90352 enGender Impact: The World Bank’s Gender Impact Evaluation Database Community-Based Conditional Cash Transfers in Tanzania : Results from a Randomized Trial Author(s) David K. Evans, Stephanie Hausladen, Katrina Kosec, Natasha Reese Contact devans2@worldbank.org Country Tanzania Women's Health, Education and Skills, Economic Opportunities and Access to Organizing Theme Assets Status Completed Intervention Category Community-based CCT Women's Health, Nutrition & Population, Education, Social Protection and Labor, Sector Voice and Agency Given the success of conditional cash transfer (CCT) programs elsewhere, in 2010 the Government of Tanzania rolled out a pilot CCT program in three districts. Its aim was to see if, using a model relying on communities to target beneficiaries and deliver payments, the program could improve outcomes for the poor the way centrally-run CCT programs have in other contexts. The program provided cash payments to poor households, but conditioned payments on complying with certain health and education requirements. Given scarce resources, the Government randomly selected 40 out of 80 eligible villages to receive the pilot program. Households in participating and comparison villages were broadly comparable at baseline. This report describes the program and the results of a rigorous mixed methods impact evaluation. Two and a half years into the program, participating households were healthier and more educated. Health improvements due to the CCT program were greatest for the poorest half of households—the poorest of the poor. They experienced a half a day per month reduction in sick days on average, Abstract and poor children age 0-4 in particular had a full day per month reduction in sick days. In education, the program showed clear positive impacts on whether children had ever attended school and on whether they completed Standard 7. Households were also more likely to buy shoes for children, which can promote both health and school attendance. In response to the program, households also made investments to reduce risk: participating households were much more likely to finance medical care with insurance and much more likely to purchase health insurance than were their comparison counterparts. The program did not significantly affect savings on average, although it did increase non-bank savings amongst the poorest half of households. Participating households also invested in more livestock assets, which they used to create small enterprises. The program did not, however, have significant impacts on food consumption. On the whole, the results suggest that households focused on reducing risk and on improving their livelihoods rather than principally on increasing consumption. There is also evidence that the project had positive effects on community cohesion. Gender Connection Gender Informed Analysis Health, school attendance, literary and completion, expenditure, assets and savings, Gender Outcomes community cohesion Last updated: 2 September 2014 1 enGender Impact: The World Bank’s Gender Impact Evaluation Database IE Design Randomized Control Trial In conjunction with the local government authority and Tanzania Social Action Fund (TASAF), community management committees assessed households’ eligibility using proxy means testing, which measures a family’s well-being based on things like housing quality, household goods and education. Once beneficiaries were chosen, committees were kept informed of people’s adherence to the requirements through monitoring reports kept by schools and clinics. If beneficiaries failed to comply, they received a warning, and after that, a 25 percent reduction in their next payment. After two unheeded warnings, they were suspended, but were given the option of reapplying. Committees were responsible for informing beneficiaries of Intervention program requirements, distributing cash payments and using peer pressure to ensure compliance with the program’s health and education conditions. Payments were computed based on the number of children and elderly in eligible households. Households received payment six times a year: $6 for every child under the age of 15 and $12 for every adult over the age of 60, with a maximum bimonthly total of $36 for the household. On average, households received $87 a year. For families to receive the money, children up to the age of five had to visit a health clinic at least six times a year, children ages 7–15 had to be enrolled in school and have at least 80 percent attendance, and elderly people needed to visit a health clinic once a year. Intervention Period 2010-now The program was piloted in three poor districts (Bagamoyo, Chamwino, and Kibaha), selected in part for their poverty relative to other parts of Tanzania. 80 Sample population communities were identified of which 40 received treatment. 2,500 households in total were invited to enroll, but only 1,764 HHs (both treatment and control) were studied at baseline after a prioritization/targeting exercise Comparison 40 control communities did not receive treatment conditions Unit of analysis Household and individual level Evaluation Period 2009-2013 On the whole, the community-based CCT program led to improved outcomes in both health and education. Households used the resources to invest in livestock, in children’s shoes, in insurance, and—for the poorest households— in increased Results savings. This suggests that the households focused on reducing risk and on improving their livelihoods rather than principally on increasing consumption. There is also evidence that the project had positive effects on community cohesion. Primary study limitations This project is being implemented by TASAF. The project and evaluation were supported by the Japan Social Development Fund. The impact evaluation also received from the Trust Fund for Environmentally and Socially Sustainable Funding Source Development, the Spanish Impact Evaluation Fund, the International Initiative for Impact Evaluation, and the Consultative Group on International Agricultural Research Research Program on Policies, Institutions and Markets. Evans, D.K., Hausladen, S., Kosec, K., & Reese, N. (2014). Community-Based Reference(s) Conditional Cash Transfers in Tanzania : Results from a Randomized Trial. Washington, DC: World Bank Last updated: 2 September 2014 2 enGender Impact: The World Bank’s Gender Impact Evaluation Database Link to Studies http://elibrary.worldbank.org/doi/pdf/10.1596/978-1-4648-0141-9 Microdata Last updated: 2 September 2014 3