Maxton Tsoka

Targeting Cash to Malawi's Ultra-Poor: A Mixed Methods Evaluation

Governments target transfers so that limited resources reach impoverished households; targeting errors therefore indicate inefficiency in resource use and inability to reach the poorest households. This article examines the Malawi Social Cash Transfer Scheme (SCTS), using mixed methods and multiple data sources, including examination of underlying assumptions, the operationalisation of key concepts, questions of implementation, and errors of inclusion and exclusion. Despite serious challenges, the schemes error rates are within the range of global averages. Its impressive impacts provide strong motivation for improving the targeting process before it is scaled up to the national level.

Interrupting the intergenerational cycle of poverty with the Malawi Social Cash Transfer

Cash transfer programs throughout the world were designed within a Social Protection framework to alleviate poverty in the short term and to interrupt the long-term intergenerational cycle of poverty. In this study, we examine the potential of the Malawi Social Cash Transfer Scheme (SCTS) to interrupt the intergenerational cycle of poverty in ultra-poor and labor-constrained households in Malawi. Using qualitative data from 16 focus groups with 163 children, we map the voices of children to various dimensions in a framework of intergenerational poverty. The framework identifies financial, material, environmental, human, social, cultural and political capital as important inputs for older generations to transfer to younger ones in order to avoid lifelong poverty. We found that focus-group participants reported dramatic and widespread changes in their lives resulting from the cash transfer in nearly all of the frameworks dimensions. Participants reported that the cash allowed them to gain access to goods and materials, including food, healthcare, school supplies, clothing, blankets, housing and livestock. Respondents described changes in their lives, such as providing less labor for the household, allocating more time to schooling, enjoying adequate and high-quality foods, accessing healthcare and purchasing medicine. They also described better mental health, with new hopes and dreams for the future. These changes have the potential to interrupt the intergenerational cycle of poverty. Nevertheless, despite these widespread and positive benefits to children, whether the SCTS will become part of the national policy, and the schemes long-term sustainability, is still uncertain.

Cash Transfers and Children's Education and Labour among Malawi's Poor

This article examines the impact on childrens education and labour of monthly cash grants targeted on ultra‐poor households and designed to reduce poverty and enable families to invest in human development. It conducts a randomised community trial, with baseline and endline surveys of intervention and control households; verifies school enrolment; and completes key‐informant interviews and focus‐group discussions. Compared with non‐beneficiaries, intervention children experienced a 5 percentage point difference in enrolment, higher educational expenditures, fewer absences, and a 10 percentage point decrease in labour outside the home. Qualitative data confirm the quantitative findings. Transfers to poor households had a positive impact. However, the Malawian educational system needs to be improved for short‐term impacts to lead to long‐term development in human capital.

Measuring Vulnerability Among Orphans and Vulnerable Children in Rural Malawi: Validation Study of the Child Status Index Tool

Objectives:To validate the Child Status Index (CSI) as an instrument that can meaningfully measure the vulnerabilities of orphaned and vulnerable children, including those infected and affected by HIV/AIDS. Methods:Two age-specific instruments, comprised of previously validated tools and indicators commonly considered best practice, were administered to 102 children aged 5-10 years and 100 children aged 11-17 years in Mchinji, Malawi. Respondents were randomly sampled from a roster of children recently scored with the CSI. For each of the CSIs 12 subdomains, we assessed construct validity using Spearman Rank correlation coefficients. We also calculated cross tabulations to explain the resulting correlation coefficients. Analyses were conducted separately for the 2 age groups. Results:No relationships exceeded the standard for high construct validity (≥0.7). Only 2 were moderate (0.3-0.7), both for the younger age group: food security (0.4) and wellness (0.36). All other relationships were weak or negative. In most subcategories, a substantial proportion of surveyed children indicated distress that was not evident from CSI scores. In the abuse and exploitation subdomain, all children were rated as “good” or “fair” by the CSI, but among surveyed children aged 11-17, 20% or more reported being beaten, kicked, locked out of the house, threatened with abandonment, cursed, and made to feel ashamed. Conclusions:In this rural Malawi population, we were not able to validate the CSI as a tool for assessing the vulnerabilities of orphaned and vulnerable children. We recommend caution in interpreting CSI scores and revisions to the tool before global scale-up in its use.

Paying for Happiness: Experimental Results from a Large Cash Transfer Program in Malawi: Paying for Happiness

Abstract This study analyzes the short‐term impact of an exogenous, positive income shock on caregivers’ subjective well‐being (SWB) in Malawi using panel data from 3,365 households targeted to receive Malawis Social Cash Transfer Program that provides unconditional cash to ultra‐poor, labor‐constrained households. The study consists of a cluster‐randomized, longitudinal design. After the baseline survey, half of these village clusters were randomly selected to receive the transfer and a follow‐up was conducted 17 months later. We find that the short‐term impact of household income increases from the cash transfer leads to substantial SWB gains among caregivers. After a years worth of transfers, caregivers in beneficiary households have higher life satisfaction and are more likely to believe in a better future. We examine whether program impacts on consumption, food security, resilience, and hopefulness could explain the increase in SWB but do not find that any of these mechanisms individually mediate our results.

Using Photo-Elicitation Methods to Understand Resilience Among Ultra-Poor Youth and Their Caregivers in Malawi:

Unconditional cash transfer programs are a form of structural intervention to address poverty, a “fundamental cause” of disease. Such programs increasingly aim to build resilience to sustain improved outcomes and provide a solid foundation for longer term transformations. As such, there is a need to understand what resilience means in specific contexts. The goal of this formative study was to explore local experiences of resilience and vulnerability among 11 youth–caregiver dyads (n = 22) who were beneficiaries of the Malawi Social Cash Transfer Program in Balaka district. We used a photo-elicitation approach informed by the participatory, visual methodology photovoice to guide the study and conducted an iterative content analysis using thematic coding of transcripts and photos. Participants took pictures of their daily struggles and shocks and participated in audio-recorded discussions to reflect on the photos using an adapted version of the SHOWeD method. We found that participants characterized resilience as a tireless process of using all available individual, family, and community resources at all times in pursuit of survival and well-being. In the context of daily struggles, resilience was an essential part of survival. Shocks, mostly health-related, were depicted through staged images candidly highlighting individual and environmental vulnerabilities. Community support was an essential component of resilience for both daily struggles and shocks. Using photo-elicitation methods facilitated an intergenerational, community-driven reflection on the meaning of resilience and the multilevel determinants of health in a context of extreme poverty. Findings can inform the design of resilience-focused cash transfer programs to improve health equity.

Social networks, social participation, and health among youth living in extreme poverty in rural Malawi

Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youths peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys. Youth exchanged social support and influence within their networks that helped cope with poverty-induced stress and sadness, and encouraged protective sexual health practices. However, poverty hampered their involvement in school, religious schools, and community organizations, directly by denying them required material means, and indirectly by reducing time and emotional resources and creating shame and stigma. Poverty alleviation policy holds promise for improving youths social wellbeing and mental and physical health by increasing their opportunities to form networks, receive social support, and experience positive influence.

Governing the Geographies of the Nongovernmental Organization Sector: Analyzing Coverage Challenges in the HIV/AIDS Campaign in Malawi

A successful program response to the HIV/AIDS pandemic requires the targeting of high-risk groups. However, when HIV prevalence is high throughout the population—as it is in Malawi—the need exists to cover the entire country. The authors examine the ability of the Malawi program to achieve national coverage. A major obstacle is that very few civil society groups, which are the main implementation agents, factor coverage into their programming. Rather than expanding their coverage, they extend their activities within their traditional catchment area to serve as many people as possible. Thus, it is necessary to clarify the division of labor between government and civil society, so that together they can respond in a coverage-sensitive manner.