2015年-世界发展银行全球_Bangladesh___Can_Conditional_Cash_Transfers_Improve_Nutrition__4页_1mb

Summary of "from EVIDENCE to POLICY: BANGLADESH: Can Conditional Cash Transfers Improve Nutrition?"

Core Content

This policy note evaluates the effectiveness of the Shombhob conditional cash transfer (CCT) program in Bangladesh, focusing on its impact on nutrition and education outcomes for poor families. The program was designed to incentivize behaviors such as school attendance, growth monitoring, and nutrition counseling for mothers.

Main Objectives

• Improve nutrition among young children
• Encourage school attendance and enrollment
• Enhance financial inclusion and transparency through electronic payments
• Assess the feasibility and impact of CCT programs in rural and urban settings

Key Findings

Nutrition Outcomes

• The program significantly improved child nutrition, especially for those under 22 months.
• Wasting (a measure of acute malnutrition) declined by 12.5 percentage points, or 40%.
• There was no impact on stunting, suggesting that chronic malnutrition may require longer-term interventions.

Food Spending

• Families receiving transfers increased their spending on food by 70% of the received amount.
• 90% of the transferred funds were spent on food, with a notable increase in protein-rich food.
• Mothers in the nutrition group spent 174 Taka more on protein-rich food than those not in the program.
• Additional 56 Taka was spent on protein-rich food by mothers who attended monthly nutrition meetings.

Education Outcomes

• No improvement in school attendance or enrollment was observed, despite conditioning payments on school attendance.
• Possible reasons for this include:
  • The program started after the school year had begun, making it too late to influence enrollment.
  • Challenges in tracking attendance due to the number of schools children attended.
  • Flooding in 2012 may have confused families about the link between attendance and payments.
  • The existing national cash transfer program may have diluted the impact.

Program Design and Implementation

• Payments were made via electronic cash cards through the Bangladesh Post Office.
• The mobile Point-of-Sales system improved access and efficiency, reducing travel time for mothers.
• Administrative costs were relatively low, at about US$1.40 per child per month, making the program cost-effective.

Targeting and Reach

• The program targeted the poorest households using proxy means test surveys.
• 14,125 families were enrolled, with 37,000 applying and 15,952 selected based on poverty scores.
• However, tracking was difficult, especially for slum dwellers, due to mobility and instability.

Conclusion

The Shombhob program demonstrated positive nutritional outcomes for young children, particularly those under two years of age, highlighting the potential of CCTs to improve child health during the first 1,000 days of life. However, the education component did not yield the expected results, underscoring the need for careful design and consideration of local contexts when implementing such programs.

The evaluation also emphasized the importance of electronic payments in promoting financial transparency, reducing administrative costs, and empowering women with greater control over family finances. These insights can guide future social protection programs in Bangladesh and other countries aiming to alleviate poverty and improve child nutrition.

Recommendations

• Focus on nutrition-focused components of CCT programs, as they showed significant positive outcomes.
• Address logistical and tracking challenges, especially in highly mobile populations.
• Consider the timing and design of education-related conditions to better align with school cycles.
• Continue exploring innovative payment methods to enhance accessibility and efficiency.

Context and Funding

• The program was piloted in Jaldhaka and Hatibandha (rural areas) and Narayanganj City (urban slums).
• The evaluation was conducted by World Bank researchers using regression discontinuity design and difference-in-difference methodology.
• The Strategic Impact Evaluation Fund (SIEF) supported the research and evaluation process, with generous funding from the British government’s Department for International Development.

This document serves as a policy guide for designing and implementing effective social protection programs, particularly those targeting child nutrition and poverty alleviation.