About this Impact evaluation
Conditional Cash Transfer programmes (CCTs) typically rely on a strong central administrative structure, unavailable in many low-income countries. Thus while CCTs 'are ubiquitous in middle-income countries in Latin America, impoverished and food-insecure regions like sub-Saharan Africa that might benefit dramatically from CCTs have implemented relatively few. .
Meanwhile, the community-driven development approach, which gives community groups or local governments control over planning resources and investment decisions, has been shown to improve service delivery in some contexts. The community-run CCT, which brings those two approaches together for the first time, was launched in January 2010 in 80 villages in three districts of Tanzania. Community committees select beneficiaries, disburse funds, monitor compliance, and run the programme, following some basic guidelines provided by a social fund agency. Given the importance of the programme as a potential flagship for other social protection programmes and CCTs in Africa, the evaluation will focus on three main areas:
- Household-level outcomes, including direct impacts on health and education
- Community dynamics, for example through a focus on informal transfers.
- Programme processes, including the effectiveness and efficiency of operations, activities, and resource use (this is important in identifying issues with scaling up the programme)
The first target audience for this evaluation is the Tanzanian government, which has secured resources to expand the programme to a national scale beginning in late 2012. Evaluation results will be essential to design the national programme to best improve outcomes for vulnerable children and elderly. 'Additionally, a number of countries with limited institutional capacity have shown interest in adapting the CCT model to delegate more duties to local communities.'
Read a policy note on the World Bank's Evidence to Policy note series.
The Government of Tanzania rolled out a Conditional Cash Transfer (CCT) program in three relatively poor districts: Bagamoyo, Chamwino, and Kibaha. The pilot intervention was implemented by the Tanzania Social Action Fund (TASAF). This study aims to validate a model relying heavily on communities to target beneficiaries and deliver payments, and see whether the intervention could improve outcomes for the poor the way centrally run CCT programmes have in other contexts.
Since 2001, the level of poverty in rural areas has remained stagnant at around 37 per cent to 40 per cent. In 2000, the Government of Tanzania, with support from the World Bank, created TASAF as part of a broader strategy to reduce poverty by stimulating local economies.
In January 2010, the government launched the community-based conditional cash transfer (CCT) programme, aimed at improving the health of young children and the elderly and increasing investment in education for children aged 7'15. This intervention uniquely involved members of the community in the programme implementation and management.
The evaluation assessed the impact of this pilot intervention on outcomes related to health-seeking behaviour, the health and education of household members, asset ownership, savings, credit, consumption and community relations.
The main objectives of this community-managed conditional cash transfer programme were to increase investments in health for young children (aged 0'5 years) and the elderly (aged 60 and over) and to increase educational investments for children aged 7'15. Payments were computed based on the number of children and elderly in eligible households. Households received payment six times a year: US$6 for every child under the age of 15 and US$12 for every adult over the age of 60, with a maximum bimonthly total of US$36 for the household. On average, households received US$87 a year.
Theory of change
The community-managed CCT programme is based on the following theory of change. The basic inputs'cash transfers within a framework of conditions requiring children's school enrollment and attendance, children's attendance at health clinics, and attendance of the elderly (age 60 and over) at health clinics'are expected to lead to the immediate outputs of increased household income (a direct result of the transfers) and increases in the behaviours on which transfers are conditioned (as these are incentivised). Project outcomes, then, would be increased consumption, increased school enrollment and attendance, and greater usage of health facilities for both the youth and for the elderly. Long-run impacts would include improvements in the wellbeing of children raised in these households'including better nutrition outcomes (possibly due to higher food consumption, or fewer and less severe bouts of illnesses), higher earnings for children raised in these households, as well as improved well-being for the elderly.
This randomised evaluation had three rounds of surveys. The baseline survey was carried out in early 2009 and transfers began in January 2010. Midline survey was carried out between July and September 2011 and the endline survey was carried out between August and October 2012. With a total of 80 participating communities (40 treatment and 40 control) and an effect size of 0.20, the study interviewed 20 households per community in order to achieve 80 per cent power. Treatment and control groups were comparable at the baseline. The evaluation also included a qualitative component- a community scorecard exercise, two rounds of focus groups, and a series of in-depth interviews to determine the programme's impact using self-reported results.
The community-based model led to better health. The poorest families got the biggest health boost in terms of a reduction in the number of days they were sick every month. The programme also had a positive effect on education, particularly for girls and the community's most vulnerable children. Participants in the programme used the money to invest in health insurance, livestock and shoes, but the programme had little impact on overall consumption, bank savings or credit decisions. The programme also had positive effects on communal cohesion; recipients had greater trust in their leaders as well as each other.
Community-based conditional cash transfers have proven to be an effective tool for alleviating poverty and improving health and education outcomes for the poor.
One of the key findings of the study is that community groups, with adequate training and support, can handle the logistics of the cash transfers, and in doing so, help improve the lives of their poorest neighbours.
The implementing agency, Tanzania Social Action Fund (TASAF) is scaling up the pilot CCT programme and is using the findings to inform its design and implementation.
Targeting and enrolment: The process for targeting and enrolment into the programme has been modified, whereby community teams comprising of two people (one member who can write while the other who is aware of the local context) have replaced the 14 member Community Management Committees making the process more flexible to local needs, while keeping the costs low and reducing time spent on targeting. Further, qualitative analysis showed that households were often unhappy with only some of their children benefiting from the programme. To remedy the issue, the programme now targets households instead of individuals for participation.
Benefit structure: the benefit structure was changed and TASAF did away with a fixed component of the transfer but retained the variable component with a strict cap of USD 36 every two months per household. Each household was entitled to USD 6 per child every two months for children aged 0-14, and USD 12 every two months for elderly aged 60 plus, subject to a maximum of USD 36 every two months.
Conditionalities: The evaluation found that minimal health impact on the elderly which helped reorient the programme focusing more on children. Educational conditionalities that were checked once every two months were made monthly in scale up since the pilot found impact on student absenteeism and therefore instituted closer monitoring. On the other, the health conditionality of visiting health clinic 6 times a year was changed to twice in a year, since the evaluation found that attendance at clinics was anyway more than what was required by the programme.
Upon hearing about the benefits of the programme in helping children transition to secondary school, especially girls, the implementing agency decided to extend the support to children in junior and senior secondary school levels.
TASAF has insisted on embedding a large scale RCT in the scale up phase taking advantage of the staggered roll out. Drawing on its learning from being involved in a RCT in the pilot phase of the programme, TASAF now is a much more sophisticated commissioner and consumer of this process. While the government is still relying on some external groups for certain technical skills they don't have but they are much more owners of this process.'
There were clear champions for the evaluation including the former and current executive director of TASAF and the head of the management unit of TASAF. The research team worked closely with the implementing agency on the endline and discussed the questions to be added to the survey that would be of interest to the implementing agency in part to help them understand the earlier results and use these results to inform the scale-up of the programme. TASAF also wanted the findings from the rigorous IE to convince the Ministry of Finance to garner resources for the next phase of the project, including resources from donors.
- Tanzania: Can Local Communities Successfully Run Cash Transfer Programs? World Bank Evidence to Policy note series, March 2014
- What is the impact of a community-managed conditional cash transfer programme in Tanzania? 3ie policy brief
- Cash Transfers and Health: Evidence from Tanzania, The World Bank Economic Review, July 2019