2 he impact of cash transfers on education indicators for T 7. 4 Conceptual framework women and girls Chapter 3 For the education indicators considered for this review, 20 studies reported sex-disaggregated Review of cash transfer reviews outcomes. This relatively high proportion of studies is probably due to the fact that these indicators are generally measured at the individual level and that some of the programmes targeted cash Chapter 4 transfers specifically at girls only (i.e. the Zomba Cash Transfer Programme in Malawi). The majority Methods of these studies look at the impact on education indicators for girls versus boys. Two studies also reported on the impact by the sex of the household head. We summarise the findings below by the Chapter 5 The evidence base included education indicator. A full summary of results can be found in Table A.5.2.1 in Annex 5. SECTION II Sex of the beneficiary Chapter 6 School attendance The impact of cash transfers on 15 studies looked at disaggregated impacts on school attendance for girls versus boys or either monetary poverty girls or boys only. Of these, 12 studies reported a statistically significant impact for at least one Chapter 7 school attendance measure for girls either at primary or secondary school level (see Table A.5.2.1 The impact of in Annex 5 for a list of studies and results). For all but one study the impact was positive (negative cash transfers on in the case of a measure of school absenteeism). education The outlier is the study by Merttens et al. (2015) of the SAGE programme in Uganda. Consistent Chapter 8 The impact of cash with the overall effect reported above, the study found a negative statistically significant impact on transfers on health the proportion of girls aged 6–17 currently attending formal education for the Vulnerable Family and nutrition Support Grant: the point estimate decreases by six percentage points for girls whereas the impact for boys is not significant. The authors do not elaborate on why they observe these differential Chapter 9 effects for boys and girls, but refer to contextual factors that may have acted as general barriers to The impact of cash transfers on children attending school, including the belief of household members that children were too young savings, investment to attend school or the need for the child to help with housework (Merttens et al., 2015). and production Test scores (maths, language, composite) Chapter 10 The impact of cash transfers on Five studies looked at disaggregated impacts on test scores by gender and four reported impacts employment for girls. Two of these evaluated the Zomba Cash Transfer Programme in Malawi that provided cash transfers to households with school-age girls. Offers included separate transfers to the girls Chapter 11 and their parents (Baird et al., 2011; 2013). One study each looked at Colombia’s Familias en The impact of Acción CCT programme (Baez et al., 2011) and the Tayssir programme in Morocco (Benhassine et cash transfers on al., 2013). Only the two studies evaluating the Zomba Cash Transfer Programme found significant empowerment impact on test scores, both of them are positive. Findings are summarised below: E • stimating the impact of the ZCTP in Malawi for girls aged 13–22, Baird et al. (2011) find SECTION III that after two years of exposure girls increased English test scores by 0.14 standard deviation Chapter 12 and maths test scores by 0.12 standard deviation (both statistically significant) in the CCT Summary of arm. Girls in the UCT arm, however, did not show a statistically significant improvement in findings and test scores. The follow-up study by Baird et al. (2013), reporting on girls not in school when conclusion the programme started, found that two years of exposure to the programme increased English References test scores by 0.13 standard deviation and maths test scores by 0.16 standard deviation, both of which are also statistically significant. Baird et al. (2011) also examine heterogeneity of

116 Cash transfers: what does the evidence say? Page 116 Contents programme impact using an indicator of whether a girl was 16 years of age or older (the legal Acknowledgements age of marriage stood at 16 in Malawi by late 2009). Interestingly, they find that the advantage in English test scores in the CCT arm disappears among girls aged 16 or above at baseline Executive summary (coefficient is not significant anymore), whereas the advantage the UCT arm has in preventing marriages and pregnancies is substantially larger among older teenagers. SECTION I • tudy by Baez and Camacho (2011) reports impacts on test scores in maths, language and a A s composite test disaggregated for boys and girls. As for the overall effect, the impact on learning Chapter 1 outcomes shows mostly no statistical impacts in test scores for either girls or boys across Introduction different model specifications. Chapter 2 enhassine et al. (2013) compared different design variants as part of the Tayssir programme B • Conceptual in Morocco that provided payments to parents of primary school-age children (aged 6–15). framework As for the overall effect, the impact of the labelled transfer provided to fathers showed no Chapter 3 significant effect for boys or girls on maths test scores (summary index). Review of cash transfer reviews Cognitive development Chapter 4 Methods Four studies assessed disaggregated impacts on cognitive scores by gender and four reported impacts for girls. Measures of cognitive skills varied between studies and included versions of Chapter 5 Raven’s Coloured Progressive Matrices (Baird et al., 2011; 2013), Woodcock-Johnson-Muñoz The evidence base III tests, the MacArthur Communicative Development Inventories and different versions of the Peabody Picture Vocabulary Test (Gertler et al., 2004). Three of the four studies found positive SECTION II and statistically significant effects among girls (Baird et al., 2011; 2013; Paxson et al., 2010; Gertler et al., 2004): Chapter 6 The impact of B • aird et al. (2011) find that after two years of exposure, girls increased cognitive scores of a cash transfers on version of the Raven’s Coloured Progressive Matrices (0.17 standard deviation; p<0.01) in the monetary poverty CCT arm of the Zomba Cash Transfer Programme in Malawi. Girls in the UCT arm, however, did not show a statistically significant improvement. The follow-up study by Baird et al. (2013), Chapter 7 looking at girls not in school when the programme started (baseline dropouts), found that The impact of two years of exposure to the programme affected cognitive scores by 0.14 standard deviation cash transfers on education (p<0.05). Overall, the authors conclude that the CCT arm that required attendance to receive the monthly cash transfer had a significant advantage in terms of schooling outcomes over the Chapter 8 UCT arm. The impact of cash transfers on health G • ertler and Fernald (2004) estimate how investments in health and nutrition as part of and nutrition Oportunidades that began during the prenatal period impacted child development indicators of children aged from 3–6 (pre-school age). The authors measure cognitive development Chapter 9 using the Woodcock-Johnson-Muñoz III tests, the MacArthur Communicative Development The impact of cash transfers on Inventories, and the Spanish version of the Peabody Picture Vocabulary Test, the Test de savings, investment Vocabulario en Imágenes Peabody. Although the authors find large impacts of the programme and production motor development in both boys and girls, and an impact on socio-emotional development in girls, they find little evidence of impact on cognitive development of boys or girls. Only one Chapter 10 of the 12 coefficients is significant (see Table A.5.1.1 in Annex 5). Explanations put forward The impact of cash transfers on by the authors include that, while the brain may be more prepared for cognitive development employment due to the better nutrition, there may be a lack of necessary stimulation to develop cognitive skills provided by parents. Oportunidades might therefore consider including teaching skills to Chapter 11 parents or introduce more intensive activities to promote child stimulation. The impact of cash transfers on P • axson and Schady (2010) found a statistically significant positive effect of the Bono de empowerment programme’s cash transfers on the physical, cognitive and socio-emotional Desarrollo Humano development of girls (0.24 standard deviaton p<0.05), but not on boys. SECTION III Sex of the household head Chapter 12 Summary of findings and School attendance conclusion Two papers looked at the impact of a conditional cash transfer on school attendance according to References the sex of the household head (Dammert, 2008; World Bank, 2011):

117 Cash transfers: what does the evidence say? Page 117 Contents D • ammert (2008) considers the impact of the Red de Protección Social (RPS) programme in Acknowledgements Nicaragua and finds that children living in a male-headed household experience a smaller impact of the programme on school attendance. Estimates suggest that the RPS programme Executive summary increased school attendance by 17 percentage points (for children living in female-headed households) compared to 14 percentage points for children living in male-headed households in 2002; both coefficients are significant. SECTION I • I n contrast, evaluating the Pilot Program Keluarga Harapan (PKH) in Indonesia, the authors Chapter 1 find that it was only for male-headed households that the transfer resulted in a significant Introduction positive impact on the number of hours spent in school by all children (both age ranges Chapter 2 reported). The effect is not statistically significant for female-headed households (World Bank, Conceptual 2011). In addition, the transfers showed no statistically significant impacts on regular primary framework and secondary school attendance, either for male- or female-headed households. Possible explanations for this observed impact on the number of days spent in school proposed by the Chapter 3 authors relate to the different opportunity costs of schooling and labour faced by different Review of cash transfer reviews types of families: female-headed households often lack a second wage earner, and therefore the cost of sending a child to school instead of working may be higher than for male-headed Chapter 4 households. Methods Chapter 5 The evidence base he role of cash transfer design and implementation features 7. 5 T A total of 15 studies shed light on the role of design and implementation features on the education SECTION II outcomes reviewed. Overall, the one study looking at transferring cash to males versus females finds no impact on the schooling outcomes, and little or no evidence is found to show a strong Chapter 6 The impact of effect of increasing transfer amounts on outcomes. However, a few studies do find the length cash transfers on of exposure and cumulative cash transfers received to have important effects on cognitive monetary poverty development and years of education. Similarly, conditioning transfers on educational outcomes does appear to have a differential impact, though evidence was also found that UCTs which are Chapter 7 strongly labelled as being for educational purposes can also be more effective than unconditional The impact of transfers without such messaging. The full table of results can be found in Table 5.2.2 in Annex 5. cash transfers on education Main recipient Chapter 8 The impact of cash transfers on health Only one study explicitly tests the differential impact of transferring money to women versus men. and nutrition Comparing across educational transfers being delivered to mothers or fathers of children aged 6–12, Benhassine et al. (2013) find no significant difference between the two in terms of school Chapter 9 attendance, enrolment or performance in a standardised maths test. The impact of cash transfers on savings, investment Transfer amount, timing and frequency and production Chapter 10 Four papers explicitly test the impact of varying transfer amounts, finding limited conclusive The impact of evidence that increases in transfer size lead to greater impacts on educational outcomes. The main cash transfers on exceptions were for the UCT branch of Malawi’s ZCTP and findings by Manley et al. (2015) that employment higher transfer amounts led to improvements in cognitive development outcomes in PROGRESA/ Chapter 11 Oportunidades. The impact of steva (2012) isolates the effects of increases in transfer size, taking advantage of discrete E • cash transfers on changes for the educational cash transfers specified in PROGRESA’s rules. cash transfer empowerment increases estimated for two comparable groups were equal to 158 and 344 Mexican pesos during pregnancy and first year of life, but little conclusive evidence of differential impacts on SECTION III medium-term physical, cognitive and motor skill developments were found. Chapter 12 • t is helpful to set these findings against another study of PROGRESA/Oportunidades, I Summary of which did find higher transfer amounts to be associated with improvements on the cognitive findings and and verbal Wechsler Abbreviated Scale of Intelligence (WASI) scores (Manley et al., 2015). conclusion Interestingly, this second study also investigates the effects of 18 additional months as a References recipient, and finds that higher transfer sizes result in stronger effects than additional exposure for all outcomes except for a strengths and difficulties questionnaire.

118 Cash transfers: what does the evidence say? Page 118 Contents ilmer and Schady (2011), basing their findings on a regression discontinuity design • F Acknowledgements distributing varying transfer amounts for Cambodia’s CESSP programme, find that the impact on attendance of an additional US$15 is modest; between one and three percentage points, Executive summary and is generally not significant at conventional levels. It should be noted, however, that the base transfer of US$45 was equivalent to just 2% of the consumption of the median recipient household in Cambodia, which is particularly low by international standards. SECTION I nalysing heterogeneity in programme impacts by transfer amounts for Malawi’s ZCTP, Baird A • Chapter 1 et al. (2011) show that increasing transfer amounts had no effect on enrolment, attendance or Introduction performance for the CCT branch (where the minimum total transfer amount offered to the Chapter 2 household, US$5 per month, seems to be responsible for the entire programme impact), while Conceptual outcomes did vary with increased transfer size in the UCT arm: enrolment rates increased framework but performance in test scores seemed to suffer. One possible interpretation of this is that transfer sizes may matter more in the absence of conditions, which does fit with the idea that Chapter 3 UCTs depend on an income effect, while CCTs exert an additional price effect through the Review of cash transfer reviews conditions, as mentioned in the conceptual framework chapter. Chapter 4 Two papers offer some insight into the role of the timing of transfers, offering some evidence Methods that tying the transfer schedule to critical moments of the school year decision cycle can have an impact, especially on enrolment. Chapter 5 The evidence base B • arrera-Osorio et al. (2008) compare a standard CCT with a treatment arm that postpones a bulk of the cash transfer due to good attendance to just before children have to re-enrol, SECTION II piloted for Bogota’s SCAE, and find that changing the timing of payments does not change attendance rates relative to the basic treatment, but significantly increases enrolment rates at Chapter 6 secondary and tertiary levels (by 3.6 and 3.3 percentage points respectively). The impact of cash transfers on T hough not explicitly designed to test the hypothesis of the impact of transfer timing on • monetary poverty ultimate outcomes, Akresh et al. (2013) shed light on this topic by noting that their results ‘show no impact of the conditional or unconditional transfers at round two for school year Chapter 7 2008-2009, the program’s first year, because the transfers were delivered too late in that school The impact of year. However, the results show significant impacts of transfers at round three for school year cash transfers on education 2009-2010, when the transfers were delivered on time’. Chapter 8 The impact of cash Length of exposure transfers on health and nutrition Nine papers offer insights into the effect of increasing the treatment spell for beneficiary households, though few explicitly test the differential impact of longer exposure to the Chapter 9 programme. Overall, there is little evidence of increased attendance due to higher exposure, The impact of cash transfers on though one study does find longer exposure in Colombia’s Familias en Acción to be associated savings, investment with more years of education (Villa, 2014). There also appears to be little evidence of any impacts and production of longer exposure on language, maths or cognitive development, except where this is combined with eligibility for higher transfers (i.e. higher cumulative transfers). Chapter 10 The impact of cash transfers on Attendance employment erova and Vakis (2012) find that being a beneficiary in Peru’s Juntos programme for two years P • Chapter 11 or longer compared to peers who participated in the programme for under one year leads to The impact of significantly higher enrolment rates. Although, in the case of attendance, there is no strong cash transfers on evidence of differences in the impacts depending on treatment spell duration. empowerment • R eporting on the TSAF (Tanzania), Evans et al. (2014) find that after 31–34 months there were no statistically significant impacts on the likelihood that children aged 0–18 were enrolled in SECTION III school, missed school or self-declared as literate (compared to initial significant impacts after 18–21 months). The authors hypothesise this may be due to changes in perceptions of how Chapter 12 rigorously conditions were imposed, or to schools becoming increasingly crowded in treatment Summary of findings and communities, creating disincentives for attendance. conclusion V • illa (2014) also provides interesting insights into the effect of higher elapsed proportions References of the maximum length of exposure to Colombia’s Familias en Acción. Drawing on a design feature that meant that children were eligible for the transfers until they reached the age of

119 Cash transfers: what does the evidence say? Page 119 Contents 17, he finds higher proportions of exposure to be highly significant in explaining the years of Acknowledgements education children receive for those who were enrolled at seven years old, and for there to be a difference of 4.4 years between those that are most and least exposed. The study also finds a Executive summary form of threshold effect, with the number of years of education increasing at a faster rate after households have benefited from 80% of their maximum length of exposure. SECTION I Language and maths Chapter 1 n the case of the TSAF (Tanzania), Evans et al. (2014) find that treatment was associated with I • Introduction children being four percentage points more likely to be literate after 18–21 months. However, Chapter 2 by the second follow-up survey (31–34 months) the impact was smaller, at just two percentage Conceptual points, and became non-significant, though potential explanations are not discussed. framework B ehrman et al. (2009) find no significant effects on reading, written language or maths tests • Chapter 3 arising as a result of an extra 18 months as a PROGRESA/Oportunidades beneficiary. By contrast, Review of cash Fernald et al. (2008) look at the effect of cumulative cash transfers in the same programme, transfer reviews which in effect represents a combination of the length of duration and the size of transfer (with families eligible for greater transfers with more children). They find that a doubling of cumulative Chapter 4 Methods cash transfers from 7,500 pesos to 15,000 pesos was associated with a significant increase in the Peabody score test of 0.18. This may suggest that while a longer duration alone may be Chapter 5 insufficient, longer duration with a higher transfer eligibility does result in significant effects. The evidence base Cognitive development SECTION II I • n the same study by Fernald et al. (2008), estimating the effect of cumulative cash transfers, they find significant effects of doubling cumulative cash transfers on long- and short-term Chapter 6 The impact of memory and visual integration for children aged 36–68 months. In a follow-up study, Fernald cash transfers on et al. (2009) test both the effect of cumulative cash transfers (combination of duration and monetary poverty transfer sizes), as well as simple duration of exposure, and find that, whereas cumulative transfers resulted in significant effects in improving cognitive and verbal assessment scores Chapter 7 after 10 years, the effect of an additional 18 months had no such significant effect. These The impact of findings suggest that simply increasing duration in itself may not have had differential effects, cash transfers on education but the combination of a longer exposure and higher transfer eligibility did. E steva (2012) finds ‘weak evidence of medium-term effects on pre-school children’s cognitive • Chapter 8 The impact of cash and motor skill development for exposure to PROGRESA during early stages of life’, with transfers on health the programme unable to correct considerable initial disadvantages of children born in and nutrition poor settings. Specifically, no advantage of being born in an early-treatment locality (longer exposure to health care and higher amounts) or being exposed to the programme during all Chapter 9 in utero development is found in most of the dimensions analysed, except for a 14 percentage The impact of cash transfers on of 20 percentage points reduction point increase in the log of long-term memory score and a savings, investment in a visual spatial integration score. The use of a novel methodology by Manley et al. (2015) and production seems to confirm low marginal effects of 18 additional months on the same programme. Chapter 10 The impact of Conditionality cash transfers on employment Three cash transfer experiments in sub-Saharan Africa compare conditional versus unconditional Chapter 11 cash transfers, two of which find higher impacts on educational outcomes for CCTs compared to The impact of UCTs and one of which finds no differential impact, but where the UCT comparison is a ‘labelled’ cash transfers on transfer, raising the important question over the extent to which full blown conditions with empowerment monitoring and enforcement (and associated costs) are required. he evaluation of Morocco’s Tayssir pilot programme (Benhassine et al., 2013), in which T • SECTION III transfers were not conditioned on school participation but school enrolment was strongly 77 found that ‘explicitly conditioning encouraged (i.e. a ‘labelled’ Cash Transfer – LCT), Chapter 12 transfers on attendance if anything decreased their impact in the context of this program, Summary of findings and particularly on re-enrolment of children who had initially dropped out, and generally on conclusion children with lower probability to re-enrol or stay in school’. For example, the effects on References 77 F or example, enrolment for Tayssir was done at schools and by headmasters, with an effort to mobilize all children, even those currently not enrolled.

120 Cash transfers: what does the evidence say? Page 120 Contents 78 were ‘2 percentage points higher (significantly so) under the LCT school participation Acknowledgements than under the CCT program’, with results being driven primarily by girls. Interestingly, moreover, while both point estimates for impacts on maths scores for LCT and CCT were Executive summary non-significant, the difference between CCT and LCT was significant at the 5% significance level (with the LCT faring better). This evidence leads the authors to suggest that ‘cash transfer programs may work in part by changing how parents perceive education’. SECTION I n Burkina Faso, the NCTPP was designed to compare a UCT to a CCT conditional on • I Chapter 1 enrolment. Akresh et al. (2013) find no significant difference between the UCT and the CCT Introduction on enrolment, though the CCT outperformed the UCT on attendance. Importantly, moreover, Chapter 2 they find that CCTs led to larger impacts than UCTs among ‘marginal children’ who are Conceptual initially less likely to go to school: girls, younger children and lower ability children. framework S imilarly, based on an experiment in Malawi comparing a CCT to a UCT, Baird et al. (2011) • Chapter 3 find that conditioning cash transfers on school attendance increased the effectiveness of the Review of cash 79 For example, although drop-out rates programme at keeping adolescent girls in school. transfer reviews declined in both treatment arms, the effect in the UCT arm is 43% of that in the CCT arm. Moreover, the CCT outperformed the UCT when measuring impacts on cognitive ability, Chapter 4 Methods mathematics and English reading comprehension (with difference in programme impacts between the two treatment arms significant for English reading comprehension). Chapter 5 The evidence base A further programme from which evidence is found on conditionalities is the CSAE in Colombia. Barrera-Osorio et al. (2008) evaluate variations of the CSAE which provide insights into the role SECTION II of conditionality and timing of transfer by comparing three treatments: a basic CCT treatment based on school attendance, a ‘savings treatment’ that postpones a bulk of the cash transfer Chapter 6 due to good attendance to just before children have to re-enrol, and a ‘tertiary treatment’ where The impact of some of the transfers are conditional on students’ graduation and tertiary enrolment rather than cash transfers on attendance. The authors find that the type of incentive mattered significantly: changing the timing monetary poverty of the payments as part of the savings treatment did not change attendance rates relative to the Chapter 7 basic treatment, but significantly increased enrolment rates at both the secondary and tertiary The impact of levels; the basic and savings treatments increased attendance in San Cristóbal by 3.3 and 2.8 cash transfers on percentage points respectively, both estimates are significant at the 1% level. Providing incentives education around graduation rather than just attendance is shown to be particularly effective, increasing attendance by five percentage points. Students who received the savings and tertiary treatments Chapter 8 The impact of cash were also significantly more likely to have re-enrolled in school than those who did not receive a transfers on health treatment, by 3.6% and 3.3% respectively. and nutrition Chapter 9 Targeting The impact of cash transfers on Only one of the studies reviewed – the midline evaluation of Uganda’s SAGE programme by savings, investment Merttens et al. (2015) – was found to provide insights on the differential impacts of different and production targeting mechanisms. For Uganda’s SAGE, one treatment arm – the Senior Citizen Grant (SCG) Chapter 10 – used age to determine eligibility targeting those aged 60 or 65 and above, depending on the The impact of region. Another treatment arm – the Vulnerable Family Support Grant (VFSG) – targeted on cash transfers on the basis of a composite index based on demographic indicators of vulnerability. The study finds employment a small reduction (three percentage points) in the proportion of school-age children attending Chapter 11 formal education among those targeted on the basis of the vulnerability index, which is driven by The impact of a greater increase in the proportion of girls attending school within the control group. However, cash transfers on no significant changes were estimated among households targeted on the basis of old age and the empowerment differences between the two targeted groups are not explained. SECTION III Chapter 12 Summary of findings and conclusion H 78 aving attended school at least once in the last month of the programme (year two). References 79 T he UCT however outperformed the CCT at averting teen pregnancy and marriage. It should also be noted that the previous version of this same paper found no significant differences.

121 Cash transfers: what does the evidence say? Page 121 Contents Complementary interventions and supply-side services Acknowledgements Two papers aim to measure the differential impact on education of complementary activities, both Executive summary referring to the Atención a Crisis programme in Nicaragua that distributed cash and childcare information on households with children up to the age of five. The programme randomised three where households with children up to basic cash transfer package treatment variations: (1) a SECTION I the age of five received the transfer every two months conditional on regular preventative health Chapter 1 training package check-ups; (2) a , whereby households received the same basic cash transfer and Introduction were also offered a scholarship to allow one household member to choose among a number of vocational training courses; and (3) a lump-sum package , in addition to the basic transfer, to start Chapter 2 a small non-agricultural activity. The lump sum was conditional on the household developing a Conceptual framework business development plan. All beneficiaries, regardless of the treatment, were also exposed to repeated information and communication on the importance of varied diets, health and education. Chapter 3 Review of cash acours et al. (2012) find no evidence of better child development outcomes (including M • transfer reviews cognitive and socio-emotional outcomes) among households that received a lump-sum payment, relative to those that only received the basic cash transfer treatment, despite Chapter 4 effectively higher transfer levels. The authors note that the lack of effect ‘cannot easily be Methods explained by other [potentially expected] changes that could have had a deleterious effect on Chapter 5 child development’. For example, there was no evidence that among lump-sum recipients the The evidence base mothers spent less time with their children, were less likely to read or tell stories or had poorer mental health compared to those that received the basic treatment. SECTION II I n an earlier paper that did not explicitly aim to measure the differential impact on education • of complementary activities to cash transfers, Macours and Vakis (2009) found largely similar Chapter 6 impacts on attendance arising from all three treatment variations in Atención a Crisis. The impact of cash transfers on monetary poverty 7. 6 P olicy implications Chapter 7 The impact of Overall, the evidence analysed in this review confirms that cash transfers can impact access to cash transfers on education in the short term by removing the direct and indirect financial barriers to education. education However, a less clear-cut pattern of impact was found for learning outcomes (as measured by test scores) and cognitive development outcomes (information processing ability, intelligence, reasoning, Chapter 8 The impact of cash language development and memory), partly as these result from a dynamic interaction between transfers on health biological, social and environmental factors, including the ultimate quality of services provided. and nutrition The review also highlighted several findings that could have important policy implications, especially Chapter 9 when analysing the mediating role of programme design and implementation features on impacts. The impact of cash transfers on savings, investment First, conditionality appears to have an important role in mediating impact for access outcomes and production (increasing marginal effects for enrolment and attendance), but only to the extent it is perceived as such by recipients. For example, cash transfers where conditionality was applied on paper but Chapter 10 not monitored, enforced or understood by recipients ultimately had lower marginal effects than The impact of cash transfers on equivalent UCTs that were strongly labelled as being aimed at human development outcomes employment (through the name of the programme, associated messaging and potentially transfer modality). For example, Morocco’s Tayssir programme UCT experiment branch was transferred through schools, Chapter 11 and this had an important ‘labelling’ role in affecting parents’ perceptions of its intended use The impact of (Benhassine et al., 2013). The type of conditionality could also play a role, with one programme cash transfers on empowerment evaluation in Colombia suggesting that incentives for graduation and matriculation can be more effective in increasing enrolment and attendance than the widely adopted conditionality on attendance (Barrera-Osorio et al., 2008). SECTION III Second – and intuitively – marginal effects were often highest where overall rates at baseline Chapter 12 were lowest (more room for improvement). This has implications for targeting design, whereby a Summary of findings and programme aiming to have a strong impact on enrolment or attendance, for example, may choose conclusion to target specific areas or categories of children least likely to be in school/more likely to drop out: children transitioning to secondary or tertiary schooling, children with disabilities, potentially girls References (depending on social norms). This also means that impacts for primary school-age children are generally smaller and less significant, given that baseline values are generally higher for this age group.

122 Cash transfers: what does the evidence say? Page 122 Contents Third, there appears to be some emerging evidence that increases in transfer size can lead to greater Acknowledgements impacts on educational outcomes, including cognitive development (Manley et al., 2015; Baird et al., 2011), though findings were not found consistently across all programmes, raising questions Executive summary over how to ensure that transfer increases do lead to improvements. Nevertheless, a number of studies reviewed also highlighted that small transfer sizes may have been a reason for observing limited impacts and two studies found that higher cumulative transfers (a combination of longer SECTION I exposure and higher transfers) did have significant impacts on language and cognitive development Chapter 1 scores (Fernald et al., 2008; Fernald et al., 2009). This is partially in line with findings presented Introduction within much of the qualitative research on this topic, and with Saavedra and Garcia (2012), who find larger primary and secondary enrolment effects for programmes with more generous transfers. Chapter 2 More attention should also be paid to the role of the timing of transfers, as two papers within this Conceptual review offered some (mostly anecdotal) evidence that tying the transfer schedule to critical moments framework of the school-year decision cycle can have an impact, especially on enrolment. Chapter 3 Review of cash Fourth, and critically, the fact that the evidence base is not sufficient to make any generalisations transfer reviews on the impacts of cash transfers on ultimate outcomes such as learning (as measured by test scores) and cognitive development is a finding in itself. This is partly due to the nature of the selected Chapter 4 Methods indicators, which have been measured in a wide variety of different ways, making it impossible to conclusively compare effect sizes. It is also due to the ultimate theory of change for these outcome Chapter 5 areas, which are affected by such a wide variety of mediating factors (e.g. children’s nutrition, The evidence base rearing practices, parents’ human capital, quality of service delivery, etc.) that pinning down the linear impact of additional cash is close to impossible. For policy-makers, the implication could be SECTION II the need to address this problem on several complementary fronts, recognising that cash transfers alone are not a silver bullet. Best practice internationally has been to complement cash transfer Chapter 6 delivery with a wide variety of other interventions including providing nutritional support, The impact of educational sessions focused on child-rearing/nutrition, and supply-side grants for schools, to cash transfers on name some. More research isolating the marginal impacts of these complementary interventions monetary poverty is needed. Within this, it will be important from a policy perspective to keep in mind the cost Chapter 7 implications of different transfer designs, to ensure that any additional benefit arising from such The impact of changes is not outweighed by associated costs. cash transfers on education Summary tables Chapter 8 The impact of cash Table 7.3: Summary of results for overall cash transfer effects on school attendance transfers on health Significance Measure of Effect Variable and treatment population (e.g. Programme Study # Details/explanation and nutrition change age of child) 1% Percentage of school days the child attended Percentage CCT, children aged 1 Akresh et al. NCTPP 0.13 4 Chapter 9 during the entire academic year (school roster) (Burkina Faso) 7–15, after 2 years (2013) The impact of cash transfers on Percentage of school days the child attended NCTPP 0.067 Percentage NS UCT, children aged savings, investment 7–15, after 2 years during the entire academic year (school roster) (Burkina Faso) and production NS Percentage UCT, after 36 months, 0.01 ZCGP (Zambia) Full attendance prior week (%) 2 A IR (2014) children aged 4–7 Chapter 10 NS Number of days Number of days in attendance prior week (0–5) ZCGP (Zambia) 0.25 UCT, after 36 months, The impact of children aged 4–7 cash transfers on employment Number of days UCT, after 36 months, NS ZCGP (Zambia) Days attended prior week if enrolled 0.05 children aged 4–7 Chapter 11 Full attendance prior week (%) ZCGP (Zambia) 0.032 Percentage NS UCT, after 36 months, The impact of children aged 7–14 cash transfers on UCT, after 36 months, NS Number of days 0.249 Number of days in attendance prior week (0–5) ZCGP (Zambia) empowerment children aged 7–14 Number of days ZCGP (Zambia) Days attended prior week if enrolled 0.113 NS UCT, after 36 months, children aged 7–14 SECTION III ZCGP (Zambia) Percentage UCT, after 36 months, Full attendance prior week (%) -0.005 NS children aged 15–17 Chapter 12 Summary of ZCGP (Zambia) Number of days in attendance prior week (0–5) -0.035 Number of days NS UCT, after 36 months, findings and children aged 15–17 conclusion ZCGP (Zambia) Days attended prior week if enrolled 0.098 Number of days NS UCT, after 36 months, children aged 15–17 References continued on next page

123 Cash transfers: what does the evidence say? Page 123 Contents continued Table 7.3: Summary of results for overall cash transfer effects on school attendance Acknowledgements Programme Study # Significance Details/explanation Measure of Effect Variable and treatment population (e.g. age of child) change Executive summary Verified attendance at school 3 Barrera-Osorio CSAE 0.033 Percentage T1= Basic CCT, San 1% Cristóbal (Colombia) et al. (2008) CSAE Verified attendance at school 0.028 Percentage 1% T2= Savings CCT, San SECTION I (Colombia) Cristóbal Chapter 1 CSAE Verified attendance at school NS 0.009 Percentage T1= Basic CCT, Suba, (Colombia) grades 6–8 Introduction Verified attendance at school Percentage 1% T3= Tertiary CCT, 0.05 CSAE Chapter 2 (Colombia) Suba, grades 9–11 Conceptual Tayssir Benhassine et Attendance rate during surprise school visits 4 0.007 Percentage NS Labelled cash framework transfer, after 2 years, among those enrolled (School visits) (Morocco) al. (2013) administered to one Chapter 3 child per household Review of cash aged 6 –12 transfer reviews Labelled cash 1% Percentage 0.74 Tayssir Attending School by end of year 2, among those 6–15 at baseline (Household survey) transfer, after 2 years, (Morocco) Chapter 4 administered to one Methods child per household aged 6 –12 Chapter 5 Attending school by end of year 2 if had dropped Tayssir Labelled cash 0.121 Percentage 1% The evidence base (Morocco) out at any time before baseline (Household transfer, after 2 years, survey) administered to one child per household aged 6 –12 SECTION II Cheema et al. 5 NS Percentage point 0.0318 Proportion of children aged 5–12 currently BISP (Pakistan) Chapter 6 attending school (2014) The impact of 6 UCT NS Percentage -0.025 School attendance Covarrubias et SCTP (Malawi) cash transfers on al. (2012) Days of school SCTP (Malawi) Days of school missed per month (absenteeism) -0.721 UCT Not clear at monetary poverty missed per what level month Chapter 7 The impact of TSAF 7 Evans et al. 5% CCT, children aged Percentage Ever attended school 0.04 (Tanzania) (2014) 0–18 years, after cash transfers on 31–34 months education CCT, children aged NS Percentage 0.02 TSAF Missed school last week if enrolled due to Chapter 8 (Tanzania) personal reasons (absenteeism) 0–18 years, after 31–34 months The impact of cash transfers on health CCT, children aged NS TSAF Percentage Took national exam-Standard IV+ 0.02 and nutrition (Tanzania) 0–18 years, after 31–34 months Chapter 9 0.511 CCT, children aged NS Number of days Number of days in school over past 2 weeks Shombhob Ferré and Sharif 8 The impact of (2014) (Bangladesh) 6–15, after 13 months cash transfers on Percentage 9 CCT, Fourth Follow 0.171 CSP 5% Filmer and Child’s presence at school during unannounced savings, investment Schady (2011) visit (Cambodia) Up – June 2007, and production US$45 scholarship, Secondary School Chapter 10 students The impact of Percentage -0.08 Whether a child missed any days of school in the LEAP (Ghana) Handa et al. 10 UCT, Children aged 5% cash transfers on Points reference period (absenteeism) 5 –17 (2014) employment 5% LEAP (Ghana) UCT, Children aged Whether a child did not attend any school in the -0.05 Percentage 5 –17 last week (Absenteeism) Points Chapter 11 The impact of 11 UCT, Children aged NS BPC (Brazil) Not clear Kassouf and de - 0.1151 Ever attended school cash transfers on Oliveira (2012) 10 –15 ears empowerment 12 Macours and Atención children aged 7–18, 1% Attending school 0.05 Percentage a Crisis Vakis (2009) after 9 months (Nicaragua) SECTION III Atención Number of days absent from school -1.352 children aged 7–18, Percentage 1% a Crisis after 9 months (absenteeism) Chapter 12 (Nicaragua) Summary of continued on next page findings and conclusion References

124 Cash transfers: what does the evidence say? Page 124 Contents Table 7.3: Summary of results for overall cash transfer effects on school attendance continued Acknowledgements Programme Details/explanation # Variable and treatment population (e.g. Effect Measure of Significance Study age of child) change Executive summary Current attendance (if child indicated she/he was 13 Maluccio and RPS After two years, age 10% 0.14 Percentage still enrolled and had missed three or fewer days (Nicaragua) Flores (2005) 7 years in the past month – or more because of illness) SECTION I Current attendance (if child indicated she/he was RPS Percentage 10% 0.28 After two years, age still enrolled and had missed three or fewer days (Nicaragua) 8 years Chapter 1 in the past month – or more because of illness) Introduction RPS Current attendance (if child indicated she/he was After two years, age 10% Percentage 0.29 still enrolled and had missed three or fewer days (Nicaragua) 9 years Chapter 2 in the past month – or more because of illness) Conceptual framework Current attendance (if child indicated she/he was RPS After two years, age 10% 0.16 Percentage still enrolled and had missed three or fewer days (Nicaragua) 1 years in the past month – or more because of illness) Chapter 3 Review of cash Current attendance (if child indicated she/he was RPS 10% Percentage 0.17 After two years, age transfer reviews (Nicaragua) still enrolled and had missed three or fewer days 11 years in the past month – or more because of illness) Chapter 4 RPS Current attendance (if child indicated she/he was NS Percentage After two years, age 0.10 Methods still enrolled and had missed three or fewer days (Nicaragua) 12years in the past month – or more because of illness) Chapter 5 RPS Current attendance (if child indicated she/he was 10% After two years, age 0.32 Percentage The evidence base still enrolled and had missed three or fewer days (Nicaragua) 13 years in the past month – or more because of illness) 14 UCT, after three years, NS Percentage -0.059 Proportion of children currently attending school HSNP (Kenya) Merttens et al. SECTION II (2013) children aged 6–17 NS Number of days Average number of days absent from school in HSNP (Kenya) -1.0 47 UCT, after three years, Chapter 6 children aged 6–17 absent the last 12 months (Absenteeism) The impact of cash transfers on Percentage -0.004 SAGE (SCG) Proportion of children currently attending formal Merttens et al. Children aged 6–17, NS 15 after one year Points education (2015) (Uganda) monetary poverty SAGE (VFSG) Percentage 10% Children aged 6–17, -0.034 Proportion of children currently attending formal Chapter 7 after one year (Uganda) education Points The impact of Mean number 0.14 Mean number of days missed in last 30 SAGE (SCG) Children aged 6–17, NS cash transfers on (Uganda) scheduled school days (absenteeism) of days missed after one year education in last 30 scheduled days Chapter 8 Mean number SAGE (VFSG) -0.36 Mean number of days missed in last 30 Children aged 6–17, NS The impact of cash scheduled school days (absenteeism) (Uganda) of days missed after one year transfers on health in last 30 and nutrition scheduled days Mean number of days absent per month UCT, Students aged 1% Days per week -1 SCTP (Malawi) Miller and 16 Chapter 9 Tsoka (2012) (absenteeism) 6 –18 The impact of Proportion of pupils 6–19 who missed school in LCGP (Lesotho) Pellerano et al. 17 Percentage 0.351 UCT, after two years, NS cash transfers on (2014) the 30 days prior to the survey – self-reported children aged 6–19 savings, investment (absenteeism) and production 18 CCT, after 5 years, 1% Percentage 0.25 Currently attending school, conditional on Juntos (Peru) Perova and children aged 6–14 registration Vakis (2012) Chapter 10 The impact of 19 Percentage Seidenfeld and UCT, children aged CTP (Zambia) Missed two or more days in last week -0.025 NS cash transfers on 6 –16 Handa (2011) (Absenteeism) employment PKH (Indonesia) 0.009 Regular primary school attendance (>85%) World Bank 20 CCT, children aged NS Percentage point (2 011) 7–12 Chapter 11 10% Hours spent in 0.319 Hours in school last week PKH (Indonesia) CCT, children aged The impact of school last week 7–12 cash transfers on empowerment PKH (Indonesia) Regular junior secondary school attendance 0.014 Percentage point NS CCT, children aged school (>85%) 13 –15 0.638 Hours spent in CCT, children aged 5% PKH (Indonesia) Hours in school last week SECTION III school last week 13 –15 Chapter 12 Notes: Results presented are overall results reported and do not include those disaggregated by gender or Summary of showing the effect of variations in design features. Figures in bold indicate statistically significant results. NS findings and means the study did not find a statistically significant result, typically up to the 10% significance level. conclusion References

125 Cash transfers: what does the evidence say? Page 125 Contents Table 7.4 Summary of results for overall cash transfer effect on Maths Test Scores Acknowledgements Measure of # Programme Variable and treatment population Effect Details/explanation Study Significance change Executive summary Maths Test Scores -0.083 Standardised maths test score NCTPP (Burkina UCT, after 2 years NS Akresh et al. 1 Change in z-score (2013) Faso) SECTION I NCTPP (Burkina Standardised maths test score CCT, after 2 years 0.051 Change in z-score NS Chapter 1 Faso) Introduction 2 Baez and Familias en Acción Standardised maths test score -0.015 NS CCT Change in 81 80 (Colombia) Camacho (2011) (Icfes test) , Standard deviation Chapter 2 3 Basic Arithmetic test – Summary Index Benhassine et al. Tayssir (Morocco) NS Labelled cash transfer, 0.081 Change in Score Conceptual (2013) (Based on ASER test developed by after 2 years, administered framework Pratham), to one child per household aged 6 –12 Chapter 3 Change in CCT, after one year, grade NS 4 Mo et al. (2013) 0.01 Maths Test Score JHS-RCT (China) Review of cash Standard deviation 7 high school students transfer reviews Chapter 4 Methods Table 7.5 Summary of results for overall cash transfer effect on language test scores Study # Details/ Significance Measure Effect Variable and treatment population Programme Chapter 5 of change explanation The evidence base Language Test Scores Change in 1 0.069 NCTPP (Burkina Faso) CCT, after 2 NS Standardised French Test Score (Overall) Akresh et al. (2013) SECTION II years z-score 0.19 6 Standardised French Test Score (reading CCT, after 2 5% NCTPP (Burkina Faso) Change in Chapter 6 z-score subsection) years The impact of UCT, after 2 NS NCTPP (Burkina Faso) Change in - 0.13 Standardised French Test Score (Overall) cash transfers on z-score years monetary poverty 0.003 UCT, after 2 NS NCTPP (Burkina Faso) Standardised French Test Score (reading Change in subsection) z-score years Chapter 7 The impact of 82 -0.05 Change in 10% CCT Baez and Camacho (2011) Familias en Acción 2 Spanish test score (Icfes test) cash transfers on standard (Colombia) education deviation Evans et al. (2014) 3 NS Change in 0.02 Literate (self-reported) TSAF (Tanzania) CCT, children Chapter 8 aged 0 –18 percentage The impact of cash years, after transfers on health 31–34 months and nutrition Chapter 9 Table 7.6 Summary of results for overall cash transfer effect on Composite Test Scores The impact of cash transfers on Details/ Significance Measure Effect Variable and treatment population Programme Study # explanation of change savings, investment and production Composite Test Scores Change in -0.025 1 Composite test score in various subjects Baez and Camacho (2011) Familias en Acción CCT NS Chapter 10 83 Standard (Icfes test) (Colombia) The impact of Deviation cash transfers on employment Notes: Results presented are overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant results. NS Chapter 11 means the study did not find a statistically significant result, typically up to the 10% significance level The impact of cash transfers on empowerment U 80 nit of observation is children (enrolled or not in school) aged 18 or below when they joined the programme and who, based on their school SECTION III attainment at the pre-programme time, could have achieved grade 11 between 2003 and 2009, and the number of years needed to complete high school was lower than the number of years of treatment. Chapter 12 81 his exam is a nationally recognised and standardised test that is administered prior to graduation from high school and mandatory for T Summary of entrance to higher education (Baez et al., 2011: 13) findings and nit of observation is children (enrolled or not in school) aged 18 or below when they joined the programme and who, based on their school 82 U conclusion attainment at the pre-programme time, could have achieved grade 11 between 2003 and 2009, and the number of years needed to complete high school was lower than the number of years of treatment. References 83 verall scores of Icfes test. The exam is a standardised test that assesses the academic achievement of students in various subjects such as O mathematics, language, biology, chemistry, physics, history, geography (Baez et al., 2011: 14)

126 Cash transfers: what does the evidence say? Page 126 Contents Table 7.7 Summary of results for overall cash transfer effect on cognitive development Acknowledgements Details/explanation Programme Variable and treatment population (e.g. Effect Measure Study Significance # of change age of child) Executive summary 1 Fernald and Language development indicator (IDHC-B BDH (Ecuador) UCT, effect after 3 years, NS 2.43 Change in 84 Hidrobo (2011) score) score children aged 12–35 months 0.08 Probability NS CCT, effect after 4 years, Child frequently/sometimes combines two or BDH (Ecuador) SECTION I more words, children aged 12–35 months Chapter 1 Atención a Crisis Cognitive and socio-emotional outcomes 0.0827 Change in Macours et al. 2 CCT, effect 2 years after 1% Introduction index (comprised of six different indicators) (2012) (Nicaragua) standard programme finished. deviation Averaged across three different CCT treatment arms Chapter 2 Conceptual Gilligan et al. 3 KWFP-cash Kaufman Assessment Battery for Children CCT, effect after approx. 18 0.7 74 Change in NS framework (2013) transfer (KABC II) total raw test score, months, score (Uganda) children aged 60–83 months Chapter 3 KWFP-cash Mullen cognitive assessment tests (visual CCT, effect after approx. 18 10% 3.208 Change in Review of cash transfer reception, fine motor skills, receptive language score months, transfer reviews (Uganda) and expressive language), children aged 54–71 months Chapter 4 Paxson and 4 Cognitive and behavioural combined index BDH (Ecuador) 0.067 Change in NS CCT, effects between 12 Methods Schady (2010) (includes scores on the TVIP test and three standard and 18 months after the noz tests from the Woodcock-Johnson-Mu deviation beginning of the programme, Chapter 5 battery assessment), children aged 3–7 The evidence base Atención a Crisis 0.074 Index of five cognitive and behavioural Change in 5 Tommasi 10% Effect 18 months after the outcomes, children aged 36 months or older (Nicaragua) (2015) standard programme had ended deviation SECTION II Notes: Results presented are overall results reported and do not include those disaggregated by gender or Chapter 6 showing the effect of variations in design features. Figures in bold indicate statistically significant results. NS The impact of means the study did not find a statistically significant result, typically up to the 10% significance level. cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 84 I DHC-B – a child’s score on the language development indicator Fundación MacArthur Inventorio del Desarrollo de Habilidades Comunicativas. The IDHC-B assessment measures the early language skills of children aged between 12–35 months using parental report. The Spanish long- form version of this measure was adapted.

127 Cash transfers: what does the evidence say? Page 127 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 8 transfer reviews Chapter 4 Methods T he impact of cash Chapter 5 The evidence base transfers on health and SECTION II Chapter 6 The impact of cash transfers on nutrition monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

128 Cash transfers: what does the evidence say? Page 128 Contents Box 8.1: Summary of evidence for health and nutrition outcomes Acknowledgements Overall, 41 studies were found to cover the health and nutrition indicators being reviewed, either reporting on overall Executive summary effects, gender disaggregated effects or on the role of design and implementation features. Overall effects of cash transfers on selected health and nutrition indicators: SECTION I • vidence extracted on the use of health facilities E mostly shows improvements. Of the 15 studies reporting overall effects on the use of health facilities, nine report statistically significant increases, ranging from an additional 0.28 Chapter 1 of a preventative visit in Jamaica’s PATH programme (Levy and Ohls, 2007) to an extra 2.3 general health visits Introduction in Tanzania’s Social Action Fund (though after 31–34 months, the effect of the latter programme was an average reduction of three visits, potentially due to observed health improvements) (Evans et al., 2014). Chapter 2 Conceptual • or dietary diversity findings also consistently show increases. F Among the 12 studies reporting on impacts on framework dietary diversity , seven show statistically significant changes across a range of dietary diversity measures, all being improvements. Chapter 3 T • is limited to 13 studies, the majority of these do not show a statistically anthropometric outcomes he evidence on Review of cash significant effect: just five out of 13 studies for stunting, one of five for wasting and one out of eight for underweight. transfer reviews All significant overall changes were improvements. Chapter 4 Methods Variation in outcomes by gender: • vidence on how outcomes vary by gender was extracted from five studies, with one disaggregating by gender of E Chapter 5 household head and the rest by individual. Most studies focused on the use of health services, with two covering The evidence base anthropometric measures. The evidence provides mixed results but does highlight the importance of disaggregating by gender and age. One set of results on child anthropometric outcomes by the gender of household head shows a negative impact on child weight-for-height only for male-headed households in an Indonesian conditional transfer SECTION II (World Bank, 2011). Another study from Pakistan finds a statistically significant reduction in wasting only among girls (Cheema et al., 2014). Chapter 6 The impact of Role of design and implementation features: cash transfers on monetary poverty O • verall, 15 studies were drawn upon, providing information on the role of design and implementation features in mediating outcomes on the specific indicators reviewed. Chapter 7 • T wo studies investigated the effect of transfer recipient , finding that transfers reaching women rather than men in The impact of the household were associated with greater improvements in preventative health facility use, but the difference is cash transfers on not statistically significant (Akresh et al., 2012), and that transfers received by older women (aged 50 and over) in education PROGRESA/Oportunidades, rather than their extended family, led to a smaller increase in health facility use (0.11 compared to 0.26), though both increases were significant (Behrman and Parker, 2013). Chapter 8 The impact of cash • transfer levels our studies looked at the effect of higher F . Just two found small, but statistically significant, effects transfers on health on child height-for-age z-score (Manley et al., 2015) and on the probability of a child having a check-up (Davis et and nutrition al., 2002). The other two studies found a very small and non-significant effect on stunting and being underweight in Mexico (Esteva, 2012), and one found no statistically significant effect of cumulatively higher transfers on dietary Chapter 9 diversity in Kenya (Merttens et al., 2013). The impact of • the duration of receipt , five finding a significant improvement in child even studies looked at the effect of S cash transfers on anthropometric measures and increasing use of health care due to a longer duration in a programme (Buser et al., savings, investment 2014; Fernald et al., 2008; Fernald et al., 2009; Perova and Vakis, 2012; Behrman and Parker, 2013). Results from and production two studies were non-significant (Manley et al., 2015; Esteva, 2012). Chapter 10 • T hree studies tested the effect of conditionalities , two finding that conditions on attending health visits led to a The impact of higher number of visits compared to transfers with no conditions (Akresh et al., 2012; Attanasio et al., 2015) and cash transfers on one finding weaker but consistent evidence (Benedetti and Ibarrarán, 2015). employment T • wo papers (on the same intervention) report findings on the effect of payment mechanisms (the effect of mobile- payment mechanisms compared to manual cash delivery) on household dietary diversity and child wasting (Aker et Chapter 11 al., 2011; 2014). The results suggest that mobile payments in Niger led to a statistically significant improvement in The impact of dietary diversity of around 16 percentage points, though no significant effect on wasting was found. The authors cash transfers on suggest that the results could be attributed to two factors: time-saving and increased intra-household bargaining empowerment power of women (who were the recipients of the mobile payments). ne study investigated the effect of receiving cash transfers with a complementary interventions and O • SECTION III supply-side services , finding that the receipt of nutritional supplements in addition to a cash transfer in Niger led to a halving of moderate acute malnutrition relative to receiving the cash transfer alone (Langendorf et al., Chapter 12 2014). Summary of findings and conclusion References

129 Cash transfers: what does the evidence say? Page 129 Contents 8.1 S ummary of findings Acknowledgements This section reports on the impacts of cash transfers on the use of health services, dietary diversity Executive summary and on a range of child anthropometric measures covering stunting, wasting and underweight. A headline summary of the overall effects, how they vary by design and implementation features, SECTION I and by gender, is provided in Box 8.1, with a more detailed narrative summary given in this section. Chapter 1 Introduction First, it is helpful to clarify briefly the anthropometric measures considered, which include: height- for-age z-scores (HAZ) and being stunted, weight-for-height z-scores (WHZ) and being wasted, Chapter 2 Conceptual and weight-for-age z-scores (WAZ) and being underweight. Each of the z-score indicators measure framework a dimension of child growth as a deviation from the average measurement for a reference group of similar age. Whether a child is then considered stunted, wasted or underweight is determined by Chapter 3 whether the measurement for the child is greater than two standard deviations from the median Review of cash for the reference population. It should be noted, therefore, that while we may see changes in the transfer reviews z-score indicators, we may not necessarily see an impact on the probability of being stunted, Chapter 4 wasted or underweight. Both types of measure are summarised under the headings of stunting, Methods wasting and underweight. Chapter 5 To help in interpreting the results, it is also worth highlighting the differences between the three The evidence base anthropometric categories. Stunting considers height by age and reflects the cumulative effect of poor nutrition and disease. As such, we may not expect changes to take place in such measures SECTION II without sustained appropriate interventions and unless they reach children in time during the critical stage of early growth, which the literature suggests includes while the child is still in Chapter 6 utero and during its first three years of life (Martorell, 1999). Wasting, by contrast, reflects acute The impact of malnutrition or a more recent inadequate diet, manifesting itself as thinness for height. Lastly, the cash transfers on monetary poverty two measures of being ‘underweight’ represent something of an amalgamation of the two previous categories as it may be that a child is underweight for their age because they are short for their age Chapter 7 or because they are thin for their height. The impact of cash transfers on In brief, the findings show how impacts across all three indicator areas – health services, dietary education diversity and anthropometric measures – were largely consistent in their direction of effect. They Chapter 8 also highlight how, while the cash transfers reviewed have played an important role in improving The impact of cash use of health services and dietary diversity, changes in design or implementation features, transfers on health including complementary actions, may be required to achieve greater and more consistent impacts and nutrition on child anthropometric measures. This is reflected in the greater proportion of significant Chapter 9 results found relating to health service use and dietary diversity and a much lower proportion for The impact of anthropometric measures. cash transfers on savings, investment Results that disaggregated by gender or by gender of household head were also extracted, with and production most focusing on the use of health services. The results include significant impacts on routine preventative health clinic visits for girls but not for boys (Akresh et al., 2012), a larger percentage Chapter 10 The impact of point increase in prenatal visits for female-headed versus male-headed households in Indonesia cash transfers on (World Bank, 2011) and significant reductions in health visits for girls and women that are not employment seen for boys or men (after an initial increase) (Evans et al., 2014). While the first two studies do not test whether these differences are statistically significant, those in Evans et al. (2014) are found Chapter 11 not to be. The impact of cash transfers on empowerment One set of results on child anthropometric outcomes disaggregates by the gender of household head and provides some indicative findings of the importance of the gender of household head for such outcomes, with a negative impact on child WHZ arising in male-headed households (World SECTION III Bank, 2011). The one study providing individual-level sex-disaggregated results for child growth also finds a significant reduction in wasting for girls and not boys in Pakistan’s BISP, raising Chapter 12 Summary of questions over possible gender preferences among the (female) recipients. findings and conclusion A range of important findings also emerge from the studies reporting on the effect of design and implementation features. Firstly, there is quite limited rigorous evidence on the effect of certain References design and implementation features compared to others in terms of their impact on the health

130 Cash transfers: what does the evidence say? Page 130 Contents indicators being reviewed. For example, while nine studies were found on the role of transfer Acknowledgements sizes or duration of transfers, no studies reported on the effect of grievance mechanisms and programme governance (in health or other outcome areas). Executive summary Among the four studies providing insights on the role of transfer sizes, there is some very limited evidence of the possible impacts that larger transfers can have on child anthropometric measures SECTION I and health service use. However, there is fairly clear evidence for the importance of the duration of Chapter 1 transfers for both the use of health services as well as on child anthropometric measures. Among Introduction the results is the crucially important finding that stopping transfers, even among recipients who have received them for several years, can still have highly detrimental effects on child growth Chapter 2 (Buser et al., 2014), underlining the vital role played by transfers in maintaining regular food Conceptual consumption among poor households, especially during critical early stages of child growth. framework Chapter 3 Among the three studies reporting on the impact of conditionalities, two find strong evidence Review of cash that linking cash transfer receipt to the use of health services can have a significant impact in transfer reviews improving service use, with the third finding consistent, but weaker, evidence. The stronger evidence comes from Colombia’s Familias en Acción and an experimental study in Burkina Chapter 4 Methods Faso. In Colombia, preventative health visits among children who were not required to fulfil a preventative health visit schedule were found to be around 50% lower than those for whom Chapter 5 the condition was binding (Attanasio et al., 2015) and, importantly, lower health visits were The evidence base associated with a worsening of child health status. Similarly, the experiment in Burkina Faso only found a significant increase in the number of preventative health clinic visits for children SECTION II under 60 months old among those households in which transfers were conditional upon quarterly visits to a local health clinic (Akresh et al., 2012). Conditions appear to have been monitored Chapter 6 in both cases, though it is not clear to what degree they were enforced. The third study, of the The impact of Bono 10,000 in Honduras, found some improvements in one health service indicator (post-natal cash transfers on check-ups) among households where transfers were labelled as health transfers and conditioned on monetary poverty regular attendance at health centres, compared to those for whom transfers were not conditional Chapter 7 nor labelled as health transfers (Benedetti and Ibarrarán., 2015). However, the difference was not The impact of statistically significant. cash transfers on education There is limited evidence showing how the person to whom transfers are given affects the health indicators being reviewed. For example, while transfers targeted to women in a CCT in Burkina Chapter 8 The impact of cash Faso led to a higher number of health visits than where transfers were given to men, the difference transfers on health was not statistically significant (Akresh et al., 2012). The age of the recipient may have played and nutrition some role in determining the size of effect in health service use in PROGRESA/Oportunidades, with transfers being received in households composed only of elderly have lower, but still positive, Chapter 9 health care use increases, compared to households where transfers were under the control of the The impact of cash transfers on extended family (Behrman and Parker, 2013). However, impacts for both groups were significant savings, investment and it is not clear that the difference between them is statistically significant. and production The impacts of payment mechanisms and complementary interventions on the selected health Chapter 10 indicators was each considered by a single study. These showed mobile payment mechanisms to The impact of cash transfers on have a significant effect on dietary diversity compared to receiving transfers manually (though not employment on anthropometric outcomes) (Aker et al., 2011; 2014), and for transfers provided with nutritional supplements to half the level of malnutrition compared to the transfer alone, even though those Chapter 11 receiving just the transfers received an additional US$7 per month (Langendorf et al., 2014). The The impact of finding on complementary nutritional supplements is likely to partly reflect the additional benefit cash transfers on of the supplements in contexts where local availability of a diverse diet is limited. However, the empowerment finding is also consistent with other studies from Mexico (included in this review but not reporting on the chosen indicators here) which identify the important role played by uptake of nutritional SECTION III supplements in PROGRESA (Ramírez-Silva et al., 2013; Behrman and Hoddinott, 2005). Chapter 12 Summary of findings and conclusion References

131 Cash transfers: what does the evidence say? Page 131 Contents 8.2 ummary of evidence base S Acknowledgements Table 8.1 provides an overview of which countries and programmes the studies report on. As can Executive summary be seen, by far the largest number of studies (27 out of 41) cover cash transfer programmes in Latin America, with a disproportionate number of those (12) focusing on Mexico’s PROGRESA/ SECTION I Oportunidades programme. Meanwhile, just 11 studies cover sub-Saharan Africa, and two 85 In total, there were 41 studies from which cover South Asia and the Asia and Pacific region. Chapter 1 evidence was extracted for the health and nutrition indicators covered in this section, covering Introduction 19 countries and 25 cash transfer programmes. All 12 programmes in Latin America and the Caribbean were CCT programmes (with Bono 10,000 also having unconditional elements for Chapter 2 Conceptual some households) as were 16 out of the 25 programmes overall. The main exceptions to this were framework cash transfer programmes in sub-Saharan Africa, where six of the ten interventions were UCTs, two were CCTs, and two were studies using both CCTs and UCTs as part of a research study. Chapter 3 Review of cash It is important to bear in mind that, while a number of programmes share similar objectives transfer reviews and designs, there are also important differences, even within conditional or unconditional Chapter 4 programmes. So, for example, while Mexico’s PROGRESA/Oportunidades was principally Methods focused on addressing inter-generational poverty among poor households through providing transfers conditional on use of health and education services, the same country’s PROCAMPO Chapter 5 was a programme targeted to farmers to offset the negative impacts of the North American The evidence base Free Trade Agreement, with transfers conditional upon continued agricultural production. Meanwhile, among the unconditional programmes in sub-Saharan Africa, while some were SECTION II clearly targeted towards benefitting children (e.g. the Child Grant Programmes in Zambia and Lesotho and WFP’s Karamoja pilot in Uganda), others targeted transfers more generally to poor Chapter 6 households. These differences, along with a wide range of other design and implementation The impact of features discussed below, could reasonably be expected to result in variations in observed cash transfers on monetary poverty outcomes. While these are discussed at various points in the discussion below, they should be borne in mind more generally when interpreting the results. Chapter 7 The impact of While many studies were of programmes that had been operating at a large scale over a number cash transfers on of years, a further distinguishing feature of some studies is that they were of experimental trials education or pilots that were limited in scale. The findings from the latter studies should be interpreted with Chapter 8 this in mind. The impact of cash transfers on health A range of different study designs and estimation methods were used in order to estimate and nutrition the effect of cash transfers or their design and implementation features on the selected health Chapter 9 indicators. Table 8.2 provides a summary of these. As can be seen, the large majority were based The impact of on experimental studies, with the remainder using observational data and employing some form cash transfers on of quasi-experimental method including DID, RDD, IV or OLS regression. savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 85 N ote: The totals in the final column of Table 8.1 do not add up to the total number of studies as two studies report results for more than one programme.

132 Cash transfers: what does the evidence say? Page 132 Contents Table 8.1: Summary of countries and programmes reported on for the health and nutrition indicators (all studies) Acknowledgements Type of cash Details if pilot or experimental study* Country # studies Programme Executive summary transfer Latin America and Caribbean = 27 studies SECTION I Colombia CCT 2 Familias en Acción 3 CCT Bono de Desarrollo Humano (BDH) Ecuador Chapter 1 Two provinces near Colombian border 2 CCT WFP Colombian refugee RCT (WFP cash transfer) Ecuador Introduction CCT Comunidades Solidarias Rurales (CSR) El Salvador 1 Chapter 2 Programa de Asignación Familiar (PRAF) Honduras 1 CCT Conceptual framework Honduras 1 CCT/UCT Bono 10,000 Jamaica 1 Programme of Advancement Through Health and CCT Chapter 3 Education (PATH) Review of cash 12 CCT PROGRESA/Oportunidades Mexico transfer reviews CCT PROCAMPO Mexico 1 Chapter 4 4 Nicaragua Red de Protección Social (RPS) CCT Pilot in 21 communities Methods One year pilot in six municipalities Nicaragua Atención a Crisis CCT 1 Chapter 5 Juntos CCT 1 Peru The evidence base Sub-Saharan Africa = 11 studies Burkina Faso Nahouri Cash Transfers Pilot Project (NCTPP) CCT/UCT 1 Two-year experimental pilot in 75 villages SECTION II Kenya Hunger Safety Net Programme (HSNP) UCT 1 Child Grant Programme (LCGP) Lesotho 1 UCT Chapter 6 The impact of Social Cash Transfer Programme (SCTP) UCT 1 Pilot phase (one district) Malawi cash transfers on Prospective study with Forum Santé Niger and Médecins Niger Prospective study in 48 villages 1 CCT/UCT monetary poverty Sans Frontières Chapter 7 Concern Worldwide drought-response unconditional Niger 2 Short-term drought-response in 96 villages UCT transfer The impact of cash transfers on 1 CCT Tanzania Social Action Fund (TSAF) Tanzania education Pilot in three districts CCT WFP Karamoja Cash Transfer (KWFP-cash transfer) Uganda 1 Chapter 8 Zambia Pilot in one district 1 UCT Monze Cash Transfer Pilot (CTP) The impact of cash UCT Child Grant Programme (ZCGP) Zambia 1 transfers on health South Asia = 2 studies and nutrition 10 unions from two rural Upazilas and one 1 CCT Shombhob Bangladesh 86 Chapter 9 urban slum The impact of BISP UCT 1 Pakistan cash transfers on East Asia Pacific = 1 study savings, investment and production Program Keluarga Harapan (PKH) Indonesia 1 CCT Chapter 10 Note: As some studies report on more than one programme, the totals here do not correspond to the total The impact of number of independent studies reported in the text. *This information, for papers that report results from a cash transfers on pilot/experimental implementation, helps distinguish such papers from those that cover cash transfer policies/ employment programmes that are operational at a larger scale and/or are long-term/permanent. It is intended as a ‘flag’ for findings which could potentially have more limited external validity. Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 86 U pazilas are the lowest administrative unit in a District and Unions are the lowest administrative unit in an Upazila. There are 64 districts in Bangladesh.

133 Cash transfers: what does the evidence say? Page 133 Contents Table 8.2: Summary of studies by methods used and type of outcome reported on Acknowledgements Study Study design and methods used for reported results Reports Reports effect Reports sex- total effect of design and disaggregated Executive summary implementation outcomes features? A IR (2014) RCT (DID) Yes SECTION I Aker et al. (2011) RCT (Multivariate regression) Yes Chapter 1 RCT (Multivariate regression) Aker et al. (2014) Yes Introduction Yes RCT (SD) Yes Akresh et al. (2012) Yes QE, DID Yes Attanasio et al. (2005) Chapter 2 Conceptual Attanasio et al. (2015) Yes QE, pooled OLS framework Benedetti and Ibarrarán (2015) Yes QE, multivariate regression using a single follow-up survey to an RCT Chapter 3 Barber and Gertler (2008) QE, IV using a single follow-up survey to an RCT Yes Review of cash Barber and Gertler (2010) QE, Random Effects regression using a single follow-up survey to Yes transfer reviews an RCT Chapter 4 Yes QE, SD from follow-up survey to an RCT Behrman and Parker (2013) Yes Methods Yes Yes QE, RDD using a single cross-section of a random sample Buser et al. (2014) Yes QE, RDD using cross-section and panel data Cheema et al. (2014) Yes Chapter 5 The evidence base Yes Yes QE, IV Probit using single cross-section follow-up from an RCT Davis et al. (2002) Yes de Brauw and Peterman (2011) QE DID estimates using a RDD approach Yes Esteva (2012) RCT (SD) SECTION II Yes Evans et al. (2014) RCT (DID) Chapter 6 Fernald and Hidrobo (2011) RCT (OLS) Yes The impact of Yes QE, OLS and Logit using single follow-up survey to an RCT Fernald et al. (2008) cash transfers on monetary poverty Fernald et al. (2009) QE, multivariate regression using a single cross-section follow-up Yes survey to an RCT Chapter 7 QE, DID Ferré and Sharif (2014) Yes The impact of Yes QE, Multivariate logistic regression from a single cross-section Gertler (2004) cash transfers on follow-up survey to an RCT education Gilligan et al. (2013) Yes RCT (ANCOVA) Chapter 8 RCT (DID) Gitter and Caldes (2010) Yes The impact of cash Yes RCT (ANCOVA) Hidrobo et al. (2012a) (WFP/IFPRI transfers on health evaluation) and nutrition Hidrobo et al. (2012b) Yes RCT (ANCOVA) Chapter 9 Yes RCT (DID) Hoddinott and Wiesmann (2008) The impact of RCT Yes Langendorf et al. (2014) cash transfers on Leroy et al. (2008) RCT (DID) Yes savings, investment and production Levy and Ohls (2007) Yes Yes QE, DID with PSM Yes Macours et al. (2012) RCT (seemingly unrelated regression) Chapter 10 The impact of Maluccio (2005) RCT (DID) Yes cash transfers on RCT (DID) Yes Maluccio and Flores (2005) employment Yes Manley et al. (2015) QE, IV using single cross-section follow-up survey from an RCT Chapter 11 Merttens et al. (2013) Yes Yes RCT (DID) The impact of Yes Miller et al. (2011) RCT (DID) cash transfers on Yes Paxson and Schady (2010) RCT (seemingly unrelated regression) empowerment Pellerano et al. (2014) RCT (DID) Yes Yes Yes Perova and Vakis (2012) QE, IV estimation using repeated cross-sectional surveys SECTION III Ruiz-Arranz et al. (2002) QE, OLS and IV using a single follow-up survey to an RCT Yes Chapter 12 Seidenfeld and Handa (2011) QE (DID with PSM) Yes Summary of Yes World Bank (2011) QE, IV using single cross-section follow-up from panel survey findings and conclusion RDD = Regression Discontinuity Design, RCT = randomised controlled trial, DID = difference-in-difference, SD = single difference, PSM = propensity score matching, IV = instrumental variables, ANCOVA = analysis of References covariance.

134 Cash transfers: what does the evidence say? Page 134 Contents he impact of cash transfers on health and nutrition T 8.3 Acknowledgements Tables 8.3 to 8.7 below summarise the overall effects of cash transfers on the indicators under Executive summary consideration. Any sex-disaggregated results found are discussed in section 8.4 and, where any effects associated with design or implementation features were found, these are discussed in SECTION I section 8.5. Chapter 1 Introduction Utilisation of health care services Chapter 2 Of the 15 studies that looked at the overall effect on health service use, nine found a statistically Conceptual significant increase (full results are reported in bold in Table 8.3) and one found a significant framework reduction (though, as discussed below, this was after an initial increase and is thought to Chapter 3 arise from improvements in health). As this point highlights, careful attention must be paid Review of cash to interpreting impacts on health service use, as cash transfers may lead to an increase in use transfer reviews of preventative services (which would generally be deemed a positive outcome), whereas, if by improving health status the need for general health services is reduced then a decrease could also Chapter 4 be considered a positive outcome. Methods Chapter 5 It is difficult to compare the size of the significant positive effects due to the different outcomes The evidence base measured, though percentage point changes range from a two percentage point increase in ‘compliance with a preventative nutritional health programme’ (a nationwide programme of preventative health care visits for children) over 48 months after transfers began in Colombia’s SECTION II 87 while Perova and Vakis (2012) find that children from beneficiary Familias en Acción, Chapter 6 households in Peru’s Juntos were 69 percentage points more likely to have received health checks The impact of in the three months prior to interview. In terms of number of visits, both the highest and lowest cash transfers on effects are found within the same programme, with Evans et al. (2014) finding Tanzania’s TSAF monetary poverty to lead to an increase of 1.9 visits to health facilities after 18–21 months, but then a statistically significant decline of three visits after 31–34 months. The explanation by Evans et al. (2014) is Chapter 7 The impact of that, at nine visits, the average number of visits was already very high at baseline – more than cash transfers on the required number as part of the conditionalities – and that the decline could have resulted education from improved health (for which evidence was found), or potentially from beneficiaries using the conditions as a guide to lower their number of visits, though this does not fit with the initial Chapter 8 increase in service use found during the midline survey. The impact of cash transfers on health and nutrition Significant impacts from other programmes range from an average increase of nearly a third of a preventative visit in Jamaica’s PATH programme (an impact of around 38% of the baseline value) Chapter 9 (Levy and Ohls, 2007), to over a half of an extra prenatal visit in Indonesia’s PKH, even though the The impact of average number of antenatal visits in Indonesia at baseline was already over six (World Bank, 2011). cash transfers on savings, investment and production While Akresh et al. (2012) found that cash transfers in a trial in Burkina Faso led to a significant transfers were not unconditional increase in health service use, their results also showed that Chapter 10 associated with the same positive effect. The difference in effects is discussed further in section 7.5. The impact of cash transfers on The estimated impacts in the remaining studies were not statistically significant. This included employment Zambia’s unconditional CTP (Seidenfeld and Handa, 2011; AIR, 2014), Lesotho’s CGP Chapter 11 (Pellerano et al., 2014), El Salvador’s CSR (de Brauw and Peterman, 2011), Ecuador’s BDH The impact of (Paxson and Schady, 2010) and one study of Mexico’s Oportunidades (Barber and Gertler, 2010). cash transfers on empowerment In explaining these non-significant results on health care attendance, it is worth noting that both the programmes in sub-Saharan Africa were UCTs, unlike many of the other programmes, SECTION III which were conditional upon certain health behaviours. Both programmes also suffered from implementation problems, such as delays in payment of funds, which the authors believe are Chapter 12 likely to have impeded positive impacts. AIR (2014) also highlight that a lack of decent and Summary of nearby health clinics is likely to have held back improvements in health and nutrition outcomes findings and more generally in Zambia’s CGP. conclusion References 87 N ote that shorter-term effects (up to 48 months) were substantially higher in magnitude.

135 Cash transfers: what does the evidence say? Page 135 Contents In explaining the absence of a positive impact in Ecuador’s BDH, Paxson and Schady (2010) note Acknowledgements that in practice the transfers were not actually conditional on attending health clinics, though that it was conditional on certain behaviours. Among 28% of women in their sample believed Executive summary these, 68% thought it was conditional upon taking children to health clinics. Also, in the case of El Salvador’s CSR, de Brauw and Peterman (2011) suggest that the lack of impact on increasing post-natal care could have been due to failings in communicating messages to women about the SECTION I importance of post-natal care. Chapter 1 Introduction In the case of Oportunidades, Barber and Gertler (2010) note that the mean number of visits for prenatal care from their baseline was already very high (94% among non-beneficiaries and Chapter 2 74.2% for obtaining five or more consultations), meaning that there was limited scope for further Conceptual increases. However, they did find positive effects on improving the quality of care received. framework Chapter 3 Dietary diversity Review of cash transfer reviews 12 studies were found to report on the overall cash transfer effect on dietary diversity measures, Chapter 4 with seven finding at least one statistically significant improvement in dietary diversity, and none Methods finding a significant negative effect. Hoddinott and Wiesmann (2008) reported on three different programmes, and found only Nicaragua’s RPS to have a significant effect. The significant effects Chapter 5 The evidence base in the study by Ruiz-Arranz et al. (2002), which looked at both PROGRESA and PROCAMPO, were all for PROGRESA with one exception (number of foods consumed), though impacts were small in magnitude for both programmes. SECTION II A range of indicators were used to measure dietary diversity (see Table 8.4). With some measures Chapter 6 The impact of more than others (e.g. those that measure the number of different foods eaten), caution may cash transfers on be needed in interpreting the health benefits of a more varied diet if part of the increase monetary poverty involves a higher level of consumption of processed foods or sugary foods. Among the studies reporting changes in the number of food items, it seems that changes were driven by increases Chapter 7 in consumption of fruit and vegetables and animal products, but also ‘other foods’ in the case of The impact of Nicaragua’s RPS, which includes items such as sugar, sweets, biscuits, fizzy drinks and fats (Gitter cash transfers on education and Caldes, 2010; Hoddinott and Wiesmann, 2008). Local context is likely to be important, depending on food availability and consumption practices. For example, two studies from Mexico Chapter 8 (a country renowned for high obesity prevalence resulting from high consumption of processed The impact of cash foods) find cash transfers to be associated with higher BMI and obesity. Fernald et al. (2008) (not transfers on health reported here but included in the annotated bibliography), find higher cumulative cash transfers and nutrition in Oportunidades to be linked to higher BMI and a higher likelihood of being overweight or Chapter 9 obese and likelihood of hypertension, while Leroy et al. (2013) found that PAL increased women’s The impact of weight, with the greatest impacts among those with already high BMI scores. cash transfers on savings, investment Returning to the indicators reviewed, among the significant effects on dietary diversity, impacts and production ranged from an average increase of just 0.01 new distinct food items in the case of Mexico’s Chapter 10 PROGRESA (Ruiz-Arranz et al., 2002) to an increase of nearly four additional food items in The impact of Nicaragua’s RPS (Hoddinott and Wiesmann, 2008; Gitter and Caldes, 2010). Gitter and Caldes cash transfers on (2010) note that the impact in RPS represented a substantial gain from an initial level of 11.5 items. employment Chapter 11 The studies that found no significant effect included an evaluation of Lesotho’s CGP (Pellerano et The impact of al., 2014), Zambia’s SCT (Seidenfeld and Handa, 2011), Kenya’s HSNP (Merttens et al., 2013), cash transfers on Bangladesh’s Shombhob pilot (Ferré and Sharif, 2014) and Pakistan’s BISP (Cheema et al., 2014). empowerment Both the Zambia and Lesotho programmes were already noted above to have suffered from implementation problems, including delays in payments, which may have undermined impacts on dietary diversity, though local contextual features could also have held back increased diversity in SECTION III food consumption. The authors of the Lesotho evaluation noted that, based on qualitative findings, Chapter 12 beneficiary households ‘were able to buy larger quantities of more varied food and food of better Summary of quality, but the effect was generally concentrated around payment dates’ (Pellerano et al., 2014). findings and conclusion Merttens et al. (2013) suggest that while there were no impacts on dietary diversity in Kenya’s References HSNP after two years, there was an improvement after one (though they do not report these results), and that poorer HSNP households were increasing the diversity of their diets. They

136 Cash transfers: what does the evidence say? Page 136 Contents suggest that the lack of significant results in the two-year follow-up may be explained by the Acknowledgements comparison households ‘reinvigorating their diets after a particularly harsh year’ and/or by ‘increased availability of diverse food stuffs in local markets’, or by ‘control households consuming Executive summary a smaller volume of food by equally diverse diets as HSNP households’. They also highlight that, in spite of various interventions in northern Kenya, food insecurity is still pervasive. SECTION I The absence of an effect in Bangladesh’s Shombhob pilot should be considered against the fact that Chapter 1 the diversity measure was defined in terms of consuming more than four out of the recommended Introduction seven food groups, and that food consumption overall did increase significantly among beneficiary households, as did protein consumption (Ferré and Sharif, 2014). In the case of Pakistan’s BISP, Chapter 2 the baseline Food Consumption Score was already very high, arguably leaving less scope for Conceptual further improvements (Cheema et al., 2014). The authors also note, however, that payments in the framework 12 months prior to the survey were irregular, with beneficiaries receiving on average just over half Chapter 3 of the expected four transfers and accompanying qualitative evidence from household interviews Review of cash suggesting that the irregularity may have impeded improvements to food consumption. transfer reviews Chapter 4 Anthropometric measures Methods Before discussing the evidence on anthropometric measures, it is important to note two issues. Chapter 5 The evidence base First, as noted earlier, it may take some time in order for any changes in anthropometric measures to be observed, particularly for stunting and being underweight. As such, impact evaluations that cover just a short time period may not be long enough to capture impacts. This is noted by Ferré SECTION II and Sharif (2014) below, for example, as a possible reason why effects on stunting and being underweight were not found in Bangladesh’s Shombhob. Chapter 6 The impact of cash transfers on Secondly, recent research has highlighted the particular importance of the first 1000 days of life monetary poverty as the period when stunting can most effectively be prevented (UNICEF, 2013). Given this, it is possible that cash transfers have greater potential to improve anthropometric measures in younger Chapter 7 children. For this reason, where evidence is reported for children of all ages, it may underestimate The impact of the effect of cash transfers on younger children. This appears to be reflected in some studies, e.g. cash transfers on education Ferré and Sharif (2014) and Attanasio et al. (2015). As such, where possible, the reported results in Tables 8.5 to 8.7 tend to focus on younger children. In the tables, age groups are given in brackets, Chapter 8 allowing for some greater nuance in interpretation of what the results may be telling us. The impact of cash transfers on health and nutrition Stunting Chapter 9 Of all the anthropometric measures considered, stunting is the one for which there is the strongest The impact of cash transfers on evidence of any positive and statistically significant effect. As shown in Table 8.5, of the 13 studies savings, investment reporting overall effects on a stunting indicator, five studies find a statistically significant effect, and production all showing increases in the HAZ, ranging from 0.07 to 0.41 (Attanasio et al., 2005; Leroy et al., 2008; Macours et al., 2012; Maluccio 2005) or a statistically significant reduction in the Chapter 10 probability of being stunted (Maluccio and Flores, 2005). The impact of cash transfers on employment While Leroy et al. (2008) did not find a statistically significant impact for Mexico’s PAL improving the HAZ of urban children up to the age of two, when looking at children up to the age of six Chapter 11 months they did find a significant impact of a 0.41 increase in the z-score. The authors note that The impact of children in the younger age group had the longest exposure to the programme benefits during their cash transfers on critical period of growth. empowerment In explaining their results, Attanasio et al. (2005) note that compliance with the growth and SECTION III development programme (which included nutritional monitoring and advice to mothers about child nutrition) in Colombia’s Familias en Acción could have been an important factor, and that Chapter 12 the transfer had also increased the consumption of protein and vegetables. Summary of findings and conclusion Among the remaining results (reported in Table 8.5), all but three find cash transfers associated with improvements in stunting indicators (either a reduction in the probability of being stunted or References an increase in the HAZ), though none of these results is statistically significant.

137 Cash transfers: what does the evidence say? Page 137 Contents In explaining the lack of a finding on stunting in Ecuador’s BDH, Fernald and Hidrobo (2011) Acknowledgements note that the transfers were the lowest cash transfer amount across the region (around 6%–10% of baseline incomes). Paxson and Schady (2010) also found no overall effect on HAZ in Ecuador’s Executive summary BDH and, without offering a firm explanation, also note the ‘relatively small cash transfers’ in the programme. SECTION I Interestingly, while the study by Maluccio and Flores (2005) finds a significant reduction in the Chapter 1 probability of suffering from wasting (5.5%) in Nicaragua’s RPS, the measured effect on HAZ, Introduction although there is an improvement of 0.13, is not statistically significant. They suggest that this is likely to be the result of a small sample, but that among the extremely poor, the estimated increase Chapter 2 is 0.22 and significant at the 10% significance level. Conceptual framework Wasting Chapter 3 Review of cash transfer reviews Of the five studies reporting cash transfer effects on overall wasting, one found a statistically significant improvement; a reduction in the probability of wasting by 13 percentage points among Chapter 4 children who were 12–24 months old when enrolled in Bangladesh’s Shombhob pilot (Ferré and Methods Sharif, 2014) (see Table 8.6). The 13 percentage point drop in wasting in Bangladesh represented a decrease of about 40% of wasted children in that age group. In explaining the results, the authors Chapter 5 The evidence base note that mothers’ knowledge of infant feeding also saw a statistically significant increase, and there was some improvement in dietary diversity among infants over six months old (though not statistically significant). SECTION II The remaining results include a mixture of two negative effects on the WHZ, one positive, and Chapter 6 The impact of one marginal reduction in the probability of being wasted, though none are statistically significant cash transfers on (AIR, 2014, Evans et al., 2014, Maluccio and Flores, 2005, and World Bank, 2011). monetary poverty Maluccio and Flores (2005) note that the finding of no effect in Nicaragua’s RPS was not Chapter 7 surprising, as wasting was not much of a concern in the programme areas to begin with (just The impact of 0.2% of children under the age of five were wasted in the intervention and control areas in 2002), cash transfers on education while AIR (2014) simply note more broadly that a lack of decent and nearby health clinics in the programme areas in Zambia was likely to have held back improvements in health more generally. Chapter 8 The impact of cash transfers on health Underweight and nutrition Evidence of any statistically significant improvements in reducing the incidence of children being Chapter 9 underweight is more limited than either of the other anthropometric measures. Among the eight The impact of cash transfers on studies reporting overall cash transfer effects on this indicator, just one reports a statistically savings, investment significant effect: a decrease of 6.2 percentage points in the probability of a child under five being and production underweight resulting from Nicaragua’s RPS (Maluccio and Flores, 2005) (see Table 8.7). The remaining results included a combination of deteriorations and improvements in measures of being Chapter 10 underweight, though none was statistically significant. The impact of cash transfers on employment 8.4 T he impact of cash transfers on health and nutrition Chapter 11 The impact of indicators for women and girls cash transfers on empowerment Among the indicators being investigated, the studies mainly reported sex-disaggregated outcomes for health care use, with one reporting the effects of the gender of household head on child anthropometric measures and one reporting sex-disaggregated effects on anthropometric SECTION III outcomes. The lack of sex-disaggregated results for anthropometric measures at the individual Chapter 12 level may be due to the small sub-sample sizes that would probably have resulted. No studies were Summary of found reporting on dietary diversity disaggregated by gender, presumably as the dietary diversity findings and measures are generally measured at the household rather than individual level. conclusion References Among the four studies reporting sex-disaggregated results for overall impacts on health care use, four report disaggregated results at the individual level and one on male versus female-headed

138 Cash transfers: what does the evidence say? Page 138 Contents households (see Table 8.8). While no obvious trends emerge, the findings include: significant Acknowledgements impacts on routine preventative health clinic visits for girls where they are not seen for boys in a pilot CCT in Burkina Faso (Akresh et al., 2012), a larger percentage point increase in prenatal Executive summary visits for female-headed versus male-headed households in Indonesia’s PKH (World Bank, 2011), and significant reductions in health visits for girls and women that are not seen for boys or men (after an initial increase) in Tanzania’s TSAF (Evans et al., 2014). While the first two studies do SECTION I not test whether these differences are statistically significant, those in Evans et al. (2014) are found Chapter 1 not to be. Levy and Ohls (2007) also find no differential effects on girls versus boys in terms of Introduction visits to health facilities in Jamaica’s PATH. Chapter 2 In terms of the evidence on anthropometric measures, the study on Indonesia’s PKH also reported Conceptual on the effect of the gender of household head, with results being generally non-significant, except framework for male-headed beneficiary households seeing a statistically significant reduction in the WHZ Chapter 3 of children up to 36 months (World Bank, 2011). The other study, on Pakistan’s BISP, found that Review of cash reductions in wasting were significant for girls and not boys, but that impacts on stunting were not transfer reviews significant for either gender (Cheema et al., 2014). Chapter 4 Methods Evans et al. (2014) found statistically significant reductions in the number of health visits made for girls aged up to 24 months and women aged 60 and over in the TSAF (Tanzania) in the second Chapter 5 follow-up (after 31–34 months). The reported effects were -3.8 visits for girls and -0.58 visits for The evidence base elderly women. Reductions among boys and men, however, were not significant, and the difference between the effect on boys and girls and elderly men and women were not statistically significant SECTION II and no further explanation is given for these (non-significant) gender differences. As noted, these reductions must be understood in the context of an initial increase in the midline survey, very high Chapter 6 existing average health care usage, and statistically significant improvements in the health status of The impact of beneficiary households. cash transfers on monetary poverty Akresh et al. (2012) report on gender differences in preventative health clinic utilisation from an Chapter 7 experimental study in Burkina Faso, which reported on effects of a conditional and unconditional The impact of transfer. Only the effects of the conditional cash transfer were significant and, when disaggregated cash transfers on by gender for children under 60 months, only the impacts for girls were significant, with an education increase of 0.48 visits, though the (non-significant) increase for boys was 0.39 and it is not clear whether the difference between girls and boys is statistically significant. Chapter 8 The impact of cash transfers on health Levy and Ohls (2007) report on gender differences in the effect of the PATH cash transfer and nutrition programme in Jamaica on visits to health facilities in the past six months among children aged six and under. They find that, while there was an overall positive effect of increasing the number Chapter 9 of visits by 0.28, when disaggregated by gender, the increase was not significant for boys or girls, The impact of cash transfers on though it was larger for girls than boys (0.45 compared to 0.16). The authors do not explain the savings, investment gender differences, but attribute the lack of significance on the sub-group analysis to the smaller and production sample sizes. Chapter 10 One study is included that reports differences in health service use by gender of household head. The impact of cash transfers on The study, by the World Bank (2011) on Indonesia’s PKH, found that CCTs given to female- employment headed households led to relatively higher increases in the number of prenatal visits and the probability of attending at least two post-natal visits. For example, while female heads saw an Chapter 11 increase of 2.3 prenatal visits, male-headed households saw an increase of just half a visit. Effects The impact of on anthropometric measures were generally not significant when disaggregated by household cash transfers on head, except that male-headed households saw a 0.26 decline in the WHZ of children up to 36 empowerment months (the increase found among female-headed households was non-significant). This does not seem to be discussed by the authors, though the result does raise some questions over the possible SECTION III role of gender and intra-household dynamics in influencing child outcomes within the context of cash transfers. Chapter 12 Summary of findings and The one study reporting sex-disaggregated effects at an individual level (rather than sex of the conclusion household head) on wasting and stunting find that Pakistan’s BISP had a significant impact in reducing the proportion of girls aged up to 59 months that were wasted, but no significant effect References on boys (Cheema et al., 2014). No significant effects were found for either on stunting. The authors suggest that the differential effect in reducing wasting among girls could be partly related

139 Cash transfers: what does the evidence say? Page 139 Contents to a preference for girls’ nutrition among the female BISP beneficiaries, though it also appears Acknowledgements that there were some gender differences in the comparison groups, with wasting increasing more for girls than boys. It is suggested that the absence of an impact on stunting may be related to Executive summary difficulties in catching up if children were already malnourished at an early age, and they also point to the fact that child nutrition outcomes may not always appear to respond to cash transfers alone, given that they depend upon a wide range of other conditions. SECTION I Chapter 1 Introduction 8.5 T he role of cash transfer design and implementation features Chapter 2 Table 8.9 below summarises the effect of design and implementation features on the indicators Conceptual under consideration. A narrative summary of the results is provided below, incorporating overall framework effects as well as some effects that provide insights into gender differentiated results. Chapter 3 Review of cash transfer reviews Main recipient Chapter 4 Two studies were found explicitly testing the difference in outcomes based on official recipients, Methods with the results indicating that CCTs given to women in Burkina Faso were marginally more effective in increasing the number of health visits compared to transfers given to men and, among Chapter 5 The evidence base women, transfers given direct to older women in Mexico led to smaller increases in the probability of attending a health clinic. SECTION II Akresh et al. (2012) found that while targeting CCTs at mothers was associated with a statistically significant increase, of around 0.45, in the number of visits to health facilities over the preceding Chapter 6 The impact of year, CCTs targeted at fathers were associated with a non-significant increase of 0.42. However, cash transfers on the difference between mothers and fathers is not statistically significant. monetary poverty Behrman and Parker (2013) investigate the effect of transfers received by either older women (aged Chapter 7 50 plus) directly, or by a younger woman in the house, on the probability of attending a clinic in The impact of the preceding 12 months after 5.5 years in PROGRESA/Oportunidades. They find that transfers cash transfers on education being received by the older women lead to an increase just under half of that for those living with extended family (0.11 compared to 0.26). However, impacts for both groups were significant and Chapter 8 it is not clear whether the difference between them is statistically significant, or whether it may be The impact of cash other factors associated with the type of household that were driving any effects. transfers on health and nutrition Transfer size Chapter 9 The impact of cash transfers on Four studies were identified which tell us something of the effect of transfer size on health and savings, investment nutrition outcomes. Overall, they provide some limited evidence that higher transfer levels in cash and production transfer programmes in Mexico appear to be more effective in improving child anthropometric outcomes, but not for PROCAMPO, the design of which was focused more around agricultural Chapter 10 production than improvements in child capital. No statistically significant effect was found to The impact of cash transfers on result from cumulatively higher transfers on dietary diversity. employment Manley et al. (2015) find that higher transfer levels in Mexico’s PROGRESA lead to a small, but Chapter 11 statistically significant, increase of 0.07 in the HAZ of children. They argue that their approach, The impact of which takes account of the potential endogeneity of transfers, suggests that improvements in child cash transfers on development ‘are more linked to the transfers themselves than to other portions of the programme, empowerment which involve medical check-ups as well as educational sessions for mothers’. However, they do not test these components directly. SECTION III Esteva (2012) also found higher transfer levels in Mexico to be associated with improvements in Chapter 12 stunting – a small reduction in the probability of being stunted – and a small positive effect of 0.15 Summary of findings and on the HAZ, though neither effect was statistically significant. It also found an increase of 0.15 on conclusion the WAZ, but again this was not significant. References Davis et al. (2002) investigate the marginal effects of an additional Mexican peso of transfers through PROGRESA and PROCAMPO (including non-recipients) on children up to the age of

140 Cash transfers: what does the evidence say? Page 140 Contents five having a health check-up. They find that, while an additional peso has a small, but significant, Acknowledgements positive effect on the probability of a check-up in PROGRESA, the effect is not significant for PROCAMPO. They note, however, that the ratio of children having health check-ups was already Executive summary very high (at around 90%) and that health care visits under PROGRESA (unlike PROCAMPO) were effectively subsidised. SECTION I Merttens et al. (2013) find no statistically significant effect of cumulatively higher transfers on Chapter 1 dietary diversity in Kenya’s HSNP (as well as no statistically significant overall effect on the same Introduction outcome), despite the study finding a significant effect of cumulatively higher transfers on mean food consumption expenditure. Chapter 2 Conceptual framework Duration of exposure Chapter 3 Seven studies test the impact of duration of exposure on the health indicators covered. Overall, Review of cash transfer reviews the evidence shows greater exposure to cash transfers (or higher cumulative payments) has tended to lead to marginally greater improvements in child anthropometric indicators within the context Chapter 4 of transfers in Mexico and Ecuador, and of the elderly and children attending clinics in Mexico Methods and Peru. Chapter 5 The evidence base Buser et al. (2014) estimate the effect on anthropometric indicators of continuing to receive transfers in Ecuador’s BDH compared to losing the transfers. Their findings provide evidence of the potentially highly detrimental effects of ending transfers to recipients while they continue SECTION II to have young children or are pregnant. The authors found that two years after families lost the transfer (which they had received for seven years), their young children weighed less, were Chapter 6 The impact of shorter and more likely to be stunted than young children of families that continued to receive cash transfers on the transfer. The authors investigate potential mechanisms for these effects and find that one of monetary poverty the key explanations is likely to result from the impact that a loss in regular income had on the ability of poor households to maintain their food expenditures (which declined) as well as the fact Chapter 7 that, for many children, their family lost the cash transfer while they were still in utero, which as The impact of suggested earlier is a time when children are especially vulnerable to malnutrition. cash transfers on education Fernald et al. (2008) estimate the effect on stunting of cumulative transfers over time in Chapter 8 Oportunidades. More specifically, it measures the effect of receiving cumulatively larger transfers The impact of cash over the duration of being a beneficiary. They find that the doubling of cash transfers from the transfers on health median of 7,500 to 15,000 pesos (US$806 to US$1,612), led to an increase in the HAZ of 0.2 and and nutrition reduced the probability of stunting by ten percentage points. They take their results to indicate Chapter 9 that the cash component of Oportunidades was associated with better outcomes and that one of The impact of the sources of variation in outcomes could be due to the amount of cash received by beneficiary cash transfers on households. They postulate that the effect could be due to the higher transfers being received savings, investment during the critical period of child growth (gestation and first 24 months of life). They suggest two and production mechanisms through which the cash component could have led to the improvements. First, the Chapter 10 cash could have been used to purchase more or higher quality food or medicines when necessary. The impact of Secondly, higher amounts of cash could have been used to invest in household goods that might cash transfers on reduce a child’s exposure to infection. employment Chapter 11 In a different study, Fernald et al. (2009) find a small but statistically significant effect on HAZ The impact of scores among children who benefited for longer from Mexico’s PROGRESA (the effect of a cash transfers on cumulative increase of cash transfers of US$926). The authors note that the greatest change was empowerment identified in children of women with no formal education, for whom the fortified food distributed by the programme may have filled gaps in dietary intake. They also speculate that the health and nutrition education and growth monitoring may have resulted in improved care and feeding SECTION III practices in the home and early identification of infectious disease. Chapter 12 Summary of Being a beneficiary in Peru’s Juntos programme for a longer period of time was found to lead to findings and statistically significant increases in the likelihood of children under five receiving a health check in conclusion the previous three months (Perova and Vakis, 2012). Being in the programme for at least one year References was found to increase the probability of receiving health checks in the preceding three months by eight percentage points compared to being in the programme for less time. Although being in the

141 Cash transfers: what does the evidence say? Page 141 Contents programme for over 36 months was associated with a 13 percentage points increase, the difference Acknowledgements in impacts between being in the programme for at least 12 months was not statistically significant. The authors take the findings to suggest that effects on health service use are lagged, though not Executive summary necessarily cumulative. Manley et al. (2015) and Esteva (2012) both compared the effect on stunting of being in the early SECTION I versus late treatment groups in Mexico’s PROGRESA (approximately an additional 18 months). Chapter 1 For Esteva (2012), this involved estimating the effect of receiving, on average, 484, 530 and 1,959 Introduction Mexican pesos more through PROGRESA during pregnancy, first year and cumulatively than ‘late entry’ households. While Manley et al. (2015) found a small positive impact on HAZ, Esteva Chapter 2 (2012) found a small increase in the likelihood of being stunted, though neither of these results Conceptual were statistically significant. framework Chapter 3 Behrman and Parker (2013) look at the effect of being in PROGRESA/Oportunidades for different Review of cash lengths of time on the probability of people over 50 attending a clinic in the past year. The overall transfer reviews findings were that the longer duration as a beneficiary, the larger the effect size, with a few very minor gender differences. The estimated effects start from between 0.03 (not significant) for men Chapter 4 Methods or 0.05 (significant) for women for an additional 1.5 years, rising to an increase in the probability of 0.20 for men and 0.23 for women with 5.5 years more exposure. The latter represented a Chapter 5 proportional increase from baseline of 63% for women and 75% for men. In general, the authors The evidence base believed that it was the presence of conditionalities that led to increased health clinic attendance and that the marginally higher effects among women may have been due to the programme being SECTION II orientated towards them (female heads are required to attend health talks) and elderly women may have accompanied their daughters or grandchildren to these talks. Chapter 6 The impact of In the same study, there were also some age differences between men and women, with the effect cash transfers on of an additional 5.5 years leading to increased probabilities being much higher among older monetary poverty women aged 70 plus than men in the same age category (0.26 versus 0.08 and not significant), Chapter 7 and also among those aged 50–59 (women with an increase of 0.29 and men with an increase of The impact of 0.21). However, the effect on those aged 60–69 appears to have been higher for men than women cash transfers on (0.24 versus 0.09 for women). However, the sample sizes for these age disaggregate effects are not education reported and it is not clear how much should be read into these findings. Chapter 8 The impact of cash Conditionalities transfers on health and nutrition Of the three studies investigating impacts of behavioural requirements on the selected health Chapter 9 indicators, two find evidence that the presence of a behavioural requirement to attend child health The impact of clinics had a sizeable and significant effect on the number of child health visits being made. The cash transfers on third, found mixed results depending on the indicator, though that study overall found conditions savings, investment and labelling combined to be strongly associated with higher impacts on health service use in and production general. Chapter 10 The impact of Attanasio et al. (2015) investigate the effect on the number of preventative health care visits cash transfers on for children under 36 months old of there being a condition of attending preventative care employment visits in Colombia’s Familias en Acción. They estimate that as a result of being born after the Chapter 11 conditionalities no longer applied to new children, the number of care visits dropped among those The impact of children by -0.57, a 50% drop in the baseline number of preventative care visits. It is not clear cash transfers on what aspect of the conditionalities led to this effect. For example, it could have resulted from the empowerment presence of the condition, or that combined with monitoring and enforcement. Akresh et al. (2012) reported a similar finding in the NCTPP experiment in Burkina Faso, where SECTION III children under the age of 60 months in households that received transfers that were conditional Chapter 12 on quarterly visits to the local health clinic for child growth had 0.43 more preventative health Summary of care visits in the previous year compared to non-recipients (a considerable 49% increase compared findings and to the mean in the control group). By contrast, the effect of receiving UCTs was not statistically conclusion significant. The difference in effects between those receiving the CCTs versus UCTs was also References highly statistically significant. In this programme, the effects could again have arisen from the presence of conditions or the fact that satisfaction of conditions was monitored using a family

142 Cash transfers: what does the evidence say? Page 142 Contents booklet which was stamped to confirm health visits had taken place. Local committees were then Acknowledgements also supposed to randomly select 20% of booklets and verify the information with data from school registers and health centre registers. Executive summary Benedetti and Ibarrarán (2015) provide further insights into the effects of conditionalities, through the case of the Honduran Bono 10,000 programme. In the programme, conditions of regularly SECTION I attending health centres were only present for households with one child under the age of six (or a Chapter 1 pregnant or nursing mother), in which case the transfer was also labelled as a health transfer. For Introduction those with older children, the payment was not labelled nor conditional. Interestingly, although the transfer size was doubled for the latter unconditional group (from US$250 to US$500 per Chapter 2 year), if anything the study finds greater impacts on some indicators of health service use among Conceptual the conditional group, including a statistically significant increase of 21 percentage points for framework post-natal care. However, although the impact on the group without conditions or labelling was Chapter 3 not significant, the difference between the two was also not significant and there was no impact Review of cash check-ups. The fact that a significant effect prenatal for either group in terms of the number of transfer reviews was found among the conditional group and not among the unconditional group (which received double the transfer) does indicate, however, that liquidity or credit constraints may not always be Chapter 4 Methods the binding constraint on health service use. Chapter 5 The evidence base Payment mechanism The two studies found testing the effect of a mobile payment mechanism (both from the same SECTION II intervention but using slightly different data) found it to have a significant impact on dietary diversity but no significant effect on child wasting. Aker et al. (2011; 2014) investigated the effect of Chapter 6 The impact of a mobile payment (m-payment) system in Niger on household dietary diversity and child wasting, cash transfers on from a UCT programme targeted at women, implemented in 96 villages following a major drought. monetary poverty They find that, compared to a control group of households who received transfers manually (but also got a mobile phone), those that were paid through their phone experienced an increase in Chapter 7 dietary diversity of an extra 0.5 food groups on average, representing an increase of 16%. This was The impact of particularly driven by an increase in the consumption of beans and fats. The increase was 0.43 in cash transfers on education the 2011 study, which only used one round of follow-up data as opposed to two. Chapter 8 The authors investigated what may be driving the results and suggested that they may be attributed The impact of cash time-saving and increased intra-household bargaining power of women . While to two factors: transfers on health the amount of time saved was just two days over a five-month period, they believe it to be a and nutrition conservative estimate and believe that the savings may have occurred at a time of year when the Chapter 9 opportunity cost of time spent waiting for manual transfers was high and note that m-payment The impact of beneficiaries were more likely to cultivate marginal cash crops, primarily grown by women, which cash transfers on could indicate some greater engagement in alternative income-generating activities. In terms of savings, investment improved bargaining power, the authors note that the female programme recipients reported that and production the m-payments were less observable to other household members and allowed the recipients to Chapter 10 temporarily conceal the arrival of the transfer. Combined with the finding that m-transfer recipients The impact of were more likely to obtain the transfer on their own, travel to weekly markets and be involved in cash transfers on selling household grains than the manual transfer group, the authors take this to suggest that the employment m-payments may have strengthened women’s bargaining power within the household. Chapter 11 The impact of In terms of child wasting (only reported in the 2014 study), there was a small increase in the WHZ cash transfers on of 0.07 associated with the mobile payment mechanism, though it was not statistically significant empowerment and there was no change in the prevalence of wasting. They suggest that the results for wasting could be partially down to limited power of the smaller sub-sample (n=691). SECTION III Complementary interventions and supply-side services Chapter 12 Summary of findings and Finally, one study reported the effect of complementary interventions, and found that receiving conclusion complementary nutritional supplements in addition to cash transfers in Niger led to significantly greater reductions in moderate acute malnutrition (MAM) compared to receiving the cash transfer References alone. The study was a prospective intervention study in Niger, in which Langendorf et al. (2014) looked at the effect of receiving different complementary nutritional supplements with cash

143 Cash transfers: what does the evidence say? Page 143 Contents transfers on moderate acute malnutrition (MAM) (i.e. < -2 WHZ ≥ -3) among children aged from Acknowledgements 6–23 months. The authors found that, regardless of the specific supplements given (providing between 250kcal/day to 820kcal/day), receiving the complementary intervention in addition to a Executive summary cash transfer led to a halving of MAM, relative to receiving the cash transfer alone, even though the ‘cash transfer only’ group received an additional US$7 per month, representing the additional cost of the nutritional supplements. Adjusted hazard ratios, showing the comparative risk of MAM SECTION I among ‘cash only’ versus ‘cash plus supplementary food’, ranged from 2.07 to 2.42 depending Chapter 1 on the specific supplements. The authors suggest that the impact of the complementary fortified Introduction foods may be explained by an absence of locally available nutritious foods (the intervention partly overlapped the ‘hunger gap’ season), meaning that even though the comparison group had a higher Chapter 2 monthly transfer amount, they may have been unable to source sufficient nutritious food. Conceptual framework The finding is also consistent with two studies from Mexico (included in this review but not Chapter 3 reporting on the chosen indicators here) which find that uptake of nutritional supplements in Review of cash PROGRESA appear to have played an important role in child diet intake and growth (Ramírez- transfer reviews Silva et al., 2013; Behrman and Hoddinott, 2005). Ramírez-Silva et al. (2013) find evidence that the effect of Oportunidades on improved dietary intake (iron, zinc and vitamin A) was the result Chapter 4 Methods of the food supplement rather than improvements in the home diet. The authors found higher intakes among Oportunidades beneficiaries who received the fortified food supplements, but that Chapter 5 intakes were not higher among beneficiaries who did not receive the fortified food supplements. A The evidence base similar finding is made by Behrman and Hoddinott (2005), who show that the actual take-up of nutritional supplements in PROGRESA (rather than allocation to receive them) is found to lead to SECTION II a significant increase of about a sixth in mean growth per year for children aged 12–36 months. Chapter 6 The impact of 8.6 olicy implications P cash transfers on monetary poverty The review of the evidence highlights a number of policy implications. First and foremost, the Chapter 7 body of evidence indicates that while cash transfers often appear able to increase the utilisation The impact of of health care services (particularly when conditions are attached) and bring about improvements cash transfers on in dietary diversity scores, improvements in anthropometric measures appear to occur less education frequently. In some cases, improvements in anthropometric measures may be difficult to achieve if there is little problem to begin with, as Maluccio and Flores (2005) note was the case for wasting Chapter 8 The impact of cash in their study of Nicaragua’s RPS. It is also possible that, in some cases, a lack of effects may transfers on health also result from insufficient time periods over which to observe anthropometric changes, or even and nutrition limited power to detect effects. However, where this is not the case, the limited improvements in anthropometric measures are likely to arise from the fact that achieving healthy physical child Chapter 9 growth is contingent upon a much wider range of intervening variables than simply increasing The impact of cash transfers on attendance at health clinics or increasing the range of foods eaten. First of all, child health savings, investment measures are themselves likely to be contingent upon utilisation of quality health services and and production information, as well as having a diverse diet. In addition, healthy child growth is recognised to depend on good care for mothers and children, a healthy environment and freedom from disease Chapter 10 (UNICEF, 2013). Furthermore, timing of transfers is likely to be crucial, with the first 1,000 days The impact of cash transfers on of a child’s life being a particularly crucial window for later development (Bhatia et al., 2013). employment This is reflected in the findings above on stunting (Leroy et al., 2008) and duration of transfer. Chapter 11 The implications of the above for policy depend on the objectives of a particular intervention. If The impact of there is a genuine desire to improve nutritional outcomes as a core objective, then there must be cash transfers on a focus on addressing a range of issues, covering not just the design and implementation of the empowerment intervention, but also looking at the local implementation context, to ensure it is supportive of improvements in nutrition. Issues of particular importance, arising from the studies covered here, SECTION III include: Chapter 12 r • egular and reliable transfers of sufficient value to allow for year-round health coverage and the Summary of consumption of nutritious foods (e.g. Pellerano et al., 2014; Seidenfeld and Handa, 2011) findings and conclusion s • ufficient duration of the transfer (Buser et al., 2014) and targeting children at critical age to attain positive and lasting effects on child growth (Buser et al., 2014; Fernald et al., 2008) References • ocal availability of affordable quality health services (e.g. AIR, 2014) l

144 Cash transfers: what does the evidence say? Page 144 Contents l • ocal availability of and access to a range of nutritious foods, or fortified supplements in their Acknowledgements absence (e.g. Langendorf et al., 2014) c • ommunications and messaging around the importance of specific health behaviours (e.g. use Executive summary of health services and providing information on nutrition and child growth) (e.g. de Brauw and Peterman, 2011; Paxson and Schady, 2010). SECTION I From the studies on cash transfer size and duration, the evidence also suggests that receiving larger Chapter 1 payments and payments for a longer duration appears to result in some improvements in certain Introduction health and nutrition outcomes. Crucially, however, the study by Buser et al. (2014) suggests Chapter 2 that stopping payments to households while there are still young children present (or in utero) Conceptual may potentially lead to relative declines in child growth outcomes. This highlights the crucial framework importance of programmes having effective monitoring and graduation systems, in order that health benefits are not lost. Chapter 3 Review of cash transfer reviews The study by Langendorf et al. (2014) also provides some initial support for the idea that complementing cash transfers with nutritional supplements could help play a key role in improving Chapter 4 nutritional intake in contexts where local availability of a diverse diet is limited, with two other Methods studies cited above from Mexico suggesting that the contributions of such an approach may not just be limited to these contexts (Ramírez-Silva et al., 2013; Behrman and Hoddinott, 2005). Chapter 5 The evidence base A second overall policy lesson emerges from the fact that improvements in health care utilisation and dietary diversity were not found in every study. Some of the explanations for a lack of SECTION II improvement in health care use given above include: an absence of conditionalities and/or adequate messaging around the importance of health care use, inadequate health facilities, already Chapter 6 The impact of high existing use of services, and implementation problems (e.g. delays in payments). Potential cash transfers on explanations mentioned for the lack of improvement in dietary diversity included implementation monetary poverty problems (e.g. payment delays) and limited cash transfer sizes. Chapter 7 From a policy perspective, improving health care utilisation is likely to depend crucially upon The impact of there first of all being adequate, locally accessible health care services, which may require cash transfers on education additional supply-side investments in some contexts. Strong communications and messaging around the importance of health care use are also likely to play an important role. Consistent with Chapter 8 previous reviews, the few studies on conditionalities suggest that the presence and/or monitoring/ The impact of cash enforcement of behaviour requirements may be important in determining the size of effects on transfers on health cash transfer beneficiaries. It is also worth noting that all of the interventions found to have a and nutrition statistically significant impact on health care use were CCTs with health conditions attached and, Chapter 9 among the interventions in sub-Saharan Africa, it was only those which had conditions attached The impact of that led to any significant impact on health service use. It is possible that other design and cash transfers on implementation features may be driving these differences, however. Nevertheless, further research savings, investment would be useful to tease out which specific aspects of conditionalities may be most important, and production particularly given recent evidence that simply labelling transfers may strengthen their impacts on Chapter 10 particular behaviours, which could help avoid the various costs associated with monitoring and The impact of enforcement of conditions (Benhassine et al., 2013). cash transfers on employment Addressing improvements in dietary diversity will again depend on many of the same design and Chapter 11 implementation issues, and in this case communications around nutrition information and child The impact of growth. It will also, however, crucially depend on the local context, including the availability of cash transfers on and access to a diverse range of foodstuffs. In contexts where a diverse food basket is not locally empowerment available or affordable, given the value of the transfer, additional measures will probably need to be taken, such as complementary nutritional supplements mentioned above. SECTION III Great care should be taken in attempting to draw out any gender-related policy lessons from the Chapter 12 relatively limited evidence base. In terms of the gender of household head, while on the one hand Summary of cash transfers might appear to be able to potentially help improve and/or redress imbalances in findings and certain areas (e.g. increasing post-natal visits among male-headed households in Indonesia’s PKH), conclusion on the other, the sex of the household head was also linked to a deterioration in the WHZ of References children up to three years old in Indonesia’s PKH. Further research is clearly warranted to explore these issues in greater depth. Lessons regarding differential outcomes by gender of the individual

145 Cash transfers: what does the evidence say? Page 145 Contents are again limited by the evidence base, though there is some evidence suggesting that appropriately Acknowledgements designed cash transfers could be used to help address imbalances in health behaviours and practices among women and girls. Executive summary Finally, further research would be welcome to investigate the role of many of the design and implementation features considered, from which limited evidence was found. For example, from SECTION I the two studies reporting on the role of the official transfer recipient, there is very limited evidence Chapter 1 to inform how who receives the transfer affects health and nutrition outcomes. Also, on the issue Introduction of payment mechanisms, while the evidence reviewed indicated that electronic transfers may lead to potential health benefits, the evidence base is extremely limited and further studies in other Chapter 2 contexts are required to corroborate the findings and to fully uncover the reasons as to why Conceptual different payment mechanisms may mediate health and nutrition outcomes. framework Chapter 3 Table 8.3: Summary of results for overall cash transfer effect on health service use Review of cash # Measure of change Significance Effect Outcome indicator and treatment population Programme Study transfer reviews and country Chapter 4 NS Percentage point -0.008 Child attended clinic for preventative care CGP (Zambia) A IR (2014) 1 Methods 0 Attendance at skilled antenatal care with a doctor or nurse (children CGP (Zambia) Percentage point NS Chapter 5 0–15 months) The evidence base 2 NCTPP (Burkina Number of routine preventative health clinic visits for child (CCT) 0.431 5% Number of visits over Akresh et al. (2012) Faso) past 12 months Number of visits over NS -0.079 Number of routine preventative health clinic visits for child (UCT) NCTPP (Burkina SECTION II Faso) past 12 months 3 Attanasio et al. Familias Compliance with preventative nutritional health programme (<24 Percentage point 5% 0.228 Chapter 6 en Acción (2005) months old) The impact of (Colombia) cash transfers on Familias 5% Compliance with preventative nutritional health programme (24–48 Percentage point 0.332 monetary poverty en Acción months) (Colombia) Chapter 7 Familias 10% Percentage point 0.015 Compliance with preventative nutritional health programme (>48 The impact of en Acción months) cash transfers on (Colombia) education 10% Oportunidades Percentage point 0.0235 Woman received any prenatal care Barber and Gertler 4 (2008) (Mexico) Chapter 8 NS Percentage point 0.0235 Woman obtained five prenatal visits Oportunidades The impact of cash (Mexico) transfers on health NS Percentage point 0.034 Woman sought any prenatal care Oportunidades Barber and Gertler 5 and nutrition (2010) (Mexico) Oportunidades Woman obtained five or more consultations 0.015 NS Percentage point Chapter 9 (Mexico) The impact of cash transfers on 0.5841 Whether child aged 0–5 had a health check-up 6 PROGRESA 1% Davis et al. (2002) Probit coefficients (Mexico) (not marginal effects) savings, investment and production NS PROCAMPO Whether child aged 0–5 had a health check-up 0.15 4 Probit coefficients (Mexico) (not marginal effects) Chapter 10 Percentage points NS -0.059 Proportion of births which had post-natal care two weeks after birth CSR (El de Brauw and 7 The impact of Salvador) Peterman (2011) cash transfers on Adequate prenatal care (five or more visits) NS CSR (El Percentage points -0.065 employment Salvador) 10% 1.87 Average number of health facility visits in the past 12 months Number of visits over 8 Evans et al. (2014) TSAF (Tanzania) Chapter 11 among children up to two years old (impact after 18–21 months) past 12 months The impact of TSAF (Tanzania) 5% Number of visits over -3.0 Average number of health facility visits in the past 12 months cash transfers on among children up to two years old (impact after 31 to 34 months) past 12 months empowerment PATH (Jamaica) 1% Number of visits 9 Levy and Ohls 0.278 Number of visits to a health centre for preventative reasons in past six months (children up to six years old) (2007) 5% Percentage points 10 Maluccio and Flores RPS (Nicaragua) Whether child under three taken to a health control visit in past six 0.16 3 SECTION III (2005) months (impact 2000–2001) Chapter 12 Percentage points NS RPS (Nicaragua) Whether child under three taken to a health control visit in past six 0.084 months (impact 2000–2002) Summary of findings and 0.06 11 Paxson and Schady NS BDH (Ecuador) Child went for growth control visit in past six months (in top three Percentage points conclusion wealth quartiles) (2010) BDH (Ecuador) Child went for growth control visit in past six months (in poorest NS -0.057 Percentage points References wealth quartile) continued on next page

146 Cash transfers: what does the evidence say? Page 146 Contents Table 8.3: Summary of results for overall cash transfer effect on health service use continued Acknowledgements # Measure of change Study Effect Outcome indicator and treatment population Significance Programme and country Executive summary 12 NS Percentage points - 0.10 3 Proportion of children 0–17 that consulted a health care provider in CGP (Lesotho) Pellerano et al. the past three months (2014) 13 0.69 Received health checks in last three months (for children under 5) Juntos (Peru) Perova and Vakis Percentage point 1% SECTION I (2012) Percentage point 0.003 Attended ‘Well Baby Check-up’ CTP (Zambia) NS Seidenfeld and 14 Chapter 1 Handa (2011) Introduction Number of prenatal visits 0.576 World Bank (2011) Number of visits 5% 15 PKH (Indonesia) Chapter 2 1% Whether attended at least four prenatal visits 0.09 Percentage points PKH (Indonesia) Conceptual 10% Number of visits 0.35 PKH (Indonesia) Number of post-natal visits framework PKH (Indonesia) Whether attended at least two post-natal visits 0.096 Percentage points 1% Number of public health facility outpatient visits (entire household) Number of visits PKH (Indonesia) 1% 0.03 Chapter 3 Review of cash Number of visits 0.018 5% Number of private health facility outpatient visits (entire household) PKH (Indonesia) transfer reviews Notes: Figures in bold indicate statistically significant. NS means the study did not find a statistically Chapter 4 significant result, typically up to the 10% significance level. Methods Table 8.4: Summary of results for overall cash transfer effect on dietary diversity Chapter 5 The evidence base Programme and country Study Significance Measure of change Effect # Outcome indicator and treatment population Cheema et al. (2014) 1 BISP (Pakistan) Food Consumption Score -2.06 Index score NS SECTION II Ferré and Sharif (2014) NS Percentage points 0.031 Consumption of more than 4 out of 7 Shombhob (Bangladesh) 2 food groups (children over 6 months) Chapter 6 The impact of KWFP-cash transfer (Uganda) Gilligan et al. (2013) 3 5% Number of foods 0.925 Dietary Diversity Index cash transfers on 1% Number of food groups Household Dietary Diversity Score 0.552 monetary poverty 5% Food Consumption Score 2.993 Index score Chapter 7 3.503 Number of unique food items RPS (Nicaragua) Gitter and Caldes (2010) 4 5% Number of food items The impact of 1% Percentage point 0.13 8 Dietary Diversity Index WFP cash transfer (Ecuador) Hidrobo et al. (2012a) 5 cash transfers on Household Dietary Diversity Score 1% Percentage point 0.044 education 0.10 8 1% Percentage point Food Consumption Score Chapter 8 2.39 Dietary Diversity Index Number of food items 6 1% Hidrobo et al. (2012b) WFP cash transfer (Ecuador) The impact of cash 1% Number of food groups 0.4 Household Dietary Diversity Score transfers on health and nutrition Food Consumption Score 6.48 Index score 1% 7 Number of foods NS Hoddinott and Wiesmann 0.508 PRAF (Honduras) Number of foods eaten Chapter 9 (2008) 0.356 NS Number of foods Number of foods eaten Oportunidades (Mexico) The impact of RPS (Nicaragua) Number of foods eaten 3.868 Number of foods 5% cash transfers on savings, investment Merttens et al. (2013) 8 Index score 0.412 Mean dietary diversity score NS HSNP (Kenya) and production Food Diversity Score 1% Additional food groups 2 (5 to 7) 9 Miller et al. (2011) SCTP (Malawi) NS 10 Pellerano et al. (2014) CGP (Lesotho) Dietary Diversity Index 0.16 1 Number of food groups Chapter 10 The impact of Proxy score 0.946 NS Food Consumption Score cash transfers on 0.011 Number of foods consumed PROGRESA (Mexico) Ruiz-Arranz et al. (2002) 11 1% Number of foods employment 0.018 Index score 5% Simpson Index Chapter 11 Shannon Index 0.072 Index score 1% The impact of NS Index score Revealed Optimal Diversity Index 0.007 cash transfers on 0.01 5% Number of foods Number of foods consumed PROCAMPO (Mexico) empowerment Simpson Index 0.006 Index score NS NS Index score 0.063 Shannon Index SECTION III NS Revealed Optimal Diversity Index 0.022 Index score Chapter 12 NS 12 Seidenfeld and Handa (2011) Monze cash transfer (Zambia) Diversity score 0.203 Number of food groups Summary of findings and Notes: Figures in bold indicate statistically significant. NS means the study did not find a statistically conclusion significant result, typically up to the 10% significance level. Diversity Score = Number of food groups purchased over past seven days; Dietary Diversity Index = Sum of number of distinct food items consumed by References the household in the previous seven days; Household Dietary Diversity Score = Frequency of 12 food groups consumed in past seven days; Food Consumption Score = Sum of number of days eight different food groups

147 Cash transfers: what does the evidence say? Page 147 Contents consumed, multiplied by weighted frequencies and summing across categories to get a single proxy indicator; = Weighted = Weighted sum of calorie shares of different foods consumed; Simpson Index Shannon Index Acknowledgements Revealed sum of calorie shares of different food groups consumed (shares multiplied by their logged values); Executive summary Optimal Diversity Index = an index reflecting how ‘optimally diverse’ households consumption baskets are relative to households in the top wealth decile. SECTION I Table 8.5: Summary of results for overall cash transfer effect on stunting Chapter 1 Introduction Programme and Significance # Measure of change Effect Outcome indicator and treatment Study country population Chapter 2 Probability of being stunted Conceptual 0.914 Whether stunted or not (12–36 months) PROGRESA (Mexico) Gertler (2004) 1 NS Log odds of being stunted framework NS Ferré and Sharif (2014) Shombhob Percentage point 0.034 2 Whether stunted or not (up to 36 months Chapter 3 at start) (Bangladesh) Review of cash Whether stunted or not (61–83 months) KWFP-cash transfer Gilligan et al. (2013) NS Percentage point 3 -0.018 transfer reviews (Uganda) 10% Percent -5.5 4 Maluccio and Flores (2005) RPS (Nicaragua) Whether stunted or not (under five) Chapter 4 Methods Height-for-age CGP (Zambia) 1 A IR (2014) NS Height-for-age (under 60 months) - 0.116 Z-score Chapter 5 The evidence base Height-for-age (under 24 months) 10% Z-score 2 Attanasio et al. (2005) 0.161 Familias en Acción (Colombia) NS Z-score 0.86 Height-for-age (up to 48 months) TSAF (Tanzania) Evans et al. (2014) 3 SECTION II (impact after 18–21m) Fernald and Hidrobo (2011) 0.01 Height-for-age (12–35 months) BDH (Ecuador) 4 NS Z-score Chapter 6 Z-score Leroy et al. (2008) 5 NS PAL (Mexico) Height-for-age (urban, up to 24 months) 0.11 The impact of cash transfers on 5% PAL (Mexico) Height-for-age (urban, up to 6 months) 0.41 Z-score monetary poverty Z-score 0.072 Height-for-age (under 6 years old at start Atención a Crisis Macours et al. (2012) 6 5% (Nicaragua) (impact after receiving of programme) Chapter 7 transfers for approx. 9m) The impact of Atención a Crisis Height-for-age (under 6 years old at start 0.045 Z-score NS cash transfers on (Nicaragua) (impact approx. 2 yrs after of programme) education transfer) Chapter 8 Height-for-age (6m to 48m) 0.3575 RPS (Nicaragua) Maluccio (2005) 7 1% Z-score The impact of cash NS Z-score 0.13 Height-for-age (under 5 years old) RPS (Nicaragua) Maluccio and Flores (2005) 8 transfers on health Paxson and Schady (2010) NS Z-score 0.008 BDH (Ecuador) Height-for-age (up to 6 months at 9 and nutrition baseline) Chapter 9 World Bank (2011) 10 0.071 Height-for-age (up to 36 months) PKH (Indonesia) NS Z-score The impact of cash transfers on Notes: Child ages are reported in brackets. Figures in bold indicate statistically significant. NS means the savings, investment study did not find a statistically significant result, typically up to the 10% significance level. and production Chapter 10 Table 8.6: Summary of results for overall cash transfer effect on wasting The impact of cash transfers on Programme and Study # Significance Measure of change Effect Outcome indicator and treatment employment population country Probability of being wasted Chapter 11 The impact of 1 Percentage point - 0.12 5 Ferré and Sharif (2014) Shombhob Whether wasted or not (12–24 months 10% (Bangladesh) when enrolled) cash transfers on empowerment RPS (Nicaragua) NS 2 Maluccio and Flores (2005) Percentage point Whether wasted or not (under 5 years 0.003 old) Weight-for-height SECTION III NS 1 Z-score CGP (Zambia) Weight-for-height (under 60 months) 0.042 A IR (2014) Chapter 12 NS 2 Evans et al. (2014) TSAF (Tanzania) Weight-for-height (up to 48 months) -0.03 Z-score (impact after Summary of 18–21 months) findings and 3 World Bank (2011) PKH (Indonesia) Weight-for-height (up to 36 months) - 0.187 Z-score NS conclusion Notes: Child ages are reported in brackets. Figures in bold indicate statistically significant. NS means the References study did not find a statistically significant result, typically up to the 10% significance level.

148 Cash transfers: what does the evidence say? Page 148 Contents Table 8.7: Summary of results for overall cash transfer effect on being underweight Acknowledgements Measure of change # Study Programme and Outcome indicator and treatment Effect Significance country population Executive summary Probability of being underweight Ferré and Sharif (2014) NS Shombhob 1 Whether underweight or not 0.046 Percentage point (Bangladesh) SECTION I NS Percentage point -0.033 Whether underweight or not (61–83 months) KWFP-cash transfer Gilligan et al. (2013) 2 Chapter 1 (Uganda) Introduction Percentage point -0.062 Being underweight (under 5 years old) RPS (Nicaragua) 5% Maluccio and Flores 3 (2005) Chapter 2 Weight-for-age Conceptual framework A IR (2014) NS Z-score -0.047 Weight-for-age (under 60 months) CGP (Zambia) 1 2 TSAF (Tanzania) Weight-for-age (up to 48 months) -0.29 NS Evans et al. (2014) Z-score Chapter 3 (impact after 18–21 months) Review of cash 0.036 Z-score (impact after receiving NS Weight-for-age (under 6 years old when Atención a Crisis Macours et al. (2012) 3 transfer reviews transfers for approx. 9 months) transfer started) (Nicaragua) Chapter 4 NS Weight-for-age (under 6 yrs when transfer Atención a Crisis 0.029 Z-score (impact approx. two Methods years after transfer) started) at time transfer started) (Nicaragua) PKH (Indonesia) 4 Weight-for-age (under 36 months) -0.065 Z-score NS World Bank (2011) Chapter 5 BDH (Ecuador) 5 Buser et al. (2014) NS Z-score (impact after receiving 0.085 Weight-for-age (under 6 years old) The evidence base transfers for two yrs) BDH (Ecuador) Being underweight (under 6 years old) -0.016 Percentage point (after receiving NS transfers for two years) SECTION II Chapter 6 Notes: Child ages are reported in brackets. Figures in bold indicate statistically significant. NS means the The impact of study did not find a statistically significant result, typically up to the 10% significance level. cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

149 Cash transfers: what does the evidence say? Page 149 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 9 transfer reviews Chapter 4 Methods he impact of cash T Chapter 5 The evidence base transfers on savings, SECTION II Chapter 6 The impact of cash transfers on investment and monetary poverty Chapter 7 The impact of production cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

150 Cash transfers: what does the evidence say? Page 150 Contents Box 9.1: Summary of evidence for savings, investment and production outcomes Acknowledgements In total, there were 27 studies from which evidence was extracted for this outcome area, covering 12 countries and Executive summary 21 cash transfer programmes. Most of these were UCTs, as most evidence on this outcome area has been recently generated through FAO’s From Protection to Production (PtoP) project, which focuses on sub-Saharan Africa. SECTION I Overall effects of cash transfers on selected savings, investment and production indicators: • alf of the studies that considered savings found cash transfers to have a statistically signficiant impact and all H Chapter 1 of these showed increases in savings. Of the 10 studies that looked at the overall effect of cash transfers on Introduction , five found statistically significant increases in the share of households reporting savings household savings (ranging from 7–24 percentage points) or the amount of savings accumulated. No significant negative impacts were Chapter 2 reported in any of the studies. Conceptual framework • indicators were mixed, as households either used the cash to increase their I mpacts on the selected borrowing access to credit or to pay off existing debt. Of the 15 studies that report any indicator for borrowing, four report Chapter 3 significant increases in the share of households in debt or borrowing and/or on total amount of debt, three Review of cash report significant reductions, one reports mixed findings and the remaining seven studies report no significant transfer reviews impacts. Chapter 4 T hree studies on agricultural productive assets find statistically significant findings, all increases. Of the eight • Methods studies reporting on relevant indicators to households’ accumulation of agricultural productive assets, three find a positive and significant impact on a wide variety of indicators (with impacts ranging from 3–32 percentage points Chapter 5 depending on the asset and programme), and the remaining five find no significant impacts. The evidence base • agricultural inputs hile drawing on a low number of studies, the evidence for W mostly shows increases. Of the eight studies reporting on these indicators, six report some form of significant increase in expenditure or use (with impacts ranging from 4–18 percentage points depending on the input and programme), primarily for fertiliser and SECTION II seeds, while one reports a significant decrease. livestock ownership and value mpacts on show consistent increases, with significant impacts found for the • I Chapter 6 majority of studies. 12 out of 17 report some form of increase (with impacts ranging from 1–59 percentage points The impact of depending on livestock type and programme), with the remaining five reporting non-significant impacts. Impacts cash transfers on monetary poverty were particularly concentrated on smaller livestock such as goats and chickens. • mpacts on business and enterprise were mixed, and more difficult to interpret than others reported in this section I Chapter 7 because of the range of indicators adopted in different studies. Of the nine studies reporting any indicator for this The impact of specific outcome area, four found significant increases in the share of households involved in non-farm enterprise or cash transfers on on the total expenditure on business-related assets and stocks, while one found a significant decrease. education Variation in outcomes by gender: Chapter 8 The impact of cash E • ight studies reported gender disaggregated outcomes, most often by separating analysis female and male-headed transfers on health households. Interestingly, three of these studies found some of the savings, investment and production results and nutrition primarily driven by female-headed households, two find different types of impacts for male versus female household heads or beneficiaries (e.g. different type of investment preferred), while another two find no significant differences Chapter 9 between the two. Overall, these results appear to be driven by different levels of asset ownership at baseline and The impact of different cultural roles and aptitudes. cash transfers on savings, investment Role of design and implementation features: and production O , finding non-significant differences • ne study assessed the different impact of having a male or female recipient across the two for impacts on savings and livestock ownership (Haushofer and Shapiro, 2013). Chapter 10 The impact of • transfer levels and ne study explicitly compares the impact on savings and investment behaviour of different O cash transfers on , finding that lump-sum recipients accumulate significantly more non-land assets and large livestock, frequency employment while monthly recipients accumulate more small livestock and birds. Overall savings and livestock holdings were also substantially higher for those receiving a larger transfer (Haushofer and Shapiro, 2013). Chapter 11 T , suggest sustained impacts over time. he two studies reporting on variations in impact due to length of exposure • The impact of cash transfers on designs. It found impacts in this area to be consistently higher • targeting O ne study looked at the effect of different empowerment and more frequently highly significant for households receiving a transfer based on demographic indicators of vulnerability rather than a form of social pension, with the exception of borrowing (Merttens et al., 2015). • O ne study comparing different payment modalities finds that, compared to standard distribution methods, mobile SECTION III money transfers affected crop choices, but not ultimate production or savings (Aker et al., 2011). our studies present evidence on to cash complementary interventions and supply-side services • F Chapter 12 transfers, showing that group organisation for grant recipients can act as a commitment device, and that Summary of coupling standard cash transfers with supervision and training, technical assistance, and with additional findings and conclusion productive investment grants or with insurance can increase productive impacts. References

151 Cash transfers: what does the evidence say? Page 151 Contents 9.1 S ummary of findings Acknowledgements This section reports on the impacts of cash transfers on saving, borrowing, purchase and Executive summary ownership of productive assets (agricultural tools and inputs, livestock and business assets) and business/enterprise. A summary of the overall effects, how they vary by design and implementation SECTION I features, and by gender, is provided in Box 9.1. Chapter 1 Our findings mostly confirm the theory of change for this outcome area, by which receiving a Introduction guaranteed and predictable source of income can help households lift liquidity, saving and credit constraints, enabling investment. Overall, impacts on savings, ownership/purchase of livestock Chapter 2 Conceptual and purchase/use of agricultural inputs were consistent in their direction of effect, with almost framework all statistically significant findings highlighting positive effects of cash transfers, though not throughout all programmes or all types of livestock and inputs. On the other hand, impacts Chapter 3 on borrowing, agricultural assets and business/enterprise were less clear-cut. These findings Review of cash are of particular importance in low- and middle-income countries, where extreme poverty is transfer reviews disproportionately concentrated in rural areas (as are many cash transfer programmes), and the Chapter 4 majority of men and women depend on agriculture for their livelihoods (FAO, 2015), all the more Methods as climate change is set to worsen the shocks and challenges faced by rural households. Chapter 5 savings , five Of the ten studies that looked at the overall effect of cash transfers on household The evidence base found statistically significant increases in the share of households reporting savings or the amount of savings accumulated (with impacts ranging from 7–24 percentage points), while no significant SECTION II negative impacts were reported in any of the studies. Evidence confirmed that households could afford to marginally increase their precautionary savings because of increased income and, in Chapter 6 some cases, increase access to formal and informal financial institutions. The impact of cash transfers on monetary poverty Impacts on the selected borrowing indicators were mixed, as households either used the cash to increase their access to credit or to pay off existing debt (which can be associated with stigma). Chapter 7 Overall, of the 15 studies that report any indicator for this outcome area, four report significant The impact of increases in the share of households in debt or borrowing and/or on total amount of debt, three cash transfers on report significant reductions, one reports mixed findings and the remaining seven studies report education no significant impacts. The authors discussed the important role of beneficiaries’ increased Chapter 8 creditworthiness, mediated by de facto transfer size and regularity. The impact of cash transfers on health The varying magnitude and directions of impact for saving and borrowing were justified in several and nutrition different ways within the studies, with two studies explicitly testing variations in impact linked to Chapter 9 variations in programme design. The evidence points to increased impacts on savings for higher The impact of transfer amounts, monthly rather than lump-sum transfers and complementary supervision and cash transfers on training. savings, investment and production Coming to the investment/production impacts that more directly pertain to poor households’ livelihoods, widespread and significant impacts were found within the selected studies for: Chapter 10 The impact of • – out of a total of eight studies, six report significant increases in the gricultural inputs A cash transfers on outcome indicators (with impacts ranging from 4–18 percentage points depending on the input employment and programme), primarily on fertiliser and seeds, and one reports a decrease. Chapter 11 • – 12 out of 17 studies report some form of increase in livestock ownership and ivestock assets L The impact of cash transfers on value, with the remaining five reporting non-significant impacts. Larger and significant impacts empowerment were mostly registered for smaller livestock, with marginal effects on chicken ownership ranging from 7–59 percentage points and on goats from 7–52 percentage points. There were also some cases of households investing in cattle. SECTION III However, less clear-cut impacts were found on: Chapter 12 Summary of gricultural assets • – with two programmes only (Malawi’s Mchinji pilot and Zambia’s CGP) A findings and out of a total of seven (eight studies) registering significant increases and impacts ranging from conclusion 3–32 percentage points for different assets. Lack of impact in four programmes was justified in References several ways, including behaviour influenced by strong programme labelling (money was to be spent for children) and low value/unpredictability of the transfer.

152 Cash transfers: what does the evidence say? Page 152 Contents usiness and enterprise • B – of the nine studies reporting any indicator, four found increases Acknowledgements in the share of households involved in non-farm enterprise or on the total expenditure on business-related assets and stocks, while one found significant decreases. Executive summary Most savings, investment and production indicators were measured at the household rather than , most often by individual level. However, eight studies reported sex-disaggregated outcomes SECTION I separating analysis for female and male-headed households. Interestingly, three of these studies Chapter 1 find some of the savings, investment and production results primarily driven by female-headed Introduction households, two find different types of impacts for male versus female household heads or beneficiaries (different type of investment preferred, with women, for example, investing more in Chapter 2 smaller rather than large livestock, etc.), while another two find no significant differences between Conceptual 88 Overall, these results appear to be driven by different levels of asset ownership at the two. framework baseline and differing cultural roles and aptitudes. Chapter 3 Review of cash Several insights were offered by the literature on the role of features design and implementation transfer reviews in mediating these productive impacts. Specifically, evidence (including studies explicitly testing different designs, qualitative research and authors’ interpretations) shows that: Chapter 4 Methods • is associated with higher productive impacts, while lump-sum payments transfer size igher h trigger investment on bulkier items (e.g. larger livestock) Chapter 5 The evidence base predictability and reliability • t he role of the of payments in enhancing beneficiaries’ risk- management capacity and planning was confirmed, with some suggestions that tying timing of SECTION II payments to the agricultural cycle could increase effects t here is heterogeneity of productive impacts based on a households’ existing asset base, with • Chapter 6 The impact of households having access to land and labour (so potentially better-off) more capable of cash transfers on (and potential trade-offs investing productively – this has important implications for targeting monetary poverty with human capital objectives) Chapter 7 t associated with the transfer: perceived (implicit) messaging here is a strong role played by the • The impact of linked to human capital objectives can reduce impacts on productive conditionality or actual cash transfers on outcomes education in • duration of exposure creasing the to the transfer leads to sustained (though not necessarily Chapter 8 increasing) impacts over time The impact of cash transfers on health c • (coupling cash transfers with productive omplementary interventions and supply-side services and nutrition investment grants, additional supervision and training, insurance) increases effects on ultimate productive outcomes. Chapter 9 The impact of cash transfers on savings, investment 9.2 ummary of evidence base S and production In total, there were 27 studies from which evidence was extracted for this outcome area, covering Chapter 10 12 countries and 21 cash transfer programmes. Most of the programmes were UCTs, as a majority The impact of cash transfers on of evidence on this outcome area has been recently generated through FAO’s From Protection to employment Production (PtoP) project, which focuses on sub-Saharan Africa. Given that productive impacts are not among the primary intended impacts of cash transfers, and that collecting data on Chapter 11 productive investments can be costly, few studies prior to PtoP explicitly focused on this. Table 9.1 The impact of provides an overview of which countries and programmes the studies reported on, highlighting cash transfers on the prevalence of studies from Africa and the almost inexistent evidence from Asia, while also empowerment 89 Findings from several pilot showing most programmes were operating primarily in rural areas. studies may be more limited in their external validity and applicability to other settings. SECTION III A range of different study designs and estimation methods were used in order to estimate the Chapter 12 effect of cash transfers, or their design and implementation features, on the selected health Summary of findings and conclusion 88 N ote that the eighth study does not compare across genders in any way, as most recipients were female. References 89 N ote: The totals in the final column of Table 9.1 do not add to the total number of studies as two studies report results for more than one programme.

153 Cash transfers: what does the evidence say? Page 153 Contents indicators. Table 9.2 provides a summary of these. As can be seen, a large majority were based on Acknowledgements experimental studies, with the remainder using observational data and employing some form of DID, RDD, IV or OLS regression. Executive summary Table 9.1: Summary of countries and programmes reported on for the investment, saving and production indicators (all studies) 90 SECTION I Country Details if pilot or Rural/urban # studies Type of cash Programme Chapter 1 experimental study* transfer Introduction 90 Latin America and the Caribbean = 8 studies Bolivida Social pension 1 Bolivia Both Chapter 2 Conceptual Mexico CCT 5 Rural, then both PROGRESA/Oportunidades framework PROCAMPO Mexico Rural 1 CCT Chapter 3 1 CCT Red de Protección Social (RPS) Rural Nicaragua Review of cash UCT 1 Rural Atención a Crisis Short term Nicaragua transfer reviews Africa = 17 studies Chapter 4 1 UCT/CCT LEAP Ghana Rural Methods Rural Innovation for Poverty Action randomised trial (IPA RCT) Ghana 1 Field trial UCT Chapter 5 Kenya OVC-cash transfer UCT in practice 1 Both The evidence base Rural 1 UCT Hunger Safety Net Programme (HSNP) Kenya Phase 1 of programme roll-out Experiment Give Directly cash transfer UCT 1 Rural Kenya SECTION II Pilot phase (one district) Malawi Social Cash Transfer Programme (SCTP) UCT 1 Rural Lesotho Rural 2 Child Grant Programme (LCGP) UCT Chapter 6 The impact of Concern Worldwide drought-response unconditional transfer Niger UCT 1 Rural Short term, experimental cash transfers on Tanzania CCT 1 Rural Pilot experiment Tanzania Social Action Fund (TSAF) monetary poverty Part of Northern Uganda Both 2 Enterprise grant Youth Opportunities Program (YOP) Uganda Social Action Fund Chapter 7 The impact of Uganda Not for profit short-term Rural 2 Enterprise grant Women’s Income Generating Support (WINGS) programme, two districts cash transfers on education UCT Both Social Assistance Grants for Empowerment (SAGE) Uganda 1 Two pilots Zambia Rural 1 UCT Monze Cash Transfer Pilot (CTP) Pilot in one district Chapter 8 The impact of cash UCT Zambia Child Grant Programme (ZCGP) Implemented in three districts Rural 2 transfers on health Europe and Central Asia = 2 studies and nutrition 1 BOTA cash transfer Rural Kazakhstan CCT Chapter 9 Pakistan 1 UCT BISP cash transfer Rural The impact of cash transfers on * This information for papers that report results from a pilot/experimental implementation helps distinguish savings, investment such papers from those that cover cash transfer policies/programmes that are operational at a larger scale and production and/or are long-term/permanent. It provides a ‘flag’ for findings which may have more limited applicability or where it has not been shown that the evidence would necessarily hold at a larger scale. Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References 90 T otal is not the sum of studies below as one study focused on both Procampo and PROGRESA.

154 Cash transfers: what does the evidence say? Page 154 Contents Table 9.2: Summary of study methods used and risk of bias for savings, investment and production Acknowledgements Reports effect Study Study design and methods used for reported results Reports Reports sex- total effect of design and disaggregated Executive summary implementation outcomes features? RCT (DID) Air (2014) Yes SECTION I Yes Aker et al. (2011) RCT (DID) Chapter 1 Angelucci et al. (2012) Yes QE (PSM) Introduction RCT (DID, and Single Difference combined with inverse probability Yes Yes Asfaw et al. (2014) weighting (SD-IPW)) Chapter 2 Blattman et al. (2012) Yes RCT (ANCOVA) Yes Conceptual framework Yes Yes RCT (DID) Blattman et al. (2015) Cheema et al. (2014) QE RDD Yes Chapter 3 Review of cash Yes Yes Covarrubias et al. (2012) RCT (DID and DID with PSM) transfer reviews Daidone et al. (2014a) RCT (DID and Single Difference or PSM, or SD with Inverse Probability Yes Weighting) Chapter 4 Methods Daidone et al. (2014b) RCT (DID or SD with IPW) Yes Yes QE (OLS linear and logistic regression with baseline levels Yes Davis et al. (2002) Chapter 5 characteristics as controls) The evidence base Yes Yes Yes RCT (DID) Evans et al. (2014) Yes Yes RCT (OLS ) Gertler et al. (2012) SECTION II Yes RCT (ITT with OLS) Green et al. (2015) Chapter 6 Handa et al. (2014) Yes Yes QE (PSM, multivariate analysis) The impact of Yes Haushofer and Shapiro (2013) RCT (DID and OLS) Yes Yes cash transfers on RCT (IV) Karlan et al. (2014) Yes Yes monetary poverty Yes Macours and Vakis (2009) RCT (OLS and two staged OLS) Yes Chapter 7 Svarch (2009) Yes RCT (Fixed effects, IV and Tobit) The impact of cash transfers on RCT (DID) Maluccio (2010) Yes Yes education Martinez (2004) RCT (OLS) Yes Chapter 8 RCT (DID) Yes Merttens et al. (2013) The impact of cash QE (RDD; DID with PSM) Yes Yes Merttens et al. (2015) transfers on health and nutrition O’Brien et al. (2013) RCT (IV estimation) Yes Pellerano et al. (2014) RCT (DID) Yes Chapter 9 Seidenfeld and Handa (2011) QE (DID with PSM) Yes The impact of cash transfers on Todd et al. (2010) Yes RCT (Single Difference OLS, OLS weighted with inverse weighting by savings, investment propensity score, and non-linear estimators (Probit, Poisson, Tobit)) and production RDD = Regression Discontinuity Design, RCT = randomised controlled trial, DID = difference-in-difference, Chapter 10 SD = single difference, PSM = propensity score matching, IV = instrumental variables, ANCOVA = analysis The impact of of covariance. cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

155 Cash transfers: what does the evidence say? Page 155 Contents 9.3 T he impact of cash transfers on savings, investment and Acknowledgements production Executive summary Tables 9.3 to 9.8 below summarise the overall effects of cash transfers on the indicators under consideration. Where any effects associated with design or implementation features were SECTION I found, these are not reported in the tables, but are discussed in section 9.5. Similarly, all sex- disaggregated results are discussed in section 9.4. Chapter 1 Introduction Saving and borrowing Chapter 2 Conceptual framework Within the studies reviewed, impacts on savings were positive, though not common to all programmes, while impacts on borrowing were mixed, partly justified in the conceptual Chapter 3 framework detailed in Chapter 2 by which households could either use the cash to increase their Review of cash access to credit or to pay off existing debt. transfer reviews Chapter 4 Saving Methods Of the ten studies that looked at the overall effect of cash transfers on household savings (share Chapter 5 91 five found statistically of households that hold any savings and the total value of these savings), The evidence base significant increases in the share of households reporting savings or the amount of savings accumulated (see Table 9.3 at the end of the chapter). While the size of effects is not fully SECTION II consistent across countries, no significant negative impacts were reported in any of the studies. Chapter 6 In Mexico, Angelucci et al. (2012) found a significant increase in the likelihood of having savings The impact of (and access to a bank account) for Oportunidades beneficiaries, but no effects on the amounts cash transfers on monetary poverty of savings. Similar – if not stronger – results were found across several of sub-Saharan Africa’s flagship cash transfer programmes: Chapter 7 The impact of I • n Zambia, Daidone et al. (2014b) estimate an impact of the CGP on the share of households cash transfers on declaring to accumulate savings in the form of cash (+24 percentage points), and on the education amounts saved, with larger results for smaller-sized households. Chapter 8 I • n Kenya, the share of HSNP beneficiaries that currently have cash savings is significantly The impact of cash higher (7.3 percentage points, 10% significance), with results driven by larger and better-off transfers on health households (Merttens et al., 2013). and nutrition I n Uganda just over one year of SAGE transfers led to a statistically significant increase in the • Chapter 9 proportion of SAGE beneficiary households that have savings (9.5 percentage points for VFSG The impact of households, non-significant but positive for SCG households) (Merttens et al., 2015). cash transfers on savings, investment and production Minor experimental programmes in Africa also registered positive impacts on saving levels, with Haushofer and Shapiro’s (2013) evaluation of Kenya’s Give Directly programme finding doubled Chapter 10 cash savings balances and a ten percentage points increase in the share of households saving with The impact of M-Pesa as a result of receiving a cash transfer (from low initial levels), and Blattman et al.’s (2015) cash transfers on study of the Women’s Income Generating Support (WINGS) in Uganda finding that savings levels employment 92 roughly tripled among both men and women. Chapter 11 The impact of Throughout these studies, the conceptual framework justifying these impacts reflects that cash transfers on outlined in Chapter 2, whereby households can afford to marginally increase their precautionary empowerment savings because of increased income and, in some cases, increased access to formal and informal financial institutions. For example, where these evaluations were triangulated with SECTION III qualitative research, some evidence was found of increased engagement with savings groups, with respondents mentioning that such savings allowed them to meet future household demands, and Chapter 12 respond to shocks such as illness (Merttens et al., 2015). Summary of findings and conclusion hese used a variety of different indicators, totalling 16 impacts extracted. 91 T References 92 S ee section 9.4 below on gender disaggregated effects for details. Note that WINGS was not a standard cash transfer, but an enterprise grant, so these impacts should be interpreted accordingly.

156 Cash transfers: what does the evidence say? Page 156 Contents No significant impacts were found on households’ propensity to save or on the size of savings for Acknowledgements Lesotho’s CGP (Daidone et al., 2014; Pellerano et al., 2014) – interpreted to be because of the size 93 and unpredictability of the transfer and the messaging associated with it – and for Kazakhstan’s Executive summary BOTA, where a bank account was opened for every beneficiary household, but people were instructed not to use the bank account for any savings other than the CCT while in the programme 94 In Ghana, LEAP households were 11 percentage points more likely (Handa (O’Brien et al., 2013). SECTION I et al., 2014) and in Pakistan BISP households were five percentage points more likely (Cheema Chapter 1 et al., 2014) to save money relative to non-beneficiary households, though findings were not Introduction significant. Similarly, in Tanzania’s community-based CCT, treatment did not significantly impact savings decisions at endline except for non-bank savings within the poorest households. Qualitative Chapter 2 fieldwork revealed this was mostly due to the low amount of the transfer (Evans et al., 2014). Conceptual framework Borrowing Chapter 3 Review of cash transfer reviews Impacts on the selected borrowing indicators (share of households that hold any loans and the total value of these loans) were overall less clear-cut than on savings, as is partly explained Chapter 4 in Chapter 2 (households could either use the cash to increase their access to credit or to pay Methods off existing debt). The picture is further complicated by the use of quite different indicators in different studies, totalling 29 results extracted. Overall, of the 15 studies that report any indicator Chapter 5 The evidence base for this outcome area, four report significant increases in the share of households in debt or borrowing and/or on total amount of debt, three report significant reductions, one reports mixed findings and the remaining seven studies report no significant impacts (see Table 9.4). SECTION II For example, in Mexico, Gertler et al. (2012) find a significant effect of Oportunidades (0.4 Chapter 6 The impact of percentage points or 66.7%) on the probability of taking loans for productive purposes, while cash transfers on previously Svarch (2009) had estimated the programme increases the probability of having loans monetary poverty by 16 percentage points while negatively impacting the amount of the loan application. In Kenya, the HSNP transfer also had a significant impact on increasing households’ uptake of credit, Chapter 7 measured over the previous 12 months (9.7 percentage points, significant at 10%) (Merttens et The impact of al., 2013), as did the SAGE programme in Uganda, where the effect was strong and significant for cash transfers on education households receiving the Senior Citizen Grant (7.3 percentage points, significant at 10%), though no significant impact was found on the size of outstanding debt (Merttens et al., 2015). Similar Chapter 8 findings were reported by O’Brien et al. (2013) for Kazakhstan’s BOTA programme (10 percentage The impact of cash point increase in the share of households with debt from any source, significant at 10%). transfers on health and nutrition In Uganda (SAGE), Kenya (HSNP) and Kazakhstan (BOTA), qualitative research triangulated Chapter 9 with these findings highlighted an increased willingness of other community members to lend The impact of to beneficiaries, as these now had a reliable and stable income stream. The debt was reportedly cash transfers on mostly used for consumption smoothing and often took the form of buying goods on credit savings, investment 95 Interestingly, the SAGE (Merttens et al., 2013; O’Brien et al., 2013; Merttens et al., 2015). and production evaluation also analysed one of the key mechanisms by which people report being able to cope Chapter 10 with the shocks they experience. Both SCG and VFSG households were significantly more likely The impact of to report being able to borrow a large amount of money (60,000 or more Ugandan shillings) in cash transfers on 96 an emergency, in case of need (Merttens et al., 2015). employment Chapter 11 Several other evaluations found ‘negative’ effects of cash transfer receipt on loan-taking The impact of behaviour, highlighting a focus on paying back loans rather than taking on new debt. Potentially cash transfers on in contrast to findings for Mexico’s Oportunidades described above, Angelucci et al. (2012) find empowerment a significant reduction in the share of households in debt and in debt amounts. In Zambia, AIR’s evaluation of the Child Grant Programme (2014) found a 7.3 percentage point reduction in the likelihood of having an outstanding loan contracted over six months before, but no significant SECTION III Chapter 12 Summary of he only significant impact was on the share of households contributing to burial societies and burial plans. 93 T findings and conclusion 94 T his is so that staff can check the balance to ensure that households have been paid the right amount. ote that indicators around buying on credit were not an explicit focus of this review, but are an important aspect of debt-taking behaviour to 95 N References untangle. 96 ote this is an impact on perceptions – yet an important indication of changes in people’s self-perceived standing within the community. N

157 Cash transfers: what does the evidence say? Page 157 Contents impact on the amount outstanding overall (except for large households) or on the amount Acknowledgements borrowed in the last six months, while – based on the same data – Daidone et al. (2014b) find a significant impact on the share of households declaring to have made some loans repayments Executive summary (1.7 percentage points). In Ghana, Handa et al. (2014) find no impact of LEAP on loans held, but a strong effect on amount repaid (23 percentage points). The authors hypothesise that, since households received a triple and then a double payment in the six months prior to the follow-up SECTION I survey, ‘a large part of these payments were essentially used to pay down loans’. Chapter 1 Introduction No significant results on borrowing behaviour were reported for Tanzania’s community-based CCT (Evans et al., 2014), Pakistan’s BISP (Cheema et al., 2014), Kenya’s cash transfer-OVC Chapter 2 (Asfaw et al., 2014) and Lesotho’s CGP (Daidone et al., 2014; Pellerano et al., 2014), though Conceptual results for the latter are reportedly biased by a substantial number of missing values. For the framework CGP, the authors hypothesise that the lack of impact on financial behaviour is partly explained Chapter 3 by the irregularity of payments and the strong messaging associated with the programme, while Review of cash for Tanzania’s CCT the authors believe the lack of change may be due to the heterogeneous, transfer reviews opposing effects of the program on borrowing behaviour. In Pakistan, further results on borrowing show that only 5% of BISP beneficiary households have current debt that was used to Chapter 4 Methods start a business or for agricultural production, while most households take on debt for current consumption, and more specifically to buy food (46%). Chapter 5 The evidence base Purchase and ownership of agricultural productive assets and inputs SECTION II As outlined within the conceptual framework, receiving a guaranteed and predictable source of income at regular intervals could help to lift the liquidity and credit constraints that limit poor Chapter 6 The impact of households from investing optimally. Evidence from the selected studies did largely confirm this cash transfers on hypothesis, showing positive trends towards the accumulation of livestock especially, purchase monetary poverty and use of agricultural inputs and, to a lesser extent, accumulation of agricultural assets. This is an important finding, as none of the cash transfers analysed explicitly focused on enhancing Chapter 7 productive impacts (with the exception of PROCAMPO in Mexico). The impact of cash transfers on education Agricultural assets (for crop production) Chapter 8 The impact of cash Overall, the evidence points to a positive, though not widespread, impact on households’ transfers on health accumulation of agricultural productive assets. Of the eight studies reporting on relevant and nutrition indicators (totalling 22 different results, with indicators on the share of households that own/spent any money on each asset, monetary value and total number owned of each asset), three find a Chapter 9 positive and significant impact on a wide variety of indicators, one reports mixed findings and the The impact of cash transfers on remaining four find no significant impacts (see Table 9.5). savings, investment and production In Malawi and Zambia, there is evidence that the receipt of a cash transfer is able to generate investments that can influence household productive capacity (Covarrubias et al., 2012). In Malawi, Chapter 10 97 ownership of agricultural assets increased 16 percentage points for hoes, 32 for axes and 30 for The impact of cash transfers on sickles – with higher impacts for female-headed households (ibid). In Zambia, both AIR (2014) and employment Daidone et al. (2014b) find significant positive impacts of the CGP on ownership of agricultural tools, with Daidone et al. describing ‘two distinct patterns: a positive impact of between three Chapter 11 to four percentage points on the share of households accumulating agricultural implements with The impact of 98 such as hammers, shovels and ploughs’ (particularly for larger low initial values at baseline ... cash transfers on households) and a ‘larger impact (18–30 percentage points) on the number of assets held, for those empowerment 99 implements already widely available at baseline ... such as axes and hoes’. SECTION III Nevertheless, in the other evaluations analysed, results were mixed or not significant. This was the case for Maluccio (2010) reporting on Nicaragua’s RPS, Merttens et al. (2013) reporting on Chapter 12 Summary of findings and conclusion he authors explain the more limited magnitude of impact for hoes is probably due to the high ownership level of this tool at the baseline (close 97 T to 90% of households at baseline). References 98 L ess than 10% of households owned these at baseline. 99 U p to approximately 90% of households at baseline.

158 Cash transfers: what does the evidence say? Page 158 Contents 100 reporting on Lesotho’s CGP and Seidenfeld and Handa Kenya’s HSNP, Pellerano et al. (2014) Acknowledgements (2011) reporting on the Monze District cash transfer pilot in Zambia. Reasons cited for the lack 101 of any significant impact included the low availability of arable land in Kenya and the strong Executive summary message encouraging child-related expenditures for Lesotho’s CGP. SECTION I Agricultural inputs (for crop production) Chapter 1 Results for agricultural input (seeds, fertiliser and pesticide) expenditure or use reported within Introduction the selected evaluations are more decisively showing an impact, though not of great magnitude Chapter 2 and not always on the same indicators. Specifically, out of a total of eight studies, six report Conceptual significant increases in the outcome indicators, primarily on fertiliser and seeds, and one reports a framework decrease (see Table 9.6). Chapter 3 In Lesotho, where few other productive impacts were found due to the strong labelling of the Review of cash transfer reviews programme (to be spent on children and their education), Daidone et al. (2014a) find that the CGP significantly increases the share of households purchasing seeds (7.4 percentage points) and Chapter 4 102 inorganic fertiliser (5.8 percentage points), as well as the share of households using pesticides Methods 103 (7.9 percentage points), the magnitude being greater for labour-unconstrained households. While the levels of expenditure on these or other inputs did not increase, according to the authors Chapter 5 The evidence base as the grant was possibly not high enough, significant increases in production were found (notably maize, the main staple commodity) (Daidone et al., 2014a; Pellerano et al., 2014). Similarly, in Zambia, the GGP led to an increase (18 percentage points) in the share of households with SECTION II any input expenditure (especially seeds and fertiliser), from a baseline share of 23%, as well as an increase of 42 Zambian kwacha on crop inputs than the corresponding control households Chapter 6 The impact of (Daidone et al., 2014b). The Monze district pilot evaluation points in a similar direction, with cash transfers on significant effects on purchase of fertiliser (8 percentage points) and ultimately crop production monetary poverty 104 (Seidenfeld and Handa, 2011). Significant impacts on the value of seeds used were also found for Ghana’s flagship LEAP programme, with results driven by female-headed households (Handa Chapter 7 et al., 2014). Also in Ghana, the IPA field trial comparing capital grants and rainfall insurance The impact of showed a highly significant impact on the value of chemicals used for capital grant recipients cash transfers on education (Karlan et al., 2014). In Latin America, Todd et al. (2010) found some impact of Oportunidades 105 (4.8 percentage points) on the probability of spending on variable crop inputs. Chapter 8 The impact of cash Missing or ‘negative’ impacts were principally reported for Kenya’s cash transfer-OVC by Asfaw transfers on health et al. (2014) with some small but significant negative impacts being found on the use of pesticides and nutrition 106 and on seed expenditure, partly justified by the authors because of the low and eroded-over- Chapter 9 time value of the transfer. The impact of cash transfers on savings, investment Livestock assets and production Livestock assets not only provide food directly, they also guarantee an income flow, can act as Chapter 10 store of value enhancing risk-bearing capacity, can aid production by providing draught animal The impact of cash transfers on power, transport and/or manure for cropping and fuel, and often have an inherent value linked employment to the status they confer to their owners. It is unsurprising, therefore, to see widespread impact on the share of households owning a wide range of livestock and on the total value of livestock Chapter 11 The impact of cash transfers on empowerment 100 ote that Daidone et al. (2014a) – who use the same data – also report no impact on asset ownership (but no not present results within a table). N he HSNP operates in the Arid and Semi-Arid Lands – ASALs. T 101 hile the purchase of pesticides is not very common, a pest and armyworm outbreak severely affected many districts in Lesotho in January W 102 SECTION III and February 2013. It should be noted, however, that a significant impact on purchase of pesticide was not found, except for non-labour constrained households. Chapter 12 103 P ellerano et al. (2014) only find this impact using complementary models. Summary of findings and eidenfeld and Handa also note a shift away from maize for direct consumption and towards more cash cropping (groundnut, sweet potato) for S 104 conclusion sale. 105 ote that this impact is not sustained in the May 1999 data (data above is from October 1998). N References 106 T he authors specify that these results are based on an SD-IPW estimation procedure which is not robust against time-invariant unobservables, so should be interpreted with these caveats in mind.

159 Cash transfers: what does the evidence say? Page 159 Contents owned. Different studies measure impact in different ways, making it difficult to uniformly Acknowledgements compare across programmes, but overall 12 of 17 studies assessed for this impact area report some form of positive impact on livestock ownership and value, with the remaining five reporting non- Executive summary significant impacts (see Table 9.7). Larger and significant impacts were mostly registered for smaller livestock (goats and chickens, for SECTION I example), though there were some cases of households investing in cattle: Chapter 1 n Malawi’s SCT programme, goat, chicken and cattle ownership increased by 52, 59 and 1.5 I • Introduction percentage points, respectively, due to the transfer (Covarrubias et al., 2012). Chapter 2 I • n Zambia, the CGP led to significant increases in the share of households with livestock (21 Conceptual percentage points, from 48% at baseline) and in the total number of goats and poultry, with framework even stronger effects for large households (Daidone et al., 2014b). Interestingly, these impacts Chapter 3 remained mostly unvaried following additional programme exposure (36 months versus 24 Review of cash months) (AIR, 2014). transfer reviews • Z ambia’s pilot Monze cash transfer evaluation similarly finds that after a three-year period Chapter 4 intervention households are significantly more likely to own goats (27 percentage points) and Methods chickens (9 percentage points) (Seidenfeld and Handa, 2011). Chapter 5 n Uganda, SAGE had a significant impact on the share of households owning livestock overall I • The evidence base (9.3 percentage points) and the share of households purchasing livestock in the previous 12 months, in particular for the VFSG (non-elderly) treatment group (26 percentage points) and SECTION II for goats and cattle. Based on triangulations with qualitative research, the authors hypothesise that the findings are likely influenced by the ‘lumpy’ nature of the first few payment tranches Chapter 6 received by a great many beneficiary households, as the programme tried to catch up after The impact of delays to the start of implementation (Merttens et al., 2015). The WINGS cash grant also cash transfers on significantly affected livestock purchases by 0.27 more cattle, two more fowl, and two more monetary poverty goats, sheep, or pigs (Blattman et al., 2015). Chapter 7 I • n Kenya, the HSNP had a positive impact on retention of livestock, with HSNP households six The impact of percentage points more likely to own any livestock after two years of programme operations cash transfers on 107 education Triangulated qualitative than control households (seven percentage points for goats/sheep). research stressed the importance of the cash transfer in retaining ownership of goats and sheep Chapter 8 in the face of drought (Merttens et al., 2013). The impact of cash transfers on health • lso in Kenya, Haushofer and Shapiro (2013) find that the Give Directly experimental UCT A and nutrition increased livestock holdings by US$85, a 51% increase relative to the control group mean, and 12% of the average transfer. This increase extends to all categories of livestock, with the largest Chapter 9 increase in absolute terms occurring in cattle holdings. The impact of cash transfers on • eporting on Tanzania’s community-based CCT programme under TASAF1, Evans et R savings, investment al. (2014) find that treatment households own 0.38 more indigenous goats and 1.1 more and production chickens, preferred to bulkier animals as they are affordable and easier to sell (and often Chapter 10 described as ‘store of value’ within qualitative interviews). The impact of cash transfers on n Mexico, Todd et al. (2010) find a positive impact of Oportunidades on both the I • employment probability of owning livestock (3 percentage points) as well as the quantity owned, with almost double the impact on per capita ownership in May 1999 compared to October Chapter 11 1998. Similarly, Gertler et al. (2012) find that Oportunidades households were 17.1% The impact of (4.2 percentage points) more likely to own draught animals and 5.1% (3.6 percentage cash transfers on points) more likely to own production animals compared to control households, while empowerment also increasing the value of draught animals owned by 21.4% and the value of production animals owned by 16.6%. Interestingly, results were highest for households who did not SECTION III own those assets at baseline. Chapter 12 Summary of findings and conclusion References 107 T he authors warn that results are not fully conclusive – when controlling for other factors, impact on livestock ownership persisted only for large and fully mobile households.

160 Cash transfers: what does the evidence say? Page 160 Contents 108 Non-significant impacts were reported by Asfaw et al. (2014) for Kenya’s cash transfer-OVC; Acknowledgements Daidone at al (2014a) and Pellerano et al. (2014) for Lesotho’s CGP; Cheema et al. (2014) for Pakistan’s BISP; Macours and Vakis (2009) for Nicaragua’s one-year Atención a Crisis pilot Executive summary programme and Maluccio (2010) for Nicaragua’s Red de Protección Social (RPS). SECTION I Overall agricultural investment Chapter 1 This section has separated the analysis of impacts on crop production assets, crop production Introduction inputs and livestock assets (with the next section focusing on business and enterprise). However, a Chapter 2 small selection of studies report on agricultural productive investment on aggregate. Specifically, Conceptual in Mexico, Davis et al. (2002) find that the impact of an additional cash transfer peso on framework agricultural investment spending is high and significant for PROCAMPO, which is explicitly linked to agriculture and primarily received by men, but less so (yet still positive and significant) Chapter 3 for PROGRESA. In Ghana, the IPA trial comparing insurance to capital grants found that farmers Review of cash transfer reviews who received the capital grant hold US$606 more post-harvest assets (livestock and grain) than the control group (Karlan et al., 2014). Chapter 4 Methods Ultimate agricultural impacts: yields, productivity and income Chapter 5 The evidence base Importantly, while this section does not explicitly report on indicators of ultimate productive 109 some evidence from the selected studies outcomes (increases in yields, productivity or income), SECTION II does show the potential income multiplier effects of cash transfers. In Mexico, for example, Gertler et al. (2012) estimate that investments in productive assets increase agricultural income Chapter 6 by almost 10% after 18 months of benefits. Analysing the issue from another angle, Todd et al. The impact of (2010) and Martinez (2004) find an increased likelihood of household food consumption from cash transfers on 110 Studies from sub- own production among PROGRESA and Bonosol households respectively. monetary poverty Saharan Africa suggest similar impacts, including increases in the share of consumption, diet Chapter 7 quality and dietary diversity from home crop production (Covarrubias et al., 2012; Asfaw et al., The impact of 111 112 2012) and in overall crop yields (Seidenfeld and Handa, 2011; Daidone et al., 2014) and cash transfers on livestock revenue and profit (Haushofer and Shapiro, 2013). education Chapter 8 Business and enterprise The impact of cash transfers on health Impacts on the selected business and enterprise indicators were mixed and more difficult to and nutrition interpret than others reported in this section because of the range of indicators adopted in Chapter 9 different studies. Of the nine studies reporting any indicator for this specific outcome area (on the The impact of share of households who operated non-farm enterprises or who owned business assets, monetary cash transfers on value of the assets and total expenditure on business assets over the reference period), four found savings, investment increases in the share of households involved in non-farm enterprise or on the total expenditure on and production business-related assets and stocks, while one found significant decreases (see Table 9.8). Chapter 10 The impact of In the two Blattman et al. studies (2012 and 2015), analysing two different enterprise-focused cash transfers on cash transfers operating in Uganda (the Youth Opportunities Program (YOP), and the Women’s employment Income Generating Support (WINGS)), substantial investments deriving from the receipt of the Chapter 11 cash grant are unsurprising. Within the YOP, treated individuals report an additional 656,016 The impact of Ugandan shillings (US$298) in acquisitions and 523,318 shillings (US$238) in asset stock, a 481% cash transfers on empowerment ote that Asfaw et al. (2014) do find positive and significant impact only on the ownership of small livestock such as sheep and goats, for both N 108 SECTION III smaller and female-headed household households. Chapter 12 T 109 his was due to inconsistent reporting across evaluations and lack of a sufficient evidence base to draw any meaningful conclusions. Summary of odd et al. (2010) specify that this included highly nutritious foods such as fruits, vegetables and meat, and link these findings to a significant 110 T findings and increase in the use of land for agricultural production. conclusion 111 T his includes a shift towards cash crops as an impact of Zambia’s CGP, with a 50% increase in the quantity of sweet potato produced (significant at 10% level), a 30% increase in the quantity of groundnut and a 16% reduction in the quantity of maize (Seidenfeld and Handa, 2011). References I 112 n Lesotho, the CGP programme had a significant impact on the production of maize, the main staple commodity (around 39 kg more than the control group), especially for households with more available household labour.

161 Cash transfers: what does the evidence say? Page 161 Contents increase in acquisitions and 150% increase in asset stock relative to the control group. The authors Acknowledgements hypothesise that the group organisation could have acted as a disciplinary and commitment device (Blattman et al., 2012). Similarly, WINGS had significant impacts on whether both female and Executive summary male recipients had started an enterprise since baseline 16 months after grants, with programme 113 follow-up of any kind increasing the chances further (Blattman et al., 2015). SECTION I In Zambia, beneficiary households of the CGP were significantly more likely to have a non- Chapter 1 farm enterprise (12 percentage points) and had higher profits than control households, with no Introduction differential impacts between the 24- and 36-month evaluation waves (AIR, 2014). Similar and more detailed results for the CGP are reported by Daidone et al. (2014b), who estimate that Chapter 2 24-month average treatment effects on the likelihood of having a non-farm business ranged Conceptual from 16 to 18 percentage points for small and large households, respectively. They also show framework that on average CGP households operated enterprises for longer periods, more profitably and Chapter 3 accumulating more assets than control businesses. In Mexico, Gertler et al. (2012) also found a Review of cash positive impact of Oportunidades on participation in non-agricultural microenterprises of 3.3 transfer reviews percentage points (a 67.3% increase in the number of households operating such businesses). Chapter 4 Methods Less clear-cut (negative, non-significant and positive for specific sub-groups) results were reported in several other studies, for example: Chapter 5 The evidence base • n egative impacts of Mexico’s PROCAMPO on non-agricultural spending (due to strong programme focus on agricultural investment) and non-significant impacts of PROGRESA (Davis et al., 2002) SECTION II n on-significant impacts overall on household participation in a non-farm enterprise, but a • Chapter 6 positive impact (seven percentage points) for female-headed and negative (-11 percentage The impact of points) for male-headed households (Asfaw et al., 2014) cash transfers on monetary poverty n egative yet non-significant impacts on the share of households operating a non-farm business • 114 in the 30 days prior to the survey for Lesotho’s CGP (Daidone et al., 2014a) Chapter 7 The impact of n egative yet non-significant impacts on participation in non-agricultural enterprise in • cash transfers on Nicaragua’s RPS (Maluccio, 2010) education • n egative yet non-significant impact of Nicaragua’s Atención a Crisis pilot on the value of Chapter 8 households’ productive assets (note impact is positive for those receiving a substantial cash The impact of cash grant) (Macours and Vakis, 2009). transfers on health and nutrition Chapter 9 he impact of cash transfers on savings, investment and T 9.4 The impact of cash transfers on production indicators for women and girls savings, investment and production Most savings, investment and production indicators were generally measured at the household rather than individual level. However, eight studies reported sex-disaggregated outcomes, most Chapter 10 often by separating analysis for female and male-headed households. Interestingly, three of these The impact of cash transfers on studies found some of the savings, investment and production results primarily driven by female- employment headed households, two find different types of impact for male versus female household heads or beneficiaries (e.g. different type of investment preferred), while another two find no significant Chapter 11 115 Overall, these results appear to be driven by different levels of differences between the two. The impact of asset ownership at baseline and differing cultural roles and aptitudes. Table A.5.4.1 in Annex 5 cash transfers on reports specific findings. empowerment SECTION III Chapter 12 Summary of findings and conclusion 113 D etailed results are presented in Table 5.4.2 in Annex 5. 114 A uthors specify this was ‘mainly driven by fewer households engaged in home brewing, an income-generating activity that is generally References performed infrequently, at small scale, and often as an activity of last resort’ (Daidone et al., 2014a). N 115 ote that the eighth study does not compare across genders in any way, as most recipients were female.

162 Cash transfers: what does the evidence say? Page 162 Contents Female-headed versus male-headed households Acknowledgements • I n Kenya, a significant impact on livestock ownership was only found for female-headed cash transfer-OVC beneficiary households and not male. Specifically, the impact was on small Executive summary livestock such as sheep and goats, perhaps due to cultural norms. Similarly, the cash transfer- OVC transfer was associated with a seven percentage point increase in household participation SECTION I in non-farm enterprise for female-headed households, mirrored by an 11 percentage point decrease for male-headed households. The transfer was reported as the most important second Chapter 1 source of capital for female-headed households (Asfaw et al., 2012). Introduction I n Malawi, female-headed households participating in the SCT scheme accumulated more • Chapter 2 agricultural tools and livestock than their male counterparts, consistent with the smaller initial Conceptual framework agricultural asset base among this group (Covarrubias et al., 2012). n Ghana, impacts on crop selling and seeds was primarily driven by female-headed I • Chapter 3 Review of cash households, while LEAP’s impact on debt repayments and reduced loan holdings was also transfer reviews higher for female-headed households (Handa et al., 2014). Chapter 4 I • n Tanzania, male-headed households were more likely to increase their ownership of goats (by Methods 0.5 units), whereas female-headed households were more likely to increase their ownership of chickens (1.62 more chickens) (Evans et al., 2014). Chapter 5 The evidence base In contrast, no significant differential results in consumption, production and investment decisions were found across male- and female-headed households by Haushofer and Shapiro (2013) in Kenya’s SECTION II Give Directly programme and by Blattman (2012) for the Youth Opportunities Programme. Chapter 6 The impact of Male versus female beneficiaries cash transfers on I • n Bolivia, male beneficiaries of the Bonosol pension programme were more likely to acquire monetary poverty goats, and female beneficiaries more likely to acquire pigs, while female beneficiaries were Chapter 7 more likely to make expenditures on seed and pesticides than were male beneficiaries The impact of (Martinez, 2004). cash transfers on education I n Uganda, Blattman (2015) finds significant positive impacts of microenterprise support • among ultra-poor women (who were by and large the main recipients of the WINGS Chapter 8 programme – meaning no comparative analysis is possible). An evaluation of Uganda’s YOP, The impact of cash however, does find significant gender differences in terms of the value of tools and machines transfers on health and stock of raw materials, tools and machines acquired (Blattman et al., 2012). Specifically, and nutrition while the programme and the large enterprise grants involved did substantially increase Chapter 9 ownership of these assets, the increase was significantly greater for men than for women. The impact of However, the authors believe these differences to be driven in particular by upper tails and cash transfers on outliers rather than representing a fundamental difference across males and females in general. savings, investment and production Chapter 10 9.5 he role of cash transfer design and implementation T The impact of cash transfers on features employment Compared to the other outcome areas, a relatively low number of studies (a total of 10) explicitly test Chapter 11 the differential impact on savings, investment and production of different design and implementation The impact of features, yet the findings within the papers reviewed do shed some light on this topic. cash transfers on empowerment O • , finding non- recipient ne study assesses the different impact of having a male or female significant differences across the two for impacts on savings and livestock ownership. SECTION III O ne study explicitly compares the impact on savings and investment behaviour of different • , finding that lump-sum recipients accumulate significantly more transfer levels and frequency Chapter 12 non-land assets and large livestock, while monthly recipients accumulate more small livestock Summary of findings and and birds. Overall savings and livestock holdings were also substantially higher for those conclusion receiving a larger transfer. References T • wo reporting on variations in impact due to length of exposure , suggest sustained impacts over time.

163 Cash transfers: what does the evidence say? Page 163 Contents ne study considered the effect of different . It found impacts in this area to be targeting designs • O Acknowledgements consistently higher and more frequently highly significant for households receiving a grant based on demographic indicators of vulnerability rather than categorically targeted at older citizens. Executive summary • found that, compared to standard payment modalities ne study comparing different O distribution methods, mobile money transfers affected crop choices, but not ultimate SECTION I production or savings. Chapter 1 • F our studies assessing the role of complementary interventions and supply-side services Introduction reported interesting and often mutually reinforcing interaction effects with cash transfers. Chapter 2 These studies are now discussed in more detail, including further insights from studies reporting Conceptual on a wider range of outcomes on this topic, qualitative research and authors’ interpretation of framework their data. Detailed findings are reported in Table A5.4.2 in Annex 5. Chapter 3 Review of cash transfer reviews Main recipient Chapter 4 Thanks to the experimental nature of the Give Directly evaluation in Kenya, Haushofer and Methods recipient , finding non- Shapiro (2013) assess the different impact of having a male or female significant differences across the two for impacts on savings and livestock ownership. Chapter 5 The evidence base Transfer levels, frequency and predictability SECTION II Only one study for this outcome area explicitly compares the impact of different transfer levels Chapter 6 and frequency on programme impacts. Haushofer and Shapiro (2013), reporting on Kenya’s The impact of experimental Give Directly programme, compare the savings and investment behaviour of cash transfers on households that received nine monthly transfers to that of households that received one lump- monetary poverty 116 sum transfer, and of households that receive a large transfer to those that receive a small one. Chapter 7 Confirming the theory of change for this outcome area, they find that monthly recipient The impact of 117 households accumulate a significantly lower value of non-land assets than lump-sum recipients. cash transfers on Similarly, impact on the value of large livestock owned (cows) was higher and more strongly education significant (US$55 versus US$43) for lump-sum recipients, while impact on the value of small livestock and birds was highly significant only for recipients of monthly transfers (US$9 and Chapter 8 The impact of cash US$13 respectively versus US$3 and US$1). The total value of savings was also marginally higher transfers on health for recipients of monthly versus lump-sum transfers. Unsurprisingly, overall livestock holdings and nutrition were also substantially higher for those receiving a larger transfer (US$118 versus US$62), with significant differences in impact for cows and small livestock especially. Similarly, the overall Chapter 9 value of savings was higher for households receiving the larger transfer (US$19 versus US$8). The impact of cash transfers on savings, investment Blattman et al. (2012) also try to estimate impacts of transfer size by analysing the per capita and production value of the transfer ultimately received (given the grant was group based, smaller groups received more per capita). They find that the correlation between transfer size and both investments and Chapter 10 ultimate performance is nearly zero and assume this may be because the de facto group size and The impact of cash transfers on distribution was greater than their de jure size. employment Qualitative evidence and authors’ interpretation of the data often point in the same direction, Chapter 11 suggesting a strong link between transfer size and productive investments (Asfaw et al., 2014; The impact of Daidone et al., 2014a; Seidenfeld and Handa, 2011; Evans et al., 2014; Pellerano et al., 2014; cash transfers on Merttens et al., 2015). For example, the differential impact between Zambia’s CGP or Malawi’s empowerment SCT (over 30% of pre-transfer expenditure) on one side, and Ghana’s LEAP, Lesotho’s CGP and Kenya’s cash transfer-OVC (around 10% of pre-transfer expenditure) on the other could ultimately SECTION III be due to different transfer sizes (FAO, 2015). In some cases, eroded values over time were also cited as an issue (Asfaw et al., 2014). A quote from a Focus Group Discussant receiving the BISP Chapter 12 transfer in Pakistan (quarterly transfer of 3,000 Pakistani rupees) eloquently summarises the issue: Summary of findings and conclusion References 116 M ost of the impacts reported in this paragraph are extracted from the study’s online annex (across village comparisons). 117 N ote, however, that the most notable impact was on the purchase of tin roofs, not agricultural investments.

164 Cash transfers: what does the evidence say? Page 164 Contents You are asking me as if the BISP is providing us with 10,000 Pakistani rupees every month. This ‘ Acknowledgements amount is not even enough for monthly groceries and you are asking me if we have been able to invest it in some way... ’ (Male beneficiary focus group. District Nawabshah, Sindh). Executive summary Overall, a great majority of the studies also cited the importance of the transfers being received at predictable intervals – an essential factor for households to be able to plan investments and SECTION I overcome credit and liquidity constraints. Chapter 1 Introduction Duration of exposure Chapter 2 Conceptual Four studies of the ones selected for this outcome area present variations in impact over time, with framework evidence suggesting sustained (though not necessarily increasing) impacts over time. Specifically: Chapter 3 ertler et al. (2012) find that Oportunidades households receiving higher accumulated • G Review of cash transfers over time (an additional four years) had consumption levels 5.6% higher than for transfer reviews the original control households, suggesting that returns on investments made by treatment households in the initial 18-month experimental period (when controls were not yet receiving Chapter 4 cash) did in fact translate into improvements in long-term living standards. Methods aluccio (2010) shows no significant differential impact over time for Nicaragua’s RPS M • Chapter 5 between 2002 and 2004. The evidence base Conditionality SECTION II While none of the papers analysed for this outcome area explicitly tests the role of CCTs versus Chapter 6 The impact of UCTs or differential impact of different types of conditionality, several studies reviewed discuss cash transfers on the strong role played by the messaging associated with the transfer (‘implicit’ conditionality). For monetary poverty example, for Lesotho Pellerano et al. (2014) and Daidone et al. (2014a) hypothesise that the strong messaging encouraging human capital and child-related expenditures for the CGP negatively Chapter 7 affected households’ propensity to invest the additional cash in productive assets or activities. The The impact of cash transfers on negative impact of human-capital-focused conditionality on productive investment is also touched education upon within Davis et al. (2002) and Maluccio (2010) for Mexico’s Oportunidades programme (versus PROCAMPO) and Nicaragua’s RPS respectively. Chapter 8 The impact of cash transfers on health Targeting and nutrition Only one study, the endline evaluation by Merttens et al. (2015) of Uganda’s SAGE programme, Chapter 9 explicitly compares different targeting mechanisms when referring to productive impacts. Across the The impact of range of indicators reported, apart from indicators on borrowing, impacts are consistently higher cash transfers on savings, investment and more frequently highly significant for households receiving the Vulnerable Family Support Grant and production (VFSG, targeted with a composite index based on demographic indicators of vulnerability) rather than the Senior Citizen Grant (SCG, a form of social pension). Importantly, it should be noted that Chapter 10 VFSG households tend to have higher dependency ratios and lower numbers of working-age adults The impact of compared to SCG households. However, for some indicators not reported within this study, most cash transfers on employment notably the amount of land cultivated, SCG beneficiaries fared better than VFSG ones. Chapter 11 Several insights into the role of targeting on mediating productive impacts were also given by The impact of other authors while commenting their results. For example, Asfaw et al. (2014); Merttens et cash transfers on al. (2013) and Todd et al. (2010) draw attention to the importance of the vibrancy of local empowerment agriculture and markets, with implications for geographic targeting. These same authors, together with Covarrubias et al. (2012) and Davis et al. (2002), discuss differences in productive SECTION III impacts based on a households’ existing asset base, with households having access to land and labour (and so potentially better-off) more capable of investing productively. Similarly, explicitly Chapter 12 targeting the poorest and most marginalised households will mediate the overall level of priority Summary of given to immediate consumption needs over investment (especially when the transfer amount is findings and conclusion low) (Merttens et al., 2013; Maluccio, 2010) and behaviours linked to social stigma (Handa et al., 2014; Pellerano et al., 2014). Importantly, moreover, the lack of clarity surrounding some References targeting approaches and their implementation may lead beneficiaries to sacrifice productive investment for fear they may compromise eligibility for the transfer (Covarrubias et al., 2012).

165 Cash transfers: what does the evidence say? Page 165 Contents Payment mechanism Acknowledgements In a unique study aimed at untangling the differential effect of three different transfer modalities, Executive summary Aker et al. (2011) find that Niger’s Zap mobile money programme did not have an impact upon the likelihood of cultivating, but did affect crop choices, with households in Zap villages growing 0.36–0.49 more types of crop than those in placebo and manual cash villages (a 12–16% increase SECTION I as compared with the manual cash intervention). Interestingly, these effects are driven by the 118 Chapter 1 rather than traditional staple cultivation of marginal cash crops such as vouandzou and okra, Introduction food and cash crops (millet, sorghum, cowpeas and peanuts). However, the changes in crop choice did not affect production levels. Nor were savings levels affected, as 98% of Zap households Chapter 2 withdrew the full amount of their cash at one time (there was a cost associated with multiple Conceptual framework withdrawals). These impacts, taken together with further significant impacts on the number of asset categories owned by Zap households, sheds important light on the relative benefits of Chapter 3 m-transfers – especially given that these were also associated with reduced costs for programme Review of cash recipients and the implementing agency. transfer reviews Chapter 4 Some further evidence emerges within the reviewed studies. For example, despite being paid Methods through purposely created bank accounts, cash transfers from Kazakhstan’s BOTA programme had no impact on household saving behaviour. The authors suggest that this is due to beneficiaries Chapter 5 being instructed not to use the bank account for any savings other than the CCT while in the The evidence base 120 119 (O’Brien et al., 2013). programme SECTION II Complementary interventions and supply-side services Chapter 6 The impact of , beyond the Blattman et al. (2015) provide insights into the role of supervision and training cash transfers on imposition of conditionality. For example, for WINGS grant-holders, savings were 19% higher monetary poverty among those receiving two follow-up visits (supervision) and an additional 22% higher with five follow-ups (supervision and advice). Similarly, a year after the grants, follow-up of any kind Chapter 7 increased business start-up and survival, by ten percentage points for those receiving supervision The impact of cash transfers on (two follow-ups) and 11 percentage points for those receiving further follow-ups with advice. education Nevertheless, the authors warn that the marginal impacts of supervision and advice were modest given that they represented a very high percentage of programme cost. Chapter 8 The impact of cash A further study using the same data (Green et al., 2015) found that a low-cost variation to transfers on health programme delivery – basic training in couples’ communication and problem solving, and joint and nutrition participation in the program with a partner – had little impact on economic outcomes. Involving Chapter 9 household partners led to a nine percentage point decrease in the proportion of women currently The impact of engaged in business and a six percentage point increase in the proportion of women belonging cash transfers on to a savings group. On the other hand, in explaining the positive impacts in investment of the savings, investment relatively unconditional, decentralised YOP targeted at poor entrepreneurs Blattman et al. (2012) and production could have acted as a disciplinary and commitment device. group organisation hypothesise that Chapter 10 The impact of vocational The Macours and Vakis (2009) study comparing the effects of a CCT with CCT plus cash transfers on found that, two years after the end of productive investment grant and CCT plus a training employment the intervention, households eligible for the complementary interventions were better protected Chapter 11 against the negative impact of drought shocks by shifting households’ income portfolios towards The impact of more diversification, and increasing returns from such activities. This was particularly the case cash transfers on for those receiving the productive grant. For example, CCT+grant households had higher profits empowerment from non-agricultural self-employment activities, and higher values from sale or self-consumption of livestock products, with significant and substantial impacts. Similarly, the Karlan et al. (2014) SECTION III Chapter 12 hese are cash crops that are primarily grown by women on marginal lands in Niger. 118 T Summary of T 119 his is so that staff can check the balance to ensure that households have been paid the right amount. findings and conclusion I n a paper that we do not include in this study, as it does not report on relevant outcomes, Masino and Nino-Zarazua (2014) compare 120 Oportunidades’ early standard transfer approach (cash handed out at distribution points) with the new electronic payment system which References involves the opening of bank accounts for beneficiaries in non-banking institutions. They find that households who received their transfer in a bank account decreased their participation in informal saving arrangements (possibly because of their higher opportunity and financial costs) and were more likely (8 percentage points) to use their savings to cope with idiosyncratic shocks.

166 Cash transfers: what does the evidence say? Page 166 Contents study comparing the use of a cash grant with rainfall insurance, shows that the cumulative effect Acknowledgements of both is higher, and particularly when measuring the value of harvest. Executive summary Reporting on indicators that were not selected for this study, but also providing important insights, Sadoulet, de Janvry and Davis (2001) show that the positive multiplier effects in agriculture generated by the PROCAMPO transfer are also strongly driven by complementary SECTION I . technical assistance Chapter 1 Introduction Several important insights into the role of the wider enabling environment for productive impacts were offered by the study’s authors when commenting their findings. For example, explaining the Chapter 2 lack of impacts on business and enterprise for Nicaragua’s RPS, Maluccio (2010) mentions the Conceptual expected low marginal returns of such activities due to lack of complementary infrastructure and framework services and/or poor macroeconomic conditions. Similarly, Asfaw et al. (2014), Merttens et al. Chapter 3 (2013) and Todd et al. (2010) explain non-significant impacts because of the lack of vibrant local Review of cash agriculture or of access to land – an issue which is also stressed by Covarrubias et al. (2012), who transfer reviews discuss the fundamental role of a household’s initial asset base (not only land and physical assets, but also labour capacity). Chapter 4 Methods Chapter 5 P 9.6 olicy implications The evidence base Overall, it is clear from the findings presented in this section that cash transfers do have the potential SECTION II to alter households’ credit and liquidity constraints, as discussed in the conceptual framework, leading to productive impacts (and related impacts on saving and borrowing behaviour). Chapter 6 The impact of This is the case even though a vast majority of existing cash transfers prioritise investments on cash transfers on human capital. While results were not widespread across all programmes, it is clear that policy- monetary poverty makers interested in enhancing the productive potential of households both in agriculture and Chapter 7 beyond should consider how to maximise these impacts without distorting the poverty-alleviation The impact of focus of cash transfer programmes and social protection more widely (as trade-offs between cash transfers on consumption-smoothing and productive objectives could exist). education These findings are of particular importance in low- and middle-income countries, where extreme Chapter 8 The impact of cash poverty is disproportionately concentrated in rural areas (as are many cash transfer programmes), transfers on health and the majority of men and women depend on agriculture for their livelihoods (FAO, 2015), all and nutrition the more as climate change is set to worsen the shocks and challenges faced by rural households. Chapter 9 The literature on this impact area highlighted some important findings related to programme The impact of cash transfers on design and implementation that are of policy relevance. A first set of considerations relates to savings, investment a cash transfer’s core design features: its value, frequency and related payment system. First, and production 121 transfer size ensuring the responds to the productive impact that is intended to be achieved. The evidence shows that higher transfers are associated with higher productive impacts and Chapter 10 saving rates, with the highest impacts achieved by coupling cash transfers with a lump-sum larger The impact of cash transfers on grant aimed explicitly at productive investment. Second, ensuring payments are predictable and employment reliable , enhancing beneficiaries’ creditworthiness, risk-management capacity and planning. In a couple of cases reviewed within this paper, where productive impacts were modest or null Chapter 11 (CGP in Lesotho and LEAP in Ghana), ‘lumpiness’ of payments was the result of implementation The impact of failures (several disbursements received in one go) rather than deliberate design. As for other cash transfers on impact areas, the timing of the transfer could also be designed to maximise impact, by tying empowerment payments to specific moments within the local agricultural cycle. SECTION III A second set of considerations relates to the potential use of explicit or implicit conditionalities linked to the cash transfer programme. In the CCTs reviewed, including where conditionality Chapter 12 was only implicit and framed in terms of strong labelling (e.g. the CGP in Lesotho), recipients Summary of findings and understandably favoured human capital investments over productive investments. Potentially, conclusion References 121 W hile this is relatively easy for emergency cash transfers, where the size of the transfer can be benchmarked to the value of assets lost, it is more complex for developmental programmes, where a deeper understanding of local markets and costs is necessary (Beazley and Farhat, 2016).

167 Cash transfers: what does the evidence say? Page 167 Contents some labelling linked to productive investments could therefore be an option (i.e. stressing that Acknowledgements this is not against programme requirements). A couple of studies also highlighted the potential in enhancing cash transfer impacts. For example, complementary/synergic initiatives role of Executive summary in Uganda’s WINGS and YOP grants aimed at enhancing youth entrepreneurship, supervision visits (monitoring), additional training and group control mechanisms all had a role in enhancing the effectiveness of the grants – though at a high programme cost. These approaches are at the SECTION I core of what is usually referred to as the ‘graduation agenda’. The evidence also discussed the Chapter 1 potential of further linking agricultural policies (inputs subsidies, credit to agriculture, weather Introduction and crop insurance and institutional procurement) with cash transfers (FAO, 2015). Chapter 2 and choice of targeting Findings related to were more difficult to interpret, but main recipient Conceptual overall there was some evidence that higher impacts were concentrated within households that framework were less labour and land constrained, and in areas with a more vibrant local economy (e.g. Chapter 3 higher population density, liquid markets, adequate public infrastructure). Choosing to explicitly Review of cash target only these types of households and areas would present trade-offs with most of the core transfer reviews objectives of existing cash transfer programmes, but policy-makers could consider a multi- pronged approach for different types of households. As for the choice of main recipient, findings Chapter 4 Methods for several countries indicated that female-headed households often invested more – and on different assets and activities – than their male counterparts, challenging the idea that female Chapter 5 recipients solely focus their transfers on their children. The evidence base Table 9.3: Summary of results for overall cash transfer effect on saving behaviour SECTION II # Measure of Study Details/ Significance Programme and Variable and treatment population (e.g. Effect country explanation children under five) change Chapter 6 Percentage point 1 Angelucci et 0.06 Oportunidades (Mexico) 5% P roportion of households saving (2004) The impact of al. (2012) change cash transfers on -20.5 (Mexico) NS Oportunidades Savings amount (pesos) (2004) Change in pesos monetary poverty 2 Cheema et BISP (Pakistan) Proportion of households with savings 0.048 Percentage point NS change al. (2014) Chapter 7 The impact of BISP (Pakistan) NS Mean value of total savings (Pakistani rupees) -594.5 Change in rupees cash transfers on -0.024 Share of households saving CGP (Lesotho) Daidone et 3 NS Percentage point education change al. (2014a) Change in loti NS -26.7 Total amount saved (Lesotho loti) CGP (Lesotho) Chapter 8 The impact of cash Percentage point 0.24 Share of households saving cash Daidone et 4 CGP (Zambia) 5% change al. (2014b) transfers on health and nutrition 5% CGP (Zambia) Amount saved Zambian kwacha 54.4 Change in kwacha Chapter 9 5 0.03 Evans et al. Community-based CCT NS Whether someone in the household has non-bank Percentage point The impact of change savings (2014) (Tanzania) cash transfers on Any Savings Handa et al. 0.10 8 LEAP (Ghana) NS % change 6 savings, investment (2014) and production Haushofer 7 1% Give Directly (Kenya) Level change Value of savings (US$) 10.22 and Shapiro Chapter 10 Give Directly (Kenya) Share of households who saved money using 0.10 Percentage point 1% (2013) M-Pesa change The impact of cash transfers on Percentage point 10% 8 Merttens et 0.073 HSNP (Kenya) Share of households that currently have cash employment savings al. (2013) change Share of households reporting current cash savings SAGE – SCG (Uganda) SCG Merttens et 9 NS Percentage point 0.049 Chapter 11 change (SCG) al. (2015) The impact of 5% Percentage point VFSG SAGE – VFSG (Uganda) Share of households reporting current cash savings 0.095 cash transfers on (VFSG) change empowerment SAGE – SCG (Uganda) SCG NS Level change -156,000 Mean total value of current savings, for those with any savings (2012 prices, Ugandan shillings) – (SCG) Level change VFSG NS 90,500 SAGE – VFSG (Uganda) Mean total value of current savings, for those with SECTION III any savings (2012 prices, Ugandan shillings) (VSFG) Chapter 12 Share of households who in the 12 months prior 10 CGP (Lesotho) Pellerano et N/A Depends on NS No impact Summary of to the survey saved with or added money to any al. (2014) specific saving informal or formal savings account institution findings and conclusion Notes: results represent all overall results reported and do not include those disaggregated by gender or References showing the effect of variations in design features. Figures in bold indicate statistically significant. NS = not significant at 10% significance level or below.

168 Cash transfers: what does the evidence say? Page 168 Contents Table 9.4: Summary of results for overall cash transfer effect on borrowing behaviour Acknowledgements Variable and treatment population Effect Details / Measure of change # Significance Study Country and programme (e.g. children under five) explanation Executive summary -0.018 Borrowed money in last 6 months CGP (Zambia) Air (2014) 1 NS Percentage point change CGP (Zambia) Amount owed (ZMK) -2 7. 0 6 7 Change in ZMK NS SECTION I 1.3 87 Change in ZMK Amount borrowed last 6 months (ZMK) CGP (Zambia) NS 5% CGP (Zambia) Still owes money from over 6 months before -0.073 Percentage point change Chapter 1 2 -0.217 Proportion of households in debt Oportunidades Angelucci et 1% Percentage point change Introduction al. (2012) (Mexico) Chapter 2 Oportunidades -991.65 Change in pesos Debt amount (pesos) 1% (Mexico) Conceptual framework 3 Asfaw et al. NS Cash transfer/OVC Received loan 0.007 Percentage point change (Kenya) (2014) Chapter 3 Cash transfer/OVC Sought credit 0.01 NS Percentage point change Review of cash (Kenya) transfer reviews 4 Percentage point change - 0.13 3 Proportion of households with current loans BISP (Pakistan) NS Cheema et al. (2014) Mean value of total outstanding loans (PKR) BISP (Pakistan) -12,8 3 6 Change in PKR NS Chapter 4 Methods NS Daidone et al. 5 Percentage point change 0.003 Share of households borrowing CGP (Lesotho) (2014a) Total amount borrowed (LSL) NS CGP (Lesotho) -114.7 Change in LSL Chapter 5 6 CGP (Zambia) Share of households repaying loan Daidone et al. Percentage point change 5% 0.017 The evidence base (2014b) Percentage point change -0.077 Share of households receiving loan CGP (Zambia) 5% Percentage point change -0.0 Whether someone in the household has taken Community-based Evans et al. 7 NS SECTION II (2014) CCT (Tanzania) out a loan in the last year Mexico, Productive loans Gertler et al. 0.004 5% Percentage point change 8 Sample: Chapter 6 (2012) Oportunidades 1998–1999 The impact of LEAP (Ghana) NS Percentage point change -0.032 Hold loan Handa et al. 9 cash transfers on (2014) monetary poverty NS Change in GHS LEAP (Ghana) Amount outstanding - 0.19 1 -0.06 IPA trial (Ghana) Karlan et al. NS 10 Percentage point change As effect of Borrowed in past 12 months from any source Chapter 7 (2014) capital grant The impact of only cash transfers on 11 Probability of having loans 1% Percentage point change 0.16 Oportunidades Svarch (2009) education (Mexico) Oportunidades Change in pesos Amount of the loan application 10% -1470.7 2 Chapter 8 (Mexico) The impact of cash transfers on health HSNP (Kenya) Merttens et al. 12 10% Percentage point change 0.097 Share of households that have borrowed (2013) money in the last 12 months and nutrition Percentage point change Share of households reporting borrowing 10% SAGE – SCG SCG 13 Merttens et al. 0.073 Chapter 9 money in last 12 months (SCG) (Uganda) (2015) The impact of SAGE – VFSG Percentage point change -0.013 Share of households reporting borrowing VFSG NS cash transfers on money in last 12 months (VFSG) (Uganda) savings, investment SAGE – SCG Mean total value of current outstanding debt, 7, 5 0 0 SCG NS Change in UGX and production (Uganda) for those with outstanding debt (2012 prices, UGX) (SCG) Chapter 10 Mean total value of current outstanding debt, SAGE – VFSG VFSG Change in UGX NS 31000 The impact of for those with outstanding debt (2012 prices, (Uganda) cash transfers on UGX) (VFSG) employment Share of households reporting being able to SAGE – SCG SCG 0.11 1% Percentage point change (Uganda) borrow a large (e.g. UGX 60,000 or more) Chapter 11 amount of cash in an emergency (SCG) The impact of SAGE – VFSG Share of households reporting being able to VFSG 0.1 5% Percentage point change cash transfers on borrow a large (e.g. UGX 60,000 or more) (Uganda) empowerment amount of cash in an emergency (VFSG) Percentage point change 10% 14 O’Brien et al. BOTA (Kazakhstan) % of all households with household debt from 0.1 (2013) any source SECTION III CGP (Lesotho) NS 15 Pellerano et Percentage point change 0.031 Share of households who borrowed in the 12 month prior to the survey al. (2014) Chapter 12 Summary of NS CGP (Lesotho) Average amount currently owed (among those Change in LSL -86.59 who owe anything, maloti, 2013 prices) findings and conclusion Notes: results represent all overall results reported and do not include those disaggregated by gender or References showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means the study did not find a statistically significant result, typically up to the 10% significance level.

169 Cash transfers: what does the evidence say? Page 169 Contents Table 9.5: Summary of results for overall cash transfer effect on agricultural assets Acknowledgements # Study Country and Significance Variable and treatment population Effect Details / Measure of change (e.g. children under five) programme explanation Executive summary 5% Air (2014) 1 Agricultural implements index – share (36 Percentage point change 0.208 CGP (Zambia) month impact) Covarrubias et Mchinji SCT Household ownership of hoes 0.159 Percentage point change 1% 2 SECTION I (Malawi) al. (2012) Chapter 1 Household ownership of axes Mchinji SCT Percentage point change 1% 0.322 Introduction (Malawi) Percentage point change Mchinji SCT 0.298 1% Household ownership of sickles Chapter 2 (Malawi) Conceptual Percentage point change NS Daidone et al. Share of households with axes CGP (Zambia) 3 0.008 framework (2014b) NS Percentage point change 0.01 CGP (Zambia) Share of households with hoes Chapter 3 Percentage point change 0.044 Share of households with hammers CGP (Zambia) 5% Review of cash CGP (Zambia) Share of households with ploughs 0.036 Percentage point change 5% transfer reviews 5% CGP (Zambia) Number of axes owned 0.18 4 Level change (number) Chapter 4 Level change (number) Number of hoes owned CGP (Zambia) 5% 0.296 Methods Number of hammers owned 0.042 Level change (number) NS CGP (Zambia) Chapter 5 Number of ploughs owned CGP (Zambia) NS 0.033 Level change (number) The evidence base 4 NS 1.61 Value of agricultural tools (US$) Give Directly cash Haushofer and Change in US$ transfer (Kenya) Shapiro (2013) SECTION II Number of productive agricultural goods RPS (Nicaragua) Maluccio 5 Level change (number) -0.023 Note that value NS (2004) – ploughs, water pumps, sprayers, (2010) was significant and tools, and carts positive in 2002 Chapter 6 The impact of Value of productive agricultural goods RPS (Nicaragua) NS -18. 2 Change in pesos cash transfers on (2004) – ploughs, water pumps, sprayers, monetary poverty tools, and carts Merttens et al. 6 Kenya, HSNP Proportion of households owning plough 0 Percentage point change NS Chapter 7 (2013) Proportion of households owning axe Kenya, HSNP Percentage point change NS 0.10 The impact of cash transfers on NS Mean value of non-livestock -220 Kenya, HSNP Change in shillings education productive assets (Kenyan shillings) Pellerano et al. Lesotho, CGP 7 Proportion of households who in the 12 Percentage point change -0.0028 NS Chapter 8 months prior to the survey Spent any (2014) The impact of cash money to purchase crop production assets transfers on health Percentage point change Monze district cash Seidenfeld and 8 Ownership small tools – axe 0.042 NS and nutrition transfer (Zambia) Handa (2011) Ownership small tools – hoe 0.017 Percentage point change Monze district cash NS Chapter 9 transfer (Zambia) The impact of cash transfers on Notes: results represent all overall results reported and do not include those disaggregated by gender or savings, investment and production showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means the study did not find a statistically significant result, typically up to the 10% significance level. Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

170 Cash transfers: what does the evidence say? Page 170 Contents Table 9.6: Summary of results for overall cash transfer effect on agricultural inputs Acknowledgements Measure of Effect Variable and treatment population (e.g. Details/ Study # Significance Programme and country children under five) explanation change Executive summary 5% Change in shillings -104.8 Expenditure (Kenyan shillings) per acre on Cash transfer-OVC Asfaw et al. 1 seeds (2014) (Kenya) NS Change in shillings -7. 4 2 8 Expenditure (shillings) per acre on pesticide Cash transfer-OVC SECTION I (Kenya) Chapter 1 Expenditure on inorganic fertiliser Cash transfer-OVC Change in shillings -72.45 NS Introduction (Kenya) NS -0.015 Percentage point Use of seeds Cash transfer-OVC Chapter 2 change (Kenya) Conceptual Cash transfer-OVC NS Percentage point Use of pesticide -0.031 framework 122 (Kenya) change Chapter 3 -0.028 Percentage point Use of inorganic fertiliser NS Cash transfer-OVC (Kenya) change Review of cash transfer reviews Percentage point 0.051 NS Share of households purchasing any crop LCGP (Lesotho) 2 Daidone et al. (2014a) input change Chapter 4 15.085 Change in loti NS LCGP (Lesotho) Total expenditure on any input (Lesotho loti) Methods LCGP (Lesotho) Share of households purchasing seeds 0.074 Percentage point 10% change Chapter 5 The evidence base Percentage point 10% LCGP (Lesotho) Share of households purchasing inorganic 0.058 fertiliser change 0.010 Share of households purchasing organic LCGP (Lesotho) NS Percentage point SECTION II fertiliser change 123 LCGP (Lesotho) Percentage point 0.051 Share of households purchasing pesticide NS Chapter 6 change The impact of Share of households using pesticide Percentage point 0.079 LCGP (Lesotho) 5% cash transfers on change monetary poverty 5% Percentage point 3 Daidone et al. ZCGP (Zambia) Share of households with any input 0.17 7 Chapter 7 expenditure change (2014b) The impact of Change in kwacha 31.2 Crop expenditure (amount Zambian kwacha) ZCGP (Zambia) 5% cash transfers on Percentage point ZCGP (Zambia) Share of households reporting expenditure 0.10 0 5% education on seeds change Chapter 8 Percentage point 0.032 5% ZCGP (Zambia) Share of households reporting expenditure The impact of cash on fertiliser change transfers on health 0.002 NS Percentage point Share of households reporting expenditure ZCGP (Zambia) and nutrition change on pesticides Percentage point -0.024 Used Fertiliser LEAP (Ghana) 4 Handa et al. NS Chapter 9 (2014) change The impact of 24.676 10% Change in GHS Seeds Expenses (value) LEAP (Ghana) cash transfers on savings, investment 124 55.63 Value of chemicals used (inputs) – (as result Change in value IPA trial (Ghana) Karlan et al. 5 1% and production of capital grant treatment alone) (2014) 6 LCGP (Lesotho) Pellerano et al. Proportion of households who in the 12 -0.057 Percentage point NS Chapter 10 months prior to the survey Spent any money (2014) change The impact of to purchase inputs for crop production cash transfers on Seidenfeld and Percentage point 5% 7 0.079 Likelihood of having any expenditure on Monze district cash employment transfer (Zambia) Handa (2011) fertiliser change Chapter 11 Household reports agricultural spending Todd et al. 5% Percentage point 0.049 Oportunidades 8 (Mexico) (Oct 1998) change (2010) The impact of cash transfers on Oportunidades 0.019 NS Household reports agricultural spending Percentage point empowerment (Mexico) (May 1999) change Notes: results represent all overall results reported and do not include those disaggregated by gender or SECTION III showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means the study did not find a statistically significant result, typically up to the 10% significance level. Chapter 12 Summary of findings and conclusion 122 S ignificant negative impacts for large and female-headed households. References 123 N ote there is a highly significant impact for non-labour-constrained households. 124 C urrency unclear from paper (US dollars or Ghanaian cedis)

171 Cash transfers: what does the evidence say? Page 171 Contents Table 9.7: Summary of results for overall cash transfer effect on livestock assets Acknowledgements Variable and treatment population (e.g. Country and Study # Effect Details/ Significance Measure of programme children under five) explanation change Executive summary 0.403 Livestock index – share 36 month impact 1 5% Air (2014) Percentage ZCGP (Zambia) point change 5% Percentage 0.403 Livestock index – number owned ZCGP (Zambia) 36 month impact SECTION I point change 125 36 month impact 0.006 NS Percentage Share of households owning cows ZCGP (Zambia) Chapter 1 point change Introduction Share of households owning cattle 0.10 4 ZCGP (Zambia) Percentage 5% 36 month impact point change Chapter 2 36 month impact NS ZCGP (Zambia) Percentage Share of households owning goats 0.016 Conceptual point change framework 0.175 ZCGP (Zambia) Share of households owning chickens Percentage 36 month impact 5% point change Chapter 3 Review of cash Share of households owning large livestock Percentage 0.038 cash transfer-OVC Asfaw et al. 2 NS (Kenya) point change (2014) (cattle, donkey, etc.) transfer reviews Share of households owning small livestock cash transfer-OVC 0.15 4 Percentage NS Chapter 4 point change (sheep, goat, etc.) (Kenya) Methods WINGS (Uganda) Number of cattle and oxen 0.275 Level change 3 1% No group Training, Blattman 16 months after (Number) (2015) Chapter 5 grants The evidence base 1.792 Level change Number of donkeys, goats, sheep and pigs 1% WINGS (Uganda) As above (Number) 3 1% As above Level change 1.988 Number of poultry WINGS (Uganda) SECTION II (Number) BISP (Pakistan) Cheema et al. 4 0.021 Proportion of households who own any livestock Percentage NS Chapter 6 point change (2014) The impact of BISP (Pakistan) Mean value of livestock (Tropical Livestock Unit) 0.0386 Level change NS cash transfers on Covarrubias et SCTP (Malawi) Household ownership of goats 0.522 1% Percentage 5 monetary poverty al. (2012) point change 5% Percentage 0.015 Household ownership of cattle SCTP (Malawi) Chapter 7 point change The impact of SCTP (Malawi) 1% Percentage Household ownership of chickens 0.593 cash transfers on point change education NS Percentage 6 Daidone et al. 0.028 LCGP (Lesotho) Share of households who own livestock (2014a) point change Chapter 8 The impact of cash LCGP (Lesotho) Total number of livestock owned -0 NS Level change (Number) transfers on health and nutrition Percentage Share of households who own goats LCGP (Lesotho) 0.007 NS point change Chapter 9 Share of households who own cattle Percentage LCGP (Lesotho) -0.027 NS The impact of point change cash transfers on 5% LCGP (Lesotho) Share of households who own pigs 0.078 Percentage savings, investment point change and production 7 NS Percentage 0.033 Share of households who own cows ZCGP (Zambia) Daidone et al. point change (2014b) Chapter 10 Share of households who own other cattle ZCGP (Zambia) 5% Percentage 0.084 The impact of point change cash transfers on 0.036 Percentage 5% Share of households who own goats ZCGP (Zambia) employment point change ZCGP (Zambia) Share of households who own chickens 0.15 4 Percentage 5% Chapter 11 point change The impact of Community-based Percentage -0.03 NS 8 Evans et al. Number of indigenous cows (including calves) cash transfers on (2014) point change CCT (Tanzania) empowerment Percentage Community-based Number of indigenous goats (including kids) 0.38 5% CCT (Tanzania) point change 1% 1.09 Community-based Number of local chickens (excluding chicks) Percentage SECTION III CCT (Tanzania) point change Chapter 12 NS Community-based Number of pigs -0.02 Percentage point change CCT (Tanzania) Summary of findings and continued on next page conclusion References 125 I mpact was significant (2.1 percentage points) at 24 months.

172 Cash transfers: what does the evidence say? Page 172 Contents continued Table 9.7: Summary of results for overall cash transfer effect on livestock assets Acknowledgements Country and Study # Measure of Details/ Significance Effect Variable and treatment population (e.g. programme children under five) change explanation Executive summary 0.042 Draught animal ownership Sample: 1998 to Gertler et al. 9 Percentage 1% Oportunidades 126 point change (2012) November 1999 (Mexico) Percentage Productive animal ownership Oportunidades 0.036 5% As above SECTION I point change (Mexico) Chapter 1 Oportunidades 6 5.124 Change in Value of draught animals As above 5% Introduction pesos (Mexico) As above 1% Oportunidades Change in 186.83 Value of productive animal Chapter 2 (mexico) pesos Conceptual 10 Haushofer and Give Directly (Kenya) Value of livestock 84.52 1% Change in US$ framework Shapiro (2013) Chapter 3 11 -2.519 Value of livestock sold or self-consumed Households receiving NS Atención a Crisis Change in Macours and (Nicaragua) Vakis (2009) Córdobas cash transfer only Review of cash transfer reviews 12 Maluccio NS RPS (Nicaragua) Number of types of animals owned (cattle, work 2004 -0.008 Level change animals and poultry) (2010) (number) Chapter 4 RPS (Nicaragua) Value of all animals owned (cattle, work animals Change in NS 2004 208.5 Methods and poultry) Córdobas Merttens et al. 0.061 HSNP (Kenya) Percentage Share of households owning any livestock 13 10% Chapter 5 point change (2013) The evidence base 5% Share of households owning goats and sheep HSNP (Kenya) 0.071 Percentage point change SECTION II HSNP (Kenya) NS Share of households owning cattle -0.018 Percentage point change Chapter 6 Share of HHs owning livestock (SCG) SAGE (Uganda) SCG) Merttens et al. NS 14 Percentage 0.041 The impact of (2015) point change cash transfers on 127 Share of HHs owning livestock SAGE (Uganda) VFSG (VFSG) 0.093 Percentage 1% monetary poverty point change Chapter 7 SCG 5% SAGE (Uganda) Percentage 0.093 Share of households purchasing livestock in last 12 months (SCG) point change The impact of cash transfers on Share ofhouseholds purchasing livestock in last SAGE (Uganda) 0.262 Percentage 1% VFSG education 12 months (VFSG) point change SCG NS Share of households owning cattle (SCG) -0.002 Percentage SAGE (Uganda) Chapter 8 point change The impact of cash VFSG 1% Percentage 0.067 Share of households owning cattle (VFSG) SAGE (Uganda) transfers on health point change and nutrition SAGE (Uganda) NS Percentage 0.021 Share of households owning goats (SCG) SCG Chapter 9 point change The impact of SAGE (Uganda) 5% Share of households owning goats (VFSG) 0.073 Percentage VFSG cash transfers on point change savings, investment 0.015 Share of households owning pigs (SCG) SAGE (Uganda) SCG NS Percentage and production point change NS VFSG Percentage SAGE (Uganda) 0.025 Share of households owning pigs (VFSG) Chapter 10 point change The impact of cash transfers on Percentage 0.496 Share of households owning any livestock in the LCSG (Lesotho) NS 15 Pellerano et al. employment point change 12 months prior to the survey (2014) 10% Percentage 0.088 Ownership chicken CTP (Zambia) Seidenfeld and 16 Chapter 11 Handa (2011) point change The impact of CTP (Zambia) Ownership pig Percentage NS 0.04 cash transfers on point change empowerment Percentage 5% CTP (Zambia) Ownership goat 0.271 point change SECTION III NS CTP (Zambia) Ownership cattle -0.022 Percentage point change Chapter 12 continued on next page Summary of findings and conclusion References 126 N ote we do not report the 2003 sample results as both treatment and control branches are receiving at that time. 127 N ote that impacts for poultry, sheep, camels and donkeys are also all positive but non-significant.

173 Cash transfers: what does the evidence say? Page 173 Contents continued Table 9.7: Summary of results for overall cash transfer effect on livestock assets Acknowledgements Variable and treatment population (e.g. Study # Country and Details/ Significance Measure of Effect explanation children under five) change programme Executive summary 0.031 Percentage Oportunidades 10% Todd et al. 17 Household owns livestock (Oct 1998) (Mexico) point change (2010) Level change Per capita livestock owned (Oct 1998) 10% Oportunidades 0.016 SECTION I (number) (Mexico) Chapter 1 Household owns livestock (May 1999) Percentage 5% 0.033 Oportunidades Introduction (Mexico) point change 1% Level change Per capita livestock owned (May 1999) Oportunidades 0.033 Chapter 2 (Mexico) (number) Conceptual framework Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means Chapter 3 the study did not find a statistically significant result, typically up to the 10% significance level. Review of cash transfer reviews Chapter 4 Table 9.8: Summary of results for overall cash transfer effect on business and enterprise Methods Variable and # Country and Study Effect Measure of Significance Details / programme treatment population change explanation Chapter 5 (e.g. children under five) The evidence base Air (2014) ZCGP (Zambia) Household operates a non- 1 0.121 Percentage 5% point change farm enterprise SECTION II 0.016 Household participation in cash transfer-OVC Asfaw et al. (2014) 2 Note increase NS Percentage point change is significant (7 non-farm enterprise (Kenya) percentage points) for Chapter 6 128 female-headed HHs The impact of cash transfers on Tools and machines YOP (Uganda) Blattman et al. (2012) 3 791.904 Change in cash transfer + 1% monetary poverty 000s Ugandan acquired since baseline training and business shillings start-up costs Chapter 7 Same as above YOP (Uganda) 658.554 Change in 1% Stock of raw materials, The impact of tools, and machines 000s shillings cash transfers on Share of households with LCGP (Lesotho) Daidone et al. (2014a) 4 -0.038 Percentage NS education off-farm business in the last point change 12 months Chapter 8 Daidone et al. (2014b) Share of households ZCGP (Zambia) 5 0.16 6 Percentage 5% The impact of cash operating a Non-Farm point change transfers on health Enterprise and nutrition Percentage ZCGP (Zambia) Share of households owning 0.045 5% point change business assets Chapter 9 The impact of Impact of additional peso on 6 Davis et al. (2002) PROCAMPO (Mexico) -5.253 Agricultural focus Change in 5% cash transfers on non-agricultural investment pesos spending – PROCAMPO savings, investment and production Impact of additional peso on PROGRESA (Mexico) NS Change in 0.265 Human capital focus non-agricultural investment pesos Chapter 10 spending – PROGRESA The impact of Running microenterprise 7 Gertler et al. (2012) Oportunidades (Mexico) Sample: 1998 to 0.033 Percentage 5% cash transfers on 129 point change 1999 employment Macours and Vakis (2009) 8 NS Level change -92.68 Value of business assets Atención A Crisis (Nicaragua) (cash transfer only) Chapter 11 9 Maluccio (2010) RPS (Nicaragua) Participation in non- Percentage NS 0.015 The impact of agricultural home point change cash transfers on production, retail, or empowerment services – 2004 Notes: results represent all overall results reported and do not include those disaggregated by gender or SECTION III showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means the study did not find a statistically significant result, typically up to the 10% significance level. Chapter 12 Summary of findings and conclusion References 128 M ale-headed households, on the other hand, show a negative impact (-11pp). 129 N ote we do not report the 2003 sample results as both treatment and control branches were receiving at that time.

174 Cash transfers: what does the evidence say? Page 174 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 10 transfer reviews Chapter 4 Methods T he impact of cash Chapter 5 The evidence base transfers on employment SECTION II Chapter 6 The impact of cash transfers on monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

175 Cash transfers: what does the evidence say? Page 175 Contents Box 10.1: Summary of evidence for employment outcomes Acknowledgements Evidence of the impact of cash transfers on employment outcomes was extracted from a total of 74 studies. By far the Executive summary largest number report on CCT programmes in Latin America. Regionally, the next most represented area is sub-Saharan Africa, with 19 studies reporting on a programme in the region for at least one of the employment indicators being reviewed. In contrast to most studies on Latin America, most of the studies on sub-Saharan Africa report on some form SECTION I of regular transfer for poverty reduction, while two studies report on large enterprise grants, and one reports on a social pension. It is important to bear these programme differences in mind when interpreting the results. Chapter 1 Introduction Overall effects of cash transfers on selected employment indicators: • F not have a statistically significant impact or just over half of studies reporting on adult work, the cash transfer does Chapter 2 on adult work. Among those studies reporting a significant effect among adults of working age, the majority find an Conceptual increase in work participation and intensity. In the cases where a reduction in work participation or work intensity is framework reported, these reflect a reduction in participation among the elderly, those caring for dependents or are linked to Chapter 3 reductions in casual work. Review of cash 1 – adult labour force participation overall 4 studies report on the effect on : among the eight that report on transfer reviews adults of working age , four found statistically significant impacts, three being increases and one a decrease. elderly adults Among the two studies on , one found a significant effect from a social pension in Mexico, of Chapter 4 reducing pensioners working for pay (Galiani et al., 2014). Methods 1 studies estimate the impact of cash transfers on adult labour force participation by sector/ – overall 1 type of employment . Of these, five find at least one significant effect, with three suggesting increased self- Chapter 5 employment (Cheema et al., 2014; Blattman et al., 2015; Macours et al., 2012), one an increase in unpaid The evidence base family work (among the elderly) (Galiani et al., 2014) and two showing reductions in casual work outside the household (Cheema et al., 2014; Daidone et al., 2014). SECTION II , with six studies associated with statistically significant overall 1 studies report on 1 – adult intensity of work impacts. Three involved reductions in time worked, though one was among the elderly (Kassouf and Oliveira, Chapter 6 2012) and another was only significant for those who did not receive all disbursements (Bazzi et al., 2012). The The impact of two interventions resulting in increases in time spent working resulted from large enterprise grants in Uganda – cash transfers on YOP and WINGS – which were specifically intended to increase employment. monetary poverty 1 – intensity of adult labour in different sectors/types of 0 studies report the impact of cash transfers on the ; of these, seven report a statistically significant effect. These include increasing time spent on employment Chapter 7 work, including market activities and skilled work in the two enterprise grants in Uganda, a shift from paid work The impact of to unpaid work due to a social pension among elderly adults in Mexico, and a combination of increases and cash transfers on education decreases in time spent in agricultural employment. T – , with findings showing that cash transfers can either increase migration hree studies report on the impact on Chapter 8 or decrease the probability of migrating internally or internationally. The impact of cash transfers on health F • or child labour, there is evidence that cash transfer programmes have played a role in reducing the prevalence and nutrition and intensity of overall child labour, though more significant effects are found for intensity (hours worked) than for prevalence (whether working/ not working). Chapter 9 The impact of , 19 studies estimate cash transfer impacts on n terms of I child labour – child labour participation cash transfers on . Of the eight studies that find any significant impact, all show a decrease in child labour. In terms participation savings, investment child labour participation by sub of , of the eight studies, five report significant results, indicating sector - and production reductions in various forms of market work, domestic work, own-farm work and one shift from physical labour to non-physical labour. Chapter 10 F – . All found statistically significant intensity of overall child labour ive studies report on impacts on the The impact of reductions in the hours spent on work, ranging from 0.3 fewer hours a week in Colombia’s SCAE (Barrera- cash transfers on Osorio et al., 2008) to 2.5 fewer hours a week in Ecuador’s BDH (Schady and Araujo, 2006). employment – F our studies report cash transfer impacts on number of hours worked by children by sector/type of Chapter 11 work . Three studies report at least one significant result, showing a mixture of increased time on a family The impact of enterprise, reductions in time spent on own-farm work and reduced time on domestic work outside the cash transfers on household. empowerment SECTION III Chapter 12 Summary of findings and conclusion References

176 Cash transfers: what does the evidence say? Page 176 Contents Box 10.1: Summary of evidence for employment outcomes Acknowledgements Variation in outcomes by gender: Executive summary The evidence extracted shows some differential effects for men and women for labour force participation and work intensity, but one of the main emerging themes around gendered effects relates to changes in time allocation to on domestic work by women. Studies different activities, with a number of studies finding an increase in time spent SECTION I focusing on children tend to show a reduction in work for both girls and boys. Chapter 1 6 studies report . Seven find at least one significant impact, with 1 • effects on labour participation among women Introduction results suggesting a heterogeneous range of effects. Seven papers then report impacts on labour participation by sector/type of employment among women . Two of these report at least one statistically significant result for Chapter 2 women, including a shift from non-farm to farm work for elderly women in Lesotho’s CGP (Daidone et al., 2014). Conceptual effects on intensity of work among women 0 studies report 1 • . At least one significant result is found in framework eight of these, though no clear patterns emerge. Six papers also report the impact of cash transfers on the . Of these, three studies find at least by sector/type of employment number of hours worked by women Chapter 3 one statistically significant result, including increases in time spent on domestic work in Colombia and Mexico. Review of cash transfer reviews effects on child labour participation among girls 0 studies report 2 • , of which 12 report a significant effect with impacts generally negative for both boys and girls. Chapter 4 E . Five report significant girls working by sector ight studies report estimates of the impact of cash transfers on • Methods effects, most suggesting reductions across the board, except an increase in household chores in Malawi’s SCTP (Miller and Tsoka, 2012). Chapter 5 The evidence base even studies report estimates of the impact of cash transfers on the • S number of hours worked by girls . Five report at least one statistically significant finding, including four studies showing in different sectors declines in time spent on domestic work in Colombia, Mexico and Nicaragua, and an increase in time on family SECTION II enterprise work in Indonesia (World Bank, 2011). Chapter 6 Role of design and implementation features: The impact of • T he evidence base on the role of design and implementation features remains limited. Findings discussed below cash transfers on monetary poverty include: – S ome limited evidence linking higher transfer levels in a CCT and social pension with higher reductions in Chapter 7 working hours (Dabalen et al., 2008; Bertrand et al., 2003). The impact of being associated with a decline in working hours compared to no – A n example of delays in transfer receipt cash transfers on significant decline without the delays (Bazzi et al., 2012). education associated with greater likelihood or intensity of work among women I – ncreased duration of transfers Chapter 8 in Ecuador and Mexico (Buser et al., 2014; Behrman and Parker, 2013), but more mixed results on The impact of cash children, with a combination of higher exposure in Mexico’s PROGRESA/Oportunidades associated with transfers on health reductions in the likelihood of working among boys and a marginal increase in migration some five years and nutrition later (Behrman et al., 2009; Behrman et al., 2011; Behrman et al., 2012) but also associated with a higher likelihood of work among beneficiaries in Peru’s Juntos (Perova and Vakis, 2012). Chapter 9 The impact of – hree studies on child labour indicating the importance of either the presence or perception of T conditionalities cash transfers on relating to school enrolment or attendance, in terms of reducing the likelihood or intensity of child labour savings, investment (Barrera-Osorio et al., 2011; Schady and Araujo, 2006; Benedetti and Ibarrarán., 2015). and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

177 Cash transfers: what does the evidence say? Page 177 Contents ummary of findings S 10.1 Acknowledgements This chapter reports on the impacts of cash transfers on labour outcomes among adults and Executive summary children. Specifically, the chapter focuses on the impacts of cash transfers on labour supply, including overall labour participation, intensity of overall labour supply, and changes in SECTION I allocations to different sub-sectors or types of work. Impacts on migration are also reviewed, though the evidence on migration outcomes is limited. The results are discussed both in terms Chapter 1 of adult and child labour and, within each, reporting on impacts on women and girls where Introduction available, considering how they vary against overall effects or relative to male counterparts. Chapter 2 Conceptual On overall adult labour participation, under half of the studies reporting on this outcome found framework any significant effect arising from cash transfers. Among those that focused on working-age adults, more found an increase in participation than a decrease, while among the elderly, one Chapter 3 study on South Africa’s old-age pension found it reduced participation in paid labour (Ardington Review of cash et al., 2009). Interestingly, it was not the large enterprise grants driving these increases, which transfer reviews instead result from two CCTs in Latin America and one in Kazakhstan (Canavire-Bacarreza and Chapter 4 Vazquez-Ruiz, 2013; Barrientos and Villa, 2013; O’Brien et al., 2013). Overall, the evidence does Methods not support the idea of cash transfers in general leading to a withdrawal from labour activities, except in the case of social pensions provided to the elderly. Chapter 5 The evidence base In terms of the intensity of adult work, again, a large proportion of studies (half) found the cash transfers reviewed to have no significant effect. Among those that did, three studies found SECTION II increases and three found decreases. Among those with decreases, one was the result of a social pension in Brazil allowing elderly individuals to reduce time in paid work (Kassouf and Oliviera, Chapter 6 2012) and another was only significant among those who had not yet received a second transfer The impact of that was due (Bazzi et al., 2012) (see section on design and implementation features below). The cash transfers on three studies reporting an increase covered two similar programmes – both large enterprise grants monetary poverty in Uganda (YOP and WINGS) which specifically aimed to support employment through enterprise Chapter 7 development (Blattman et al., 2012; Blattman et al., 2013; Blattman et al., 2015). Taken as a The impact of whole (including the statistically non-significant results), the evidence therefore does not support cash transfers on labour intensity and, the idea of cash transfers consistently leading to a reduction in overall education depending on the nature of the programme or policy, cash transfers can actually be used to help Chapter 8 bring about desired increases or decreases in time spent in paid work. The impact of cash transfers on health Also of interest is evidence of the impacts of cash transfers on changes in labour participation and nutrition and intensity in different sectors or types of work. Here the evidence suggests that, in many cases (over half of the studies) transfers did not significantly affect overall participation in the specific Chapter 9 sectors studied. A significant impact was seen in the large increase of 40 percentage points in The impact of cash transfers on non-agricultural self-employment in Uganda’s WINGS (specifically designed with this objective) savings, investment (Blattman et al., 2015), and the much smaller increase (four percentage points) among recipients and production of a conditional transfer in Nicaragua’s Atención a Crisis (the percentage point increase was three times as large when combined with a lump-sum grant for a non-agricultural enterprise) Chapter 10 (Macours et al., 2012). Other significant impacts on sector participation included: an increase in The impact of cash transfers on working for no pay among recipients in Mexico’s PAAMZR social pension, due to a shift from employment paid work to working on a family business (Galiani et al., 2014); a reduction in paid work outside the household in Lesotho’s CGP (Daidone et al., 2014); and a shift from casual labour to self- Chapter 11 employment in Pakistan’s BISP (Cheema et al., 2014). The impact of cash transfers on time allocation There is much stronger evidence, however, in cash transfers impacting on empowerment towards different activities. All but two studies reporting on this found some significant impact on changes in time spent on different sectors or types of work. This includes reductions in time SECTION III spent on paid wage labour in Kenya’s OVC-cash transfer, Lesotho’s CGP and Malawi’s SCTP, which may represent positive developments in so far as the wage labour available for beneficiary Chapter 12 households in these cases is typically highly casual and low paid (Asfaw et al., 2014; Covarrubias Summary of findings and et al., 2012; Daidone et al., 2014). Interestingly, Ghana’s LEAP, by contrast, lead to increased conclusion time spent on paid employment (the increase in hours spent on non-farm enterprises was not significant) (Mochiah et al., 2014). Again, and as expected, the WINGS and YOP enterprise grant References programmes in Uganda significantly increased time dedicated to labour, including market and skilled work, agricultural and non-agricultural work.

178 Cash transfers: what does the evidence say? Page 178 Contents Among the sex-disaggregated results for adult employment, there is again a trend in many Acknowledgements studies not to report any significant impacts in terms of overall labour participation (10 of 16 studies). Among the few that did, there are different examples of gender differences. For example, Executive summary Lesotho’s CGP led to an increase in women working by eight percentage points but there was no corresponding effect among men (Daidone et al., 2014). Three studies find fairly small effects for Mexico’s PROGRESA/Oportunidades, with some evidence of increases being found more SECTION I among women than men (e.g. Behrman and Parker, 2013). Women also appear not to have shown Chapter 1 the reduction in labour participation that was found among men in households benefitting from Introduction South Africa’s Old-Age Pension (Ardington et al., 2009), but similar effects by gender were found arising from Colombia’s Familias en Acción, with significant increases for both single females with Chapter 2 children and young adult men (Barrientos and Villa, 2013). Conceptual framework As regards overall labour intensity, all but two studies find significant impacts, with a range of Chapter 3 gender differences apparent. In Uganda’s YOP, the programme increased women’s overall working Review of cash hours more than men’s (though the difference is not statistically significant) (Blattman et al., 2012; transfer reviews 2013). Some interventions in Latin America appeared to either only impact significantly on male overall labour intensity (e.g. reductions or increases) with no significant change for women, or had Chapter 4 Methods opposite effects such as increasing hours spent by urban mothers and decreasing hours by urban fathers for Bolsa Família/Bolsa Escola recipients (Ferro and Nicollela, 2007). Chapter 5 The evidence base Aside from the differential effects on overall working time, one of the main emerging themes around gendered effects relates to changes in time allocation to different activities. For example, SECTION II in Latin America, a number of studies find an increase in time spent on domestic work by women (alongside a reduction in time spent on domestic chores by younger girls). In the case of Chapter 6 Colombia’s Familias en Acción, Ospina (2010) found that the increase in hours spent on domestic The impact of labour by women was matched by a decrease in time spent on it by men, who increased hours cash transfers on spent on paid work. In brief, while each intervention and local context differs, cash transfers do monetary poverty appear to have significant gendered impacts in the shifting allocation of work by men and women. Chapter 7 The impact of The clearest and most consistent finding in this chapter is the evidence of the role that a number cash transfers on of cash transfer programmes have played in reducing the prevalence and particularly the intensity education of child labour. This should be understood against the findings in Chapter 7, which found a strong impact arising from many cash transfers on increasing time spent in school. While just Chapter 8 The impact of cash under half of the programmes on child labour participation found a significant effect, the effect transfers on health was in all cases a reduction in child labour, and all five of the studies on overall labour intensity and nutrition found significant reductions. It is interesting to note here, however, that the significant reductions are driven by programmes in Latin America (with the exception of one programme in Indonesia Chapter 9 and one in Morocco), and that none of the studies reporting on child labour participation effects The impact of cash transfers on from a cash transfer programme in sub-Saharan Africa found any significant impact. This raises savings, investment questions over why such differences exist, and whether they relate to programme design features and production (e.g. transfer sizes or conditionality messaging). Chapter 10 Lastly, just three studies report on the overall effect of cash transfers on migration and two on The impact of cash transfers on sex-disaggregated migration findings. Of the two significant studies finding statistically significant employment overall effects, one finds transfers leading to greater migration and the other to a reduction in migration. On the sex-disaggregated effects, one study finds that transfers lead to an increase Chapter 11 in internal migration in South Africa for men and women, with the impact slightly greater for The impact of men (Ardington et al., 2009). The other finds an increase in migration for boys and a decrease in cash transfers on internal migration for girls arising from Mexico’s Oportunidades (Behrman et al., 2009). empowerment SECTION III 10.2 S ummary of evidence base Chapter 12 Table 10.1 provides a summary of which programmes and countries are covered in the 74 Summary of findings and studies from which evidence is extracted on the selected employment indicators reviewed in this conclusion section. As can be seen, by far the largest number of studies report on CCT programmes within Latin America, with many of those focusing on PROGRESA/Oportunidades. Regionally, the References next most represented area is sub-Saharan Africa, with 19 studies reporting on a programme in the region for at least one of the employment indicators being reviewed. Very little evidence on

179 Cash transfers: what does the evidence say? Page 179 Contents the selected employment indicators comes from other regions such as the Middle East and North Acknowledgements Africa or Asia. Executive summary In contrast to the programmes from Latin America, all but one of the programmes from sub- Saharan Africa report on some form of UCT, though there is considerable variation between these. For example, two programmes in Uganda – the Youth Opportunities Programme (YOP) SECTION I and Women’s Income Generating Support (WINGS) programme – provided substantial grants Chapter 1 to individuals who were poor but had the means to establish a business, and the grants were Introduction technically conditional upon developing a business plan. These are likely to have quite different impacts to UCTs which targeted very poor households and were designed to pay a much smaller Chapter 2 regular income, primarily for consumption smoothing. South Africa’s Old-Age Pension is quite Conceptual distinct again, in that it provided large regular grants to elderly individuals. framework Chapter 3 Table 10.1 Summary of countries and programmes reported on for employment indicators (all studies) Review of cash Type of cash Programme Country Details if pilot or experimental # transfer reviews studies study* transfer Chapter 4 Latin America and Caribbean = 46 studies Methods Brazil CCT 1 Bolsa Família/Bolsa Escola Chapter 5 CCT Brazil Bolsa Família 2 The evidence base Social pension Brazil 1 Benefício de Prestação Continuada (BPC) Colombia Familias en Acción CCT 4 SECTION II CCT 2 Colombia Subsidios Condicionados a la Asistencia Escolar (SCAE) Solidarity Program (SP) 1 CCT Dominican Republic Chapter 6 3 CCT Bono de Desarrollo Humano (BDH) Ecuador The impact of cash transfers on Honduras Programa de Asignación Familiar (PRAF) CCT 4 monetary poverty Bono 10,000 1 CCT Honduras Chapter 7 PROGRESA/Oportunidades CCT Mexico 13 The impact of 1 Mexico Programa de Apoyo Alimentario (PAL) CCT cash transfers on Social pension Programa de Atención a Adultos Mayores en Zonas Rurales (PAAMZ) Mexico 1 education 8 CCT Red de Protección Social (RPS) Nicaragua Chapter 8 CCT Nicaragua Atención a Crisis 5 The impact of cash transfers on health 1 Peru Juntos CCT and nutrition Sub-Saharan Africa = 19 studies Ghana UCT/CCT Livelihood Empowerment Against Poverty (LEAP) 2 Chapter 9 The impact of Trial covering 502 households 1 UCT Innovation for Poverty Action randomised trial (IPA RCT) Ghana cash transfers on 1 UCT Hunger Safety Net Programme (HSNP) Kenya savings, investment and production Kenya 1 UCT Cash Transfer for Orphans and Vulnerable Children Programme (OVC- cash transfer) Chapter 10 UCT Lesotho Child Grant (LCGP) 2 The impact of Social Cash Transfer Pilot (SCTP) Malawi Pilot phase (one district) 2 UCT cash transfers on employment Old-Age Pension (SA-OAP) South Africa Social pension 3 1 Social Assistance Grants for Empowerment Programme (SAGE) UCT Uganda Chapter 11 Youth Opportunities Programme (YOP) Uganda Funding for 265 groups 2 Enterprise grant The impact of cash transfers on 1800 beneficiaries from 120 villages 2 Enterprise grant Women’s Income Generating Support (WINGS) Uganda empowerment UCT Zambia Child Grant Programme (ZCGP) 2 Middle East and North Africa = 1 study SECTION III Experiment covering 600 Morocco Tayssir UCT/CCT 1 communities Chapter 12 Europe and Central Asia = 2 studies Summary of findings and Albania Ndihma Ekonomike (NE) UCT 1 conclusion Kazakhstan BOTA CCT 1 References continued on next page

180 Cash transfers: what does the evidence say? Page 180 Contents Table 10.1 Summary of countries and programmes reported on for employment indicators (all studies) continued Acknowledgements Programme Type of cash Details if pilot or experimental # Country transfer studies study* Executive summary South Asia = 2 studies Pakistan Benazir Income Support Programme (BISP) UCT 1 SECTION I Pakistan CCT 1 Female School Stipend Program (PFSSP) East Asia and Pacific = 4 studies Chapter 1 Introduction CESSP Scholarship Program (CSP) Labelled transfer 1 Cambodia 1 CCT Bantuan Siswa Miskin cash transfer for poor students (BSM) Indonesia Chapter 2 Indonesia 1 UCT Temporar y UCT Conceptual framework CCT Program Keluarga Harapan (PKH) Indonesia 1 Chapter 3 Note: As some studies report on more than one programme, the totals here do not correspond with the total Review of cash number of independent studies reported in the text. *This information, for papers that report results from a transfer reviews pilot/experimental implementation, helps distinguish such papers from those that cover cash transfer policies/ programmes that are operational at a larger scale and/or are long-term/permanent. It provides a ‘flag’ for Chapter 4 findings which may have more limited external validity or where it has not been shown that the evidence Methods would necessarily hold at a larger scale. Chapter 5 The evidence base Table 10.2 summarises the 74 studies reviewed for the selected employment indicators by the overall methods used in investigating those specific indicators, whether the study reports on SECTION II overall effects of cash transfers, effects of design and implementation features, and/or if it reports Chapter 6 on sex-disaggregated outcomes. The impact of cash transfers on As can be seen, a relatively small proportion report on the effect of design and implementation monetary poverty features in mediating programme outcomes, though a much larger proportion report sex- disaggregated impacts. Chapter 7 The impact of cash transfers on Over half of the studies draw on some form of experimental design, with the remainder employing education a range of quasi-experimental methods, such as RDD, DID or DID with PSM. Chapter 8 Table 10.2 Summary of study methods used and reporting on design and implementation and gender The impact of cash transfers on health disaggregation and nutrition Study design/methods used for reported results Study Reports total Reports effect Reports sex- effect of design and disaggregated Chapter 9 implementation outcomes The impact of features cash transfers on No No Yes RCT DID A IR (2014) savings, investment QE RDD Alam and Baez (2011) No Yes No and production Yes Alzúa et al. (2013) RCT DID (OLS) Yes No Chapter 10 Angelucci (2004) Yes No QE cross-sectional Probit using cluster randomised treatment No The impact of No Yes Yes QE repeated cross-sectional OLS regression Ardington et al. (2009) cash transfers on employment RCT SD with IPW Asfaw et al. (2014) No No Yes RCT DID No No Attanasio et al. (2010) Yes Chapter 11 Yes No Yes QE PSM Canavire-Bacarreza and The impact of Vazquez-Ruiz (2013) cash transfers on empowerment Yes Barrera-Osorio et al. (2008) RCT SD Yes Yes No Barrera-Osorio et al. (2011) RCT SD No Yes Yes QE RDD No Barrientos and Villa (2013) Yes SECTION III Yes No Bazzi et al. (2012) QE DID with IPW Yes Chapter 12 Behrman and Parker (2013) QE using DID with PSM No Yes Yes Summary of Yes Behrman et al. (2009) RCT DID with PSM No Yes findings and conclusion Behrman et al. (2011) RCT and QE DID with matching No Yes Yes Behrman et al. (2012) QE DID with PSM No No Yes References continued on next page

181 Cash transfers: what does the evidence say? Page 181 Contents Table 10.2 Summary of study methods used and reporting on design and implementation and gender disaggregation continued Acknowledgements Study Reports total Reports effect Study design/methods used for reported results Reports sex- Executive summary effect of design and disaggregated implementation outcomes features SECTION I Benedetti et al. (2015) RCT SD Yes Yes Yes Yes RCT SD (OLS) No No Benhassine et al. (2013) Chapter 1 Introduction QE SD (OLS) No No Yes Bertrand et al. (2003) RCT multivariate regression Yes Yes No Blattman et al. (2012) Chapter 2 Yes Blattman et al. (2013) RCT multivariate regression No Yes Conceptual framework Yes Yes No Blattman et al. (2015) RCT SD (OLS) No Yes Yes Buser et al. (2014) QE RDD Chapter 3 Bustelo (2011) Yes No Yes RCT DID (OLS) Review of cash transfer reviews Yes Yes QE RDD Cheema et al. (2014) Yes No RCT DID with PSM Covarrubias et al. (2012) No Yes Chapter 4 No QE Fixed Effects with PSM Dabalen et al. (2008) Yes Yes Methods Daidone et al. (2014a) (Lesotho) RCT DID Yes No Yes Chapter 5 Yes RCT DID Yes No Daidone et al. (2014b) (Zambia) The evidence base Dammert (2008) RCT Tobit and OLS No No Yes de Holanda Barbosa and No QE RDD Yes No SECTION II Corseuil (2014) de Silva and Sumarto (2015) QE PSM Yes No No Chapter 6 Yes Yes QE Tobit using panel data, based on randomised treatment Del Carpio (2008) Yes The impact of cash transfers on No Del Carpio and Loayza (2012) QE cross-sectional Tobit based on randomised treatment Yes No monetary poverty Yes Del Carpio and Macours (2009) No No RCT Random Effects No Yes RCT IV Edmonds and Schady (2008) Yes Chapter 7 The impact of Yes No No QE RDD Ferreira et al. (2009) cash transfers on Yes No QE cross-sectional Probit and Heckman selection models Ferro and Nicollela (2007) No education No Fitzsimons and Mesnard (2014) RCT Fixed Effects OLS Yes No Chapter 8 RCT SD (OLS) Galiani and McEwan (2013) Yes Yes Yes The impact of cash No Yes QE DID Galiani et al. (2014) No transfers on health No Yes QE cross-sectional Tobit based on randomised treatment Gee (2010) No and nutrition No Green et al. (2015) QE cross-sectional based on randomised treatment Yes Yes Chapter 9 Yes Yes Handa et al. (2014) QE DID with PSM No The impact of No Yes Karlan et al. (2014) RCT IV No cash transfers on savings, investment No No Yes Kassouf and de Oliveira (2012) QE RDD, DID, and PSM and production No No RCT DID Lincove and Parker (2015) Yes No Macours et al. (2012) RCT IV (2SLS) Yes Yes Chapter 10 The impact of Maluccio (2003) No No RCT DID Yes cash transfers on Maluccio (2005) RCT DID Yes No Yes employment No No Maluccio and Flores (2005) Yes RCT DID Chapter 11 No No Yes RCT DID Merttens et al. (2013) The impact of No Merttens et al. (2015) RCT DID with PSM Yes Yes cash transfers on empowerment Miller and Tsoka (2012) RCT DID No No Yes Mochiah et al. (2014) QE DID with PSM Yes No Yes No QE DID Yes No Novella et al. (2012) SECTION III Yes No No O’Brien et al. (2013) RCT DID Chapter 12 Yes No Ospina (2010) QE DID Tobit No Summary of No Parker and Skoufias (2000) QE DID (Probit) and Heckman selection models, based on Yes No findings and cluster randomised treatment conclusion Pellerano et al. (2014) RCT DID Yes No No References Perova and Vakis (2012) QE IV estimation Yes Yes No continued on next page

182 Cash transfers: what does the evidence say? Page 182 Contents Table 10.2 Summary of study methods used and reporting on design and implementation and gender disaggregation continued Acknowledgements Reports total Study Study design/methods used for reported results Reports effect Reports sex- Executive summary of design and effect disaggregated implementation outcomes features SECTION I Rubio-Codina (2009) No No RCT Probit and Tobit Yes RCT DID No No Yes Sadoulet et al. (2004) Chapter 1 Introduction RCT SD (OLS), Tobit, and IV (2SLS) Yes Yes No Schady and Araujo (2006) No No RCT IV and Probit Schultz (2004) Yes Chapter 2 No Siaplay (2012) QE RDD Yes Yes Conceptual framework Yes Skoufias and di Maro (2008) RCT DID (Probit) No No QE DID and SD based on cluster randomised treatment Skoufias and Parker (2001) Yes No No Chapter 3 Yes Skoufias et al. (2013) RCT DID No No Review of cash transfer reviews Skoufias et al. (2013) Yes No No RCT DID Stecklov et al. (2005) RCT DID Yes No No Chapter 4 Teixeira (2010) QE PSW No No Yes Methods RCT SD (Probit) Yes No Yes Winters et al. (2009) Chapter 5 World Bank (2011) QE IV Yes No Yes The evidence base RCT = randomised controlled trial, QE = Quasi-experimental; RDD = Regression Discontinuity Design, DID = difference-in-difference, SD = single difference, PSM = propensity score matching, PSW = propensity score SECTION II weighting, IV = instrumental variables, OLS = Ordinary Least Squares, 2SLS = Two-stage least squares. Chapter 6 The impact of cash transfers on monetary poverty 10.3 T he impact of cash transfers on employment Chapter 7 Tables 10.3 to 10.9 below summarise the overall effects of cash transfers on the indicators under The impact of cash transfers on consideration. We also include a discussion of sex-disaggregated findings. Where any effects education associated with design or implementation features were found, these are not reported in the tables, but are discussed in section 10.4. Chapter 8 The impact of cash transfers on health A 10.3.1 dult labour and nutrition Chapter 9 Overall adult labour force participation The impact of cash transfers on savings, investment One of the various outcomes we are interested in is whether the receipt of a cash transfer affects and production the labour force participation of adults in the household. Impacts and our interpretations of them may well differ between adults that we might consider to be of ‘working age’ and more elderly Chapter 10 individuals, so where the results allow us to distinguish between them, they are differentiated in The impact of the discussion below. cash transfers on employment 14 studies were found to report on the overall effect of cash transfers on adult labour force Chapter 11 participation (see Table 10.3 at the end of the write-up for this section). Among them, many The impact of reported separate results on working-age adults (9), two report effects on elderly adults, three cash transfers on report on all adults (e.g. aged 18–80), and two report on all individuals within a household. empowerment adults of working age Among the nine studies reporting on , four found statistically significant SECTION III impacts, three being increases in participation and one a decrease. For five studies, including on Pakistan’s BISP, Honduras’s PRAF and Lesotho’s LCGP, results suggest that the transfers do not Chapter 12 affect labour market participation among adults of working age. Among the studies reporting Summary of significant increases, one of these concerns Kazakhstan’s BOTA transfer on single-parent findings and conclusion main carers of children, where, while they reduced participation in self-employment (by four percentage points) they increased participation in paid employment (by around ten percentage References points) (O’Brien et al., 2013). This arguably represents a shift to a somewhat more secure and reliable income source, and an increase in labour force participation of those adults that did

183 Cash transfers: what does the evidence say? Page 183 Contents not work previously (possibly because children can now attend pre-school, which is an explicit Acknowledgements conditionality of the BOTA transfer). Executive summary As for the other two significant increases in labour participation among adults of working age, these were found to result from the Dominican Republic’s SP (Canavire-Bacarreza and Vásquez- Ruiz, 2013) and Colombia’s Familias en Acción (Barrientos and Villa, 2013). In the case of the SECTION I former, both those aged 15–24 and 25–64 saw an increase in the likelihood of working by six Chapter 1 percentage points and three percentage points respectively. Labour participation in Colombia Introduction increased to the magnitude of around nine percentage points. Chapter 2 The reduction in labour force participation was found in response to South Africa’s Old-Age Conceptual Pension, where resident members of a pensioner household saw a small reduction in the likelihood framework of working of around three percentage points (Ardington et al., 2009). This reduction in labour Chapter 3 force participation of working-age adults may be described as an unintended effect of cash Review of cash transfers, though further analysis would be needed to uncover what is happening here. transfer reviews Among the two studies reporting on labour participation of elderly adults , just one reported a Chapter 4 Methods significant effect, which was a reduction in pensioners working for pay in the preceding week by around five percentage points (Galiani et al., 2014). Chapter 5 The evidence base The two studies focusing on impacts on all adults, and also those reporting on labour participation of all individuals within the household, found no significant effects. SECTION II Sex-disaggregated impacts on adult labour participation Chapter 6 The impact of cash transfers on We also consider the sex-disaggregated impacts on adult labour participation. Full results are monetary poverty reported in Table A5.5.1 in Annex 5. 17 studies reported sex-disaggregated overall cash transfer effects on adult labour participation from a wide range of programmes. Among them, seven find Chapter 7 at least one statistically significant impact among women, with results appearing to suggest quite a The impact of heterogeneous range of effects, with no immediately obvious overall pattern. cash transfers on education Nevertheless, there were a number of clear differences in the way cash transfers affected overall Chapter 8 labour participation of women compared to men. For example, while Ardington et al. (2009) The impact of cash found South Africa’s Old-Age Pension to have led to a decline in the probability of overall work transfers on health among male adults living with pensioners (a five percentage point reduction), no significant effects and nutrition 130 However, when the analysis includes non-resident prime-age members were found for women. Chapter 9 (labour migrants), they find no statistically significant effect on the probability of employment The impact of for either men or women and, in fact, the presence of a pensioner is significantly associated with cash transfers on labour migrant status for both men and women. savings, investment and production In Pakistan’s BISP UCT, a significant reduction is recorded in the proportion of working-age Chapter 10 men engaged in economically productive activities, while there is no impact on the labour The impact of participation of women (Cheema et al., 2014). The evidence presented in the study suggests cash transfers on that the result for men is driven by vulnerable household members – the old/retired and sick – employment reducing their labour participation. Chapter 11 The impact of There were also differential impacts in Lesotho’s CGP, which appears to have led to an increase cash transfers on in labour participation among women (around eight percentage points), with no significant effect empowerment on men (Daidone et al., 2014). Parker and Skoufias (2000) find relatively little or no impact overall of Mexico’s PROGRESA on SECTION III male and female labour participation, though they did find in the latest follow-up an increase Chapter 12 in the probability of working of around four percentage points for older women (above the age Summary of of 55), and smaller marginally significant increases for men aged 35–54. It is noted that the findings and conclusion References 130 O ne reason the study by Siaplay (2012) on the same intervention did not make the same finding may be that it restricts the analysis to younger adults (21–26 years old).

184 Cash transfers: what does the evidence say? Page 184 Contents magnitude of effects for men reflect the already high pre-programme participation of men in Acknowledgements the labour market and that, unlike other programmes where transfers are defined on the basis of income (meaning if individuals earn extra income their benefits are reduced), PROGRESA Executive summary provided benefits to families for three years irrespective of family income, limiting a disincentive effect on adult labour. They do note, however, that if beneficiaries perceived that they would be included or excluded from further benefits after the three years based on how ‘poor’ they SECTION I appeared, this could have implications for future work effort and reported work effort and so Chapter 1 they called for studies to continue monitoring longer-term employment effects. Introduction Another three studies on PROGRESA/Oportunidades that disaggregate by gender did not Chapter 2 find any significant effects, which might be explained by differences in the analytical and Conceptual methodological approaches. Interestingly, however, the study by Behrman and Parker (2013), framework which did look at longer-term effects of PROGRESA/Oportunidades, found that it led to Chapter 3 relatively small but significant increases in the proportion of both men and women working in an Review of cash activity contributing to household income after six and a half years; an increase of 10 percentage transfer reviews points for women and four percentage points for men. It is hypothesised that the increase in labour market participation by women may be partly explained by the finding of an improvement Chapter 4 Methods in women’s health (being able to carry out vigorous activities) and the fact that women began with very low rates of market participation. Chapter 5 The evidence base Barrientos and Villa (2013) also found statistically significant increases in adult labour force participation among both women and men arising from Familias en Acción. The level of effects SECTION II was fairly similar between them, at 8% for young adult men and 11% for single females with young children. Chapter 6 The impact of cash transfers on Intensity of overall adult employment monetary poverty Table 10.4 at the end of this chapter summarises the overall effects on the intensity of work among Chapter 7 adult beneficiaries. A total of 11 studies were identified reporting on the intensity of work among The impact of adults overall, covering 11 interventions, with six studies associated with statistically significant cash transfers on education effects. Three of these three studies represented a reduction in overall time worked and three studies an increase. Chapter 8 The impact of cash Looking into the results more closely, Bazzi et al. (2012) only find a statistically significant transfers on health reduction in hours worked for those who received their first disbursement, and were awaiting and nutrition their (delayed) second transfer. No significant effect was found for those who had received two Chapter 9 disbursements, with the authors suggesting that this could be due to a household altering its The impact of labour supply in anticipation of receiving a further transfer in the future, and that this may have cash transfers on been difficult to change in response to the delayed receipt of their second quarterly transfer. savings, investment and production Daidone et al. (2014a) found Lesotho’s CGP to reduce hours worked in any labour by 2.8 hours in Chapter 10 the previous week, with much of this seeming to be due to a reduction in casual wage labour. The impact of cash transfers on Kassouf and Oliviera (2012) find that Brazil’s BPC social pension led to a reduction in hours employment worked, but by elders (over 65 years old), suggesting that the pension enabled elderly householders Chapter 11 to retire and reduce the time spent in active work. The impact of cash transfers on One of the interventions in which an increase was found on the intensity of overall adult labour empowerment supply was for Uganda’s YOP, which appears to have led to an increase of approximately 20 hours per month, increasing to 25 hours per month after four years (Blattman et al., 2012; 2013). The authors of the studies find that the increase is entirely in market activities, with no change in SECTION III subsistence production, and also reflects a shift towards skilled and market work. As noted above, Chapter 12 however, this intervention differs substantially from the other cash transfer programmes reported Summary of here, in that the programme provided young women and men with large grants specifically to start findings and a new vocation or enterprise and, while the programme targeted poor youth, it incorporated those conclusion who had a minimum capacity to benefit from vocational training and so not the very poorest. References

185 Cash transfers: what does the evidence say? Page 185 Contents The other programme that led to an increase in overall hours worked was another enterprise grant Acknowledgements programme in Uganda – WINGS – providing large one-off grants for enterprise development, which led to an average increase of 9.4 working hours per week 16 months after receipt of the Executive summary grant (Blattman et al., 2015). SECTION I Sex-disaggregated effects on intensity of adult work Chapter 1 A full list of the sex-disaggregated effects on the intensity of work among adult beneficiaries can Introduction be found in Table A5.5.2 in Annex 5. 10 studies are covered, with all but two finding at least one Chapter 2 statistically significant impact. Again, no clear gender-related patterns emerge overall and the Conceptual effects appear to constitute a mixture of increases and decreases in overall work intensity. framework Uganda’s YOP is found by Blattman et al. (2012; 2013) to have led to a significant increase in Chapter 3 hours worked by both men and women, with larger impacts on hours worked among females Review of cash transfer reviews (though the differences are not statistically significant). As shown in the tables on impacts of design and implementation features on adult work (see Table A5.2.10 in Annex 5), the effects also Chapter 4 increase over time for females after the end of the programme. Again, it should be noted that this Methods programme explicitly aimed to increase employment among young adults, and provided a large transfer and support to facilitate this. Chapter 5 The evidence base Alzúa et al. (2013) report on three programmes in Latin America, but the only significant effect on the intensity of work is for female beneficiaries of Mexico’s PROGRESA, for whom they find SECTION II being a beneficiary led to a small increase of 0.18 hours per week. The authors note that these among working women, and are compatible with the idea that female beneficiaries results are Chapter 6 The impact of have more time available than previously because of the increase in children’s school enrolment cash transfers on documented for PROGRESA. monetary poverty They explain the negative effects on working time as resulting from the requirement of having to Chapter 7 take children to school, taking on chores previously carried out by children, or simply enjoying The impact of more leisure time due to the increase in income. However, they also explain the increase in cash transfers on education work time of urban mothers as a result of their finding that beneficiary children were less likely to work in the labour force, and therefore had more time to spend on other activities besides Chapter 8 school, including chores, which means mothers may be able to spend more time in the labour The impact of cash force. In explaining the differences between urban and rural mothers, the authors note that the transfers on health effect of the CCT on child labour is negative in both areas, so we might expect an increase due and nutrition to higher involvement in home chores. The observed differences, they argue, may arise from the Chapter 9 fact that schools are closer to home in urban areas, allowing more time for chores. However, The impact of they acknowledge they cannot really explain why urban mothers and fathers appear to respond cash transfers on differently to the transfer. savings, investment and production Novella et al. (2012) report on the same three programmes as Alzúa et al. (2013) and, again, Chapter 10 find in most cases the impacts on adult labour hours to be small and statistically non-significant. The impact of Additionally, they do not find that the changes in labour supply are correlated with the size of the cash transfers on grant. As with Alzúa et al. (2013), they find a significant effect for Mexico’s PROGRESA, but, employment among men (around 2.1 hours per week) rather than for interestingly, find it to be an increase Chapter 11 women, as Alzúa et al. (2013) found. They also identify a significant reduction in hours worked The impact of among men as a result of RPS (2.9 hours per week), though the effect is not significant for women. cash transfers on empowerment In contrast to Novella et al. (2012), Rubio-Codina (2009) identifies a statistically significant reduction in hours worked among men attributed to Mexico’s Oportunidades (around 0.14 hours), which she notes is translated into an increase in leisure time, though there is no such SECTION III effect for women, who are found to be more likely to substitute for decreases in the house work Chapter 12 that children were doing before the intervention. Reasons for the difference with Novella et al. Summary of (2012) may be that those authors restricted their analysis to ‘couple households’. Rubio-Codina findings and also reports on hours spent in the day prior to interview (rather than weekly hours) and only uses conclusion weekday time-use information. References

186 Cash transfers: what does the evidence say? Page 186 Contents Ferro and Nicolella (2007) find that while Brazil’s Bolsa Escola/Bolsa Família did not affect Acknowledgements the work decisions of parents, it did change the amount of hours supplied by working parents. Contrasting findings for urban father and mothers benefitting from Bolsa Escola/Bolsa Família, Executive summary they found that the programme appears to have led to a reduction of 0.6 hours per week for working fathers, but an increase of 1.5 hours a week for working mothers. By contrast, in rural areas, the programme appears to reduce working hours of mothers by around 1.8 hours a week. SECTION I Chapter 1 Teixeira (2010) also found statistically significant reductions in hours worked resulting from Bolsa Introduction Família, though for both men and women (0.6 hours and 1.2 hours a week less respectively). They suggest the gender differences in levels may arise from women placing a higher value on their Chapter 2 time’s ‘shadow price’ (hours dedicated to housework activities), due to cultural norms around the Conceptual domestic division of labour, with women contributing more to domestic ‘production’ (including framework childcare, children’s education, housework, etc.). This is supported by their finding that female Chapter 3 beneficiaries increased housework activities. Meanwhile, the decrease in male working hours Review of cash appears to be converted into leisure time. transfer reviews By contrast, Ospina (2010) finds that Colombia’s Familias en Acción led to a significant increase Chapter 4 in hours spent in the previous day on paid work, but only for men. The estimated impact is an Methods increase of around 0.89 hours. The author explains this through identifying a cross-substitution Chapter 5 effect arising from a reduction in labour among boys, whereas hours of domestic work between The evidence base girls and female adults are estimated to be complementary, explaining why women did not increase paid work as men did. More broadly, they suggest the positive effects on paid work among men are probably due to a low-income elasticity of leisure for extremely poor households SECTION II (for which they find empirical support in their analysis). They also suggest the positive effect on Chapter 6 increasing school attendance may free time previously spent in childcare, therefore reducing the The impact of cost of working for adults. cash transfers on monetary poverty Sub-sector employment among adults Chapter 7 The impact of Overall adult participation by type of employment cash transfers on education Changes in overall participation or intensity can only tell us so much. Another important question Chapter 8 we are interested in addressing is whether the evidence points to an increase in participation in The impact of cash particular sectors, such as agricultural work or in skilled employment among adults of working transfers on health age. We found 12 studies reporting overall cash transfer effects on adult labour force participation and nutrition by sector or type of employment, with five of those finding at least one statistically significant Chapter 9 effect. A summary of the results is provided in Table 10.5. The impact of cash transfers on Overall, in just over half of the studies (seven), transfers did not significantly affect overall savings, investment participation in the specific sectors studied. Among those studies that did, there were increases in and production non-agricultural self-employment (Pakistan’s BISP, Uganda’s WINGS and Nicaragua’s Atención a Crisis), an increase in working for no pay among elderly pension recipients (Mexico’s PAAMZR) Chapter 10 The impact of and a reduction in paid work outside the household (the LCGP in Lesotho). cash transfers on employment engagement in small business/non-farm/self-employment With regard to work or , Blattman et al. (2015) find that WINGS (Uganda) led to a significant 40 percentage point increase in involvement Chapter 11 starting an enterprise non-farm self-employment in and to a 49 percentage point increase in The impact of 16 months after the grant. As noted previously, this programme was specifically focused on cash transfers on empowerment encouraging entrepreneurship, accompanied by substantial grants. Macours et al. (2012) also found a statistically significant increase in non-agricultural self-employment of around four percentage points, arising from Atención a Crisis in Nicaragua. SECTION III Cheema et al. (2014) find that Pakistan’s BISP is associated with a clear and significant reduction Chapter 12 in casual labour among working-age adults. Summary of findings and conclusion Alzúa et al. (2013) found that neither Honduras’s PRAF, Nicaragua’s RPS nor Mexico’s PROGRESA induced any significant shift in labour allocation to agricultural sectors at the References aggregate level. Similarly, no significant impact was found for RPS leading to an increase in small business activity (Maluccio, 2005).

187 Cash transfers: what does the evidence say? Page 187 Contents Asfaw et al. (2014) test whether the OVC-cash transfer (Kenya) led to some form of substitution Acknowledgements between wage labour and labour used on the recipients’ own farm. The results are not statistically significant: overall, the programme does not have a significant impact on the decision to Executive summary participate and supply labour supply on one’s own farm. own non-farm business Daidone et al. (2014a) find no significant effect of the LCGP (Lesotho) on SECTION I they also find that the transfer significantly reduces household but paid work outside the household Chapter 1 in the last 12 months, by three percentage points. They conclude ‘the CGP seems to have reduced Introduction the intensity of adult participation in paid occasional and irregular work, particularly piecework labour; generally considered to be a negative coping mechanism in times of hardship’. Chapter 2 Conceptual One study reports statistically significant shifts in participation by sector/type of work for older framework individuals: Galiani et al. (2014) find that Mexico’s PAAMZR non-contributory old-age pension Chapter 3 to adults aged 70 years old and over led to an 6.1 percentage point increase in participation Review of cash , e.g. on a family farm or in a family business. This should be in work last week for no pay transfer reviews understood alongside the finding discussed above that the pensions allowed elderly beneficiaries in the programme to reduce their time spent in paid work. Chapter 4 Methods A further question of interest in terms of sector participation is whether there is any evidence of the Chapter 5 impact of cash transfers on the likelihood of working in the informal sector. De Holanda Barbosa The evidence base et al. (2014) investigate this in the context of the Bolsa Família (Brazil), and find a negative but non- . significant impact on the propensity of household heads occupying informal jobs SECTION II Sex-disaggregated effects on adult participation in work by sector/type of employment Chapter 6 The impact of Seven papers report sex-disaggregated effects on whether adults are working/not working by cash transfers on sector. Just two of these report any statistically significant result for women. A full set of results monetary poverty are provided in Table A5.5.3 of Annex 5. Chapter 7 The impact of The first significant female shift in participation by sector/type of employment is a very small, but cash transfers on significant, increase of around two percentage points for women aged 55 and above employed education in salaried work as a result of Mexico’s PROGRESA (Parker and Skoufias, 2000). Effects for women of other ages are not significant, nor are impacts in probability of participating in any self- Chapter 8 The impact of cash employment or family business. transfers on health and nutrition The other significant shift in participation among women by type of work is found by Daidone et al. (2014a), with elderly females from beneficiary households in the LCGP (Lesotho) reducing Chapter 9 business by around 14 percentage points and increasing by non-farm their participation in own The impact of cash transfers on the same degree their participation in own-farm agricultural activities. This could indicate that the savings, investment programme has allowed older women to make small investments in farming. This fits with some and production of the findings on investments in farming activities discussed in the previous chapter. Chapter 10 In all of the other studies, no significant changes were identified in women’s participation in The impact of cash transfers on specific sectors of employment or types of work. For example, Alzúa et al. (2013) found negative, employment but not significant, coefficients on women working in an agricultural occupation for PRAF, RPS and PROGRESA. Skoufias et al. (2013) also found that PAL (Mexico) had no significant effect Chapter 11 on the probability of rural women aged 18–60 at baseline working in agriculture or in non- The impact of agricultural activities. By contrast, men were found to have a significant five percentage point cash transfers on reduction in the probability of working in agricultural activities, and a 6.3 percentage point empowerment increase in the probability of working in non-agricultural activities. SECTION III Results from Galiani and McEwan (2013) for PRAF (Honduras) are broadly consistent with Aluza et al. (2013), generally finding no significant impact on working outside or working online Chapter 12 inside the home for women, and just a very small and marginally significant increase (less than Summary of findings and one percentage point) in the probability of men ‘only working inside the home’, which appears conclusion to be offset by a small decrease in work outside the home, though the coefficient for that is not significant. References

188 Cash transfers: what does the evidence say? Page 188 Contents For Pakistan’s BISP, Cheema et al. (2014) find that there is a substitution away from casual labour Acknowledgements and unpaid family help towards self-employment for men of working age. However, they do not report a similar effect among women of working age due to the low labour participation rates. Executive summary Overall adult number of hours worked by type of employment/sector SECTION I When it comes to changes in time allocation by sector or type of work, there is much stronger Chapter 1 evidence of significant change occurring. Of the 10 studies reporting on the overall impact of Introduction cash transfers on adult labour intensity by type of employment or sector, all but three find some significant impact. For a full breakdown of results, see Table 10.6. Chapter 2 Conceptual Reductions in wage labour were found in Kenya’s OVC-cash transfer (Asfaw et al., 2014), framework Lesotho’s CGP (Daidone et al., 2014) and Malawi’s SCTP (Covarrubias et al., 2012). All of these Chapter 3 may in fact represent positive developments in so far as the wage labour available for beneficiary Review of cash households in these cases is typically casual, low-paid and used as a coping mechanism. For transfer reviews example, Covarrubias et al. (2012) find that the SCTP led to a reduction of nearly five days per (casual labour) one year after starting to receive transfer, and a reduction of month spent on ganyu Chapter 4 Methods 3.8 hours after six months. Considering household heads worked on average 7.5 days per month at the baseline, this represents a sizeable impact. labour is a low-wage informal activity Ganyu Chapter 5 utilised by many households as a coping strategy in response to shocks, as well as during the The evidence base hungry season in Malawi. Improvements in household poverty or vulnerability would therefore ganyu be associated with reductions in work ganyu participation. A reduction in the intensity of SECTION II indicates an increased availability of the household for other activities, such as home-based agriculture. Chapter 6 The impact of Interestingly, Mochiah et al., (2014) find that Ghana’s LEAP led to a 32% increase in hours spent cash transfers on on paid employment, though Handa et al. (2014) find no significant impact on intensity of paid monetary poverty employment when looking at number of weeks worked. Chapter 7 The impact of Another set of significant impacts on changing intensity of work across sectors or types of work cash transfers on was found in the two enterprise programmes in Uganda – WINGS and YOP. Both significantly education increased time dedicated to labour, including market and skilled work, agricultural and non- agricultural work. Specifically, Blattman et al. (2013) find that the YOP led to a substantial increase Chapter 8 The impact of cash i - in the preceding four market activities ntensive work. They find time spent on in skilled or capital transfers on health weeks increased by 22 hours, with a 34 percentage point increase in current engagement in skilled and nutrition . The increase is entirely in market activities, with no change in subsistence production and work reflects a shift in occupational choice towards skilled and market work. Chapter 9 The impact of cash transfers on Meanwhile, Blattman et al. (2015) find that the WINGS programme led to a 3.5-hour increase savings, investment per week (16 months after receiving a grant). Time spent on farm agricultural hours in average and production activities rises from about 9.5 hours per week in the control group to about 13 among those benefitting from the grant. Most of this increase comes from increased hours caring for livestock, Chapter 10 as ownership of cattle, sheep, goats and pigs more than doubles. The programme also led to a The impact of cash transfers on non-agricultural activities per week. The authors find a large 5.9-hour increase in time spent on employment shift in occupation choice towards non-farm enterprise , mainly wholesale and retail trade, kiosks, and shops, but also including some services. As a result, non-farm hours of work in the treatment Chapter 11 group doubled compared to controls, rising from about five to 11 hours per week on average. The impact of cash transfers on For the PAAMZR non-contributory pension in Mexico, Galiani et al. (2014) find that elderly empowerment individuals (aged 70 and over) switch from former activities in paid work to work in family businesses . They find that beneficiaries reduced their participation in formal gainful employment SECTION III outside the home (by 2.6 hours a week) in favour of less stressful and demanding informal unpaid work within the household, which increased by 2.2 hours a week. The programme therefore Chapter 12 appears to be effective in allowing older poor people to exit the formal labour market. It should be Summary of findings and noted, however, that they did not completely retire, but instead continued to work in the delivery conclusion of unpaid services on family farms or in family businesses. Thus, the programme appears to be an effective tool for improving the living conditions of older people who are living in poverty. References

189 Cash transfers: what does the evidence say? Page 189 Contents Lastly, in line with the finding above of no significant effect with regard to informality, de Acknowledgements Holanda Barbosa et al. (2014) find that, in terms of intensity, Bolsa Família (Brazil) had a negative, but not statistically significant, impact on the proportion of working hours that Executive summary beneficiary households dedicated to informal activities. They conclude: ‘That is, if anything Bolsa- Familia shifts the supply of working hours to the formal sector. However, we cannot reject the hypothesis that all estimates may be zero at the 95% confidence level ... That is, we were unable to SECTION I identify any effect of Bolsa Família in the proportion of working hours of the household dedicated Chapter 1 to informal activities.’ Introduction Sex-disaggregated effects on work intensity by sector/type of employment Chapter 2 Conceptual Six studies reported number of hours worked by sector/type of employment for women. Three framework report at least one statistically significant result. A full summary of results is available in Table Chapter 3 A5.5.4 of Annex 5. Review of cash transfer reviews In terms of the , Daidone et al. (2014a) find that the number of hours on own crop and livestock LCGP (Lesotho) led to a reduction in own non-farm enterprise among elderly females of around Chapter 4 Methods 2.5 hours per week and an increase of around 3.6 hours worked on own crop and livestock. Among younger adult women no significant changes were found in intensity by type of work (e.g. Chapter 5 with the main changes emerging instead from men, who reduced hours worked in wage labour The evidence base by 5.2 hours a week), substituting part of that by increasing time spent on their own non-farm enterprises (30 minutes a week on average). SECTION II own-farm activity In Ghana’s LEAP, while Handa et al. (2014) find an increase in days on Chapter 6 among women, it is not statistically significant, unlike the results for men, with days increasing The impact of by 7.7 over the previous season, especially among smaller households (13 days). The authors also cash transfers on investigate impacts by sex of the household head and find that female-headed households saw a monetary poverty significant increase in female labour to own-farm activities of around nine days in the previous Chapter 7 season, with the effect again being much larger in smaller households (13 days). Asfaw et al. The impact of (2014) also report on changes in in own-farm labour and time spent on own crop and livestock cash transfers on Kenya’s OVC-cash transfer. However, the effects were not significant. education Two studies from Latin America find that transfers led to an increase in time spent on domestic Chapter 8 The impact of cash by women. Ospina (2010) finds that Familias en Acción (Colombia) led to a significant work transfers on health increase of around 0.27 hours. The author finds that males increased time spent on paid work and nutrition at the expense of domestic labour and that females increased domestic labour at the expense of leisure time. Ospina (2010) also observes that hours of domestic work between girls and female Chapter 9 adults of the household are complementary and that hours in labour market activities between The impact of cash transfers on males and boys are substitutes. These cross-substitution effects help explain the increased labour savings, investment supply in paid work for male adults and in domestic labour for female adults as a response to and production the CCT programme. She links this observed opposite behaviour (hours of paid work increase for male adults, and hours of domestic labour increase for female adults) to the fact that adults Chapter 10 could be substituting for hours of work of children in all work activities. For instance, there The impact of cash transfers on may have been a substitution between male adults and boys in income-generating labour, but a employment complementary relationship between women and girls in domestic labour. Rubio-Codina (2009) also finds a statistically significant increase in number of hours worked in domestic labour as a Chapter 11 result of Mexico’s PROGRESA/Oportunidades (around five percentage points among all women). The impact of cash transfers on Lastly, Blattman et al. (2012) find no differential effect on women compared to men in terms empowerment of time spent on market activities. The impact on hours spent on market activities is strongly significant, with an increase for men of around 20 hours over the preceding month and around 26 SECTION III hours for women. Chapter 12 Summary of C 10.3.2 hild labour findings and conclusion Having looked at impacts on adult labour, this section now considers the effects of cash transfers References on child labour, again looking at labour participation and intensity overall and within sectors, and by gender.

190 Cash transfers: what does the evidence say? Page 190 Contents Overall child labour force participation Acknowledgements 19 studies were identified as reporting on the effect of a cash transfer on overall child participation Executive summary in labour activities. Eight of these find statistically significant impacts, all of them representing a reduction in child labour. A summary of the results can be found in Table 10.7 at the end of this chapter. SECTION I Chapter 1 For example, Attanasio et al. (2010) found a 15 percentage point decrease in labour participation Introduction of urban children aged 14–17 (and a similar effect for urban children aged 10–13) arising from Colombia’s Familias en Acción. Other authors looking at Nicaragua’s RPS found smaller impacts, Chapter 2 for instance Maluccio and Flores (2005) found a five percentage point decrease in children aged Conceptual framework 7–13 working. Likewise, Galiani and McEwan (2014) find that PRAF (Honduras) reduced the likelihood of children working outside the home by three percentage points among beneficiary Chapter 3 households. Review of cash transfer reviews As with adult labour force participation, it is important to note that many of the estimated effects Chapter 4 are also not significant, suggesting that cash transfers do not always lead to behavioural responses Methods in terms of child labour activity. Among these, none of the three transfer programmes from sub- Saharan Africa reporting on child labour participation found any significant effect (Zambia’s Chapter 5 ZCGP, Lesotho’s LCGP and Uganda’s SAGE). The evidence base Sex-disaggregated effects of cash transfers on child labour participation SECTION II Of the 21 studies for which sex-disaggregated effects were identified on overall child labour Chapter 6 The impact of participation (see Table A5.5.5 in Annex 5), over half (13) report any statistically significant effect, cash transfers on and such impacts are generally negative for both boys and girls, with a few exceptions of small monetary poverty positive impacts among girls of between four to six percentage points (Alam et al., 2011; Behrman et al., 2011; Maluccio, 2005). Chapter 7 The impact of cash transfers on In the case of Pakistan’s PFSSP, the increase in participation in work is only among older girls and education may be due to the broad definition of work participation adopted by the study, which includes paid and unpaid work including that inside the home (Alam et al., 2011). Chapter 8 The impact of cash The increase in the likelihood of participating in work in Mexico’s PROGRESA/Oportunidades is transfers on health six percentage points (an increase of 20%), but is also only found among the oldest girls (aged 19– and nutrition 21 by the time of the survey) (Behrman et al., 2011). The authors note that this result is consistent Chapter 9 with the theory that cash transfers may help increase employment among older children, but that, The impact of as this particular group did not see a significant increase in school attendance, the transfers appear cash transfers on to have led to higher work participation among older girls through other channels, one possibility savings, investment being that older girls substitute in the labour market for their younger siblings, who did see an and production increase in schooling, and a reduction in work (for boys). Chapter 10 The impact of The positive impact for girls in Nicragua’s RPS was only found after two years, which may again cash transfers on be related to children being older (Maluccio, 2005). Also, as Dammert (2008) notes, with higher employment age, potential earnings increase and transfers may not be high enough to compensate for foregone Chapter 11 earnings. However, some programmes such as PROGRESA/Oportunidades provide higher The impact of transfers for older children in anticipation of such effects. cash transfers on empowerment There is also evidence from four studies of boys reporting statistically significant reductions in labour participation with no significant effect on labour participation for girls. Behrman et al. (2012) found significant negative reductions of around 10 percentage points among boys (aged SECTION III 6–20) in urban areas after two years of benefitting from PROGRESA in Mexico, while finding no Chapter 12 such effect for girls. Dammert (2008) makes the same finding in Nicaragua’s Atención a Crisis, Summary of with boys aged 7–13 at baseline reducing labour participation by around 14 percentage points, and findings and Lincove and Parker (2015) finding a 20 percentage point reduction among boys aged 12–13 due to conclusion Nicaragua’s RPS. In the case of Pakistan’s BISP, Cheema et al. (2014) find a significant reduction References in the proportion of boys aged 5–14 engaged in child labour, and no significant effect (though the coefficient is negative) on the proportion of girls in the same age group engaged in child labour.

191 Cash transfers: what does the evidence say? Page 191 Contents More generally, the evidence suggests girls typically experience lower reductions in child labour Acknowledgements as a result of cash transfers than boys. Exceptions include the increases in girls’ labour mentioned above and in Ferro and Nicolella (2007) which showed a larger percentage point reduction in Executive summary labour participation among rural girls (aged 11–15) than urban boys of the same age. Some explanations given for the higher impacts in reducing child labour among boys include SECTION I a lower proportion of girls working than boys (Behrman et al., 2012; Lincove and Parker, Chapter 1 2015; Ferro and Nicolella, 2007) and, in some cases, the definition of work being used not Introduction including non-remunerated work (e.g. chores in the household) (Dammert, 2008), which girls often tend to be more involved with than boys in many low and middle-income settings. In the Chapter 2 case of Pakistan’s BISP, Cheema et al. (2014) discuss the absence of an impact on girls due to a Conceptual combination of prevailing cultural norms and the type of activities in which girls are engaged. The framework most significant type of child labour in which girls are engaged is household chores, while boys Chapter 3 are more likely to engage in economic activities outside the home. The authors explain that, given Review of cash prevailing cultural norms regarding girls’ responsibilities and how the burden of household duties transfer reviews fall on girls, such results are unlikely to change without a corresponding change in cultural norms, which a cash transfer is unlikely to change in the short term. Chapter 4 Methods Lastly, Dammert (2008) looked at the effects of Nicaragua’s Atención a Crisis on child labour Chapter 5 participation for male-headed and female-headed households. They find that the programme has The evidence base less of a reduction on child labour among female-headed households (statistically different to male-headed households) and also on hours worked. The differences between male- and female- SECTION II headed households are, however, not different in the 2002 follow-up a year later (see Table A.5.5.11 in Annex 5). Chapter 6 The impact of cash transfers on Intensity of overall child labour monetary poverty Five studies were found to report overall effects on total hours worked among children (see Table Chapter 7 10.8 below). All found statistically significant reductions in the number of hours spent on work, The impact of ranging from -0.33 hours per week in Colombia’s SCAE (Barrera-Osorio et al., 2008), to -32 cash transfers on education minutes in the previous day in Morocco’s Tayssir (Benhassine et al., 2013). Attanasio et al. (2010) refer to hours worked in the previous day, dropping any children interviewed on a Sunday or Chapter 8 Monday and providing their overall effects separately for urban and rural areas. They find a range The impact of cash of reductions, from -0.64 among rural and urban 10–13-year-olds to -1.03 for urban 14–17-year- transfers on health olds. The one population for whom the reduction in overall hours worked was not statistically and nutrition significant was among rural 14–17-year-olds. Chapter 9 The impact of Attanasio et al. (2010) find that reduced time at work may be partly, but not fully, explained by cash transfers on increased time at school, depending on age and location. For example, for children aged 14–17 in savings, investment urban areas (and 10–13 in rural areas) over a quarter of the increase in time spent at school comes and production from time that would have otherwise been spent on work activities. Chapter 10 The impact of Del Carpio (2008) explains the significant negative impact on overall child labour intensity by cash transfers on virtue of the CCT representing ‘a tax on child labour, making it less appealing for parents to send employment their children to work’. Chapter 11 The impact of The studies on cash transfers in sub-Saharan Africa do not have significant impacts for labour cash transfers on force participation. empowerment Sex-disaggregated effects of cash transfers on child labour intensity SECTION III Eight studies reported on such outcomes relating to the sex-disaggregated effects on the intensity Chapter 12 of overall child labour. All but one found that cash transfers led to at least one statistically Summary of findings and significant reduction in the amount of time spent on child labour among boys and/or girls. In conclusion general, findings tend to suggest slightly larger impacts on intensity of overall work for boys compared to girls. This is typically explained by differences in the kind of work boys and girls References engage in, with boys tending to spend more time on paid labour activities on agricultural work. A full set of results can be found in Table A5.5.6 of Annex 5.

192 Cash transfers: what does the evidence say? Page 192 Contents Alam and Baez (2011) identify a reduction of just over six days per month (2.8 hours a day) spent Acknowledgements by girls aged 15–16 as a result of Pakistan’s PFSSP – a school stipend aimed at girls. No such effect was found when looking at a broader range of ages (12–19). The authors point out that this fits Executive summary with their hypothesis that younger cohorts of girls should see stronger impacts on education (and in turn child labour) due to this group of girls being exposed for longer, joining the programme when there was greater awareness of its existence, and the fact that only the younger cohorts had SECTION I the additional incentive of receiving cash transfers to enrol in high school. Chapter 1 Introduction In their study on Colombia’s SCAE, which was specifically designed to improve school attendance and enrolment and to encourage matriculation in tertiary education, Barrera-Osorio et al. (2008) Chapter 2 find a significant reduction in hours worked in the previous week for both boys and girls, with Conceptual the reduction slightly larger for boys (-0.62 hours versus -0.38 for girls), though these differences framework are not statistically significant. They suggest that the differences, however, are consistent with the Chapter 3 higher levels of engagement in paid work for boys than girls and that girls may have also reduced Review of cash the number of hours spent helping in the home (which was not measured). transfer reviews Del Carpio and Loayza (2012) again find a larger reduction for boys than girls arising out of Chapter 4 Methods Nicaragua’s Atención a Crisis, of -1.7 hours per week compared to -1.2, although the difference between them is again not statistically significant. The difference in levels, however, is explained Chapter 5 by the authors as a result of the fact that, in the households analysed, boys reduced their farm The evidence base work more than girls, while girls increased their skilled labour more than boys. In particular, this seems to be related to the programme design in that children in households that received an SECTION II additional ‘business grant’ seem to work one hour more in skill-forming activities than those who only received the basic grant, indicative of the business grant leading households to involve their Chapter 6 children in the new (typically commercial and retail) activities stimulated by the grant. The impact of cash transfers on Del Carpio and Macours (2009) also found significant reductions in intensity of child labour monetary poverty arising from Nicaragua’s Atención a Crisis, though with this effect driven by boys, whose Chapter 7 reduction in time spent on labour overall was statistically greater than girls’, by around 15 The impact of 131 This was seen to arise from an increase in school attendance. The overall percentage points. cash transfers on effect for girls was, however, not significant, except among younger girls (aged 6–9). It was education suggested that one of the reasons for this may be that, whereas for boys school and work may be substitutes (with boys working more in agriculture, which mainly occurs in the mornings at the Chapter 8 The impact of cash same time as classes), this is less often the case for girls. transfers on health and nutrition When looking at children from households which received a productive investment package in addition to the cash transfer in Nicaragua, Del Carpio and Macours (2009) find that, while Chapter 9 there were no significant effects overall for either boys or girls, younger girls did see a significant The impact of cash transfers on reduction in hours spent on ‘all work’, while older girls (10–15 years old) were significantly savings, investment increase more likely to see an in hours compared to younger girls (driven by an increase in non- and production agricultural activities and domestic activities), though the overall effect on older girls (calculated by adding the coefficient to that of the younger girls) ends up being around zero and not Chapter 10 statistically significant. The impact of cash transfers on employment Ferro and Nicolella (2007) only find statistically significant effects for Brazil’s Bolsa Escola/Bolsa Família for urban boys (aged 11–15); a reduction of around -2.4 hours per week once the decision Chapter 11 to work has been affected, while no significant effects on labour intensity are found for girls. The impact of cash transfers on A similar story of larger reductions in work intensity (paid or unpaid) for boys is found by empowerment Lincove and Parker (2015) in Nicaragua’s RPS. For example, among children aged 6–11, the programme led to a reduction of around -2.7 hours a week for boys, whereas the reduction was SECTION III just -0.49 hours a week for girls. They suggest that this reflects the higher initial incidence of child labour among boys, and their higher income elasticity in terms of labour supply, making Chapter 12 them more sensitive to the income effects of the transfers. Summary of findings and conclusion References 131 O lder boys (aged 10–15) experienced a statistically greater reduction than younger boys.

193 Cash transfers: what does the evidence say? Page 193 Contents Rubio-Codina (2009) finds a marginally greater reduction in overall work hours per day among Acknowledgements boys than girls (-0.10 versus -0.08) through Mexico’s Oportunidades, and for girls the reduction appears to have been driven by older girls (aged 12–17), for whom the author notes that child Executive summary labour tends to be typically higher than among younger age groups (which may partly explain the heterogeneous impacts on girls by age). SECTION I Dammert (2008) also looks at the effect on hours worked among children in male- versus Chapter 1 female-headed households in the context of Nicaragua’s Atención a Crisis, finding that children Introduction in female-headed households are significantly more likely to reduce hours worked by a greater amount than those in male-headed households. There are no significant differences between both Chapter 2 types of households by 2002. Conceptual framework Sub-sector employment among children Chapter 3 Review of cash transfer reviews Overall child labour participation by sub-sector Chapter 4 Beyond looking at the effects on overall work, as with adult labour we also look at impacts on Methods participation in different sub-sectors. Eight studies report impacts on child labour participation by sector of work. Five papers report significant results, which can be found within Table 10.9. Chapter 5 The evidence base : Del Carpio (2008) finds Atención a Crisis Impact on physical and non-physical labour (Nicaragua) significantly reduced child labour among 8–15 year-olds and led to an increase in SECTION II non-physical labour. Chapter 6 The impact of Domestic work and work outside the household : Covarrubias et al. (2012) find that the SCTP cash transfers on (Malawi) led to a significant reduction in domestic work outside the household and in paid monetary poverty domestic work outside the household. Involvement in domestic work outside the household, paid and unpaid, fell by 7%. Although there is evidence of reductions in child labour outside the Chapter 7 household, the time freed seems to be replaced with greater involvement in within-household tasks. The impact of cash transfers on education Edmonds and Schady (2008) document that the randomised increase in income brought about by the BDH (Ecuador) is associated with increased schooling and decreased work for pay in those Chapter 8 most vulnerable to transitioning from school to work. Children aged 10 and above who receive the The impact of cash additional BDH transfer income are less likely to engage in market work, work for pay or unpaid transfers on health market work. They are more likely to work in domestic work (though coefficient shows positive and nutrition but no significant impact on children 10 or older doing domestic work). The impact of actually Chapter 9 receiving the BDH, correcting for the endogeneity in this decision, suggests that receipt of the The impact of BDH reduces market work by 24 percentage points, or just under 50%. The decrease in work for cash transfers on pay and increase in schooling, relative to the control population, are largest for girls. savings, investment and production Galiani and McEwan (2013) show that PRAF (Honduras) decreased the proportion of children Chapter 10 who worked outside the home by three percentage points (or 30%), and decreased the proportion The impact of who worked inside the home by four percentage points (or 29%). Boys drive the full-sample effects cash transfers on on work outside the home. Girls drive the full-sample effects on work inside the home. employment Chapter 11 Covarrubias et al. (2012) find no significant impact associated with Malawi’s SCTP on the The impact of probability of children working in non-household income work or in family farm/non-farm cash transfers on business. Daidone et al. (2014a) find no significant impact of the LCGP (Lesotho) on children’s empowerment participation in any sector working/not working. They find that for children aged 5–18, the LCGP has not had any impact on children’s work, in either paid or unpaid activities. In a different study on the ZCGP (Zambia), Daidone et al. (2014b) find that, overall, the programme did not have any SECTION III impact on the work of children (aged 5–18), in either paid or unpaid activities. Chapter 12 Summary of Labour participation by sub-sector among girls findings and conclusion Eight studies report estimates of the impact of cash transfers on girls’ work by sector/type of References employment. Five report significant effects. The results of the studies are summarised in Table A5.5.7 in Annex 5.

194 Cash transfers: what does the evidence say? Page 194 Contents Parker and Skoufias (2000) distinguish between Probability of working on salaried work: Acknowledgements participation in salaried and other work activities (other work activities principally include self- employment and unpaid work activities such as working in a family business). For girls, the results Executive summary on participation in salaried or other work activities is affected to a greater degree by Mexico’s PROGRESA and vary substantially depending on the age group analysed. For girls aged 12–13, there are only significant reductions in the probability of participating in salaried activities. SECTION I Nevertheless, for girls aged 14–15, the reductions in work are apparently due to a reduction in Chapter 1 participation in other activities. Overall, it is difficult to say that one or another type of work is Introduction being affected to a larger degree than other types of work. Both types of work are clearly being affected under PROGRESA. Chapter 2 Conceptual Skoufias and Parker (2001) find that for boys, Market work, farm work and domestic work: framework PROGRESA led to a reduction in participation in domestic work, particularly for boys aged 14 Chapter 3 and over. With respect to farm work, whereas all the coefficients are negative, none are significant Review of cash at conventional levels, implying there is no evidence that participation in farm work for boys is transfer reviews reduced with PROGRESA. Results show few impacts of PROGRESA on reducing market work for girls, with the exception of the group of girls aged 14–15, where participation in work is Chapter 4 Methods significantly reduced, although there is no impact on hours. The largest reductions in work for girls correspond to the reductions in domestic work, particularly for girls ages 14 and over, which Chapter 5 show reductions in participation in domestic work of about 10%. The evidence base Edmonds and Schady (2008) find that BDH (Ecuador), has a significant impact, reducing work SECTION II participation of girls aged 10 and above in market work and unpaid work, though no significant impact on work for pay. Chapter 6 The impact of Miller and Tsoka (2012) find that in the evaluation of SCTP (Malawi), between baseline and cash transfers on endline, there was an 8–11 percentage point difference in the proportion of both boys and girls monetary poverty doing household chores in intervention versus comparison households. They were both more Chapter 7 likely to engage in household chores and less likely to work outside the home compared with non- The impact of recipient children. The larger percentage of intervention young people doing chores is probably cash transfers on due to the increase in the number of household activities in intervention households, such as education shopping, food preparation and tending gardens. However, chores and family work did not appear to interfere with school enrolment, given that enrolment rates did not fluctuate based on whether Chapter 8 The impact of cash children did chores. Moreover, transfers may have enabled children to switch from work outside transfers on health the household (for cash) to household chores that did not interfere with schooling. Significant and nutrition decrease in income-generating activities in Malawi (12–10 percentage point difference for girls and boys respectively). Schultz (2004) finds that PROGRESA (Mexico) led to a significant reduction in Chapter 9 the percentage of girls working in market and household and a higher reduction among secondary The impact of cash transfers on school girls (-46.3%) compared with primary school girls (-14.8%) – a slightly higher reduction savings, investment than for boys among secondary school girls. and production At the same time, Galiani and McEwan (2013) find no impact of PRAF (Honduras) on girls ‘only Chapter 10 work inside the home’ though the coefficient is negative. Daidone et al. (2014a) find that the The impact of cash transfers on LCGP (Lesotho) has no significant impact on girls’ participation in paid work outside household, employment own non-farm business, own agricultural activities. Daidone et al. (2014b) find that the ZCGP (Zambia) had no impact on girls’ paid work and unpaid work. Chapter 11 The impact of Lastly, Behrman et al. (2011) find no significant effect of PROGRESA/Oportunidades on girls’ cash transfers on participation in agriculture after 5.5 years, which contrasts with a significant reduction of nine empowerment percentage points for boys aged 15–16 (a percentage change of 26%). This is partly explained by the much lower participation of girls in agricultural labour, with the authors highlighting that the SECTION III significant increase in work overall for older girls is driven by increasing non-agricultural work. Chapter 12 Overall number of hours worked by children by type of work Summary of findings and conclusion Four studies report overall effects of cash transfers on number of hours worked by children in different sectors, among which three report statistically significant results (see Table 10.10). First References of all, Handa et al. (2014) find no significant effect on number of days spent on farm/unpaid family labour among children in LEAP (Ghana).

195 Cash transfers: what does the evidence say? Page 195 Contents Among the significant changes to time allocation, the main theme was one of either increasing or Acknowledgements time spent on family farm/non-farm enterprise work decreasing . In the case of Indonesia’s PKH, the programme was not associated with any significant change in wage work overall, though the Executive summary programme did lead to an increase in time spent on family enterprises: approximately two hours (over the preceding week) for 7–12 year-olds and almost three hours for 13–15 year-olds (World Bank, 2011). As the programme was not effective in keeping children in school, it is perhaps not SECTION I surprising that the programme did not significantly reduce child labour either. Chapter 1 Introduction Meantime, Covarrubias et al. (2012) find that Malawi’s SCTP did lead to a reduction in hours the household – by around quarter of an hour – though the spent on domestic work outside Chapter 2 results suggest that the time freed up was replaced with greater involvement on tasks the within Conceptual household. Transfers were not associated with increases in leisure time, but were associated with framework more hours spent participating in family farm/non-farm business activities (similar to the PKH Chapter 3 above). The authors explain this finding by saying that some children appear to have been pulled Review of cash into domestic tasks that were previously performed by adult household members, who shifted transfer reviews their own allocation of time over to household on-farm activities, arising from new investments in tools and livestock. The reduction in children participating in paid and unpaid work outside the Chapter 4 Methods household is explained by the authors as reflecting the increased liquidity arising from the transfer, which allowed some children to be pulled from working outside the household into similar tasks Chapter 5 in their own households, as well as household agricultural work. The evidence base In contrast to the above two studies, Daidone et al. (2014a) find that the LCGP (Lesotho) SECTION II decreased hours worked in preceding week on own crop and livestock activities, but had no effect on hours worked on own enterprises or on paid labour. non-farm Chapter 6 The impact of These results highlight the importance of looking at children’s overall time allocations when cash transfers on considering impacts on child labour as, although there may be changes to work outside the monetary poverty within the household. household, there can also be shifts in time allocation Chapter 7 The impact of Intensity of child work by sub-sector for girls cash transfers on education Seven studies report estimates of the impact of cash transfers on number of hours worked for girls. Four report significant findings. The full set of results can be found in Table A5.5.8 in Annex 5. Chapter 8 The impact of cash transfers on health Del Carpio and Loayza (2012) find that Atención a Crisis (Nicaragua) led to a significant and nutrition reduction in girls number of hours worked on household chores and to a reduction in girls’ farm labour and an increase in skilled work; they find that the programme increased the number of Chapter 9 hours of girls on skilled labour by 0.5 hrs per week. The impact of cash transfers on savings, investment An evaluation of the same programme by Del Carpio and Macours (2009) find that it led to and production an increase in number of hours worked in non-agricultural work for girls (a bit less than for boys), a reduction in agricultural work and a reduction in domestic work. The results also show Chapter 10 that households that randomly received a productive investment grant, in addition to the basic The impact of cash transfers on conditional cash transfer benefits, both targeted at women, show an increased specialisation of employment older girls in non-agricultural and domestic work, but no overall increase in girls’ child labour. Chapter 11 The paper also finds that the programme helped compensate for some of these intra-household The impact of differences, but exacerbated others. In particular, it reduced total hours worked more for older cash transfers on boys, and for boys with low past academic achievements. Both child labour in all economic empowerment activities and total child labour fell more for boys than for girls, leading to a reduction of the gaps in total numbers worked with 1.5 hours. When accounting for heterogeneity by age when SECTION III considering gender differences in impact, it becomes clear that the reductions in agriculture, livestock, domestic work and total work are particularly large for older boys, when compared to Chapter 12 their siblings. In contrast, the impact on child labour allocation for older girls does not seem to Summary of findings and be bigger than for their younger sisters, and there was some indication of an increase in domestic conclusion work, relative to their younger sisters. Yet, in terms of total hours worked the impact for girls does not increase or decrease significantly as age increases, which contrasts with the results found for References boys.

196 Cash transfers: what does the evidence say? Page 196 Contents Finally, Rubio-Codina (2009) finds that PROGRESA (Mexico) led to a reduction in the number of Acknowledgements hours on domestic work among girls and that this effect was higher for girls aged 12–17 compared with younger girls aged 9–11. Somewhat in contrast, the World Bank (2011) finds that the PKH Executive summary (Indonesia) led to an increase in number of hours worked for girls (aged 7–12) in family enterprise work. Daidone et al. (2014a), however, find that the LCGP (Lesotho) had no significant effect on girls’ sector of work. SECTION I Chapter 1 Introduction 10.3.3 igration M Chapter 2 As outlined in the conceptual framework, access to social protection can increase or decrease the Conceptual likelihood of migration. On the one hand, access to a social protection programme may render framework the need to migrate obsolete, if remittances and social protection benefits are viewed as substitutes Chapter 3 by potential migrants. On the other hand, migration and social protection could be seen as Review of cash complementary strategies by prospective migrants, with the cash obtained from receiving a social transfer reviews protection transfer being used to finance migration. Chapter 4 Three studies report the overall effect of cash transfers on migration and two studies report sex- Methods disaggregated findings. Of the 11 effects reported, four are statistically significant (Tables 10.9 Chapter 5 below for the overall effects and Table A5.5.9 in Annex 5 for the sex-disaggregated effects). The evidence base Looking at overall effects, of the two studies to find significant results, one finds a positive effect and the other a negative effect. Ardington et al. (2009) find that the Old-Age Grant in SECTION II South Africa increased the likelihood of household members (including non-residents) migrating Chapter 6 within the country. Stecklov et al. (2005) find that participation in Mexico’s PROGRESA led to The impact of a statistically significant decrease in the probability of moving to the US, but find no statistically cash transfers on significant impact for internal migration. Winters et al. (2009) find no significant impact for monetary poverty Nicaragua’s RPS. This evidence is consistent with the results from other reviews on this topic. Chapter 7 The impact of In terms of gender, Ardington et al. (2009) find positive and statistically significant effects on cash transfers on internal migration for both male and female household members, with the impact on men being education marginally larger (5.1 percentage points for men, compared to 3.4 percentage points for women). Behrman et al. (2009) find a positive impact for boys and a negative impact for girls for Mexico’s Chapter 8 Oportundidades. However, for girls, the only impact that is statistically significant is for the 9–10 The impact of cash transfers on health age group, which shows a 3.5% point decrease in internal migration. The authors argue that this and nutrition fl e gender difference could re ct a greater tendency for boys to migrate for work and for girls to migrate for marriage – the implicit assumption is that participation in Oportundidades has kept Chapter 9 girls in schools and out of early marriages. Chapter 11 considers the link between access to the The impact of transfer and marriage more closely. cash transfers on savings, investment and production he role of cash transfer design and implementation features T 10.4 Chapter 10 The impact of cash transfers on I mpacts on adult labour 10.4.1 employment Chapter 11 The full set of results for the impacts of design and implementation features on adults may be The impact of found in Table A5.5.10 in Annex 5. cash transfers on empowerment Official recipient SECTION III Siaplay (2012) looks at differences between only-male-household members receiving South Africa’s Old-Age Pension versus only-female-household members receiving the pension in terms Chapter 12 of impacts on young adults (aged 21–26). The results indicate significant impacts on males living Summary of findings and within the OAP households, though there are important differences between the two. Those conclusion living with female pensioners seem to reduce the probability of labour force participation by about 19 percentage points, yet when qn only-male-household member receives the old-age pension it References increased the probability of labour force participation (by around 14 percentage points). These differences are not explained by the authors, however.

197 Cash transfers: what does the evidence say? Page 197 Contents Timing of transfers Acknowledgements Bazzi et al. (2012) exploit the random staggered roll-out of an Indonesian UCT as a result of Executive summary delays in disbursement to identify the effect of variation in timing (and cumulative magnitude) of transfers received. Whereas the timely receipt of a second transfer by early 2007 had no effect on weekly work hours per adult, the delayed receipt is associated with a decline of 2.3 hours, which is SECTION I economically meaningful given a baseline mean of 22 hours worked per adult. Chapter 1 Introduction The authors suggest the following potential explanation: ‘in early 2006 households had re- optimised their labour supply to a lower level in anticipation of receiving transfers at a given date Chapter 2 in the near future. Insomuch as those decisions had persistent effects (e.g. previously declined Conceptual framework positions were already filled), it may have been difficult for households to increase their labour in response to the delayed receipt of the second quarterly transfer.’ Somewhat puzzling, though, is Chapter 3 that a similar finding is made in 2007, several months after a second transfer had been received, Review of cash suggesting to the authors long-run consequences of differential timing of receipt. transfer reviews Chapter 4 Duration of exposure Methods Chapter 5 Of the four studies looking at the role of transfer duration, three find significant employment The evidence base effects on adult labour. Buser et al. (2014) investigated the effect of being a long-term transfer recipient in Ecuador’s SECTION II BDH versus being one that lost their transfers around two years ago on the number of hours that mothers worked. They found that those who continued to benefit worked an additional 8.4 hours Chapter 6 The impact of (no reference period is given). cash transfers on monetary poverty Behrman and Parker (2013) investigate the differential impact of being a beneficiary in PROGRESA/Oportunidades, reporting outcomes by gender among adults aged 50 or older at the Chapter 7 beginning of the programme. They find that while an additional 1.5 years’ exposure increases by The impact of cash transfers on five percentage points the proportion of older women working in the previous week in an activity education contributing to family income, there is no differential effect for older men. Chapter 8 A number of other studies reporting on more than one follow-up period allow for some insights The impact of cash into differential impacts over time. As noted above, Bazzi et al. (2012) find statistically significant transfers on health reductions in the weekly hours worked per adult relating to a temporary UCT in Indonesia (but and nutrition not for those who had received both disbursements on time). In terms of duration, however, Chapter 9 they find that the effect on labour supply increases in size over time, with the reduction in hours The impact of increasing from -1.8 hours a week to -2.3. cash transfers on savings, investment In all of the impacts on hours worked in the past week resulting from Nicaragua’s RPS, Maluccio and production (2005) finds no significant differences either one or two years after baseline. Chapter 10 The impact of cash transfers on Transfer level employment Four studies reviewed tell us something about the role of transfer levels in affecting the chosen Chapter 11 adult employment indicators. Three of these suggest that, as expected, the level of transfer does The impact of play a role in mediating outcomes, generally with higher transfers strengthening the observed cash transfers on empowerment impacts. Bertrand et al. (2003) estimate the impact of transfer levels in South Africa’s Old-Age Pension SECTION III and find that, among those aged 16–50 who live with age-eligible elderly individuals, higher individual incomes arising from the pension lead to a greater decrease in hours worked per week. Chapter 12 The estimated effect of a 100 rand increase is a reduction of 1.7 hours a week. This compares to Summary of findings and an average work week of 41 hours (among those that work) and the maximum benefit in the year conclusion when the survey data were collected was 370 rand per month, which was more than twice the median per capita income among African households in South Africa. References

198 Cash transfers: what does the evidence say? Page 198 Contents Looking at the sex-disaggregated effects, a higher pension income significantly reduces Acknowledgements employment rates and working hours among prime-age men, but only significantly reduces working hours among women. The reduction in working hours for women is around 1.3 hours per Executive summary week less for an increase of 100 rand in pension income. This contrasts with a reduction of around 2.2 hours per week for men. SECTION I Dabalen et al. (2008) look at the effects of increasing transfer levels from Albania’s NE Chapter 1 programme and find that the hours worked in the past week among adults decline in response to Introduction receiving transfers. As the analysis includes non-beneficiary households, the effects are not simply among those who received any transfers, and so incorporate an overall effect. They find that an Chapter 2 additional 100 Albanian lek results in a reduction of hours worked by around 6.7 hours. This Conceptual result appears to be particularly driven by women, with the impact not significant among male framework adults. While not discussing the effects of changes in transfer levels per se, the authors suggest Chapter 3 a disincentive effect is to be expected in the presence of widespread unemployment, inadequate Review of cash employment generation and a high degree of worker discouragement (i.e. in urban areas and transfer reviews among females). However, it is worth noting that two particular aspects of this programme’s design could also potentially have led to under-reporting of employment (or even discouraged Chapter 4 Methods it), with eligibility depending upon the heads of households being unemployed and the level of transfers received also depending upon reported earnings. Chapter 5 The evidence base Bazzi et al. (2012) investigate the effect of variations in Indonesia’s short-term (2005–2006) UCT transfer levels on weekly hours worked per adult within a households, but find no significant SECTION II effects. Chapter 6 In the same study in which Angelucci (2004) investigated the impacts of conditions on migration, The impact of she looks at the effect of receiving higher or lower transfers. She finds that the receipt of higher cash transfers on transfers versus lower transfers in PROGRESA leads to a significant increase in US migration, and monetary poverty a significant reduction in domestic (Mexican) migration. Chapter 7 The impact of Conditionalities cash transfers on education One study by Angelucci (2004) investigates the role of conditionalities on adult labour in the Chapter 8 context of Mexico’s PROGRESA. Specifically, it looks at how conditions may have influenced The impact of cash labour migration. She finds fairly limited differences between households for which part of transfers on health their transfer is conditional upon school attendance versus those where the entire transfer is and nutrition unconditional. The main significant difference is for households where part of the transfers they Chapter 9 conditional, in which case it was less likely that someone from their household were receiving was The impact of would migrate to the US in 1999 (though no such effect was found in 1998). The differences cash transfers on between follow-ups is suggested to be due to the fact that more money had been distributed savings, investment by then and households had more time to respond to the new set of incentives provided by the and production programme. However, households with a higher proportion of conditional transfers were more Chapter 10 likely to show some migration to the United States than those with low to medium conditional The impact of grants (results not shown). cash transfers on employment Regarding domestic migration, there appear to be no significant differences between households Chapter 11 that have a low to medium proportion of CCTs versus those with only UCTS. However, those The impact of with a high proportion of CCTs were significantly less likely to migrate within Mexico in 1999 cash transfers on (results not shown). empowerment The explanation given for a higher proportion of conditions being linked to greater US migration relates to the presence of a cap on the maximum size of transfers, whereby households with a SECTION III number of eligible children, and so taking the household above the maximum subsidy level, Chapter 12 have their education grants re-scaled. The author believes, and finds some suggestive supporting Summary of evidence, that this may lower the monetary incentives to send children to school and instead raise findings and the incentives for migration. conclusion References

199 Cash transfers: what does the evidence say? Page 199 Contents Targeting Acknowledgements Only one of the studies reviewed – the midline evaluation of Uganda’s SAGE programme by Executive summary Merttens et al. (2015) – was found to provide insights on the differential impacts of different targeting mechanisms. For Uganda’s SAGE, one treatment arm – the Senior Citizen Grant (SCG) – used age to determine eligibility targeting those aged 60 or 65 and above, depending on the SECTION I region. Another treatment arm – the Vulnerable Family Support Grant (VFSG) – targeted on the Chapter 1 basis of a composite index based on demographic indicators of vulnerability. The study finds that Introduction impacts on the proportion of adults engaged in productive activities, casual labour and the average number of hours spent working were not significant for either group. However, the impact on the Chapter 2 mean number of months spent working in the past year was a significant increase of around half a Conceptual framework month, but only for those targeted using a vulnerability index. The differences between groups are not explained. Chapter 3 Review of cash transfer reviews Complementary interventions and supply-side services Chapter 4 Three studies reviewed provide insights into the effect of complementary interventions on adult Methods labour. Blattman et al. (2015) find no significant impacts from the WINGS enterprise grant Chapter 5 programme (Uganda) on a range of labour participation and labour intensity measures as a result The evidence base of receiving additional group training or additional supervisory visits. Closer inspection of the results does show that, although the test for statistically significant differences between different groups is not significant, when looking at the impacts on each of these groups individually (not SECTION II presented in Table A5.2.10 of Annex 5), some differences are recorded. For example, a statistically significant increase in average work hours per week of 4.8 for those receiving five supervisory Chapter 6 The impact of visits, with no significant effect for those receiving two. However, as the authors note, the cash transfers on supervisory costs represent a considerable expense given the limited difference in outcomes. monetary poverty Green et al. (2015) also report on the effects of a complementary component of the WINGS Chapter 7 programme, but explore the role of including women’s husbands (or another household member The impact of cash transfers on who is responsible for financial decisions) as joint participants in the programme. This variation education also involved them receiving basic training in couples’ communication and problem solving. However, while the overall effects of the programme led to a 94% increase in non-agricultural Chapter 8 employment hours (from five to 10 hours a week), the involvement of another household member The impact of cash had no significant effect on the same indicator. transfers on health and nutrition In contrast to the lack of significant differences found by Blattman et al. (2015), Macours et al. Chapter 9 (2012) found that, compared to receiving a basic transfer or a basic transfer plus a scholarship The impact of for vocational training in Nicaragua’s Atención a Crisis, those receiving a cash transfer plus a cash transfers on productive investment grant saw a considerably higher significant effect on non-agricultural self- savings, investment employment (increases of four percentage points compared to 13 percentage points). and production Chapter 10 The impact of 10.4.2 fects of design and implementation features on child labour Ef cash transfers on employment The full set of results for the impacts of design and implementation features on child labour may be found in Table A5.5.11 in Annex 5. Chapter 11 The impact of cash transfers on Official recipient empowerment The one study looking at the effect of official recipients on child labour outcomes is Siaplay SECTION III (2012), which does not find any significant effects on employment status for boys or girls (14–20 years old), regardless of whether South Africa’s Old-Age Pension recipient is male or female. Chapter 12 Summary of findings and Duration of exposure conclusion Six studies look at the role of duration of exposure on child labour outcomes, with three studies References on Mexico’s PROGRESA/Oportunidades finding that longer exposure leads to a greater reduction

200 Cash transfers: what does the evidence say? Page 200 Contents in child labour (specifically among boys), while one on Peru’s Juntos finds longer exposure Acknowledgements associated with higher likelihood of employment, and one on Nicaragua’s RPS finds a very small increase in girls’ participation only after the second year. The sixth study finds that significant Executive summary reductions in child labour participation arising from Nicaragua’s RPS that were observed in 2001 did not continue in the following year. SECTION I Behrman et al. (2011) explicitly test for differences in the likelihood of children working as a Chapter 1 result of PROGRESA/Oportunidades, depending on how long beneficiaries had received transfers. Introduction They find that the effect of an additional 1.5 years’ exposure on work participation five and a half years later significantly reduced the proportion of children (by then aged around 14–20) who were Chapter 2 working by 4.1% for boys, with no significant effects for girls (though the definition of work does Conceptual exclude domestic work, and so may underestimate impacts for girls). framework Chapter 3 These findings are consistent with result from an earlier study by Behrman et al. (2009). In the Review of cash earlier study, the authors also find that boys who were aged 9–15 in 1998 from households that transfer reviews started receiving transfers earlier were marginally more likely to have migrated by 2003 than those who received them a year and a half later (by two percentage points). A four percentage Chapter 4 Methods point decrease was found for girls who were aged 9–10 in 1998. Chapter 5 A third study involving Behrman and looking at impacts of Oportunidades in urban areas finds The evidence base significant reductions in urban boys being employed for pay, with the point estimate being slightly larger after two years compared to just one (Behrman et al., 2012). This pattern is also reflected SECTION II in the finding of Oportunidades only reducing the likelihood of boys overall (aged 6–20) being employed for pay after two years (around 10 percentage points), with no significant effect after Chapter 6 just one. The impact of cash transfers on Regarding Peru’s Juntos, Perova and Vakis (2012) find evidence that children aged 6–14, from monetary poverty households that benefited from the programme for longer, saw an increase in the likelihood of Chapter 7 working in the previous week. Those that had been exposed to Juntos for 24–36 months were The impact of three percentage points more likely to have worked than those who had benefited for under 12 cash transfers on months, while those who had been in it for over 36 months were 13 percentage points more likely education to have worked than those benefitting for less than 12 months. This could potentially be related to the increasing likelihood of children working as they get older, however. Chapter 8 The impact of cash transfers on health The main difference relating to duration of exposure found by Dammert (2008) is when looking and nutrition at impacts on labour participation among male- and female-headed households, where significant negative reductions for both arising from Nicaragua’s RPS found in 2001 do not continue into the Chapter 9 2002 follow up. The impact of cash transfers on savings, investment Maluccio (2005) reports a slight difference in effects among young girls working two years after and production baseline compared to one year afterwards in Nicaragua’s RPS, with a marginally significant increase of around six percentage points in the probability of them working after no significant Chapter 10 effect in the first year, though in coffee-growing areas there is a substantial decrease in the The impact of cash transfers on probability of girls working, which decreases further from year one to two (8–11 percentage employment points). Chapter 11 The impact of Conditionalities cash transfers on empowerment Three studies suggest that the presence or perception of conditions attached to transfers relating to school enrolment or attendance have had a significant impact in reducing the probability or intensity of child labour. One of these includes insights into the types of condition that may be SECTION III more effective in terms of employment outcomes. Chapter 12 Summary of In a comparison of effects of different types of transfer on child labour, Barrera-Osorio et findings and al. (2011) find that a basic transfer conditional on school attendance in Colombia’s SCAE, a conclusion savings treatment (postponing a bulk of the transfer to good attendance just before the child has References to re-enrol), and a transfer where part of it is conditional on students graduating and tertiary enrolment , rather than attendance, all have a significant effect in increasing school attendance

201 Cash transfers: what does the evidence say? Page 201 Contents and reducing the hours worked by young children (aged 6–10). However, the impact appears to Acknowledgements be strongest among those for whom the transfer is conditional on student graduation and tertiary enrolment. The authors suggest that this specific form of condition may, therefore, be the most Executive summary effective in furthering educational improvements (and in turn reducing child labour). Schady and Araujo (2006) look at the impacts of Ecuador’s BDH CCT on whether children SECTION I are either working or working full time (40 plus hours) and the number of hours worked, Chapter 1 disaggregated by whether the household believed that transfers were conditional upon school Introduction enrolment. While being in a household that did not believe there to be any conditions did not lead to any significant change in whether the child worked full time, those households that believed Chapter 2 there was a condition saw an eight percentage point decrease in the likelihood of their child Conceptual working full time, and the number of hours worked by a child was also lower by nearly six hours, framework compared to no significant effect for those not perceiving any condition. The differences between Chapter 3 the two groups on both measures was highly significant. Review of cash transfer reviews Benedetti and Ibarrarán (2015) exploit a particular design feature of Honduras’s Bono 10,000, in which beneficiary households with any number of children aged 6–18 were officially required to Chapter 4 Methods enrol one child in school, meaning that school-age children in larger families had relatively lower probabilities of being subject to the condition. They find that the interaction between treatment Chapter 5 and having just one school-age child leads to a significant reduction in the likelihood of working in The evidence base the previous week (six percentage points), whereas no significant effect was found when treatment was interacted with households containing more than one child, even after controlling for family SECTION II size. The authors take this to indicate a significant role of the conditions in reducing child labour participation. Chapter 6 The impact of cash transfers on Complementary interventions and supply-side services monetary poverty Evidence was extracted from two studies regarding the role of complementary interventions and Chapter 7 supply-side services, both from Nicaragua’s Atención a Crisis. Del Carpio (2008) find variations The impact of in a number of child labour measures between the different groups. For example, one of the main cash transfers on education findings is that children aged 8–15 from households that received a complementary business grant saw a significant increase in their weekly work hours in non-physical labour (6.3 hours), Chapter 8 while those from the basic cash transfer group and the group receiving complementary vocational The impact of cash training saw no significant increase. Hours spent on physical labour and overall work also only transfers on health saw a statistically significant reduction in the group receiving the transfer plus vocational training. and nutrition This seems to have been driven by boys rather than girls as, when broken down by gender, boys Chapter 9 saw significant reductions in overall hours worked for both the basic transfer group and the The impact of transfer plus vocational training group. cash transfers on savings, investment Another paper by Del Carpio and Macours (2009) does not compare results by the type of and production intervention, but focuses specifically on the combination of the basic cash transfer with the Chapter 10 productive investment grant to provide more of a breakdown of impacts by the type of work and The impact of age group. The main finding here is that, among those who received a productive investment grant cash transfers on in additional to the basic conditional transfer, there was an increased specialisation of older girls employment in non-agricultural and domestic work, but no overall increase in labour among girls. Chapter 11 The impact of cash transfers on P olicy implications 10.5 empowerment A key finding from the programmes and policies reviewed is that, of the studies which looked at impacts on adult labour participation and labour intensity, in each case less than half found SECTION III any significant impacts across all adults. Among those that did, the majority of studies finding Chapter 12 a significant effect found that the cash transfer interventions (including two CCTs from Latin Summary of America and one from Kazakhstan) led to increases in labour participation among working-age findings and adults. When looking at overall intensity of employment, among the significant results there were conclusion two reductions in overall time worked among working-age adults and positive impacts in labour References intensity arising from Uganda’s YOP and WINGS programmes.

202 Cash transfers: what does the evidence say? Page 202 Contents However, when interpreting the results it is crucial to differentiate between the range of different Acknowledgements adults, some reductions were found all programmes reviewed. For example, when looking across to arise in paid labour participation and time spent in paid work among the elderly in Mexico Executive summary and Brazil, as a result of the PAAMZR and BPC social pensions respectively. This should be interpreted positively, however, in so far as it shows that these social pensions have enabled the elderly to reduce their dependence upon paid work to meet their subsistence needs. Another key SECTION I distinction should be made when it comes to the increase in overall employment intensity observed Chapter 1 in Uganda’s YOP and WINGS programmes, as these were both providing substantial enterprise Introduction grants specifically designed to increase employment. While these examples help to highlight the potential that such enterprise-focused programmes may have for supporting improvements in Chapter 2 employment opportunities for specific groups, it must be recognised that they operate in a very Conceptual different way, and with a different cost-structure, to the other transfer programmes reviewed in framework this study, which instead provide regular transfers, typically for consumption smoothing and/or Chapter 3 inter-generational poverty reduction. Review of cash transfer reviews The evidence reviewed also suggests that cash transfers can lead to some changes in the allocation of labour across different sub-sectors, depending on the programme and local context. For Chapter 4 Methods example, in Lesotho’s LCGP and Malawi’s SCTP, reductions in paid work outside the household appeared to represent a trend of beneficiary households no longer needing to engage in casual Chapter 5 labour, typically used as a coping strategy by the poorest households (Daidone et al., 2014; The evidence base Covarribias, 2012). This was accompanied in the case of Lesotho with some increase in time spent on the household’s own non-farm enterprise, indicating the potential opening up of a SECTION II gradual sectoral shift out of casual labour. Ghana’s LEAP programme also led to an increase in the number of days spent by male beneficiaries on their own farm. As the previous chapter on Chapter 6 savings, investment and production highlighted, these programmes also led to increases in the The impact of accumulation of agricultural assets and/or inputs, which is obviously supportive of vulnerable cash transfers on households spending more time in self-employment and away from a dependence upon casual or monetary poverty exploitative labour. Chapter 7 The impact of As noted above, the evidence also points to cash transfers being able to reduce the need for cash transfers on vulnerable elderly individuals to engage in paid work, allowing them instead to dedicate time to, education for example, their own farm or non-farm business (Kassouf and de Oliveira, 2012; Galiani et al., 2014). Evidence from South Africa also highlights how the provision of old-age pensions is Chapter 8 The impact of cash likely to have important intra-household effects, which may include either an increase or decrease transfers on health in labour force participation among working-age household members, e.g. if they are no longer and nutrition forced to financially support their elderly relatives (Siaplay, 2012). Chapter 9 There was also no evidence of increases in informality. The only study that tackles this issue, The impact of cash transfers on studying Brazil’s Bolsa Família (De Holanda Barbosa et al., 2014), finds a negative but non- savings, investment significant impact associated with a head of household’s likelihood to work in the informal sector. and production Perhaps the strongest and most consistent message emerging from the evidence reviewed, however, Chapter 10 is that a number of cash transfer programmes have led to a consistent reduction in the likelihood The impact of cash transfers on and intensity of participation in child labour. In many programmes this has been associated with employment an increase in time spent in school (see Chapter 7 on education). However, an important point to note here is that these significant reductions appear to be driven by programmes in Latin Chapter 11 America (with the exception of one in Indonesia), and that none of the four studies reporting on The impact of child labour participation effects from a cash transfer programme in sub-Saharan Africa found cash transfers on any significant impact. This raises important questions as to whether these differences relate to empowerment particular programme design features (e.g. transfer sizes or conditionality and messaging). Further research in this area could prove useful for harnessing the full benefit of such interventions. SECTION III One of the implications of children reducing their labour participation, however, is that this may Chapter 12 leave adults within the household with more work to do around the house or, where relevant, in Summary of findings and agricultural activities. This may have important gender dimensions. For example, some trend was conclusion found in Latin America of increased time spent by women on domestic work arising from cash transfers (Ospina, 2010; Rubio-Codina, 2009), which may be explained by the opposite trend of References decreasing time spent on household chores among young girls in three programmes in the region (Del Carpio and Loayza, 2012; Del Carpio and Macours, 2009; Ospina, 2010; Rubio-Codina,

203 Cash transfers: what does the evidence say? Page 203 Contents 2009). Similarly in Kazakhstan there was evidence of an increase in labour market engagement Acknowledgements as a result of children accessing pre-school (one of the conditionalitis of the BOTA programme) (O’Brien et al., 2014). Executive summary Studies investigating the impact of design and implementation features on employment were limited, but provide a number of interesting policy insights. One of the main areas of evidence SECTION I covered the effect of size of transfers on adult labour, with the few studies finding higher transfers Chapter 1 to have some significant effects on adult labour, e.g. enhancing the reduction in hours worked Introduction among male and female adults living in old-age pension recipient households in South Africa (Bertrand et al., 2003) and women working in Albania’s Ndhima Ekonomi social transfer Chapter 2 (Dabalen et al., 2008). While reductions in labour intensity in these programmes appear to be Conceptual linked to higher transfer levels, the policy conclusion here is not necessarily that higher transfers framework are therefore a bad thing. In the case of South Africa’ old-age pension, higher transfers could Chapter 3 simply have done more to ease the pressures on adults in poor households who previously had to Review of cash support their elderly relatives. In the case of Albania’s Ndhima Ekonomi, it is important to note transfer reviews that two particular aspects of the programme’s design could have created disincentive effects, or at least incentives to underreport employment. First, eligibility was dependent upon heads of Chapter 4 Methods households being unemployed and, secondly, the level of transfers received depended upon the income level that households reported (Dabalen et al., 2008). Methodologically, it is therefore Chapter 5 less surprising that households with higher transfers were associated with lower employment. The evidence base No significant effects on weekly hours worked were found to result from higher transfers in an Indonesian UCT evaluated by Bazzi et al. (2012). SECTION II The three studies looking at the role of conditionalities in affecting child labour also appear Chapter 6 to demonstrate a significant effect on employment from conditioning transfers upon school The impact of enrolment or attendance (Benedetti and Ibarrarán, 2015; Schady and Araujo, 2006; Barrera- cash transfers on Osorio et al., 2011). One also provides some insights into how the way transfers are conditioned monetary poverty (e.g. holding back part of a transfer until students have graduated) may help to further reduce Chapter 7 child labour (Barrera-Osorio et al., 2011). The impact of cash transfers on Looking at the issue of complementary and supply-side services, some evidence from Nicaragua’s education Atención a Crisis programme emerged of the higher impacts on promoting a shift away from agricultural towards non-agricultural employment (among adults and children) from combining Chapter 8 The impact of cash a regular cash transfer with a grant labelled as a ‘productive investment grant’ (Macours et al., transfers on health 2012). The example seems to point to how combining regular transfers with lump-sum grants and nutrition designated for productive activities may be useful for speeding up shifts away from dependence or reliance upon agriculture. However, the same study shows how cash transfers alone, or when Chapter 9 combined with vocational training, also still led to statistically significant increases in non- The impact of cash transfers on agricultural self-employment, though with a lower impact, suggesting trade-offs between the level savings, investment of impact and costs of these different approaches. and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

204 Cash transfers: what does the evidence say? Page 204 Contents Adult labour Acknowledgements Table 10.3 Summary of results for overall cash transfer effect on adult labour force participation Executive summary Programme and # Study Significance Measure of change Outcome indicator and treatment population Effect country SECTION I PRAF (Honduras) - 0.011 Individual is working (adults aged 15–80) (2002) NS Alzúa et al. (2013) 1 Percent point change Individual is working (adults aged 15–80) (2001) -0.005 Percent point change NS RPS (Nicaragua) Chapter 1 PROGRESA (Mexico) Individual is working (adults aged 15–80) (1999) -0.009 NS Percent point change Introduction -0.027 Individual is working (resident members aged 18–50) SA-OAP (South Africa) Ardington et al. 2 Percent point change 5% Chapter 2 (2009) SA-OAP (South Africa) 0.003 Percent point change NS Individual is working (resident and non-resident Conceptual members aged 18–50) framework Asfaw et al. (2014) NS OVC-cash transfer -0.026 3 Percent point change Individual is participating in labour force (over 18) (Kenya) Chapter 3 Review of cash Canavire- 4 10% SP (Dominican Republic) Individual is working (all aged 15–24) 0.059 Percent point change transfer reviews Bacarreza and 5% Percent point change 0.025 Individual is working (all aged 25–64) SP (Dominican Republic) Vazquez-Ruiz (2013) Chapter 4 Percent point change -0.003 Individual is working (all aged 65 or above) SP (Dominican Republic) NS Methods 1% 0.087 5 Adult is participating in labour force (aged 21 and over Percent point change Familias en Acción Barrientos and Villa (2013) from single adult household) (Colombia) Chapter 5 Proportion of working-age adults (18–64) engaged in 6 Cheema et al. BISP (Pakistan) NS Percent point change -0.081 The evidence base economically productive activities (2014) Anyone in household participated in any labour Daidone et al. NS Percent point change 7 0.004 LCGP (Lesotho) (2014a) activity in past 12 months SECTION II 8 Percent point change NS Galiani et al. (2014) PAAMZR (Mexico) Pensioner worked in the past week 0.014 Chapter 6 PAAMZR (Mexico) -0.047 1% Percent point change Pensioner worked for pay in the past week The impact of 9 Handa et al. (2014) NS Percent point change LEAP (Ghana) Anyone in household engaged in paid work over past 0.014 cash transfers on week monetary poverty Not stated -0.027 Individual is working in past week (co-residents aged BPC (Brazil) Kassouf and de 10 NS Chapter 7 18 – 49) Oliveira (2012) The impact of Merttens et al. HSNP (Kenya) 11 Percent point change NS 0.024 Proportion of adults (aged 18–54) whose main cash transfers on (2013) activity is productive work education Proportion 12 Individual is engaged in economically productive NS SAGE Senior Citizens Merttens et al. 0.62 (2015) Grant (Uganda) activity (aged 18–64) Chapter 8 The impact of cash NS SAGE Vulnerable Family Proportion -1. 2 Individual is engaged in economically productive activity (aged 18–64) Support Grant (Uganda) transfers on health and nutrition Percent point change 5% 0.10 Main carer of child is in paid employment (typically O’Brien et al. 13 BOTA (Kazakhstan) women under 50) (2013) Chapter 9 Percent point change LCGP (Lesotho) Pellerano et al. NS 14 0.031 Individual engaged in any work over past 12 months The impact of (aged 18–59) (2014) cash transfers on Percent point change Individual engaged in paid work over past 12 months -0.052 NS LCGP (Lesotho) savings, investment (aged 18–59) and production Notes: results represent all overall results reported and do not include those disaggregated by gender or Chapter 10 showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means The impact of cash transfers on the study did not find a statistically significant result, typically up to the 10% significance level. employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

205 Cash transfers: what does the evidence say? Page 205 Contents Table 10.4: Summary of results for overall cash transfer effect on overall intensity of work by adults Acknowledgements Significance Measure of # Effect Outcome indicator and treatment population Programme and Study change country Executive summary Hours per week 1 Alzúa et al. (2013) PRAF (Honduras) No. of hours worked (among those working) 0.68 NS NS Total hours per week 0.451 Total hours worked by adults in the household (per adult) PRAF (Honduras) SECTION I NS Hours per week -1.9 9 No. of hours worked (among those working) RPS (Nicaragua) Total hours worked by adults in the household (per adult) -1.6 0 2 Total hours per week NS RPS (Nicaragua) Chapter 1 Introduction 0.04 No. of hours worked (among those working) Hours per week PROGRESA (Mexico) NS NS Total hours per week -0.384 PROGRESA (Mexico) Total hours worked by adults in the household (per adult) Chapter 2 Conceptual -2.285 No. of hours worked per week per adult – 2007 follow Temporar y UCT Bazzi et al. (2012) 2 5% Hours per week up (after 1 disbursement) (Indonesia) framework NS - 0.17 3 Temporar y UCT Hours per week No. of hours worked per week per adult – 2007 follow Chapter 3 up (after 2 disbursements) (Indonesia) Review of cash Hours spent on all economic YOP (Uganda) Blattman et al. (2012) Hours per month 19.71 1% 3 transfer reviews activities in past 4 weeks Blattman et al. (2013) YOP (Uganda) Monthly employment hours (after 4 years) 1% 4 Hours per month 25.36 Chapter 4 Methods Hours 9.391 Average work hours per week (16m after grant) WINGS (Uganda) 5 Blattman et al. (2015) 1% -2.8 1% Hours per week Hours worked last week (any labour) LCGP (Lesotho) Daidone et al. (2014a) 6 Chapter 5 The evidence base Galiani et al. (2012) NS Hours per week -0.44 Hours worked last week (age 70–74) PAAMZR (Mexico) 7 Kassouf and Oliviera No. of hours worked (over 65-year-olds) 8 BPC (Brazil) -15.75 Hours per week 5% (2012) SECTION II 9 RPS (Nicaragua) Maluccio (2005) 0.3406 Hours per week NS Total hours worked last week by household members (2 years after baseline) Chapter 6 Hours per week RPS (Nicaragua) NS 0.7732 Average hours per worker worked last week (2 years The impact of after baseline) cash transfers on monetary poverty Mean number of hours spent working per week (all NS Hours per week 10 Merttens et al. (2015) SAGE Senior Citizens -0.62 Grant (Uganda) occupations) Chapter 7 Hours per week SAGE Vulnerable Family Mean number of hours spent working per week (all 0.48 NS The impact of occupations) Support Grant (Uganda) cash transfers on Total household labour hours 0.263 Percent LEAP (Ghana) NS Mochiah et al. (2014) 11 education Notes: results represent all overall results reported and do not include those disaggregated by gender or Chapter 8 The impact of cash showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means transfers on health the study did not find a statistically significant result, typically up to the 10% significance level. and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

206 Cash transfers: what does the evidence say? Page 206 Contents Table 10.5: Summary of results for overall cash transfer effect on adult labour force participation – Acknowledgements by sector Programme and # Study Significance Measure of Effect Outcome variable Executive summary change country -0.028 Working in agricultural occupation NS Alzúa et al. (2013) 1 percentage points PRAF (Honduras) SECTION I -0.013 Working in agricultural occupation RPS (Nicaragua) percentage points NS 0.004 NS percentage points Working in agricultural occupation PROGRESA (Mexico) Chapter 1 2 % of working-age adults who are self employed Cheema et al. (2014) 0.15 41 percentage points BISP (Pakistan) 1% Introduction percentage points NS BISP (Pakistan) -0.01054 % of working-age adults who are engaged as an Chapter 2 employee Conceptual NS BISP (Pakistan) % of working-age adults who are engaged as an unpaid -0.02552 percentage points framework family helper percentage points - 0.16 4 5 BISP (Pakistan) % of working-age adults who are engaged as a casual 5% Chapter 3 labourer Review of cash transfer reviews % of working-age adults who are engaged as an owner- percentage points 0.01608 BISP (Pakistan) NS cultivator Chapter 4 % of working-age adults who are engaged as a share- BISP (Pakistan) - 0.0112 3 percentage points NS Methods cropper De Holanda Barbosa 3 Bolsa Família (Brazil) Probability of the main occupation held by the head of NS -3.237 Unclear Chapter 5 the household being informal and Corseuil (2014) The evidence base 4 1% Percentage points 0.061 Worked last week for no pay (e.g. on a family farm or in PAAMZR (Mexico) Galiani et al. (2014) a family business) SECTION II Maluccio (2005) 0.0619 If engaged in small business activity in last week RPS (Nicaragua) 5 NS Percentage point RPS (Nicaragua) Had non-agricultural home production for sale, resell 0.015 percentage points NS Chapter 6 purchased goods or sell services other than labour The impact of (2003 – 3 years after baseline) cash transfers on 0.016 6 Household participation in non-farm enterprise (HH) NS OVC-cash transfer Asfaw et al. (2014) Percentage point monetary poverty (Kenya) NS Percentage point Participation in own-farm labour (individual) -0.047 OVC-cash transfer Chapter 7 (Kenya) The impact of cash transfers on SCTP (Malawi) Covarrubias et al. 7 Participation in on-farm activities (if have zero Percentage point 0.07 NS education income, i.e. subsistence, then definition assumes no (2012) participation) (1 year later) – household Chapter 8 NS SCTP (Malawi) Self-employment (1 year later) – household Percentage point 0.039 The impact of cash Daidone et al. (2014a) 8 NS Percentage point -0.006 Participation last 12 months own non-farm business – LCGP (Lesotho) transfers on health Household and nutrition Percentage point 0.023 LCGP (Lesotho) Participation last 12 months own agricultural activities NS – household Chapter 9 The impact of Percentage point -0.03 10% LCGP (Lesotho) Participation last 12 months paid work outside cash transfers on household – household savings, investment NS 0.004 Percentage point LCGP (Lesotho) Participation previous week own non-farm business – and production household LCGP (Lesotho) 5% Percentage point -0.035 Participation last week own crop and livestock Chapter 10 production – household The impact of cash transfers on Percentage point -0.044 LCGP (Lesotho) Participation last week paid work outside household – 5% household employment 0.401 Percentage point Involved in any non-farm self-employment (16 months 1% 9 Blattman et al. (2015) WINGS (Uganda) Chapter 11 after grants) The impact of 1% WINGS (Uganda) Started enterprise since baseline (16 months after grant) 0.487 Percentage point cash transfers on empowerment Karlan et al. (2014) IPA RCT (Ghana) Household has non-farm income-generating activity -0.04 Percent point change NS 10 Macours et al. (2012) 11 NS Atención a Crisis Percent point change Participates in non-agricultural wage-employment 0.0221 (effect of basic CCT) (Nicaragua) SECTION III 10% Percent point change 0.0396 Atención a Crisis Participates in non-agricultural self-employment (Nicaragua) (basic CCT) Chapter 12 Summary of Figures in bold indicate statistically significant. NS means the study did not find a statistically significant findings and result, typically up to the 10% significance level. conclusion References

207 Cash transfers: what does the evidence say? Page 207 Contents Table 10.6: Summary of results for overall cash transfer effect on adult labour force participation (labour intensity) – by sector Acknowledgements # Measure of change Effect Outcome variable Programme and Study Significance Executive summary country Asfaw et al. (2014) -20.41 1 Days worked per year in any wage labour 5% OVC-cash transfer Days per year (Kenya) SECTION I Days worked per month in own-farm labour NS OVC-cash transfer -0.042 Days per month (Kenya) Chapter 1 Introduction YOP (Uganda) Blattman et al. (2012) 2 1% Hours 22.239 Hours spent on market activities in past 4 weeks Currently engaged in skilled work YOP (Uganda) 0.34 percentage point 1% Chapter 2 Conceptual Blattman et al. (2015) Average agricultural hours per week (16m after grant) 3.496 Hours 5% WINGS (Uganda) 3 framework 1% Hours 5.895 Average Non-agricultural hours per week (16m after WINGS (Uganda) grant) Chapter 3 Days 1% 4 -4.875 Days of ganyu (casual) labour worked by HH head Covarrubias et al. (2012) SCTP (Malawi) Review of cash (1 yr later) transfer reviews Days of ganyu (casual) labour (6m later) 1% hours -3.868 SCTP (Malawi) Chapter 4 NS Daidone et al. (2014a) LCGP (Lesotho) Hours worked last week own non-farm enterprise - 0.1 hours 5 Methods Hours worked last week own crop and livestock hours NS LCGP (Lesotho) -1.1 Chapter 5 NS hours -1.7 Hours worked last week paid labour LCGP (Lesotho) The evidence base NS -2.006 Proportion of working hours of the household Bolsa Família De Holanda Barbosa 6 (Brazil) and Corseuil (2014) dedicated to informal activities PAAMZR (Mexico) 7 Galiani et al. (2014) 1% Hours 2.17 Hours worked last week for no pay (e.g. on a family SECTION II farm or in a family business) Chapter 6 1% PAAMZR (Mexico) Hours worked last week for pay -2.61 Hours The impact of cash transfers on Weeks 2.4 Handa et al. (2014) Weeks worked if did paid work 8 LEAP (Ghana) NS monetary poverty NS Hours -4.0562 9 Maluccio (2005) RPS (Nicaragua) Total hours dedicated to agriculture last week (2002 – two years after baseline) Chapter 7 The impact of Impact of LEAP on household labour hours in 10 Mochiah et al. (2014) LEAP (Ghana) Log of household’s -0.074 NS labour supply for agriculture cash transfers on agriculture (percentage) education 0.315 Impact of LEAP on household labour hours in paid LEAP (Ghana) Log of household’s 10% Chapter 8 employment labour supply for agriculture (percentage) The impact of cash transfers on health LEAP (Ghana) Log of household’s 0.11 Impact of LEAP on household labour hours in non- NS and nutrition labour supply for farm expenditure agriculture (percentage) Chapter 9 The impact of Note: When results are reported for last 12 months and last week/shorter time span, reporting working/not cash transfers on working and hours over last 12 months. Figures in bold indicate statistically significant. NS means the study savings, investment did not find a statistically significant result, typically up to the 10% significance level. and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

208 Cash transfers: what does the evidence say? Page 208 Contents Child labour Acknowledgements Table 10.7 Summary of results for overall cash transfer effect on child labour force participation Executive summary # Study Effect Outcome indicator and treatment population Significance Measure of change Programme and country 1 NS Percent point change 0.02 Child is engaged in any work after 36 months (aged 7–14) ZCGP (Zambia) A IR (2014) SECTION I ZCGP (Zambia) Child is engaged in paid work after 36 months (aged 7–14) -0.005 NS Percent point change Chapter 1 ZCGP (Zambia) 0.027 Child is engaged in any work after 36 months (aged 15–17) NS Percent point change Introduction NS ZCGP (Zambia) Child is engaged in paid work after 36 months (aged 15–17) -0.04 Percent point change Chapter 2 NS Familias en Acción Percent point change Attanasio et al. 2 0.004 Child is working (rural child 14–17) Conceptual (Colombia) (2010) framework Familias en Acción Child is working (rural child 10–13) -0.0744 Percent point change NS (Colombia) Chapter 3 1% Percent point change Familias en Acción - 0.14 9 9 Child is working (urban child 14–17) Review of cash (Colombia) transfer reviews Familias en Acción 1% - 0.1417 Percent point change Child is working (urban child 10–13) Chapter 4 (Colombia) Methods Child’s primary activity is work (in grade 6-10) SCAE (Colombia) Barrera-Osorio 3 NS Percent point change -0.001 et al. (2008) Chapter 5 Percent point change 4 Benedetti and NS PRAF (Honduras) Participated in any work in past week (aged 6–17 at baseline) -0.002 The evidence base Ibarrarán (2015) 5 Bustelo (2011) RPS (Nicaragua) Child is working (impact on targeted children 7–13) -0.075 Percent point change NS SECTION II 0.004 Participated in any labour activity in past 12 months LCGP (Lesotho) Daidone et al. NS Percent point change 6 (2014a) Chapter 6 Percent point change -0.032 Child is working (poorest quintile) BSM (Indonesia) De Silva and 7 1% The impact of Sumarto (2015) 5% Percent point change -0.0238 Child is working (2nd quintile) BSM (Indonesia) cash transfers on monetary poverty Percent point change -0.0037 Child is working (3rd quintile) BSM (Indonesia) NS BSM (Indonesia) NS Percent point change -0.0073 Child is working (4th quintile) Chapter 7 BSM (Indonesia) NS Percent point change -0.0039 Child is working (top quintile) The impact of cash transfers on NS Percent point change -0.0716 Child works for pay (aged >10) 8 Edmonds and BDH (Ecuador) education Schady (2008) Marginal effect -0.0257 Participates in any work including looking for work Familias en Acción Fitzsimons and 9 1% Chapter 8 Mesnard (2014) (Nicaragua) The impact of cash -0.03 Galiani and Child works outside the home 1% PRAF (Honduas) 10 Percent point change transfers on health McEwan (2014) and nutrition Percent point change - 0.10 6 Child is working (aged 9–15) RPS (Nicaragua) Gee (2010) 11 1% Chapter 9 NS 12 Kassouf and de BPC (Brazil) -0.0843 Not stated Child is working in past week (children aged 10–15) The impact of Oliveira (2012) cash transfers on 5% Percent point change -0.056 Child is working (child aged 7–13 in first to fourth grades but RPS (Nicaragua) Maluccio and 13 savings, investment Flores (2005) not completed the fourth grade) and production 14 Child is working (10–13 year-olds who have not completed Percent point change Maluccio (2003) RPS (Nicaragua) -0.088 5% fourth grade) Chapter 10 NS SAGE Senior Citizens Grant Proportion Merttens et al. Child is engaged in economically productive activity (aged 15 -0.04 The impact of (2015) (Uganda) 6 –17 ) cash transfers on employment 0.01 Child is engaged in economically productive activity (aged SAGE Vulnerable Family NS Proportion 6 –17 ) Support Grant (Uganda) Chapter 11 Child engaged in any work over past 12 months (aged 6–17) 16 Pellerano et al. Percent point change LCGP (Lesotho) NS -0.0239 The impact of (2014) Child engaged in paid work over past 12 months (aged 6–17) LCGP (Lesotho) NS 0.00070 Percent point change cash transfers on empowerment Juntos (Peru) NS 17 Perova and Vakis 0.17 Percent point change Child is working in past week (aged 6–14) (2012) Percentage points 1% 18 Schady and - 0.17 2 BDH (Ecuador) Child is working in follow-up survey SECTION III Araujo (2006) BDH (Ecuador) Child started working between baseline and follow-up survey -0.269 Percentage points 1% Percent point change NS -0.005 World Bank Worked for wage in past month (aged 7–12) PKH (Indonesia) 19 Chapter 12 (2 011) Summary of NS PKH (Indonesia) Worked for wage in past month (aged 13–15) -0.001 Percent point change findings and conclusion Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means References the study did not find a statistically significant result, typically up to the 10% significance level

209 Cash transfers: what does the evidence say? Page 209 Contents Table 10.8 Summary of results for overall cash transfer effect on overall intensity of child labour Acknowledgements Study Significance Measure of change Effect # Outcome indicator and treatment population Programme and country Executive summary Attanasio et al. 1 NS Hours per day -0.31 Hours of work (rural 14–17 year-olds) Familias en Acción (2010) (Colombia) Hours per day Hours of work (rural 10–13 year-olds) -0.64 1% SECTION I 1% Hours of work (urban 14–17 year-olds) -1.0 3 Hours per day Hours per day -0.64 1% Hours of work (urban 10–13 year-olds) Chapter 1 Introduction -0.33 Hours worked last week (children grades 6–10 at registration) SCAE (Colombia) 1% Hours per week 2 Barrera-Osorio et al. (2008) Hours worked last week (children grade 11 at registration) -2.02 Hours per week 10% Chapter 2 Conceptual Minutes spent in day prior to interview working on household 3 Tayssir (Morocco) Benhassine et 5% -31.77 Minutes al. (2013) business, farm or outside (combined effect among UCT and framework CCT groups) Chapter 3 10% ‘Hours’ -1.10 2 Total hours of work, including domestic work Atención a Crisis Del Carpio 4 Review of cash (Nicaragua) (2008) (8–15 year-olds) transfer reviews -2.46 Hours worked in last week 1% 5 Schady and Hours per week BDH (Ecuador) Araujo (2006) Chapter 4 Methods Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means Chapter 5 the study did not find a statistically significant result, typically up to the 10% significance level. The evidence base SECTION II Table 10.9: Summary of results for overall cash transfer effect on child labour participation by sector Significance Measure of change # Child age Study Outcome variable Programme and Effect Chapter 6 country The impact of OVC-cash transfer Asfaw et al. (2014) 1 1% Percentage points - 0.124 Participation in own-farm labour by 10 –15 cash transfers on (Kenya) children monetary poverty SCTP (Malawi) 4 –18 NS 0.003 2 Non-household income work percentage point Covarrubias et al. (2012) Chapter 7 4 –18 NS percentage points 0.021 Family farm/non-farm business SCTP (Malawi) The impact of cash transfers on 1% percentage points -0.074 Domestic work outside the household 4 –18 SCTP (Malawi) education 1% percentage points SCTP (Malawi) 4 –18 Paid domestic work outside the -0.077 household Chapter 8 Percentage point LCGP (Lesotho) 3 Participation last 12m own non-farm NS -0.002 Daidone et al. (2014a) The impact of cash business transfers on health NS -0.018 Participation last 12m own agricultural LCGP (Lesotho) Percentage point and nutrition activities Chapter 9 LCGP (Lesotho) NS 0 Participation last 12m paid work outside Percentage point The impact of household cash transfers on 5 –18 ZCGP (Zambia) 4 Daidone et al. (2014b) NS Percentage point -0.018 Paid child labour supply savings, investment NS Percentage point 0.039 Unpaid child labour supply 5 –18 ZCGP (Zambia) and production Impact on physical labour 10% -1.178 Atención a crisis 5 Del Carpio (2008) 8 –15 Chapter 10 (Nicaragua) The impact of 3.504 Atención a crisis 1% 8 –15 Impact on non-physical labour cash transfers on (Nicaragua) employment Children 10 and older do market work 5% 10 and BDH (Ecuador) Edmonds and Schady (2008) Percent point change ‐0.244 6 older Chapter 11 The impact of 10 and 5% Percent point change BDH (Ecuador) ‐0.209 Children 10 and older do unpaid market older work cash transfers on empowerment 0.0492 NS Percent point change BDH (Ecuador) 10 and Children 10 and older do domestic work older Percent point change 10% -0.032 7 Galiani and McEwan (2013) PRAF (Honduras) Only works inside the home in previous SECTION III week; intent to treat LCGP (Lesotho) Proportion of children who in the 12 8 Pellerano et al. (2014) 6 –17 NS Percent point change - 0.19 4 Chapter 12 months prior to the survey engaged in: Summary of own non-farm business activities findings and LCGP (Lesotho) 6 –17 Proportion of children who in the 12 Percent point change NS -1.76 6 conclusion months prior to the survey engaged in: own crop/livestock production References

210 Cash transfers: what does the evidence say? Page 210 Contents Table 10.10: Summary of results for overall cash transfer effect on child labour intensity by sector Acknowledgements Study Programme and Significance Child Outcome variable # Effect Measure of age country change Executive summary Covarrubias et al. (2012) 1% hours -0.261 1 Hours spent on domestic work outside the SCTP (Malawi) household SCTP (Malawi) 0.161 Hours 5% Hours spent on family farm/non-farm business SECTION I 2 Daidone et al. (2014a) LCGP (Lesotho) hours worked last week own non-farm enterprise 0 hours NS Chapter 1 hours -2.2 hours worked last week: own crop and livestock LCGP (Lesotho) 5% Introduction NS LCGP (Lesotho) hours worked last week Paid labour 0 hours Chapter 2 NS LEAP (Ghana) 3 0.8 days Handa et al. (2014) Days on farm Conceptual 1% Hours 1.94 Family enterprise work last week PKH (Indonesia) World Bank (2011) 4 7 to 12 framework 2.93 13 to 15 PKH (Indonesia) Hours 1% Family enterprise work last week Chapter 3 Hours NS -2.04 Wage work last week 7 to 12 PKH (Indonesia) Review of cash transfer reviews NS Hours 13 to 15 Wage work last week PKH (Indonesia) 0.814 Chapter 4 Methods Table 10.11 Summary of results for overall cash transfer effect on migration Chapter 5 Outcome indicator and treatment population Programme and Significance Study # Measure of Effect country change The evidence base SA-OAP (South Africa) 5% Percentage points 0.045 1 Ardington et al. (2009) Migrating internally (resident and non-resident household members) SECTION II 2 Stecklov et al. (2005) PROGRESA (Mexico) Migrating internally -0.003 Percentage points NS Migrating to US Percentage points -0.002 PROGRESA (Mexico) 5% Chapter 6 The impact of NS Marginal effect 3 Winters et al. (2009) RPS (Nicaragua) Migrated internally or internationally 0.0055 cash transfers on monetary poverty Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS means Chapter 7 the study did not find a statistically significant result, typically up to the 10% significance level. The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

211 Cash transfers: what does the evidence say? Page 211 Contents Acknowledgements Executive summary SECTION I Chapter 1 Introduction Chapter 2 Conceptual framework Chapter 3 Review of cash Chapter 11 transfer reviews Chapter 4 Methods T he impact of Chapter 5 The evidence base cash transfers on SECTION II Chapter 6 The impact of cash transfers on empowerment monetary poverty Chapter 7 The impact of cash transfers on education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

212 Cash transfers: what does the evidence say? Page 212 Contents Box 11.1: Summary of evidence for empowerment outcomes Acknowledgements The evidence presented here is taken from 31 studies evaluating impacts on empowerment using our selected indicators. In 26 of these studies, impacts on these indicators are reported for women and girls only. The remaining Executive summary men/boys. The indicators for which evidence was available by gender are: and five report on impacts for women/girls marriage, contraceptive use and multiple sexual partners. SECTION I Effects of cash transfers on selected empowerment indicators: Chapter 1 • he evidence compiled here supports the finding that transfers can reduce physical abuse, but may increase non- T Introduction physical abuse, such as emotional abuse or controlling behaviour. Eight studies considered the impact of cash abuse by a male partner of a woman: six had significant results for physical transfers on physical or non-physical Chapter 2 or sexual abuse, all showing a reduction in reports of abuse (the one non-significant result suggested a rise); six had Conceptual significant results for non-physical (e.g. emotional) abuse, of which four indicated a decrease in reports of abuse framework and two indicated an increase (the non-significant results also indicated a rise in non-physical abuse). • ash transfers can lead to increased involvement of women in decision-making. Eight studies examined the impact C Chapter 3 of cash transfers on women’s decision-making power ; all eight looked at expenditure-related decisions and four Review of cash out of five significant results indicated a rise, ranging from 5% to almost 90%, in a woman’s likelihood of being transfer reviews the sole or joint decision-maker; five also looked at involvement in non-expenditure decisions, with one showing a significant decrease in the likelihood of the female being the sole or joint decision-maker and one showing a Chapter 4 significant increase (both were for decisions relating to contraceptive use). One study reported differential impacts Methods according to the sex of the household head, finding that only in female-headed households were female transfer recipients more likely to become the main budget decision-maker (Merttens et al., 2013). The results, which were Chapter 5 non-significant, were split in terms of showing positive or negative impacts. The evidence base • , with five T he evidence largely shows that cash transfers can delay marriage. Six studies looked at marriage yielding significant results. Three of these indicated delayed marriage in the treatment group (by 1.5 years at one estimate (Alam and Baez, 2011)), one yielded results which differed by gender, and one suggested that the SECTION II intervention actually incentivised marriage (Honduras’s PRAF, analysed by Stecklov and colleagues). The study with only non-significant results also indicated a decrease. Chapter 6 The impact of • fertility . 10 studies here is fairly strong evidence against anecdotal arguments that cash transfers increase T cash transfers on contained results on the impact of cash transfers on fertility (pregnancy or giving birth) and, of the seven yielding monetary poverty significant results, five indicated that the transfer decreased the likelihood of pregnancy or giving birth. The two exceptions again related to the unique case of Honduras’s PRAF. Of the three studies reporting non-significant Chapter 7 results, two indicated a decline in the likelihood of pregnancy and one a rise. The impact of • , with one study he evidence mostly shows that cash transfers lead to increases in the use of contraception T cash transfers on having mixed findings for men only. There were nine papers dealing with the impact of a cash transfer on the use of education five out of the six studies with significant results found unambiguous evidence that the transfer contraception and increased the use of contraceptives or reduced the likelihood of unsafe sex (one estimate was that females were Chapter 8 17% more likely to report safe sex). The one other study with statistically significant results found that while males The impact of cash were more likely to report condom use they were also less likely to report having had safe sex. transfers on health • for women, multiple sexual partners he evidence shows that cash transfers can reduce the likelihood of having T and nutrition but there is no evidence showing this for men. Of the four studies considering the effect of the transfer on an individual having multiple sexual partners, three yielded significant results, all of which indicated that the transfer Chapter 9 lowered this likelihood among females. The impact of cash transfers on Role of design and implementation features: savings, investment • gender of the main transfer recipient ne study disaggregated spillover effects in the household by the O , and production specifically of an old-age pension. It found that young adults were more likely to be married at follow-up, relative to old-age pension recipient. When the pension recipient was the comparison group, when in a household with a male Chapter 10 , young males in the household were instead less likely to be married at follow-up, and the impact on females female The impact of was not statistically significant. cash transfers on employment • wo studies considered differences by T , and both yielded significant results. One indicated that an transfer level increase in transfer size could increase the likelihood of abuse, the other indicated that a higher transfer had a larger Chapter 11 impact on contraceptive use or abstinence but only for females (Kohler and Thornton, 2011). The impact of duration of exposure hree studies considered , with two finding significant results to the effect that prolonged • T cash transfers on exposure to a cash transfer programme lowered the likelihood of marriage and pregnancy and increased the empowerment likelihood of contraceptive use. (both of the Malawian Zomba transfer) but • conditionality/behavioural requirements wo studies compared effects by T significant results were only found in one which indicated a reduction in marriage likelihood in the UCT group only. SECTION III • wo studies looked at payment mechanisms (both of the same programme in Niger), testing the difference T between payment via mobile money transfer and cash in hand, but neither yielded significant results. Chapter 12 Summary of • wo studies considered complementary interventions and supply-side services , specifically business training T findings and (both in the same programme in Uganda), and both yielded significant results, one representing an increase in non- conclusion physical abuse and the other a decrease in women’s decision-making power. • O ne study compared two transfers within the same broad intervention which use different targeting mechanisms References although no significant impact on female decision-making power was observed under either mechanism.

213 Cash transfers: what does the evidence say? Page 213 Contents S 11.1 ummary of findings Acknowledgements This chapter presents evidence on the impact of cash transfers on empowerment. Among the six Executive summary indicators for which evidence is reported, three (abuse, decision-making power and pregnancy) are measured for women and girls only, while the remaining three (marriage, contraceptive use and SECTION I multiple sexual partners) are measured for both women/girls and men/boys. 26 of the 31 studies included in this chapter report indicators only for women/girls and the remaining five report Chapter 1 impacts for both women/girls and men/boys (Behrman et al., 2005; Cluver et al., 2013; Handa Introduction et al., 2014; Kohler and Thornton, 2011; Siaplay, 2012). The criteria for selecting indicators are explained in Chapter 4 of this report. Chapter 2 Conceptual framework The evidence retrieved in this review suggests that transfers reduce physical abuse of a woman non-physical abuse, such as emotional by a male partner, but in some circumstances increase Chapter 3 abuse or controlling behaviour . The evidence base supports, to some extent, both the theory Review of cash that increased income lowers stress-related abuse and the theory that increased income enables transfer reviews the woman to bargain out of abuse. The relatively strong evidence that decision-making power Chapter 4 increases for women in beneficiary household also offers substance to this latter theory. Methods Other empowerment indicators reviewed here – marriage, pregnancy, contraceptive use and Chapter 5 multiple sexual partners – are studied mainly in relation to unmarried women and girls of school The evidence base age (there are exceptions, notably pregnancy, which in many cases is conditional on marriage). On the whole, the evidence reveals that risky sexual behaviour and also early marriage differ by SECTION II gender, but in both cases increased income to an extent lifts the constraints that drive engagement in these behaviours. In the case of women and girls, the evidence that directly or indirectly Chapter 6 receiving a transfer reduces the likelihood of having multiple sexual partners indicates that cash The impact of transfers may reduce the incidence of relationships that are transactional. Taken together, the cash transfers on monetary poverty evidence in this section points to cash transfers having a positive impact on women’s choices as to fertility and engagement in sexual activity. In the case of men and boys, some of the evidence Chapter 7 collected here suggests that cash transfers do not have the same effect of reducing risky sexual The impact of activity and, in fact, may lead to an increase in this type of behaviour. cash transfers on education The 11 studies reviewed which examine differences in programme impact depending on design Chapter 8 transfer gender of the main recipient and implementation features reveal findings relating to the , The impact of cash conditionality complementary interventions and supply-side services level , duration of exposure , , transfers on health and . A small number of studies find that increased transfer level and male targeting mechanisms and nutrition increase appear to involvement in complementary business training the prevalence of physical Chapter 9 abuse and controlling behaviour by a male towards his female partner/spouse, respectively, in The impact of the beneficiary group. Duration of exposure to a transfer reduced the likelihood of marriage and cash transfers on pregnancy and increased the likelihood of contraceptive use even more over time, compared to savings, investment the comparison group (these results were statistically significant only for women). Conditionality and production is also relevant to whether or not a transfer had an impact on marriage and pregnancy in one study but it must be emphasised that, for the most part, the effect of differences in design and Chapter 10 The impact of implementation features is non-significant. cash transfers on employment ummary of evidence base S 11. 2 Chapter 11 The impact of cash transfers on In total, there were 31 studies from which evidence was extracted for the specific indicators empowerment reported in this study, covering 13 countries and 19 cash transfer programmes. Table 11.1 provides an overview of which countries and programmes the studies reported on. SECTION III The evidence base is fairly evenly split between conditional and unconditional interventions, although these were clustered geographically, with all of the Asian and Latin American Chapter 12 Summary of programmes being conditional (with the exception, in practice, of the Ecuadorian Bono findings and de Desarrollo Humano) and all but one of the African interventions being at least partly conclusion unconditional. The interventions studied range in size from coverage of around 1,200 households (the Zomba cash transfer in Malawi) to several million (Bolsa Família in Brazil, PROGRESA/ References Oportunidades in Mexico).

214 Cash transfers: what does the evidence say? Page 214 Contents The most-reported indicator categories were pregnancy (10 studies), use of contraception (nine Acknowledgements studies), physical or non-physical abuse (eight studies) and woman as sole decision-maker (eight studies). Marriage was reported on in seven studies (although in only one was the impact of Executive summary different lengths of exposure to the transfer reported) and multiple sexual partners in four studies. For abuse, women’s decision-making power and pregnancy most of the results come from the Latin American studies, and for the other indicators – marriage, contraception and multiple sexual SECTION I partners – most of the results are from African studies. Chapter 1 Introduction Just over half of the studies used a randomised control trial (RCT) impact estimation design and the remainder used quasi-experimental estimation strategies, involving matching or regression Chapter 2 discontinuity design (RDD) on cross-sectional datasets, see Table 11.2. Conceptual framework Table 11.1: Summary of countries and programmes reported on for the health indicators (all studies) Chapter 3 Details if pilot or # of studies Type of cash transfer Programme Country Review of cash experimental study transfer reviews Latin America = 19 studies Chapter 4 1 CCT Bolsa Família Brazil Methods Ecuador WFP Colombian refugee RCT (WFP cash transfer) CCT 2 Chapter 5 1 CCT Bono de Desarrollo Humano (BDH) Ecuador The evidence base Programa de Asignación Familiar (PRAF) Honduras CCT 2 CCT Mexico PROGRESA/Oportunidades 8 SECTION II Nicaragua CCT 3 Red de Protección Social (RPS) Peru 2 CCT Juntos Chapter 6 The impact of Sub-Saharan Africa = 14 studies cash transfers on UCT 1 Orphans and Vulnerable Children Cash Transfer (OVC-cash Kenya monetary poverty transfer) Experimental study 1 UCT Give Directly experiment Kenya Chapter 7 The impact of 1 UCT Hunger Safety Net Programme (HSNP) Kenya cash transfers on 3 CCT, UCT Zomba Cash Transfer Program (ZCTP) Malawi education Experimental study 1 CCT Malawi Sexual health incentive programme (M-IP) Chapter 8 Experimental study 2 UCT Concern Worldwide drought-response unconditional transfer Niger The impact of cash (Mobile money experiment) transfers on health Child Support Grant and Foster Grant (CSGFG) UCT 1 South Africa and nutrition Old-age pension (SA-OAP) Social pension South Africa 1 Chapter 9 Social Assistance Grants for Empowerment (SAGE) Uganda 1 UCT The impact of 2 Uganda Enterprise grant Experimental study Women’s Income Generating Support (WINGS) cash transfers on savings, investment Europe and Central Asia = 1 study and production 1 CCT Social Risk Mitigation Project (SRMP) Turkey South Asia = 1 studies Chapter 10 The impact of Punjab Female School Stipend Program (PFSSP) Pakistan 1 CCT cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

215 Cash transfers: what does the evidence say? Page 215 Contents Table 11.2: Summary of study methods used for empowerment indicators Acknowledgements Study design/methods used for reported Reports total effect Reports effect Study Reports sex- of design and results disaggregated Executive summary implementation outcomes features? Adato et al. (2000) Pooled multinomial logit model Yes SECTION I Ahmed et al. (2007) RDD Yes Chapter 1 Yes RCT (Pooled OLS) Aker et al. (2011) Introduction Aker et al. (2014) Yes RCT (Pooled OLS) Chapter 2 Yes RDD Alam and Baez (2011) Conceptual Yes Yes Angelucci (2008) RCT (OLS) framework Baird et al. (2010) Yes RCT (DID with fixed effects) Chapter 3 Baird et al. (2011) RCT (Pooled OLS) Yes Review of cash Yes RCT (logistic regression) Baird et al. (2012) transfer reviews Yes Yes (marriage) Behrman et al. (2005) RCT (DID) Chapter 4 Blattman et al. (2015) RCT (DID) Yes Yes Methods Yes Fixed effects cross-sectional logit model Bobonis et al. (2013) Chapter 5 PSM SD Yes Yes (multiple partners; Cluver et al. (2013) The evidence base contraceptive use) de Brauw et al. (2014) PSM SD Yes Yes Feldman (2009) Pooled logit model SECTION II Green et al. (2015) RCT (DID) Yes Yes Chapter 6 Handa et al. (2009) Fixed effects cross-sectional OLS and logit models Yes The impact of cash transfers on Yes (multiple partners; RCT (Logit model) Handa et al. (2014) Yes contraceptive use) monetary poverty Haushofer et al. (2015) Yes RCT (OLS) Chapter 7 Yes Yes RCT (ANCOVA) Hidrobo et al. (2012) The impact of cash transfers on Yes RCT (ANCOVA) Hidrobo et al. (2013) education Yes RCT (ANCOVA) Hidrobo and Fernald (2013) Pooled logit model Kohler and Thornton (2011) Yes Yes (contraceptive use) Chapter 8 The impact of cash Yes Yes RCT (DID) Merttens et al. (2013) transfers on health Yes Merttens et al. (2015) PSM DID and nutrition Yes DID for repeated cross-section Perova (2010) Chapter 9 Yes Perova and Vakis (2012) IV; Intensity Dose Analysis Yes The impact of Yes (multiple partners; Yes Yes Siaplay (2012) RDD cash transfers on contraceptive use; savings, investment marriage) and production Yes RCT (SD and DID) Stecklov et al. (2006) Chapter 10 Stecklov et al. (2007) Yes RCT (DID) The impact of Todd et al. (2011) RCT (Hazard model and DID) Yes cash transfers on employment RDD = regression discontinuity design, RCT = randomised controlled trial, DID = difference-in-difference, Chapter 11 SD = single difference, PSM = propensity score matching, IV = instrumental variables, ANCOVA = analysis The impact of of covariance. cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

216 Cash transfers: what does the evidence say? Page 216 Contents he overall impact of cash transfers on empowerment 11.3 T Acknowledgements This subsection presents the evidence on the overall impact of cash transfers on the selected Executive summary empowerment indicators. Some indicators apply only to women and girls and others to both sexes, as listed below: SECTION I 132 A buse (physical and non-physical) – women only • • D ecision-making power – women only Chapter 1 Introduction arriage – women/girls M • men/boys (one out of six studies reports overall impacts on both) and P • regnancy – women only Chapter 2 and C men/boys (four out of nine studies report on both) • ontraceptive use – women/girls Conceptual ultiple sexual partners – women/girls M • men/boys (three out of four studies report on both) and framework Chapter 3 In this section, treatment effects are always in relation to a control group of the same gender. Review of cash Given the variety of variations in programme design and implementation, a separate subsection transfer reviews presents heterogeneity of impacts depending on these features (11.4). The evidence on the overall impact of cash transfers on these indicators is now described in detail. Chapter 4 Methods Abuse: physical and non-physical of women by men Chapter 5 The evidence base Overall numbers SECTION II Of the eight studies that looked at the impact of a cash transfer on abuse of women by men, six looked at both physical and non-physical abuse, one at physical abuse only (Angelucci, 2008) Chapter 6 and one at non-physical abuse only (Green et al., 2015). In all the studies, the abuse referred to The impact of was perpetrated by a male in the household: in six studies this was specifically abuse of a female cash transfers on monetary poverty individual by her male partner and in the remaining two cases this was abuse of the female partner of the male household head (i.e. abuse was measured at the household level). Chapter 7 The impact of Six of the seven studies reporting on physical or sexual abuse contained significant results and in cash transfers on all cases the impact of the cash transfer was a reduction in the likelihood of abuse being reported education by the respondent. Six of the seven studies looking at non-physical abuse contained statistically Chapter 8 significant results: two indicated that the transfer increased the likelihood of non-physical abuse The impact of cash and the other four indicated a decline in non-physical abuse. The findings of these studies will now transfers on health be briefly described and then elaborated on with reference to theories of change. and nutrition Chapter 9 Physical abuse The impact of cash transfers on Seven studies looked at the impact of a cash transfer on (reports of) physical abuse, of which six savings, investment contained significant results for these indicators (Table 11.3). and production The studies on Ecuador (Hidrobo et al., 2012, focuses on the WFP programme targeting Chapter 10 134 133 The impact of study focuses on the BDH) the Bobonis Colombian refugees; Hidrobo and Fernald, 2013, cash transfers on 135 (2013) on PROGRESA in Mexico and the Perova (2010) study on Juntos in Peru offer the employment most substantial evidence that a cash transfer reduces physical abuse. In terms of percentage Chapter 11 The impact of cash transfers on I 132 n one case here results are also disaggregated by the gender of the transfer recipient, though the indicator still measures levels of abuse empowerment reported by women. 133 n Hidrobo et al. (2012; 2013) and Hidrobo and Fernald (2013) physical or sexual abuse is identified if the respondent selected yes to any of I the following in the last six months ‘(1) pushed, shoved, or had an object thrown; (2) slapped or had her arm twisted; (3) punched or hit with SECTION III object; (4) kicked or dragged; (5) strangled or burned; (6) attacked with knife or other weapon; (7) threatened to be attacked with knife or other weapon; (8) forced to have sexual interactions, and (9) forced to conduct sexual acts that woman does not approve.’ Chapter 12 Summary of 13 4 P hysical abuse is defined in Bobonis et al. (2013) as if the female respondent answered yes to having been the victim of abuse ‘for example, push, beating, attack with blade’; sexual abuse is defined as having answered yes to being the victim of sexual abuse ‘for example use of force findings and to have sexual relations’. conclusion 135 I n Perova (2010) physical violence indicator is equal to one if a woman experienced at least one type of physical violence, such as pushing, References slapping, hitting, attacking with weapons or attempts to strangulate or burn during the last 12 months. The sexual violence indicator is equal to one if during the last 12 months a respondent’s partner/husband forced her to have sexual relations or to participate in sexual acts she did not approve of.

217 Cash transfers: what does the evidence say? Page 217 Contents points the impact is between 0 and nine percentage points (Haushofer et al., 2015; Perova, 2010, Acknowledgements respectively), however, taking into account the different baseline levels of reported violence, we see a very wide range in the reduction in physical or sexual violence: -24% (Perova, 2010), -34% Executive summary (Angelucci, 2008), -43% (Bobonis et al., 2013), -45% (Hidrobo et al., 2013), and -54% (Hidrobo et al., 2012). SECTION I 136 (2008), also using PROGRESA data, the overall impact on drunken violence In Angelucci’s study Chapter 1 is negative, although subsequent models show that the effect varies by relative education level and Introduction age of the male partner (at the maximum transfer level the reporting of violence was five percentage points higher, which is a doubling of the 5% mean level of violence reported at baseline). Chapter 2 Conceptual Non-physical abuse framework Chapter 3 Seven studies looked at the impact of a cash transfer on (reports of) non-physical abuse such as Review of cash controlling behaviour or emotional abuse, of which six contained significant results for these transfer reviews indicators (Table 11.4). Two indicated an increase in the likelihood of non-physical abuse and four indicated a decrease in this likelihood. Chapter 4 Methods 137 (2013) on PROGRESA indicates an increase in emotional abuse (threats, The Bobonis study Chapter 5 insults, etc.) in the treatment group, only when not accompanied by physical abuse, and this The evidence base increase is relatively large compared to the baseline level of abuse (an increase of 72%). This is explained as rent-seeking behaviour by the male partner: the female partner now has more SECTION II resources to bargain out of being physically abused, hence the male partner increases his threat level to take advantage of this (Angelucci, 2008, also puts forward this theory). The study by Chapter 6 Green et al. (2015) on the Ugandan WINGS programme also indicates an increase in emotional The impact of abuse and controlling behaviour of two and 14 percentage points respectively (no baseline mean cash transfers on is provided to contextualise this increase) – again this is explained through rent-seeking theory. monetary poverty The indicator for emotional abuse in this case also captures physical abuse so it is not clear Chapter 7 whether both types of abuse rise together. The impact of cash transfers on The studies on the WFP grant and BDH in Ecuador again show a decrease in abuse, this time non- education physical: Hidrobo et al. (2012) find that the female-targeted transfer reduced reported controlling behaviour by 10 percentage points; in a similar study by Hidrobo et al. (2013) this difference for Chapter 8 The impact of cash controlling behaviour is eight percentage points, equivalent to a 47% reduction from baseline; transfers on health and Hidrobo and Fernald (2013) find a smaller overall reduction in controlling behaviour of and nutrition 139 138 Perova’s (2010) study of Juntos in Peru also finds six percentage points, equivalent to 10%. that emotional abuse decreased in the treatment group by 11 percentage points more than in the Chapter 9 control (a drop of 35% from the baseline level of emotional abuse). In additional models to test for The impact of cash transfers on heterogeneity of impacts, emotional abuse fell most (16 percentage points) for women who have a savings, investment cash-paying job, from which the author concludes that the ‘change in incidence of violence varies and production depending on the woman’s outside of marriage options’ (Perova, 2010). Chapter 10 Haushofer et al. (2015) find that, in the context Evidence of a weak or non-existent relationship. The impact of cash transfers on of the Kenyan Give Directly transfer, the impact of the transfer on emotional abuse is negligible employment and not statistically significant. Green et al. (2015, on the WINGS programme in Uganda) note that a possible explanation for the absence of statistically significant effects in their study (for Chapter 11 certain types of non-physical abuse) is that these mechanisms may both be operating to some The impact of extent, but cancel one another out. They interpret their findings as showing that if any of the cash transfers on empowerment SECTION III 136 n Angelucci (2008) violent behaviour is identified using the question ‘While drinking, does this person (referred to the heaviest drinker) have I an aggressive behavior?’ (in 96% of the cases the ‘heaviest drinker’ identified is the male household head). Chapter 12 E motional abuse is defined in Bobonis et al. (2013) as if the respondent answered yes to any in a range of perceptions based questions ‘e.g. 137 Summary of locked you in, threatened to leave you’. findings and 138 I n both papers the indicator of controlling behaviour is based on having reported any of the following behaviours in the last six months: ‘(1) conclusion accuses woman of being unfaithful, (2) limits woman’s contact with her family, (3) limits woman’s contact with friends, (4) wants to know where the woman is at all times, and (5) ignores or is indifferent to woman.’ References motional abuse is identified if the respondent answers yes to any of the following: ‘having been humiliated by her husband/partner, or if he 139 E threatened to do harm to her or to anyone she cares about, or if he threatened to leave and deprive her of economic aid’ in the last 12 months.

218 Cash transfers: what does the evidence say? Page 218 Contents hypothesised mechanisms is indeed operating then its impact is very weak. Hidrobo and Fernald Acknowledgements (2013, on the BDH in Ecuador) offer under-reporting of physical violence as another partial explanation for some of the non-significant effects. Executive summary This section now turns to mechanisms explaining the statistically significant results. SECTION I Evidence that transfers decrease abusive behaviour. There are two principal theories of change Chapter 1 by which the transfer could lead to less abusive behaviour: Introduction F 1. emale bargaining power increases, as does the woman’s ability to bargain out of violence Chapter 2 – linked to this is the theory of increased ‘reservation utility, or out of marriage options’ Conceptual (Tauchen et al., 1991) framework T ransfers reduce poverty-related stress, in which case abusive behaviour would decrease, 2. Chapter 3 regardless of the gender of the official transfer recipient (Farmer and Tiefenthaler, 1997). Review of cash transfer reviews Hidrobo et al. (2012) on the WFP grant in Ecuador note that the comparison group in their study experienced a surprisingly high surge in reported abuse, for which they do not have a Chapter 4 Methods definitive explanation. The Hidrobo and Fernald (2013) study on the BDH in Ecuador finds that the overall treatment effect for controlling behaviour is a reduction of approximately 10% of the Chapter 5 baseline control group mean level of abuse. However, in a subsequent model which disaggregates The evidence base by the woman’s level of schooling it is found that the effect is only significant for women with six years of schooling or more and that the effect is even larger (a reduction of approximately SECTION II 25% in controlling behaviour), and when disaggregating in this way the effect for emotional abuse becomes significant, too (women with six years of schooling or more experienced a 14% Chapter 6 reduction in emotional abuse). In the Bobonis study (2013) of PROGRESA (Mexico), a decrease The impact of in physical abuse and a simultaneous increase in controlling behaviour as a result of the transfer is cash transfers on explained through the female-bargaining-power hypothesis. In the Angelucci study (2008), also on monetary poverty PROGRESA, abuse also decreases in households receiving the minimum transfer, primarily as a Chapter 7 result of the second mechanism outlined above. The impact of cash transfers on Perova (2010), studying Juntos in Peru, tests both the theory that a woman’s individual income education increases her ‘threat point’, that is her ability to threaten the dissolution of marriage, and increased rent-seeking from the male partner (mechanism number 1 below). She concludes that Chapter 8 The impact of cash the mechanism which drives a husband to increase his level of violence is constrained by his need transfers on health to keep violence below a level at which his female partner would dissolve the marriage. Crucially, and nutrition a female-targeted transfer can enhance out-of-marriage options, and as a consequence lower this ‘threat point’. Perova also refers to focus group discussions in which participants attributed Chapter 9 decreases in domestic violence to 1) women’s improved bargaining power and 2) the reduction in The impact of 140 cash transfers on poverty-related stress. savings, investment and production Alternative mechanisms predict an increase Evidence that transfers increase abusive behaviour. in abusive behaviour by the partner/spouse: Chapter 10 The impact of 1. emale bargaining power increases so the partner/spouse increases his level of non-physical F cash transfers on abuse as an instrument to align expenditure more closely with his preferences (Eswaran and employment Malhotra, 2011) or as a means to extracting rents (Bloch and Rao, 2002). Chapter 11 ncreased female earnings result in ‘male backlash’ or the use of violence to reassert control 2. I The impact of where it is perceived to have been lost. cash transfers on empowerment Despite finding an overall negative effect on both types of abuse, Hidrobo and Fernald’s (2013) finding that emotional abuse and controlling behaviour does not decrease among beneficiary SECTION III women with six years of education or less is a cause for concern (BDH, Ecuador). Of even greater concern is that, for women with six years’ schooling or less who had more or equal schooling to Chapter 12 increase their male partner, the transfer was associated with a nine percentage point or a 16% Summary of findings and in emotional abuse. What this suggests is that ‘violence is likely to increase ... where outside-of- conclusion References 140 H ere Perova (2010) cites Jones et al. (2006) ‘Transferencias condicionadas de efectivo en el Perú: las muchas dimensiones de la pobreza y la vulnerabilidad de la infancia.’ Presentation at UNICEF/New School Conference, New York, October 2006.

219 Cash transfers: what does the evidence say? Page 219 Contents marriage options are not a credible threat point and a power imbalance exists among the couple’, Acknowledgements meaning that less educated women have fewer options to escape abuse and the abuse may even increase as a result of one of the mechanisms outlined above. Perova (2010) draws a similar Executive summary conclusion from her finding that beneficiary women saw the greatest reduction in non-physical abuse when they already had a cash-paying job (this is taken by the author as an indicator of enhanced out-of-marriage options). SECTION I Chapter 1 Although in the Angelucci study (2008, PROGRESA in Mexico), abuse declined initially as a Introduction result of reduced poverty-related stress, an increase in abuse was observed when the transfer was large, especially if the husband was uneducated and married to a younger wife. This is most Chapter 2 consistent with the theory of male backlash against female control of a substantial portion of Conceptual household resources. framework Chapter 3 The study by Bobonis et al. (2013, also on PROGRESA) finds an increase in non-physical violence Review of cash which the authors explain as evidence of increased rent-seeking behaviour by the husband. The transfer reviews study by Green et al. (2015) of the Ugandan WINGS programme shows a similar increase in non- physical violence as a result of ‘increased efforts from intimate partners to capture and control Chapter 4 Methods earnings’. In both cases this is explained more in the language of rent-extraction theory rather than wilful assertion of control over resources. Chapter 5 The evidence base Women’s decision-making power SECTION II Eight studies examined the impact of cash transfers on a woman’s decision-making power – all the results here are reported for women only. These effects are measured at the household level since Chapter 6 The impact of only one woman per household is considered (in some, but not all, cases the transfer recipient). cash transfers on The studies can be categorised into two areas of decision-making: sole decision-making or sole monetary poverty or joint decision-making on expenditures by the woman (eight studies); and any involvement in decision-making on non-expenditure issues by the woman (five studies). The studies were evenly Chapter 7 split between Latin America (Mexico, Ecuador and Brazil) and Africa (Uganda, Kenya and Niger). The impact of cash transfers on education Sole decision-making or involvement in decision-making on expenditure Chapter 8 Five studies yielded statistically significant results and in four cases these results were in a The impact of cash positive direction, meaning that greater autonomy over expenditure decisions was observed in transfers on health specific areas of expenditure as a result of the transfer (Table 11.5). For de Brauw et al. (2014, on and nutrition Brazil’s Bolsa Família), of the five domains of expenditure tested, one yielded a significant result Chapter 9 (expenditure on durable goods) indicating a 7.5 percentage point increase or 54% increase from The impact of the baseline mean. In Handa’s study on PROGRESA (2009) a woman in the treatment group is cash transfers on 4.7 percentage points more likely to have autonomy over how her own income is spent compared savings, investment to the control. and production Chapter 10 In Uganda (Green, 2015, on the WINGS enterprise grant), female transfer recipients were nine The impact of percentage points higher on an index of self-reported autonomy in purchases than the comparison cash transfers on group. As reported in the subsequent section on design and implementation effects (11.4) this employment effect turns negative, meaning the female recipient’s self-reported autonomy is worse than in the Chapter 11 comparison group, for those in the WINGS+ programme where a male partner was allowed to The impact of also partake in the business training classes. cash transfers on empowerment In the Kenyan study by Merttens et al. (2013), the sex of the household head appears to determine transfer impact to the extent that autonomy over budgetary decisions only increased in female-headed households (Merttens, 2013, on the Kenyan HSNP). In the case of Merttens SECTION III et al. (2013) on the Kenyan HSNP, the result on female-headed households, though statistically Chapter 12 significant, must be taken with caution for two reasons: firstly, female-headed households were not Summary of systematically sampled and their representation in the sample is low; secondly, in female-headed findings and households female respondents already reported being the main budget decision-maker 82% of the conclusion time, therefore the increase of 3.8 percentage points in the treatment group represents a modest References 5% increase in the end.

220 Cash transfers: what does the evidence say? Page 220 Contents In the study by Merttens et al. (2015) on the Ugandan SAGE programme, no statistically Acknowledgements significant impact was found for programme participants with regard to the woman being the main decision-maker on how to spend money. This was found to be the case regardless of which Executive summary targeting mechanism was used (the SCG which targeted eligible households on the basis of age criteria or the VFSG which targeted on the basis of a composite index of vulnerability indicators). The authors (Merttens et al., 2015) propose that the lack of an impact might be partly explained SECTION I by the reaction of men to the targeting of female beneficiaries, which in the qualitative data was Chapter 1 sometimes described as an increased tendency to control household decisions, even through the Introduction use of violence in isolated cases. Chapter 2 Decision-making on non-expenditure issues Conceptual framework There were two instances of statistically significant impacts for decisions on non-expenditure Chapter 3 issues (out of four studies), both relating to the decision on the use of contraceptives (Table 11.6). Review of cash In de Brauw et al. (2014) (Bolsa Família, Brazil) the treatment increases the likelihood of the wife transfer reviews being the sole decision-maker about contraception by 10 percentage points. The control mean is 27.5 so this represents roughly a 36% increase. By contrast, in Hidrobo et al. (2012) (looking Chapter 4 Methods at the WFP programme in Ecuador), women in the treatment group are nine percentage points less likely to be the sole or joint decision-maker on the use of contraception (no baseline mean is Chapter 5 given to contextualise this increase). In the case of Bolsa Família (Brazil), the compulsory health The evidence base information sessions are cited as a possible reason for the increase in women’s autonomy over contraception (de Brauw et al., 2014). In Ecuador, transfers were also conditional on attendance SECTION II at monthly nutrition training, however, it is not clear whether this condition was enforced and the training did not relate to reproductive health in any way. Chapter 6 The impact of Importantly, there are no significant differences in female control over decisions relating to child cash transfers on health and schooling, or expenditure in these areas. Theory stipulates that women’s increased monetary poverty personal income will increase her bargaining power (Adato, 2000, on PROGRESA in Mexico) Chapter 7 and a cornerstone of many large-scale interventions is that funds distributed to the principle The impact of female in the household (usually the mother) will be most likely to be used for expenditure on cash transfers on children and health-related matters (the IEG (2015) systematic review goes into these arguments education in detail). According to Adato’s typology (2000), outlined in the theory of change section of this report, the mechanism by which a transfer might increase female decision-making power is Chapter 8 The impact of cash influenced by other pressures within the household, by interpersonal networks and by attitudinal transfers on health norms. It is also possible that the lack of significant results is due to female sole or joint decision- and nutrition making already being at a high level in some categories. Chapter 9 Again, in the Merttens et al. (2015) study no significant impact was detected for the female as The impact of cash transfers on the main decision-maker on children’s schooling and what to do about a serious health problem. savings, investment The authors (Merttens et al., 2015: 86) do, however, refer to qualitative data collected for the and production same project that suggests programme participation ‘helped to promote male acknowledgement of [women’s] contribution to the household’. Chapter 10 The impact of cash transfers on Marriage employment Chapter 11 This subsection contains the evidence for the impact of a cash transfer on the likelihood of The impact of marriage. All the studies in this section only included women and girls within their samples cash transfers on with the exception of Siaplay’s study of the South African old-age pension receipt on marriage empowerment likelihood among adolescent and young adult females and males (Siaplay 2012). Six studies examined the impact of a cash transfer on marriage (Table 11.7). Of these, five yielded SECTION III significant results, three of which suggested delayed marriage in the treatment group (Baird et al., Chapter 12 2010; Baird et al., 2011; Alam and Baez, 2011 – all these studies focused only on females). One Summary of study reported results for males and females separately, finding that the overall impact for females findings and was non-significant, but for males it was also a statistically significant delaying of marriage conclusion (Siaplay, 2012). The remaining study finding significant results suggested that the intervention References actually incentivised marriage, and in this case the sample was composed only of females (Stecklov et al., 2006: the Honduras results).

221 Cash transfers: what does the evidence say? Page 221 Contents For the most part, the studies focused on girls and women between the ages of approximately Acknowledgements 13–26. In one case the sample also included women up to the age of 47. The only study that included impacts for males was Siaplay’s study which looked at a sample of males and females Executive summary aged 14–16. A total of six interventions were studied across the papers. Of these, two were specifically designed to keep girls and young women in school, meaning that delayed marriage was an expected consequence. Three interventions (PROGRESA, the RPS and the PRAF) had school SECTION I enrolment as one condition among several others intended more generally to lead to human capital Chapter 1 formation. The final intervention was an old-age pension, therefore any effect on marriage among Introduction younger household members would be indirect. Chapter 2 Two of the three studies of the Zomba Cash Transfer Programme in Malawi by Baird et al. Conceptual (2010 and 2011) show a reduction in the likelihood of marriage in the treatment group of framework around two or three percentage points. As stated, the results here refer only to women and Chapter 3 girls. It is worth noting that in the later of these two studies the effect was only observed for the Review of cash unconditional treatment group (this will be elaborated on in the section on the impact of design transfer reviews and implementation features). In Alam and Baez (2011, on the Pakistan Female School Stipend Programme) the trade-off effect of schooling and marriage is observed in the finding that CCT Chapter 4 Methods beneficiaries delay marriage by one and a half years on average. Chapter 5 Siaplay’s study (2012, South Africa) of the impact of old-age pension receipt on the marriage The evidence base and fertility outcomes of younger household members yields mixed results which are not fully explained. This is the one study on marriage which reports impacts for both genders. At follow-up, young males in treatment households were 18 percentage points less likely to be married than their SECTION II counterparts in comparison households, and this difference was statistically significant. Young Chapter 6 women in treatment households were five percentage points more likely to be married at follow-up. The impact of However, this difference was not statistically significant. Siaplay also tests for differential impacts cash transfers on by the gender of the pension recipient and these results are presented in section 11.4. monetary poverty Chapter 7 Pregnancy The impact of cash transfers on 10 studies contained results on the impact of cash transfers on fertility: of these five looked only education at the likelihood of pregnancy, two looked only at the likelihood of giving birth, two looked at Chapter 8 both the likelihood of pregnancy and giving birth, and one looked at the likelihood of giving birth The impact of cash and also at number of children (Table 11.8). All studies reported on impacts solely for women and transfers on health girls. Four of the studies focused on South and Central America (Mexico, Honduras, Nicaragua), and nutrition four on Africa (Malawi), one on Pakistan and one on Turkey. All interventions were CCTs with Chapter 9 the exception of the Zomba Malawi cash transfer (the focus of two studies by Baird et al.), which The impact of also includes an unconditional treatment arm. cash transfers on savings, investment Seven studies found a statistically significant impact of the transfer on this outcome. Of these, and production five indicated that the transfer decreased the likelihood of pregnancy or giving birth (Ahmed et al., 2007; Alam and Baez, 2011; Todd et al., 2011; Baird et al., 2011; and Baird et al., 2012). The Chapter 10 The impact of other two statistically significant results show that in the case of Honduras’s PRAF the transfer cash transfers on appears to have incentivised pregnancy (Stecklov et al., 2006 and Stecklov et al., 2007), but this employment appears to be a special case as explained in the text. Chapter 11 The result reported in Ahmed et al. (2007) on the Turkish Social Risk Mitigation Project explains The impact of the decrease in the likelihood of women of childbearing age in beneficiary households becoming cash transfers on empowerment pregnant as a combination of the income effect and exposure to family planning information during the compulsory health check-ups that were a condition of the programme for pregnant women. The result is considered surprising as it has been thought that households might escalate SECTION III their fertility rate to take advantage of the free health centre visits. The income effect may also suggest that household fertility patterns and behaviours differ when a transfer is introduced. Chapter 12 Summary of findings and Alam and Baez (2011) find that the Female School Stipend Program in Pakistan reduces the conclusion number of children that a woman had, if she had any during the study period, by 33 percentage points (although at 10% significance). This is consistent with later marriage ages in the treatment References group. The authors speculate that the transfer may not have an effect on eventual lifetime births, but rather on delaying marriage and pregnancy in favour of schooling.

222 Cash transfers: what does the evidence say? Page 222 Contents On the Nicaragua RPS, Todd et al. (2011) find that the likelihood of giving birth in a given Acknowledgements time period decreases among beneficiaries, indicating wider birth spacing which they tentatively interpret as an indicator of lower fertility rates overall. Of the two studies by Baird et al. (2010; Executive summary 2011) on Malawi, only one (2011) finds a significant impact on pregnancy and this represents a large decrease in the odds of pregnancy in the unconditional treatment group. As with marriage, the explanation here is that this coefficient shows something like the pure income effect of SECTION I the transfer on fertility, since the unconditional transfer group are under no incentive to swap Chapter 1 childbearing for school. Introduction In the case of Honduras’s PRAF, Stecklov et al. find in two similar studies that women in the Chapter 2 treatment group were four to six percentage points more likely to have given birth between survey Conceptual rounds or to be pregnant at the time of survey. In the 2006 paper this is equivalent to a 20% framework increase on baseline at first follow-up and 19% increase after two years. In the 2007 paper the Chapter 3 overall effect is found to be an increase of approximately 17% in the likelihood of having given Review of cash birth or being currently pregnant compared to the control group, and a much higher 36% increase transfer reviews among treatment women who were married at baseline. The authors suggest this to be a result of incentives created by the programme, in which the transfer amount increases with the addition of Chapter 4 Methods a pregnant woman and/or new child (Stecklov et al., 2007). Chapter 5 The evidence base Contraception Nine papers dealing with the impact of a cash transfer on the use of contraception were reviewed SECTION II for this study (Table 11.9). Five papers looked at impacts solely on females (Baird et al., 2010; Feldman et al., 2009; Perova and Vakis, 2012; Stecklov et al., 2006; Stecklov et al., 2007) and the Chapter 6 The impact of remaining four looked at impacts for males and females separately (Cluver et al., 2013; Handa cash transfers on et al., 2014; Kohler and Thornton, 2011; Siaplay, 2012). Five of the studies reported only on the monetary poverty prevalence/likelihood of any modern contraceptive, two reported only on the use of condoms, and two reported on the use of condoms and also on safe sex (meaning condom use or abstinence). Chapter 7 The period being reported on differed considerably by study. One study reported on having The impact of used contraceptives in the last year, one in the last three months, one the last nine days, two the cash transfers on education most recent instance of sexual intercourse (with no time restriction) and four the current use of contraceptives over an unclear window of time. Chapter 8 The impact of cash With three exceptions, the interventions were all conditional cash transfers. There were two transfers on health instances of an unconditional child grant (Cluver et al., 2013, in South Africa and Handa et al., and nutrition 2014, in Kenya) and one of an unconditional old-age pension (Siaplay, 2012, in South Africa). Chapter 9 The impact of Six of the studies yielded statistically significant results. Five out of these six studies found cash transfers on relatively unambiguous evidence that cash transfers increase the use of contraceptives or reduce savings, investment the likelihood of unsafe sex (Cluver et al., 2013, in South Africa; Feldman et al., 2009, in Mexico; and production Perova and Vakis, 2012, in Peru; Stecklov et al., 2006, and Stecklov et al., 2007, in Nicaragua and Chapter 10 Mexico). The two studies by Stecklov et al. (2006; 2007) indicate that programme participation The impact of increased the use of any modern contraceptive over the last 18 months by five to six percentage cash transfers on points in Nicaragua and around two percentage points in Mexico, above what was observed in employment the control group (no baseline means are given). In Peru, Perova and Vakis (2012) identify an Chapter 11 increasing gap between the treatment and control groups over time as to the likelihood of using The impact of contraception. The effect ‘accumulates over time’, starting at eight percentage points at 12–23 cash transfers on months exposure to Juntos and reaching 18 percentage points after 36 months in the programme. empowerment The authors note that in the absence of data on initial impacts (<12 months in the programmes) it is not clear whether this represents a lagged effect or simply a cumulative effect. SECTION III The remaining study with a statistically significant result found an increase in contraceptive use Chapter 12 or abstinence among female beneficiaries and an opposite effect for males (Kohler and Thornton, Summary of 2011, on the Malawian incentive experiment). The effect for females is an increase in reported findings and safe sex or abstinence equivalent to around 17%. Male beneficiaries are more likely to use conclusion condoms (taking into account the very low baseline mean level of condom use, this represents References an increase of approximately 65%) but also to engage in riskier sex (approximately 18% less likely), which is explained as males in the treatment group engaging in more sex overall. The

223 Cash transfers: what does the evidence say? Page 223 Contents same study compared outcomes for low and high transfer level beneficiaries (approximately US$4 Acknowledgements and US$10, respectively) and found a statistically significant response to different transfer levels only for females. The authors note two possible explanations for the results: that the additional Executive summary income could have been used by males to purchase risky sex and used by women as a substitute for ‘selling’ risky sex; alternatively, the transfer was conditional on the beneficiary testing negative to an HIV test which may have removed a constraint to risky sex by acting as proof of negative SECTION I status (but only for men). Chapter 1 Introduction Handa et al. (2014), focusing on the Kenyan OVC-cash transfer, compare the transfer’s impact by the gender of the household member being interviewed (specifically young adults in the household Chapter 2 aged 15–25) on contraceptive use and having had unprotected sex. Both males and females were Conceptual more likely to report condom use (although this was not statistically significant), but males were framework more likely to report having engaged in unprotected sex while females were less likely to report Chapter 3 this (although again this was not statistically significant). Review of cash transfer reviews Multiple partners Chapter 4 Methods Four studies investigated the effect of the transfer on an individual having multiple sexual partners in a given space of time (in all cases this period was the 12 months prior to the survey), see Chapter 5 The evidence base Table 11.10. Three out of four papers reported results for males and females separately with the remainder reporting only for females (Baird et al., 2010). All the studies focused on countries in sub-Saharan Africa (Baird et al. on Malawi; Handa et al. on Kenya; and Siaplay and Cluver et al. SECTION II on South Africa). In one study the outcome variable of interest was the number of sexual partners (Baird et al., 2010) and in the others it was a binary variable for having had two or more sexual Chapter 6 The impact of partners. In two of the studies the respondent was the beneficiary himself or herself, and in the cash transfers on remainder he or she was a member of a household that received a child grant for orphaned and monetary poverty vulnerable children (Handa et al., 2014) or an old-age pension (Siaplay, 2012). All the studies focused on sub-Saharan Africa (Malawi, South Africa and Kenya). Three out of four studies Chapter 7 yielded statistically significant results, the exception being another South African study, on the The impact of pension (Siaplay, 2012). cash transfers on education The studies which yielded statistically significant results all showed a reduction in the incidence of Chapter 8 multiple partners among beneficiaries. The studies by Baird et al. (2010) and Cluver et al. (2013) The impact of cash were similar in that they tested the effect of a cash transfer on the sexual behaviour of an adolescent transfers on health or young adult beneficiary. In both cases the effect is reported jointly for a conditional and and nutrition unconditional transfer since in the South African case the Child Grant is de facto unconditional Chapter 9 while the less prevalent Foster Grant has many conditions attached (Cluver et al., 2013), and in the The impact of Malawian case a conditional and unconditional arm were built into one experimental intervention cash transfers on (Baird et al., 2010). In the case of South Africa (Cluver et al., 2013), female beneficiaries had savings, investment much lower odds of having two or more sexual partners in the past year, compared to female and production non-beneficiaries. However, the effect did not hold for male beneficiaries. The authors (Cluver et Chapter 10 al., 2013) rule out the possibility that conditionality (health check-ups and so on) drive the effect The impact of by noting that only 0.7% of the sample received the CCT Foster Grant as opposed to the UCT cash transfers on child grant. A partial explanation is the reduction in transactional and age-disparate relationships employment resulting from a rise in female income. In the treatment group, 41% were male and this figure was Chapter 11 46% in the control group. In the Malawian case, beneficiaries had on average 25% fewer sexual The impact of partners than non-beneficiaries – all beneficiaries were female (Baird et al., 2010). cash transfers on empowerment Handa et al. (2014, on the Kenyan OVC transfer) also find substantially reduced odds of having two or more sexual partners in the past year among females in households receiving a child grant. Again, the result did not hold for males in beneficiary households. The OVC transfer is earmarked for SECTION III spending on the care of an orphan or vulnerable child in the household, and is given to their primary Chapter 12 caregiver, however no enforcement exists as to how the money is spent. Since not all interviewees Summary of were necessarily an orphan or vulnerable child, it is not clear what benefit they are directly findings and receiving from the lump-sum household transfer. However, Handa and colleagues (2014) explain conclusion the reduction in the prevalence of multiple partners in the treatment sample as a consequence of the References reduced need to engage in transactional sex of some kind. They also speculate as to whether a kind of ‘hopefulness’ dividend from the transfer leads to a reduction in risky sexual behaviour.

224 Cash transfers: what does the evidence say? Page 224 Contents In the study by Siaplay (2012) the impact on multiple partners is not significant for either Acknowledgements gender. There is however a statistically significant and negative impact of transfer receipt on the probability that a young adult/adolescent in the house has ever had sex (this indicator is not Executive summary included in our study) and on marriage (although results differ by gender). SECTION I 11.4 he role of cash transfer design and implementation features T Chapter 1 Introduction Eleven studies reported specific findings on the role of design and implementation features (see Table 5.6.1 in Annex 5 for impacts found) and statistically significant results were found in eight. Chapter 2 They found the following results: Conceptual framework • transfer ne study disaggregated spillover effects in the household by the gender of the O . Siaplay (2012, on South Africa) found that young adults (aged 14–26 at baseline) recipient Chapter 3 were more likely to be married at follow-up, relative to the comparison group, when in a Review of cash transfer reviews household with a male old-age pension recipient. When the pension recipient was female, young males in the household were instead less likely to be married at follow-up, and the Chapter 4 impact on females was not statistically significant. Methods wo studies considered differences by transfer level • T of which both yielded significant results. Chapter 5 They find that under certain circumstances a larger transfer increases the likelihood of physical The evidence base abuse and that, for females only, the larger the transfer the more likely the recipient is to report using contraception or abstaining from sex. SECTION II T , with two finding at least one significant result. hree studies considered duration of exposure • These indicate that prolonged exposure lowered the likelihood of marriage and pregnancy and Chapter 6 The impact of increased the likelihood of contraceptive use. cash transfers on T wo studies compared effects by (both of the conditionality/behavioural requirements • monetary poverty Malawian Zomba transfer) and significant results were found in one. In this case the UCT Chapter 7 group was overall less likely to be married at follow-up but no effect was observed in the CCT The impact of group. cash transfers on education T • wo studies looked at (both of the same intervention in Niger which payment mechanisms distributed payments through mobile money transfer or cash) but neither yielded statistically Chapter 8 significant results. The impact of cash transfers on health T wo studies considered , specifically complementary interventions and supply-side services • and nutrition business training (both in the same programme in Uganda) and both yielded significant results. Women in households receiving complementary interventions were more likely to report non- Chapter 9 physical abuse and experience a decline in decision-making power. The impact of cash transfers on O • ne study compared two transfers within the same broad intervention which use different savings, investment targeting mechanisms , although no significant impact on female decision-making power was and production observed under either mechanism. Chapter 10 The impact of These studies are now discussed in more detail. cash transfers on employment Main recipient Chapter 11 The impact of n a study of old-age pension recipient households in South Africa, Siaplay (2012) observes • I cash transfers on spillover effects of a pension on adolescent and young adult household members with regard empowerment when . Siaplay disaggregates by the gender of the pension recipient, finding that marriage to the likelihood of the young adult respondent being married at the pension recipient is male, follow-up increases, regardless of the young adult’s gender, relative to the comparison group. SECTION III This impact is a 23 percentage point increase for young females and a 24 percentage point Chapter 12 increase for males. Conversely, , both young females and when the pension recipient is female Summary of young males in the household are less likely to be married at follow-up than the comparison findings and group, although the difference is only statistically significant for young males, where it conclusion represents a 27 percentage point decrease. The partial explanation given for the increase in References marriage rates in the treatment group is that early marriage is a protective strategy against pre- marital pregnancy and HIV infection (Bracher et al., 2003; and Clark, 2004, are cited) and the

225 Cash transfers: what does the evidence say? Page 225 Contents pension transfer alleviates the related financial constraint. The finding that males in female- Acknowledgements pension-recipient households are less likely to marry is possibly linked to other findings in the study indicating that transfer decreases labour force participation of males in female-pension- Executive summary recipient households. SECTION I Transfer levels Chapter 1 A ngelucci (2008) shows that the overall impact of PROGRESA on drunken violence by a male • Introduction partner is negative (-1.6 percentage points). However, when disaggregated by transfer level the highest possible transfer level yields a positive impact of five percentage points. The largest Chapter 2 transfer size is 625 Mexican pesos while the smallest is 100 pesos. The author notes that the Conceptual additional income from the smallest transfer still leaves the husband as the main provider framework of income (providing 70%, down from 96%) while the largest transfer causes his share in Chapter 3 providing income to almost half (52%, down from 96%). Review of cash transfer reviews ohler and Thornton (2011) test the differential impact of a transfer on safe sex practices. K • However, their impact estimates are relative to the control group and the difference between Chapter 4 them is not tested. They find that there was no statistically significant impact on condom use Methods among males or females, regardless of transfer size (amounts of either roughly US$4 or US$10 (condom use at last sex or abstinence) indicator, they find safe sex were distributed). For the Chapter 5 The evidence base that the transfer decreased the likelihood of safe sex among males by -8.8 percentage points (low transfer) and -9.2 percentage points (high transfer) and these differences were significant relative to the control group. For females the high transfer produced an impact of 8.7 SECTION II percentage points (significantly different to the control group) and the low transfer an impact of 4.6 percentage points (not significant). The authors (Kohler and Thornton, 2011) report Chapter 6 The impact of that differential impacts by transfer size were only statistically significant from one another for cash transfers on female beneficiaries. monetary poverty Chapter 7 Duration of exposure The impact of • aird et al. (2011) estimate the effect of the Malawian ZCTP on women and girls at around B cash transfers on education 12 months and just after 24 months (the programme ran for two years so the final survey , longer exposure to the treatment increased was conducted after it had ended). For marriage Chapter 8 the difference between the treatment and control group to the effect that beneficiaries were The impact of cash 7.9 percentage points less likely to be married after two years. However, this effect was only transfers on health significant for the UCT group. Related to this, the UCT group were also much less likely to be and nutrition pregnant after two years compared to the control group. Chapter 9 I n Behrman et al. (2005) the impacts of longer exposure to the programme on the likelihood of • The impact of cash transfers on marriage are negligible, -1 percentage point for females, -0.6 percentage points for males and savings, investment not statistically significant. The longer length of duration is 4.5 years compared to a shorter and production length of three. Elsewhere in the study the authors find that, when disaggregating by years of schooling completed in 1997 (at baseline), there is a significant effect of the transfer on the Chapter 10 likelihood of abuse if they had seven or more years of schooling (-25.4%), also four years of The impact of cash transfers on schooling. They argue that if the intervention happened at certain critical ages then it had an employment , as in the table, none of the age effect on marriage likelihood; however, when disaggregated by coefficients is significant. Chapter 11 The impact of • erova and Vakis (2012) find that the impact of treatment on women and girls is cumulative P cash transfers on as the duration of exposure increases. In Juntos (Peru), beneficiaries in the programme for less empowerment ; for 12–23 contraception than 12 months were 1.2 percentage points more likely to be using months this figure was eight percentage points; for 24–36 months it was 12 percentage points; and for over 36 months it was 18 percentage points. SECTION III Chapter 12 Conditionalities Summary of findings and B • aird et al. (2011) test the difference between the UCT and CCT treatment groups with regard conclusion to marriage and pregnancy outcomes for women and girls. The authors find a significant References difference in the likelihood of marriage among beneficiaries of the Malawian ZCTP to the effect that the UCT had a substantially larger effect of decreasing marriage rate (by three

226 Cash transfers: what does the evidence say? Page 226 Contents percentage points more than the control group). The UCT had a similarly stronger effect Acknowledgements on reducing pregnancy (two percentage points more than the CCT group) but this was not statistically significant. This effect was almost entirely accounted for by UCT beneficiaries Executive summary who were in school at baseline but dropped out. The authors conclude that the cash enabled women to avoid reliance on relationships with men, noting that ‘approximately 25% of the young women who were sexually active at baseline reported that they started their sexual SECTION I relationships because they “needed his assistance” or “wanted gifts/money”.’ Chapter 1 • I n a similar study on the same intervention (the Malawian ZCTP) the same authors (2012) Introduction find that beneficiaries were less likely to get married than the comparison group, and this did Chapter 2 not differ to a statistically significant degree between conditional and unconditional treatment Conceptual arms (odds ratio of 0.93 for the conditional arm; 0.36 for the unconditional arm). In the same framework study, the conditional arm appeared to be more likely to be pregnant at follow-up (odds ratio of 1.17, not statistically significant) but the unconditional arm beneficiaries were much less Chapter 3 likely to be pregnant at follow-up (odds ratio of 0.16) compared to the control group. Review of cash transfer reviews Targeting mechanism Chapter 4 Methods T • he study by Merttens et al. (2015) of the Ugandan SAGE programme compares impacts across the programme’s two sub-interventions. One intervention is the Senior Citizens’ Grant Chapter 5 The evidence base (SCG) which targets on the basis of age (over 65) and the other is the Vulnerable Family Support Grant (VFSG) which targets using a composite index designed to capture household vulnerability. Although, strictly speaking, the difference in impact of one targeting mechanism SECTION II over another is not tested using statistical methods, the paper does allow for and encourage comparison between the two. It should also be noted that there are differences between Chapter 6 The impact of the two sub-interventions that go beyond targeting criteria. Merttens et al. (2015) find no cash transfers on statistically significant impact of programme participation in either of the treatment groups monetary poverty (SCG and VFSG). A partial explanation for this is that male backlash against the targeting of females as beneficiaries in some cases increased levels of controlling behaviour by males in the Chapter 7 household, and in specific cases even increased domestic violence. There are visible, though The impact of untested, differences in the impacts: for the SCG (age-targeted) group they are larger and cash transfers on education generally positive in direction, while those for the VFSG grant are in fact negative in sign, and minimal in size (though in neither case are the impacts statistically significant). Chapter 8 The impact of cash transfers on health Payment mechanism and nutrition T • he two extensive studies by Aker et al. (2011 and 2014, of the Zap Mobile Cash Transfer Chapter 9 Programme in Niger) comparing transfer delivery methods yielded almost no significant results The impact of : the only case of statistical women’s decision-making power when testing for impacts on cash transfers on significance indicated that the respondent (it is implied that the respondent is female, but savings, investment this is not explicitly stated in the paper) was more likely to be involved in deciding how the and production transfer was spent in the mobile-delivery and cash-delivery-with-mobile treatment arms, as Chapter 10 opposed to plain cash delivery. It is not therefore possible to disentangle the effect of owning The impact of a mobile phone from receiving the cash transfer via mobile payment. The authors suggest that cash transfers on differences in norms between the major ethnic groups captured in the sample might obscure employment the effect (Aker et al., 2011). They also provide some qualitative evidence that the use of a text Chapter 11 message to announce the arrival of the transfer allowed the female beneficiary to retain this The impact of information until she identified a favourable time to share the news with her husband, resulting cash transfers on in her being more included in the discussion of how to spend it (Aker et al., 2014). empowerment Complementary interventions and supply-side services SECTION III • women’s and B lattman et al. (2015) estimate the impact on physical and emotional abuse Chapter 12 of an intervention which gave women cash earmarked for a business decision-making power Summary of and also delivered complementary training workshops (the WINGS intervention in Uganda). findings and The study estimates the additional effect on the outcomes of being entitled to attend these conclusion trainings. The authors find that physical and emotional abuse decrease when beneficiaries (and References their partners) take part in complementary workshops (however the result is non-significant). The authors find a large increase in reports of controlling behaviour by the male partner in

227 Cash transfers: what does the evidence say? Page 227 Contents the training group (13 percentage points higher than the non-training group). It is not clear Acknowledgements whether the husband participated in the training, although they were encouraged to attend, but the fact that the wife participated suggests a model where husbands ‘encourage but then Executive summary control their wife’s business earnings, in return for weak increases in purchasing autonomy’. The authors do, however, test whether participation in the programme and the complementary trainings have an effect on the wife’s autonomy in purchases , and find no significant result. SECTION I In the Blattman paper (2015), under-reporting of domestic violence is given as a partial Chapter 1 explanation for the lack of significant results. Introduction reen et al. (2015) also study the impact of the WINGS programme in Uganda, but pool the G • Chapter 2 effect of the cash and the complementary business training. In the paper they first consider Conceptual the impact of participation in the WINGS programme and then the impact of the sub- framework programme WINGS+, which encouraged (but did not enforce) the beneficiary to attend the business training with another household member who was typically responsible for financial Chapter 3 decisions (in most cases this was the woman’s male intimate partner). This second part of Review of cash transfer reviews the study estimates the impact of a male intimate partner attending the training with the female beneficiary. For , women’s decision-making power and physical and emotional abuse Chapter 4 the authors compare the intent-to-treat effect between women with and without an intimate Methods partner, on the assumption that the partner would have attended the training. The authors find that the difference between the groups that did and did not attend training with a male partner Chapter 5 The evidence base is not statistically significant. I n Green et al. (2015) it is also found that self-reported autonomy over purchases was 11 • SECTION II percentage points lower than in the control group for female WINGS+ beneficiaries as a whole (however, the statistical significance of this result disappeared when limiting the sample to Chapter 6 those who recorded having an intimate partner at baseline). This is a very different result The impact of to that found using the full sample (all female WINGS beneficiaries rather than the reduced cash transfers on WINGS+ sample), where self-reported autonomy over spending decisions rose by nine monetary poverty percentage points in the treatment group. Chapter 7 The impact of cash transfers on olicy implications P 11.5 education The evidence synthesised here points to female cash transfer beneficiaries reducing engagement Chapter 8 The impact of cash risky sexual behaviours, delaying marriage and pregnancy and increasing contraceptive use in transfers on health (Baird et al., 2010, Handa et al., 2014, Cluver et al., 2013, Kohler and Thornton, 2011, Feldman and nutrition et al., 2009, Perova and Vakis, 2012, Stecklov, 2006, Stecklov, 2007). The reduction appears to be mostly explained by females using the extra income to opt out of sexual relationships that are to Chapter 9 an extent transactional. However, for males there was at times an increase or no reduction in risky The impact of cash transfers on sexual behaviours (Kohler and Thornton, 2011; Cluver et al., 2013). These initial findings offer savings, investment some indication that gender should be a consideration in the design of interventions. However, the and production evidence base is rather thin and needs bolstering. Chapter 10 Secondly, there is consensus in the evidence that cash transfers reduce the physical abuse of The impact of cash transfers on within the home (Angelucci, 2008; Bobonis et al., 2013; Hidrobo et al., 2012; Hidrobo women employment et al., 2013; Hidrobo and Fernald, 2013), although with some nuances that are highlighted later in this section. Theory stipulates that cash transfers may have the unwanted consequence Chapter 11 by the male partner. The evidence base is quite evenly non-physical types of abuse of increasing The impact of split on this subject, with several studies capturing a decrease in non-physical abuse (Hidrobo cash transfers on et al., 2013; Hidrobo and Fernald, 2013) however there are some compelling examples of empowerment unintended consequences, for example in the WINGS programme in Uganda studied by Green et al. (2015) and Blattman et al. (2015). In this case, male partners were encouraged to attend SECTION III the complementary business trainings. However, the evidence suggests that exposure to the programme without having access to the cash (the beneficiaries were for the most part female) Chapter 12 may have increased rent-seeking and controlling or threatening behaviour. To offset these negative Summary of findings and consequences, such interventions could include a component aimed exclusively at men, such as an conclusion information/education campaign. References Third, almost all the significant results for female decision-making power showed that the transfer impact is positive, the vast majority of results showed no significant impact (six out of

228 Cash transfers: what does the evidence say? Page 228 Contents almost 40 pieces of evidence extracted for this review were significant). What this suggests is that Acknowledgements the assumed mechanism through which an increase in women’s individual income increases her autonomy may not be functioning as imagined. Particularly when taking into account the evidence Executive summary that in some circumstances a transfer increases controlling behaviour by the male partner, there is a clear suggestion that intra-household politics, perhaps in particular gender politics, disrupts the imagined linear relationship between income and power. A common assumption is that when a SECTION I female controls the household purse we are likely to see an increase in expenditure on child-related Chapter 1 items and nutritious food (Whitehead, 1981; Roldán, 1987). However, Chapter 4 of this report Introduction shows there is little evidence that, for instance, female-headed households have comparatively higher food expenditure. This means that more research is needed to test the link between Chapter 2 decision-making power and changes in expenditure patterns. Conceptual framework Fourth, in some circumstances the impact of a transfer is clearly limited by supply-side factors. In Chapter 3 other words, in order for cash transfers to be more effective in improving empowerment outcomes Review of cash they may need to be combined with parallel or complementary initiatives. Future interventions transfer reviews could be designed taking into account the severity of supply-side restrictions and the possibility of mitigating these, some of which are: Chapter 4 Methods B • arriers to contraceptive uptake and information sessions on reproductive health (sessions seen to be effective in de Brauw et al., 2014). Chapter 5 The evidence base • ack of opportunities for women without recourse to relationships with men that are in some L manner transactional (transactional sexual relationships were observed in several of the papers, SECTION II including those by Baird et al., 2010, 2011, and 2012; Siaplay, 2012; Cluver et al., 2012; and Handa et al., 2015). Chapter 6 The impact of L • ow school quality and barriers to accessibility, in particular the undervaluing of girls’ cash transfers on education (Baird et al., 2011). monetary poverty The existing evidence on the impact of complementary interventions and supply-side services is Chapter 7 limited since only two studies considered the effect of participation in these. The impact of cash transfers on education Finally, based on the existing evidence, design and implementation features appear to sometimes affect these impacts. However, the evidence is extremely sparse. There are examples presented Chapter 8 (Perova and Vakis, 2012; Baird et al., 2011) and also here of impacts that accumulate over time The impact of cash of impacts that differ by transfer size (Angelucci, 2008; Kohler and Thornton, 2011). In the transfers on health Angelucci study the worrying conclusion is that a larger transfer increased the prevalence of and nutrition physical domestic abuse. This is explained as a consequence of the transfer’s disruptive effect on Chapter 9 the balance of income provision in the household. Conditionality also proved to be important in The impact of the Baird studies of the Malawian Zomba cash transfer to school-age girls and young women in cash transfers on un conditional transfer proved to be effective at reducing pregnancy and the sense that only the savings, investment marriage rates. However, the authors’ explanation for the differential impacts relates more to the and production design of the study than to incentives created by the (lack of) conditionality requirement. Again, it Chapter 10 should be emphasised that the evidence base is thin and there is a need for more studies testing the The impact of role of different design and implementation features in shaping empowerment outcomes. cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

229 Cash transfers: what does the evidence say? Page 229 Contents Table 11.3: Summary of results for overall cash transfer effect on physical or sexual abuse Acknowledgements Size of Programme Paper Unit of Statistical Effect of (default Specific variable effect significance = overall effect) change Executive summary Male partner is aggressive 1% 1 Percentage PROGRESA (Mexico) Angelucci (2008) -0.016 when drinking points SECTION I Male partner is aggressive Percentage 0.051 5% Transfer level PROGRESA (Mexico) when drinking (maximum transfer) points Chapter 1 Bobonis et al. (2013) 2 10% -0.055 PROGRESA (Mexico) Physical abuse Percentage Introduction points −0.050 PROGRESA (Mexico) NS Sexual abuse Percentage Chapter 2 points Conceptual Give Directly (Kenya) 3 Haushofer et al. (2015) Physical abuse NS Percentage -0.00 framework points Chapter 3 -0.00 Sexual abuse 5% Give Directly (Kenya) Percentage points Review of cash transfer reviews 4 Hidrobo et al. (2012) Physical and/or sexual abuse WFP cash transfer Percentage 10% -0.07 points (Ecuador) Chapter 4 NS 5 Hidrobo and Fernald (2013) Physical abuse -0.02 Percentage BDH (Ecuador) Methods points 5% WFP cash transfer 6 Hidrobo et al. (2013) Moderate physical abuse -0.05 Percentage Chapter 5 points (Ecuador) The evidence base NS Percentage -0.01 Severe physical abuse WFP cash transfer (Ecuador) points SECTION II Sexual abuse -0.05 Percentage WFP cash transfer NS (Ecuador) points Chapter 6 5% Percentage -0.09 Physical abuse Perova (2010) Juntos (Peru) 7 The impact of points cash transfers on NS Sexual abuse Percentage -0.03 Juntos (Peru) monetary poverty points Chapter 7 Notes: ‘Physical abuse’ here refers to physical abuse of a female by a male partner. Results represent all The impact of overall results reported and do not include those disaggregated by gender or showing the effect of variations cash transfers on in design features (with exceptions). Figures in bold indicate statistically significant. NS = not significant at education 10% significance level or below. Chapter 8 The impact of cash Table 11.4: Summary of results for overall cash transfer effect on emotional/non-physical abuse transfers on health and nutrition Paper Specific variable Size of Effect of Unit of change Programme Statistical effect significance Chapter 9 Percentage points 0.027 Emotional abuse Bobonis et al. (2013) 1 PROGRESA (Mexico) NS The impact of cash transfers on Emotional abuse 0.04 Percentage points Only those who did not 10% PROGRESA (Mexico) savings, investment experience physical violence and production WINGS (Uganda) 5% 2 Green et al. (2015) Physical and emotional abuse 0.02 Percentage points Chapter 10 Percentage points Controlling behaviour 0.14 WINGS (Uganda) 5% The impact of Emotional abuse 3 Haushofer et al. (2015) 0.00 Percentage points NS Give Directly (Kenya) cash transfers on employment -0.03 Emotional abuse NS WFP cash transfer 4 Hidrobo et al. (2012) Percentage points (Ecuador) Chapter 11 Percentage points - 0.10 Controlling behaviour WFP cash transfer 5% The impact of (Ecuador) cash transfers on Hidrobo et al. (2013) WFP cash transfer 5 NS Emotional abuse -0.05 Percentage points empowerment (Ecuador) WFP cash transfer 5% Controlling behaviour Percentage points -0.08 (Ecuador) SECTION III BDH (Ecuador) 6 Hidrobo and Fernald NS Emotional abuse -0.02 Percentage points Chapter 12 (2013) 5% BDH (Ecuador) Controlling behaviour -0.06 Percentage points Summary of BDH (Ecuador) Emotional abuse -0.08 Percentage points 10% Mothers with >6 years findings and of schooling only conclusion Controlling behaviour - 0.14 Percentage points 5% Mothers with >6 years BDH (Ecuador) of schooling only References 7 Perova (2010) Emotional abuse - 0.11 Percentage points 5% Juntos (Peru)

230 Cash transfers: what does the evidence say? Page 230 Contents Table 11.5: Summary of results for overall cash transfer effect on woman as sole or sole/joint decision- maker on expenditures Acknowledgements Specific variable Paper Size of Effect of Unit of Programme Statistical Executive summary significance effect change -0.33 1 PROGRESA (Mexico) NS Z-score Adato et al. (2000) Woman is sole decision-maker on child clothing expenditures SECTION I Woman is sole decision-maker on -0.845 Z-score NS PROGRESA (Mexico) Chapter 1 food expenditure Introduction -1.0 4 8 Z-score NS PROGRESA (Mexico) Woman is sole decision-maker on expenditure on durable goods Chapter 2 PROGRESA (Mexico) Woman is sole decision-maker on - 0.117 Z-score NS Conceptual expenditure on house repair framework Woman is sole decision-maker on PROGRESA (Mexico) 0.281 Z-score NS how to spend her extra income Chapter 3 Review of cash 0.00 Bolsa Família (Brazil) 2 Woman is sole decision-maker on Percentage de Brauw et al. (2014) NS transfer reviews points food expenditure NS Bolsa Família (Brazil) Woman is sole decision-maker on Percentage 0.028 Chapter 4 clothing expenditure for self points Methods Bolsa Família (Brazil) Woman is sole decision-maker on NS Percentage 0.043 child clothing expenditures points Chapter 5 The evidence base Woman is sole decision-maker on 0.059 NS Percentage Bolsa Família (Brazil) health expenditures for children points 10% Percentage 0.075 Woman is sole decision-maker on Bolsa Família (Brazil) SECTION II expenditure on durable goods points Z-score 0.09 Green et al. (2015) WINGS (Uganda) 3 10% Self-reported autonomy/influence in Chapter 6 purchase (z-score) The impact of Handa et al. (2009) Percentage 0.047 4 Woman is sole decision-maker on PROGRESA (Mexico) 1% cash transfers on how to spend her extra income points monetary poverty 0.074 PROGRESA (Mexico) Units Decision-making index (composed of 1% Chapter 7 unspecified five questions) The impact of Woman is sole or joint decision- 5 Hidrobo et al. (2012) WFP cash transfer NS -0.00 Percentage cash transfers on maker on food expenditure (small points (Ecuador) education daily purchases) Woman is sole or joint decision- -0.01 Percentage NS WFP cash transfer Chapter 8 maker on food expenditure (large (Ecuador) points The impact of cash food purchases) transfers on health Woman is sole or joint decision- -0.01 NS Percentage WFP cash transfer and nutrition maker on expenditure on durable (Ecuador) points goods Chapter 9 Woman is sole or joint decision- Hidrobo et al. (2013) 6 Percentage WFP cash transfer NS 0.01 The impact of maker on food expenditure (small (Ecuador) points cash transfers on daily purchases) savings, investment and production Woman is sole or joint decision- NS -0.02 WFP cash transfer Percentage maker on food expenditure (large points (Ecuador) food purchases) Chapter 10 The impact of Woman is sole or joint decision- NS Percentage -0.03 WFP cash transfer cash transfers on maker on expenditure on durable points (Ecuador) goods employment 7 Percentage HSNP (Kenya) NS Merttens et al. (2013) Female is main budget decision- 0.027 Chapter 11 maker points The impact of 0.038 HSNP (Kenya) 5% Percentage Female-headed Female is main budget decision- cash transfers on households points maker empowerment HSNP (Kenya) Female is main budget decision- 0.016 Percentage Male-headed NS points maker households Female is decision-maker on how to SAGE (Uganda) Percentage 8 Merttens et al. (2015) SCG 0.0081 NS SECTION III invest money points Chapter 12 Female is decision-maker on how to -0.0056 Percentage NS VFSG SAGE (Uganda) Summary of invest money points findings and conclusion Notes: results represent all overall results reported and do not include those disaggregated by gender or showing the effect of variations in design features. Figures in bold indicate statistically significant. NS = not References significant at 10% significance level or below.

231 Cash transfers: what does the evidence say? Page 231 Contents Table 11.6: Summary of results for overall cash transfer effect on woman being involved in decision- making on issues other than expenditure Acknowledgements Specific variable Effect Statistical Unit of change Size of Paper Programme Executive summary significance effect of Z-score 1 Adato et al. (2000) Woman is sole decision-maker on whether to take -0.304 NS PROGRESA child for medical treatment (Mexico) SECTION I PROGRESA NS Z-score -0.377 Woman is sole decision-maker on whether child goes out (Mexico) Chapter 1 Introduction NS de Brauw et al. Percentage points Woman is sole decision-maker on children’s Bolsa Família 0.07 2 (Brazil) school attendance (2014) Chapter 2 0.033 Percentage points NS Bolsa Família Woman is sole decision-maker on whether she Conceptual should work (Brazil) framework Percentage points 0.096 Woman is sole decision-maker on use of Bolsa Família 5% (Brazil) contraception Chapter 3 Review of cash WFP cash transfer 3 Hidrobo et al. (2012) Woman is sole or joint decision-maker on whether -0.01 Percentage points NS transfer reviews she should work (Ecuador) Percentage points NS WFP cash transfer Woman is sole or joint decision-maker on -0.03 Chapter 4 (Ecuador) children’s school attendance Methods WFP cash transfer -0.01 NS Percentage points Woman is sole or joint decision-maker on matters relating to children’s health (Ecuador) Chapter 5 NS WFP cash transfer Percentage points 0.02 Woman is sole or joint decision-maker on matters The evidence base relating to her own health (Ecuador) WFP cash transfer NS Percentage points Woman is sole or joint decision-maker on whether Hidrobo et al. (2013) 4 0.01 SECTION II she should work (Ecuador) NS Percentage points -0.04 Woman is sole or joint decision-maker on WFP cash transfer Chapter 6 (Ecuador) children’s school attendance The impact of -0.03 WFP cash transfer NS Percentage points Woman is sole or joint decision-maker on matters cash transfers on relating to children’s health (Ecuador) monetary poverty 0.02 NS Woman is sole or joint decision-maker on matters Percentage points WFP cash transfer (Ecuador) relating to her own health Chapter 7 The impact of WFP cash transfer Woman is sole or joint decision-maker on use of Percentage points 1% -0.09 cash transfers on (Ecuador) contraception education Merttens et al. 5 SAGE (Uganda) SCG NS Percentage points 0.032 Female is decision-maker on what to do about a serious health problem (2015) Chapter 8 Female is decision-maker on what to do about a NS SAGE (Uganda) -0.0095 Percentage points SCG The impact of cash serious health problem transfers on health and nutrition Percentage points NS 0.042 Female is decision-maker on children’s education SAGE (Uganda) VFSG Percentage points -0.002 Female is decision-maker on children’s education SAGE (Uganda) VFSG NS Chapter 9 The impact of cash transfers on savings, investment and production Chapter 10 The impact of cash transfers on employment Chapter 11 The impact of cash transfers on empowerment SECTION III Chapter 12 Summary of findings and conclusion References

232 Cash transfers: what does the evidence say? Page 232 Contents Table 11.7: Summary of results for overall cash transfer effect on marriage Acknowledgements Effect of Unit of Statistical Gender of Programme Paper Size of Specific variable effect change significance individual Executive summary 141 0.008 Probability of getting married NS Female PFSSP (Pakistan) Percentage Alam and Baez (2011) 1 points SECTION I 0.0006 Female PFSSP (Pakistan) NS Age 15 –16 Percentage Probability of getting married points Chapter 1 PFSSP (Pakistan) Years 1.46 Age at marriage Female 5% Introduction 142 2 Baird et al. (2010) Percentage Female 10% 0.023 Never married ZCTP (Malawi) points Chapter 2 Conceptual Percentage -0.012 Ever married Baird et al. (2011) 3 ZCTP (Malawi) CCT Female NS framework points treatment arm UCT Percentage -0.079 Ever married Female 1% ZCTP (Malawi) Chapter 3 points treatment arm Review of cash Female NS Ever married Percentage 0.037 Aged over 15, ZCTP (Malawi) transfer reviews CCT points treatment arm Chapter 4 Methods Female Aged over 15, Ever married 0.007 Percentage 5% ZCTP (Malawi) points UCT treatment arm Chapter 5 The evidence base CCT Female NS Odds ratio 0.93 Ever married 4 Baird et al. (2012) ZCTP (Malawi) treatment arm Female ZCTP (Malawi) Ever married UCT 0.36 NS Odds ratio SECTION II treatment arm 143 Percentage Married at time of survey 0.05 SA-OAP (South Female NS Siaplay (2012) 5 Chapter 6 Africa) points The impact of Married at time of survey - 0.175 SA-OAP (South Male 5% Percentage cash transfers on points Africa) monetary poverty 1% Probability 0.021 PRAF (Honduras) 6 Stecklov et al. (2006) Honduras Female Married at time of survey Chapter 7 Nicaragua RPS (Nicaragua) Married at time of survey 0.012 NS Probability Female The impact of cash transfers on NS -0.005 Female Mexico PROGRESA Probability Married at time of survey (Mexico) education Chapter 8 The impact of cash transfers on health and nutrition Chapter 9 The impact of cash transfers on savings, investment and