2007年-世界发展银行全球_Does_Money_Matter__The_Effects_of_Cash_Transfers_on_Child_Health_and_Development_in_Rural_Ecuador_53页_415kb

Does Money Matter? The Effects of Cash Transfers on Child Health and Development in Rural Ecuador

Core Content

This paper evaluates the impact of an unconditional cash transfer program, the Bono de Desarrollo Humano (BDH), on the health and development of children aged 3 to 7 in rural Ecuador. The study is part of the World Bank's Impact Evaluation Series and was conducted by Christina Paxson and Norbert Schady.

The BDH was introduced in 2003 as a replacement for the Bono Solidario, a previous unconditional cash transfer program. The key difference is that BDH is means-tested and targets the poorest families. The program provides $15 per month to families in the first two quintiles of the Selben poverty index, and the transfers are distributed directly to mothers through the banking system.

The study uses a randomized experimental design, where parishes were randomly assigned to treatment or control groups. In treatment parishes, poor families with pre-school children became eligible for the BDH early, while in control parishes, eligibility was delayed. This design allows the researchers to isolate the effects of the cash transfer program.

Main Findings

• Positive Effects on Child Development: The cash transfer program had positive effects on the physical, cognitive, and socio-emotional development of children.
• Treatment Effects by Income Level: The benefits were more pronounced for the poorest children, with outcomes that were on average more than 20 percent of a standard deviation higher than those of the control group.
• Differential Effects by Gender and Education: Treatment effects were somewhat larger for girls and children with more highly-educated mothers.
• Mechanisms of Impact: The study examines three potential mechanisms through which cash transfers might influence child development:
  • Better Nutrition: The program appeared to improve children's nutrition, particularly in terms of helminth infections.
  • Greater Use of Health Care: Despite the improvements in nutrition, there was no evidence that treatment group children were more likely to visit health clinics for growth monitoring.
  • Better Parenting: There was no significant improvement in the mental health or parenting behaviors of mothers in the treatment group.

Key Information

• Program Overview:

  • The BDH was launched in 2003 and is means-tested.
  • Transfers are $15 per month, representing a 10 percent increase in family expenditure.
  • Transfers are given directly to mothers, not fathers.

• Study Design:

  • Randomization: Parishes were randomly assigned to treatment or control groups.
  • Sample Selection: The study focused on 3,426 families with 5,547 children, selected from 378 parishes in six provinces (three coastal, three highland).
  • Baseline and Follow-up Surveys: Data were collected from October 2003 to September 2004 (baseline), and again from September 2005 to January 2006 (follow-up).

• Take-up Rates:

  • In the treatment group, 75% of families received at least one transfer between June 2004 and November 2006.
  • The average monthly transfer was $10.51.
  • The control group had very low take-up, with only 3.7% of families receiving transfers in at least one month after the program was introduced in treatment parishes.

• Outcome Measures:

  • Physical Outcomes: Hemoglobin levels, height-for-age, and fine motor control were measured.
  • Cognitive and Behavioral Outcomes: Five measures were used, including the Test de Vocabulary en Imagenes Peabody (TVIP) and three tests from the Woodcock-Johnson-Muñoz battery (WJ-1, WJ-2, WJ-5) to assess long-term memory, short-term memory, and visual integration.

• Implications:

  • The study suggests that unconditional cash transfers can have significant positive effects on child development, even without conditionality.
  • It highlights the importance of targeting the poorest families, as they benefit the most.
  • The findings contribute to the debate on the necessity of conditionality in cash transfer programs.

Conclusion

The paper concludes that cash transfers, even without conditions, can have substantial positive effects on child health and development in rural Ecuador. The results challenge the assumption that conditionality is essential for such programs to be effective. The study also underscores the importance of understanding the mechanisms through which cash transfers influence child outcomes, particularly in the context of poverty and limited access to health and education services.