unite for children

The Transfer Project: Rigorous evidence on Social Cash transfers in sub-Saharan AfricaHow do the elderly benefit?

Tia PalermoUNICEF Office of Research – Innocenti / Stony Brook University (SUNY)

December 14, 2016Pensioners Without Borders / ABFStockholm, Sweden

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The big picture: Gov’t cash transfer programs in sub-Saharan Africa

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No Cash TransfersAfter 2004Prior to 2004No dataTransfer Project

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Households covered & percent of population: Gov’t programmes

Nigeria

Zimbab

we

Rwanda

Ghana

Lesotho

Malawi

Botswan

a

Zambia

Namibia

Mozambique

Kenya

Tanza

nia

Ethiopia0

200000

400000

600000

800000

1000000

1200000

64000 69000 80000150000 163000 170000 182000 190000

250000310000

455000

11000001125000

2.0% 3.2%2.5% 34.8% 4.6% 21.5% 5.4%

46.8%5.1%

4.6%

2.0%

Not included (due to scale): CSG in South Africa (>11 million recipients)

0.2%

5.2%10.6%

Percent of population are estimates assuming average household size and one beneficiary per household (child grant and pension designs)

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Programs tend to be unconditional (or with ‘soft’ conditions)

Targeting is based on poverty and vulnerability (OVC, labor-constraints, elderly)

Important community involvement in targeting process

Payments tend to be manual (‘pulling’ beneficiaries to pay-points)

Opportunity to deliver complementary services

Key features of the African ‘Model’

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The Transfer Project • Who: Community of research, donor and implementing partners – focus

on coordination in efforts and uptake of results UNICEF, FAO, UNC, Save the Children UK, National Governments

• Mission: Support African governments to create better policies and programmes by undertaking long term, multi-country impact evaluation research of social cash transfer programmes

• Motivation: Income poverty has highly damaging impacts on human development Cash empowers people living in poverty to make their own decisions on

how to improve their lives

• Approach: National programs & research-policy interface (close relationship between

all national stakeholders) Impact evaluations as part of broader evidence/learning agendas & policy

processes at national & regional level

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The Transfer Project & From Evidence to Action

Ethiopia, Ghana, Kenya, Lesotho, Malawi, Madagascar, South Africa, Tanzania, Zambia and Zimbabwe

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From Evidence to Action: Research uptake

Country levelResults from impact evaluations have influenced design of programs and contributed to strategic policy decisions

Regional levelSocial cash transfers can work in low-income contexts, including Sub-Saharan Africa; can be affordable; are a worthwhile investment

Global levelContribution to strengthening the evidence-based case for promoting social protection as a poverty reduction instrument

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From Evidence to Action: Government response

• Ghana – Gov triples transfer size after baseline simulations show level too low

• Kenya – Increase transfer size based on 4-year follow-up; Gov able to respond to criticisms w/ rigorous data

• Lesotho – Scale up after secondary analysis/ large impacts seen on the ground

• Malawi – Ghana & Zambia lessons on predictability ensured payments not skipped

• Zimbabwe – Revised targeting system after comparison to more mature programs

• Zambia – Massive scale up: Gov contribution jumped from $4m to $35m (2014)Continues to increase; campaign issue in recent elections

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Responding to the critics with evidence

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National cash transfers targeting older persons

Country Programme Year Prog. Began

Target Group

Ethiopia Tigray Social Cash Transfer Pilot (SCTPP) 2011 Labour constrained, ultra-poor female,

elderly, or disabled

Ghana Livelihood Empowerment Against Poverty (LEAP) 2008 Extreme poor w/ elderly, disabled

or OVC member

KenyaCash Transfers for Orphans and Vulnerable Children (CT-OVC)

2004 Poor hhlds w/ OVC

Lesotho Child Grants Programme (CGP) 2009 Poor hhlds w/ OVC

Malawi Social Cash Transfer Programme (SCTP) 2006 Ultra-poor, labour constrained

South Africa Child Support Grant (CSG) 1998 Poor children

Zambia Child Grant (CG) 2010 Hhld w/ child under 5 yrs old (in 3 poor districts)

Zambia Multiple Categorical Targeting Grant (MCTG) 2011 Poor female & elderly-headed hhlds w/

OVC; hhlds w/ disabled person

Zimbabwe Harmonized Social Cash Transfer (HSCT) 2011 Food poor & labour constrained

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Targeted population receiving cash transfers

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Elderly cash transfer beneficiaries in Zambia

Multiple Categorical Targeting Grant population by age & gender

Zambian population by age & gender

(n= 102,881) (n=15,360)

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Elderly cash transfer beneficiaries in Ghana

LEAP population by age & genderGhanaian population by age & gender

Source: GLSS 2012/13 Source: LEAP 2010

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Across-the-board impacts on food securityEthiopia

SCTPGhana LEAP

Kenya CT-OVC

Lesotho CGP

Malawi SCTP

Zambia MCTG

Zambia CGP

Zim HSCT

Spending on food & quantities consumed

Per capita food expenditures ü ü ü ü ü ü ü üPer capita expenditure, food items ü ü ü ü ü üKilocalories per capita ü üFrequency & diversity of food consumption

Number of meals per day ü ü üDietary diversity/Nutrient rich food ü ü ü ü ü üFood consumption behaviours Coping strategies adults/children ü ü ü üFood insecurity access scale ü ü ü

Green check marks represent significant impact, black are insignificant and empty is indicator not collected

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From Evidence to Action: How are older people benefitting from cash transfers?

Kenya CT- OVC: Increase in savings & investment in livestock assets Hhlds were more able to hire labour for farm production – essential given the composition of many of the households composed of elderly grandparents & orphans

Ghana LEAP: Significant impact on both on beneficiaries & their families, including the elderly- Hhld level: Food security, health, education, savings, and investments- Community level: Community development and economic growth

“I used to be a slave to ganyu (informal work) but now I am a bit free”

- elderly person from Lesotho

Ghana LEAP recipientphoto credit: Michelle Mills

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Morbidity and health seeking impacts – aged 60 and older

Ghana LEAP

Malawi SCTP

Zambia MCTG

Zimbabwe HSCT

Morbidity (last 2 weeks or 4 weeks) Any illness ü ü ü üMalaria/Fever ü ü ü üRespiratory Illness ü ü ü üDiarrhea ü ü ü ü

ü üWell-beingSelf assessed health ü ü ü ü

Health Seeking (sick last 2 or 4 weeks)Seeking medical care for illness ü ü ü üHealth expenditure ü ü ü ü

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Emerging evidence that effect of cash larger depend on supply side factors

Example 1: Skilled attendance at birth improved in Zambia CGP, only among women with access to quality maternal health services

Example 2: Anthropometry in Zambia CGP improved among households with access to safe water source

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Evidence, potential, gaps

Evidence: Cash transfers are protective — they work

Potential: Programs are affordable, can contribute to inclusive growth strategy

Gaps: Health and nutrition effects are inconsistent Health infrastructure always well developed,

attitudes & other factors at play in demand for health

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Transfer Project is a multi-organizational initiative of the United Nations Children’s Fund (UNICEF) the UN Food and Agricultural Organization (FAO), Save the Children-United Kingdom (SC-UK), and the University of North Carolina at Chapel Hill (UNC-CH) in collaboration with national governments, and other national and international researchers.

Current core funding for the Transfer Project comes from the Swedish International Development Cooperation Agency (Sida), as well as from staff time provided by UNICEF, FAO, SC-UK and UNC-CH. Evaluation design, implementations and analysis are all funded in country by government and development partners. Top-up funds for extra survey rounds have been provided by: 3IE - International Initiative for Impact Evaluation (Ghana, Malawi, Zimbabwe); DFID - UK Department of International Development (Ghana, Lesotho, Ethiopia, Malawi, Kenya, Zambia, Zimbabwe); EU - European Union (Lesotho, Malawi, Zimbabwe); Irish Aid (Malawi, Zambia); KfW Development Bank (Malawi); NIH - The United States National Institute of Health (Kenya); Sida (Zimbabwe); and the SDC - Swiss Development Cooperation (Zimbabwe); USAID – United States Agency for International Development (Ghana, Malawi); US Department of Labor (Malawi, Zambia). The body of research here has benefited from the intellectual input of a large number of individuals. For full research teams by country, see: https://transfer.cpc.unc.edu/

Acknowledgements

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• Transfer Project website: www.cpc.unc.edu/projects/transfer • Briefs: http://www.cpc.unc.edu/projects/transfer/publications/briefs

• Facebook: https://www.facebook.com/TransferProject • Twitter: @TransferProjct • Email: tmpalermo@unicef.org

For more information

Ghana, credit: Ivan Griffi