2014年-世界发展银行全球_Philippines___Are_Cash_Transfer_Programs_Effective__4页_2mb

Philippines: Are Cash Transfer Programs Effective?

Core Content

Conditional cash transfer (CCT) programs have become a key tool for improving health and education outcomes for the poorest populations globally. The Philippines, through the Pantawid Pamilya (Family Cash Transfer) Program, has implemented one such initiative to support vulnerable families. The program was developed in partnership with the World Bank in 2007 and has been evaluated to assess its impact and effectiveness.

Main Points

• Program Overview:
  The Pantawid Pamilya Program provides monthly cash transfers to poor families in exchange for meeting specific health and education conditions. The payments are relatively modest, with a maximum of $32 per month, and are targeted at households with children under 14 and/or pregnant women.

• Targeting Mechanism:
  The program uses a proxy means test to identify poor households based on factors like housing quality, household goods, and education levels. It aims to support families living below the provincial poverty line.

• Impact on Education:

  • Preschool and Primary Enrollment: Increased by 10.3 and 4.5 percentage points, respectively.
  • Attendance: Rose by 3.8 percentage points for elementary school children.
  • Older Children (12-14): Attendance improved by 4.9 percentage points, but enrollment remained unchanged.
  • Children 15-17: Attendance increased by 7.6 percentage points, suggesting a spill-over effect from younger children's education incentives.

• Impact on Health:

  • Severe Stunting: Reduced by 10 percentage points among children aged 6 months to 3 years.
  • Nutrition and Health Check-ups: Parents spent 38% more on protein-rich foods and increased health check-up frequency.
  • Deworming: Older children (6-14) were 9 percentage points more likely to take deworming pills.

• Maternal Health:

  • Prenatal Care: Poor mothers in the program were 10.5 percentage points more likely to receive four prenatal check-ups.
  • Postnatal Care: Increased by 10 percentage points, with more women receiving care after childbirth.
  • No Improvement in Birth Outcomes: Despite the benefits, there was no significant increase in births at health facilities or with trained assistance, and maternal and infant health outcomes remained unchanged.

• Behavioral Effects:

  • Work Hours: No decline in working hours was observed, indicating that the program did not discourage labor.
  • Fertility Rates: Women receiving transfers were not more likely to have additional children than those in the control group.

• Overall Spending:

  • Education and Health: Beneficiaries spent 38% more on education and 34% more on medical expenses.
  • Alcohol Consumption: Declined among participants.

Key Findings

• The program has successfully improved education and health outcomes for young children and pregnant women.
• Older children (12-14 and 15-17) showed improved attendance but no significant increase in enrollment, suggesting that the incentives may not be sufficient to encourage older children to start school.
• The cash transfer amount was found to be insufficient to offset the costs of schooling for older children, leading to the expansion of the program to include those aged 15-18.
• The program did not lead to unintended consequences, such as reduced work hours or increased fertility rates.

Conclusion

The Pantawid Pamilya Program demonstrates the effectiveness of CCTs in improving health and education outcomes, particularly for young children. However, it also highlights the need for adaptation to address the specific needs of older children and improve broader health indicators. The evaluation results have informed policy changes, such as increasing the cash transfer amount and expanding the program's scope, to ensure more inclusive and impactful social protection strategies. The World Bank continues to support such evaluations to help governments design more effective poverty reduction initiatives.