2014年-世界发展银行全球_Community-Based_Conditional_Cash_Transfers_in_Tanzania___Results_from_a_Randomized_Trial_191页_12mb

Summary of Community-Based Conditional Cash Transfers in Tanzania: Results from a Randomized Trial

Core Content

This document presents the findings of a randomized trial evaluating the impact of Community-Based Conditional Cash Transfers (CB-CCT) in three poor districts of Tanzania: Bagamoyo, Chamwino, and Kibaha. The study was conducted by the Tanzania Social Action Fund (TASAF) in partnership with the World Bank, and it aims to assess whether a community-targeted and community-delivered CCT program can achieve similar outcomes to centrally managed CCT programs in other regions.

The program was designed to provide bimonthly cash transfers to poor households based on the number of vulnerable children (0–15 years) and elderly (60+) members. Households had to meet specific conditions related to education and health, such as ensuring children attend school and visit clinics regularly, to receive benefits.

Main Views and Key Findings

1. Program Design and Implementation

• The program was piloted in 40 villages out of 80 eligible ones, selected randomly.
• Communities were responsible for targeting beneficiaries and monitoring compliance through community management committees.
• The study used a difference-in-differences method to compare outcomes between treatment and comparison groups.

2. Baseline Survey Results

• The study population was identified as the most vulnerable households in the selected districts.
• Key baseline characteristics included:
  • High prevalence of poverty, illness, and limited education.
  • Many households were female-headed.
  • Poor access to sanitation, clean water, and basic infrastructure.
  • Low literacy rates and school enrollment.

3. Health Outcomes

• Treatment households showed improved health at the endline (31–34 months post-program), with:
  • A 5 percentage point reduction in sickness rates across all ages.
  • A 11 percentage point reduction in sickness rates for children aged 0–4.
• Health insurance usage increased significantly among treatment households, which is crucial for reducing out-of-pocket costs and increasing treatment-seeking behavior.

4. Education Outcomes

• The program had positive effects on school attendance and completion.
• Girls in treatment households were 23 percentage points more likely to complete primary school than their counterparts in comparison groups.
• Children out of school at baseline in treatment households showed significant improvements in literacy and school attendance.
• The program required 80% school attendance, which may have influenced the results, as absenteeism was not a major issue.

5. Economic and Asset Outcomes

• Nonbank savings increased fivefold among the poorest half of treatment households.
• Livestock ownership increased in treatment households, with families using animals to generate income or create productive savings.
• Children’s shoes were more frequently purchased by treatment households, especially the poorest ones.

6. Community Impact

• Community trust improved, particularly in community leaders and public services.
• Political participation and community engagement increased in treatment areas.
• Community score cards and focus groups provided qualitative insights into local perceptions and the program's influence on community dynamics.

7. Methodology and Evaluation

• The study combined quantitative data from surveys with qualitative data from community score cards and focus groups.
• Midline and endline surveys were conducted to measure changes over time.
• The program had no significant effect on average savings or non-food expenditures, except for health insurance and children's shoes.

Key Information

• Duration: The program ran from January 2010 to late 2012, with baseline, midline, and endline data collected.
• Participants: The study involved 40 treatment villages and 40 comparison villages.
• Conditions: Households had to ensure:
  • Children aged 0–5 visited the clinic 6 times per year.
  • Children aged 7–15 had 80% school attendance.
  • Elderly members visited the clinic once per year.
• Funding: The project was supported by the Japan Social Development Fund (JSDF), Trust Fund for Environmentally and Socially Sustainable Development (TFESSD), Spanish Impact Evaluation Fund (SIEF), International Initiative for Impact Evaluation (3ie), and CGIAR Research Program on Policies, Institutions and Markets (PIM).

Conclusion

The CB-CCT program in Tanzania had positive impacts on health, education, and community engagement, particularly for poorest and female-headed households. While the program did not lead to significant increases in overall savings or non-food expenditures, it had a notable effect on health insurance adoption, children's health, school enrollment and completion, and community trust. The study highlights the potential of community-driven approaches in improving social outcomes and underscores the importance of local participation in the delivery and success of CCT programs.