Conditional cash transfers (CCTs) have become increasingly popular in the developing world. Appealing to policy-makers and the poor alike, they offer an innovative solution to the challenge of addressing mass poverty. Rather than simply building more schools and hospitals (the ‘supply-side’ approach), CCTs aim to stimulate effective demand by paying poor families a monthly income supplement on condition that they send their children to school and attend health clinics. By stimulating demand for basic services while targeting scarce resources at the most vulnerable groups, governments and international aid organisations hope that such transfers will relieve poverty and lead to more efficient service provision. At the same time, improved health and education conditions would strengthen human capital as a springboard for development. Furthermore, this kind of mutual agreement or contract between government and citizens is seen as an exercise in ‘co-responsibility’; official support is matched by people's personal commitment to lifting themselves out of poverty. Thus, for many observers, CCTs constitute, in theory at least, the perfect ‘win-win’ anti-poverty solution.
Latin America has been at the forefront of this social policy revolution, with practically all countries in the region having adopted CCT programmes since the mid-1990s: some are large-scale, as in Mexico and Brazil, and others much smaller. The present volume is a timely contribution to the growing literature on the subject. Many ambitious claims have been made in professing the virtues of CCTs, but until quite recently there has been little hard evidence to back them up. This study is particularly welcome since it focuses on the results of evaluations undertaken by the Washington-based International Food Policy Research Institute (IFPRI) relating to four major CCT programmes in Brazil, Mexico, Honduras and Nicaragua. It thus goes some way towards providing a clearer empirical picture of what has been happening on the ground.
Chapter 1 looks at the origins of CCTs in Latin America, their defining characteristics and the major conclusions of the four case studies. It questions whether, despite impressive initial achievements, income transfers are quite the ‘magic bullet’ they are often cracked up to be. Chapter 2 contains a detailed discussion of the quantitative and qualitative evaluation methods employed by IFPRI in the four countries, which will be helpful for researchers in this field. This is important in view of the fact that further assessments will be critical for producing evidence-based results both as a measure of progress and as a guide for future CCT design.
Part II examines the rise of CCTs in the four countries under consideration. Chapters 3 to 5 show how their main features and impacts have been shaped by the specific political economies of each country and their distinctive evolutionary paths. A shared feature, however, especially in the cases of Mexico and Brazil, is the fact that CCT policy has in the main been driven internally by changing national and sub-national government priorities, with vital support from (but not imposed by) agencies such as the World Bank and the Inter-American Development Bank. Chapter 6 raises a number of questions over the supposed economic benefits arising from CCTs more generally, while chapter 7 urges caution in attempting to calculate cost efficiencies for comparative purposes, given the methodological complications involved.
The six chapters in part III consider the impacts of CCT programmes in a number of key areas, such as education, health, nutrition, gender relations and people's participation. Outcomes in education are found to have been generally positive, with higher enrolments attributed to cash transfers, but reservations are expressed with regard to low completion rates and the continuing poor quality of services actually delivered in the absence of adequate school infrastructure investments. Results in the fields of health and nutrition have been mixed, and these generate a critical discussion by the authors about claimed causality and the extent to which CCTs can be shown to have played a significant role in improvements in child immunisation rates and nutritional status. The final two chapters in this section deal with social relations in these programmes and how they have shaped outcomes. Chapter 12 surveys the changing status of women in Mexico as the appointed cash recipients, pointing to some signs of empowerment but still leaving much room for improvement. In chapter 13, the role of community participation in CCT programmes is considered. This is an area in which very little work has so far been done, but which could yield important lessons for future expansion, attempting to link income transfers with employment generation and community development more widely.
Chapter 15 concludes the volume by raising important questions about the future direction of CCTs in Latin America and more widely. Understandably, concerns include longer-term programme impact sustainability in the face of fiscal pressures and the need to expand supply-side provision alongside boosting demand through cash incentives, as in the education sector, mentioned above. A number of challenges are highlighted as CCTs expand in scope to cover contrasting poverty situations and country contexts in Africa and Asia. This final section could, however, have been strengthened by including a more detailed consideration of the challenges and opportunities suggested by each of the cases studied in terms of linking CCTs with the broader employment generation and development process. If the challenge of integration is not taken seriously, income transfers run the risk of becoming residual, politically inspired, charitable handouts, rather than a potentially powerful tool for promoting economic and social advancement. As CCTs grow in their coverage and become more mainstream instruments of social policy, this collection is a welcome addition to the literature. It will undoubtedly encourage constructive debate about appropriate ways forward, pointing both to the promise held by cash transfers and to their possible pitfalls.
