David Seidenfeld

Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia

There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambias Child Grant Program on a range of maternal health utilization outcomes using a randomized design and difference-in-differences multivariate regression from data collected over 24 months from 2010 to 2012. Results indicate that while there are no measurable program impacts among the main sample, there are heterogeneous impacts on skilled attendance at birth among a sample of women residing in households having better access to maternal health services. The latter result is particularly interesting because of the overall low level of health care availability in program areas suggesting that dedicated program design or matching supply-side interventions may be necessary to leverage unconditional cash transfers in similar settings to impact maternal health.

The Social and Productive Impacts of Zambia's Child Grant.

Accumulated evidence from dozens of cash transfer programs across the world suggest that there are few interventions that can match the range of impacts and cost-effectiveness of a small, predictable monetary transfer to poor families in developing countries. However, individual published impact assessments typically focus on only one program and one outcome. This article presents two-year impacts of the Zambian Governments Child Grant, an unconditional cash transfer to families with children under age five, across a wide range of domains including consumption, productive activity and women and childrens outcomes, making this one of the first studies to assess both protective and productive impacts of a national unconditional cash transfer program. We show strong impacts on consumption, food security, savings and productive activity. However, impacts in areas such as child nutritional status and schooling depend on initial conditions of the household, suggesting that cash alone is not enough to solve all constraints faced by these poor, rural households. Nevertheless, the apparent transformative effects of this program suggest that unconditional transfers in very poor settings can contribute to both protection and development outcomes.

Cash for Women’s Empowerment? A Mixed-Methods Evaluation of the Government of Zambia’s Child Grant Program

Summary. — The empowerment of women, broadly defined, is an often-cited objective and benefit of social cash transfer programs in developing countries. Despite the promise and potential of cash transfers to empower women, the evidence supporting this outcome is mixed. In addition, there is little evidence from programs at scale in sub-Saharan Africa. We conducted a mixed-methods evaluation of the Government of Zambia’s Child Grant Program, a poverty-targeted, unconditional transfer given to mothers or primary caregivers of young children aged zero to five. The quantitative component was a four-year longitudinal clustered-randomized control trial in three rural districts, and the qualitative component was a one-time data collection involving in-depth interviews with women and their partners stratified on marital status and program participation. Our study found that women in beneficiary households were making more sole or joint decisions (across five out of nine domains); however, impacts translated into relatively modest increases in the number of decision domains a woman is involved in, on average by 0.34 (or a 6% increase over a baseline mean of 5.3). Qualitatively, we found that changes in intrahousehold relationships were limited by entrenched gender norms, which indicate men as heads of household and primary decision makers. However, women’s narratives showed the transfer increased financial empowerment as they were able to retain control over transfers for household investment and savings for emergencies. We highlight methodological challenges in using intrahousehold decision making as the primary indicator to measure empowerment. Results show potential for unconditional cash transfer programs to improve the financial and intrahousehold status of female beneficiaries, however it is likely additional design components are need for transformational change.

The impact of Zambia’s unconditional child grant on schooling and work: results from a large-scale social experiment

ABSTRACT This article reports on the impact on child schooling and work of the Government of Zambia’s Child Grant Program (CGP), an unconditional cash transfer programme targeted to households with children under age 3 years in three districts of the country. Although the CGP’s focus is on very young children, we look to see if the programme has impacts on older children who are not the explicit target group. We use data from a large-scale social experiment involving 2519 households, half of whom were randomised out to a delayed-entry control group, that was implemented to assess the impact of the programme. We find that the CGP has no discernible impact on school enrolment of children age 7–14. However, when we break the sample by older (11–14) and younger (7–10) children – based on the grade structure of the Zambian schooling system – we find a significant impact among children age 11–14, which coincides with the exact age range where a sharp drop-out begins to occur in Zambia with point estimates in the range of 7–8 percentage points. Finally, we provide evidence on the potential pathways through which the unconditional cash transfer impacts on enrolment. Households in the CGP spend more on education, and in particular on uniforms and shoes, two items cited as key barriers to school enrolment in study areas.

Can unconditional cash transfers raise long-term living standards? Evidence from Zambia

In Africa, state-sponsored cash transfer programs now reach nearly 50 million people. Do these programs raise long-term living standards? We examine this question using experimental data from two unconditional cash transfer programs implemented by the Zambian Government. We find far-reaching effects of the programs both on food security and consumption as well as on a range of productive outcomes. After three years, household spending is on average 67 percent larger than the value of the transfer received, implying a sizeable multiplier effect, which works through increased non-farm activity and agricultural production.

Does money buy happiness? Evidence from an unconditional cash transfer in Zambia

The relationship between happiness and income has been at the center of a vibrant debate, with both intrinsic and instrumental importance, as emotional states are an important determinant of health and social behavior. We investigate whether a government-run unconditional cash transfer paid directly to women in poor households had an impact on self-reported happiness. The evaluation was designed as a cluster-randomized controlled trial in rural Zambia across 90 communities. The program led to a 7.5 to 10 percentage point impact on women’s happiness after 36- and 48-months, respectively (or 0.19–0.25 standard deviations over the control group mean). In addition, women have higher overall satisfaction regarding their young children’s well-being, including indicators of satisfaction with their children’s health and positive outlook on their children’s future. Complementary analysis suggests that self-assessed relative poverty (as measured by comparison to other households in the community) is a more important mediator of program effects on happiness than absolute poverty (as measured by household consumption expenditures). Although typically not the focus of such evaluations, impacts on psychosocial indicators, including happiness, should not be discounted as important outcomes, as they capture different, non-material, holistic aspects of an individual’s overall level of well-being.

Cash Transfers Enable Households to Cope with Agricultural Production and Price Shocks: Evidence from Zambia

ABSTRACT Climate change is projected to dramatically disrupt rainfall patterns and agricultural yields in sub-Saharan Africa. These shocks to food production can mire farming households in poverty traps. This study investigates whether unconditional cash transfers can help households cope with agricultural production and price shocks. We find that cash empowers poor, rural households facing these negative shocks to employ coping strategies typically used by the non-poor and enables them to substantially increase their food consumption and overall food security. Extending relatively small cash payments unconditionally to the rural poor is a powerful policy option for fostering climate-resilient development.

An Intervention to Increase the Condom Supply in Rural Zambia

More than US

Cash transfer programmes, weather shocks and household welfare: evidence from a randomised experiment in Zambia

800 million per year is spent on programs in low- and middle-income countries to increase demand for condoms, yet in rural areas of Africa condoms are often distributed for free only by regional health clinics that may be located far from home. Anecdotal evidence suggests that limited supply, resulting primarily from long travel times to acquire condoms, is a major barrier to use. This study investigates the potential unmet demand for condoms in rural sub-Saharan Africa. I provide empirical evidence of the importance of supply effects, based on an evaluation of a distribution program in which nine agents were enlisted to sell condoms across 92 rural villages in Zambia. I find that the number of individuals acquiring condoms tripled and the number of condoms distributed rose by more than 250 percent. The study demonstrates that individuals in poor rural areas are willing to pay for condoms and provides a model whereby public health goods can be acquired through market forces without the government incurring large costs and without detracting from public health services.

Income shocks and maternal health: evidence from a large-scale randomised cash transfer experiment in Zambia

ABSTRACT We assess the role of social cash transfer programmes against the negative effect of weather risk on rural households’ welfare using experimental impact evaluation data from Zambia. We find strong evidence that cash transfer has a mitigating role against the negative effects of weather shocks. Our results in fact highlight how important social cash transfer is for households lying in the bottom quantile of consumption and food security distributions in moderating the negative effect of weather shock. Integrating weather risk and social protection tools into a comprehensive poverty reduction strategy should therefore be of primary interest for policymakers.