| Literature DB >> 24019380 |
Morten Skovdal1, Laura Robertson2, Phyllis Mushati2, Lovemore Dumba2, Lorraine Sherr2, Constance Nyamukapa3, Simon Gregson3.
Abstract
Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash transfers is an issue of controversy. Contributing to policy debates on the appropriateness of conditions, this article sets out to investigate the overall buy-in of conditions by different stakeholders and to identify pathways that contribute to an acceptability of conditions. The article draws on data from a cluster-randomized trial of a community-led cash transfer programme in Manicaland, eastern Zimbabwe. An endpoint survey distributed to 5167 households assessed community members' acceptance of conditions and 35 in-depth interviews and 3 focus groups with a total of 58 adults and 4 youth examined local perceptions of conditions. The study found a significant and widespread acceptance of conditions primarily because they were seen as fair and a proxy for good parenting or guardianship. In a socio-economic context where child grants are not considered a citizen entitlement, community members and cash transfer recipients valued the conditions associated with these grants. The community members interpreted the fulfilment of the conditions as a proxy for achievement and merit, enabling them to participate rather than sit back as passive recipients of aid. Although conditions have a paternalistic undertone and engender the sceptics' view of conditions being pernicious and even abominable, it is important to recognize that community members, when given the opportunity to participate in programme design and implementation, can take advantage of conditions and appropriate them in a way that helps them manage change and overcome the social divisiveness or conflict that otherwise may arise when some people are identified to benefit and others not. Published by Oxford University Press in association with The London School of Hygiene and Tropical MedicineEntities:
Keywords: Cash transfers; community acceptability; conditions; orphaned children; social protection
Mesh:
Year: 2013 PMID: 24019380 PMCID: PMC4186208 DOI: 10.1093/heapol/czt060
Source DB: PubMed Journal: Health Policy Plan ISSN: 0268-1080 Impact factor: 3.344
Summary of study participants
| Individual interviews | Focus groups | Total number of interviews | ||
|---|---|---|---|---|
| Adults | Youth | Adults | ||
| 15 | 0 | 1 (9 people) | 16 | |
| 6 | 1 | 1 (9 people) | 8 | |
| 5 | 3 | 0 | 8 | |
| 5 | 0 | 1 (9 people) | 6 | |
| 31 | 4 | 3 (27 people) | 38 | |
| 62 | ||||
Thematic network: local perceptions of conditions
| Basic theme (percentage of interviews discussing a theme) | Organizing themes | Global themes |
|---|---|---|
| Conditions avoid misuse of money (24) | Ensure good use of money | Conditions believed to encourage ‘good’ behaviours |
| Conditions ensure children benefit (21) | ||
| Conditions help people set priorities (26) | Conditions facilitate learning and behaviour change | |
| Conditions sensitize people to the needs of children (26) | ||
| Conditions encourage behaviour change (10) | ||
| Some people fail to comply to conditions (21) | People recognize there are limitations to conditions | |
| People with conditions have little spending freedom (10) | ||
| Poor household dynamics and situations can take priority (29) | ||
| Money spent inappropriately if there are no conditions (24) | There is a perception of a need to monitor use of money | Conditions facilitate social accountability |
| Difficult to monitor cash transfers if no conditions (14) | ||
| There are consequences for those who fail to comply (16) | Conditions facilitate a sense of ownership, social responsibility and participation | |
| Getting ‘free’ cash comes with a responsibility (21) | ||
| Community members take an active role in monitoring compliance (26) | ||
Community acceptability of conditions by household eligibility status and trial arm
| Eligible households | Non-eligible households | ||||||
|---|---|---|---|---|---|---|---|
| Control | UCT | CCT | Control | UCT | CCT | ||
| The conditions were appropriate | Agree | 70.9% | 74.6% | 92.2% | 82.8% | 69.4% | 83.5% |
| Disagree | 7.9% | 13.2% | 5.4% | 9.2% | 10.0% | 11.1% | |
| Don’t know | 21.3% | 12.2% | 2.4% | 8.0% | 20.6% | 5.4% | |
| 1115 | 1451 | 1247 | 436 | 389 | 297 | ||
| There were too many conditions | Agree | 3.6% | 5.1% | 7.6% | 5.3% | 3.3% | 3.4% |
| Disagree | 74.0% | 81.5% | 89.1% | 86.2% | 74.6% | 90.2% | |
| Don’t know | 22.4% | 13.4% | 3.3% | 8.5% | 22.1% | 6.4% | |
| 1116 | 1450 | 1248 | 436 | 389 | 297 | ||
Gender differences in community acceptability
| Control arm | UCT arm | CCT arm | |||||
|---|---|---|---|---|---|---|---|
| Female respondents | Male respondents | Female respondents | Male respondents | Female respondents | Male respondents | ||
| The conditions were appropriate | Agree | 70.0% | 68.8% | 75.6% | 73.1% | 93.0% | 90.5% |
| Disagree | 8.1% | 6.3% | 12.2% | 16.6% | 4.9% | 6.3% | |
| Don’t know | 21.9% | 24.9% | 12.3% | 10.3% | 2.0% | 3.2% | |
| 807 | 205 | 1052 | 271 | 891 | 221 | ||
| There were too many conditions | Agree | 3.5% | 4.9% | 4.9% | 4.8% | 7.3% | 9.5% |
| Disagree | 74.0% | 67.8% | 82.0% | 83.8% | 89.9% | 86.9% | |
| Don’t know | 22.5% | 27.3% | 13.1% | 11.4% | 2.8% | 3.6% | |
| 808 | 205 | 1051 | 271 | 891 | 222 | ||