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Review
. 2009;21 Suppl 1(S1):60-75.
doi: 10.1080/09540120903112351.

Social protection to support vulnerable children and families: the potential of cash transfers to protect education, health and nutrition

M Adato  1 , L Bassett
Affiliations
Review

Social protection to support vulnerable children and families: the potential of cash transfers to protect education, health and nutrition

M Adato et al. AIDS Care. 2009.

Abstract

Investing in social protection in sub-Saharan Africa has taken on a new urgency as HIV and AIDS interact with other drivers of poverty to simultaneously destabilise livelihoods systems and family and community safety nets. Cash transfer programmes already reach millions of people in South Africa, and in other countries in southern and East Africa plans are underway to reach tens and eventually hundreds of thousands more. Cash transfers worldwide have demonstrated large impacts on the education, health and nutrition of children. While the strongest evidence is from conditional cash transfer evaluations in Latin America and Asia, important results are emerging in the newer African programmes. Cash transfers can be implemented in conjunction with other services involving education, health, nutrition, social welfare and others, including those related to HIV and AIDS. HIV/AIDS-affected families are diverse with respect to household structure, ability to work and access to assets, arguing for a mix of approaches, including food assistance and income-generation programmes. However, cash transfers appear to offer the best strategy for scaling up to a national system of social protection, by reaching families who are the most capacity constrained, in large numbers, relatively quickly. These are important considerations for communities hard-hit by HIV and AIDS, given the extent and nature of deprivation, the long-term risk to human capital and the current political willingness to act.

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Figures

Figure 1.
Figure 1.
An asset-based social protection framework.
Figure 2.
Figure 2.
Use of unconditional cash transfers, by type of spending and programme. Sources: Acacia Consultants (2007); Devereux (2002); Devereux et al. (2007); Devereux, Mvula, & Solomon (2006); MCDSS/ GTZ (2006); Moller and Ferreira (2003). Note: In the case of Zambia SCTS the figure represents the proportion of overall spending by beneficiaries on health. In the case of Malawi DECT, these spending numbers refer to three months of the five-month programme period January–March 2007.
Figure 3.
Figure 3.
Impacts of conditional cash transfers on health service usage. Sources: Attanasio et al. (2005); Gertler (2000); Gertler and Boyce (2001); IFPRI (2003); Maluccio and Flores (2005). Note: The mean of the range of estimates is plotted for Honduras. For Mexico the figure represents the impact on growth monitoring visits 15 months after baseline. No information on health visits separate from growth monitoring is available for Colombia.
Figure 4.
Figure 4.
Impacts of conditional cash transfers on stunting prevalence. ∗p < 0.01.
See this image and copyright information in PMC

References

    1. Acacia Consultants. Evaluation of cash transfer programme in Nairobi, Kwale, and Garissa districts: Final report. Kenya: Acacia Consultants/UNICEF; 2007.
    1. Adato M., Bassett L. A review of the evidence on impacts and key policy debates. Boston, MA: Joint Learning Initiative on Children and AIDS; 2008. What is the potential of cash transfers to strengthen families affected by HIV and AIDS?
    1. Adato M., Coady D., Ruel M. An operations evaluation of PROGRESA from the perspective of beneficiaries, promotoras, school directors, and health staff. 2000. Final report to PROGRESA, Government of Mexico. Washington, DC: International Food Policy Research Institute.
    1. Adato M., Roopnaraine T. A social analysis of 'Red de Protección Social' (RPS) en Nicaragua. Washington, DC: International Food Policy Research Institute; 2004.
    1. Adato M., Roopnaraine T., Smith N., Altinok E., Çelebioğlu N., Cemal S. An evaluation of the conditional cash transfer program in Turkey: Second qualitative and anthropological study. 2007. Final report submitted to the General Directorate of Social Assistance and Solidarity, Prime Ministry, Republic of Turkey. Washington, DC: International Food Policy Research Institute.

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