Transferencias Condicionadas

Conditional Cash Transfers as Social Policy in Latin America: An Assessment of Their
Contributions and Limitations

Author(s): Enrique Valencia Lomelí
Source: Annual Review of Sociology, Vol. 34 (2008), pp. 475-498
Published by: Annual Reviews
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Conditional Cash Transfers
as Social
Policy in Latin
America: An Assessment
of their Contributions
and Limitations*
Enrique Valencia Lomeli

Centro de Investigaci?n Observatorio Social, Universidad de Guadajalara, Guadalajara,
Jalisco,M?xico; email: enrivalo@gmail.com
Anno. Rar. Sociol. 2008.34*75-99

KeyWords
First published online as a Review inAdvance on
poverty,welfare, targeting,human capital, social rights
April17,2008
The AmiumIReview ofSoaoiogy isonline at Abstract
nor.annnalreviews.org Conditional cash transferprograms have recently spread throughout
This articled doit Latin America, and early findings suggest theirpotential to overcome
10ai4d/annarevunc.34.040507.134537
povertyand createhuman capital.This reviewundertakes an assessment
? 2008byAnnualReviews.
Copyright ofCCT programs and the conventional theory thathas evolved to jus?
All rights reserved
tify them. It concludes that successes to date are limited,with positive
0360-O572/D8/D8U-O475$20.00 effectson schooling and some aspects of health and nutrition in poor
?The original Spanish version is available online households, butweak effectson alleviatingpoverty in theshort termand
at http_(^rww4mnqalre?tews*oi^go/ uncertain effectson educational aspects of human capitalformation and
EValendaLomelL
poverty reduction in the long term.In a broader andmore comprehen?
siveview of social policy, as opposed to aminimalistfocus, thekey issue
ishow to integrateCCT programswith other social programs toover?
come traditionalpatternsof segmentation inLatin America and thereby
cultivate citizenship.
415

INTRODUCTION now have a CCT program in operation. On av?
erage, these programs have been for

Programs of Conditional Cash Transfers
operating
four years, though eight of them only started in
(CCT) began to be applied in differentparts
the past one to two years. Just two have been
of Latin America and the Caribbean halfway
for a decade or more, and six have
through the 1990s, and in littlemore than
functioning
been active for periods from three to
a decade they spread widely throughout the ranging
six years.
Under a CCT is
region. program, money
transferred from the state to Compared with total social spending, the
particular needy
amounts allocated to CCT programs
households to generally
help support them?provided
constitute a small share of GDP?around 0.4%
to certain
they conform expectations?about
for the two largest (in absolute terms) programs
health care, and nutrition?deemed
schooling,
tobe in thebroader public interest. (in Brazil andMexico) and 0.6%-0.8% in the
As indicated
middle range of programs (in Argentina and
in Table 1, at least 16 countries in the region
Table 1 Conditional cash transfer programs in Latin America by year of initiation, budget, and coverage
Argentina Plan JefasyJefes(PJJ) 2002 0.80% (2003) 1991persons(2003)

Plan Familiaspor la InclusionSocial (PF) 2005
Brazil ProgramadeErradica?aodoTrabalho Infantil(PETT) 1996 0.04% (2001) 5600 families(2002)
Bolsa Escola (BE) 2001 11,200families(2006)
Bolsa Familia (BF) 2003 0.41% (2006) 44,000 persons(2006)
Colombia FamiliasenAcci?n (FA) 2001 0.09% (2005) 515 persons(2005)
Costa Rica Super?monos(SUP) 2000 0.02% (2002) 12 families(2001)
Programa de Transferencias Monetarias Condicionadas 2006
(PTMC)
Chile Chile Solidario(CHS) 2002 0.10% (2005) 157 families(2004)
Ecuador Bono deDesarrolloHumano (BDH) 2004 0.60% (2005) 1060 families(2006)
El Salvador Red Solidaria(RS) 2005 0.27% (2006) 35 families(2007)
Honduras Programade Asignaci?nFamiliar(PRAF) 1998 0.20% (2001) 629 persons(2005)
Jamaica Program of Advancement Through Health and Education 2001 0.15% (2006) 175persons(2005)
(PATH)
Mexico (PROP)
Progresa/Oportunidades 1997 0.39% (2005) 5000 families(2005)
24,060persons(2005)
Nicaragua Red de Protecci?nSocial (RPS) 2000 0.22% (2005) 24 families(2006)
Panama Red deOportunidades(RO) 2006 34 families(2006)
Paraguay Red de Promoci?ny Protecci?nSocial (RPPS) 2005 5 families(2005)
Peru Peru Juntos(PJ) 2005 0.11% (2006) 71 families(2006)
Dom. Rep. Plan de Solidaridad(PS) 2005 0.34% (2006) 230families(2006)
Uruguay Plan deAtenci?nNac. a laEmergenciaSocial (PANES) 2005 0.60% (2006) 83 persons(2005)
Sources: Arim & Vigorito (2006), Braun & Chudnovsky (2005), Cohen et al. (2006b), Cohen & Villatoro (2006), CEPAL (2007b), Britto (2007), Draibe
(2006), Francke & Mendoza (2006), Golbert (2006b), Ivo (2006), Largaespada Fredersdorff (2006), Levy (2006), Lindert et al. (2006), N??ez & Cuesta
(2006), Ponce (2006), Presidencia de laRep?blica Dominicana (2006), and the followingwebsites: http://www.mides.gob.pa, http://www.
redsolidaria.gob.sv, http://www.worldbank.org, and http://www.npep.jm
476 Valencia Lomel?

Ecuador), with just 0.1% to 0.3% in other TRANSFERS FOR RELIEF
cases. Nonetheless, their activities now serve a VERSUS DEVELOPMENT
of Latin American households.
large number The theory behind CCT programs in Latin
Over the past decade, CCT programs have ex?
America is quite new. Ifwe consider the earliest
and at one time or an?
panded significantly, the earliest actions of pioneer
designs, govern?
other in the past decade some 70 million
people, the earliest the first publica?
ments, evaluations,
conservatively estimated, have received CCT
tions, and the first wave of new programs pro?
support, around 12% of the pop?
constituting moted international financial
by institutions,
ulation in Latin America and the Caribbean
the bulk of CCT history occurs in the sec?
(CEPAL 2007a). ond half of the 1990s.This shortperiod covers
Most CCT programs include a component
the operational design of the first programs in
to invest in education, and according to
Morley Brazil and Mexico and their subsequent imple?
& Coady (2003), CCT contributions in the
mentation, evaluation, and synthesis into a the?
region represent around 5% of total govern?
oretically coherent framework for application
ment on education and 15% of
expenditures elsewhere. Of were eval?
particular importance
those spent on education.
primary Although uations done in international
by officials finan?
some CCT programs were domes?
designed cial and
organizations prominent academics,
tically by national governments (as in Brazil, who a as well as technical
together had political
Argentina, and Mexico), direct participation by in promoting their wider inter?
goal adoption
international financial institutions has been ris?
nationally (Rawlings 2005). These early stud?
ing over time (Aguiar 2006, Golbert 2006a, ies also had the practical of set?
consequence
G?mez-Hermosillo Mar?n 2006). Indeed, sup?
ting the stage for further evaluations, which
port from the International Development Bank
were
generally required by international orga?
alone accounted for $4.5 billion during 2000
nizations providing the funds (Morley& Coady
2005, a period inwhich the largestnumber of
2003).
CCT programs were created in Latin
being The first CCT to be evaluated was
program
America (IADB 2006). Depending on whom
Mexico's Progresa program, which in
began
one credits, CCT represent either
programs 1997 under President Ernesto Zedillo and was
a new to
daring approach fighting poverty? continued successor Vicente Fox
by his (though
one that respects market
principles (Rawlings in 2002 he renamed it Oportunidades?hence
a in a
2005)?or stripped down approach region the acronym PROP used inTable 1 and the
dominated by aminimalist social policy (Barba
remainder of this article). A research proto?
Solano 2006). For some observers, CCT pro? col was included as of the project's
part orig?
stand for greater for
grams efficiency, whereas inal design, and early in 1998 those running
others a reduction in the com?
they constitute the program asked the International Food Pol?
mitment to social one that focuses
justice, only
icy Research Institute (IFPRI) to coordinate
on the most extreme cases of
poverty. a first round of evaluations. The IFPRI as?
In this review, I consider the principal the?
sembled a team of some 20 researchers who
oretical arguments that have been advanced to
presented their conclusions in 2000 (Skoufias
CCT programs inLatin America and of?
justify
2000). In theirdetailed analysis of the effectof
fer an evaluation of how well they have worked PROP's educational &
transfers, Morley Coady
to outcomes with respect to education,
improve
(2003) concluded thatrising interest in CCT
health, and nutrition, as well as the to
degree after 2000 stemmed from the posi?
programs
which to reduce
they have functioned poverty. tive conclusions reached by these
early evalua?
I also assess their influence on social relations,
tions, which emphasized the program's relative
relations, and end with a dis?
notably gender and effectiveness in edu?
efficiency improving
cussion of the role played by CCT programs cational outcomes.
within the region
today.
?
www.a7inualreviews.org Conditional Cash Transfers 477

A number of other articles have under? thus concluded that CCT programs "have been
scored the connection between research successful" in oflevels

early particularly reducing
and later adoptions (Britto 2004). Over the poverty in the region as well as in
promoting
there seems to have been a process human accumulation and access to so?
years, capital
in a recent
of cross-fertilization and mutual influence cial services. Moreover, study of
between makers in different countries. transfers for the World Bank, Lindert
policy public
For example, the RPS program in Nicaragua et al. (2006) found thatCCT programs were
was influenced by the BF program in Brazil promising
not
just because of their redistribu
and the FA in Colombia, as well as tive effects on income, but also because of
program
by PROP inMexico and PRAF inHonduras. "their demonstrated impacts

on human capi?
Then itself went on to influence tal" and "their to break the
Nicaragua ability intergen
later such as RS in El Salvador, erational transmission of poverty." went
programs They
RPPS in Paraguay, and PS in theDominican on to underscore the "emerging popularity" of
Republic (Largaespada Fredersdorff 2006). the CCT programs in Latin America, label?
The general impactof BF inBrazil and PROP ing them "islands of success" in the region's
in Mexico, and more of CHS in sea of social Another
recently large protections. study
Chile, can be seen on the new round of CCT by theWorld Bank concluded that "evidence
in Latin America after from several countries demonstrates that these
programs inaugurated
2000, which 13 of the programs are directed to the
together represent right population,
countries listed inTable 1. reduce the poverty of the poorest households,
The enthusiasm and with which and improve the education and the health of the
speed
CCT programs were received in parts of the children" (World Bank 2007).
is astonishing, and their enthusias? In a very short time, therefore, evalua
academy
tic embrace international financial institu? tors, consultants, and academics close to in?
by
tions is even more surprising. For Rawlings & ternational financial institutions have achieved
Rubio (2003), whose bibliography focuses on a remarkable consensus about the principal
evaluations made the IFPRI in Honduras, of CCT programs: They reach the
by strengths
and Mexico, the rapid of inhabitants the
Nicaragua, expansion poorest directly; they promote
CCT programs reflects "solid evidence of their accumulation of human capital; they reduce
on in the short and
positive impact the accumulation of human poverty long term; they lower
income
capital."
In her
analysis of the first generation of inequality; they break the intergenera
evaluations (in Brazil, Mexico, and tional transmission of poverty; and, finally, they
Nicaragua,
Colombia), Rawlings (2005) found thatCCT are cost effective. These are strong conclusions
were efficient" and to reach so soon after the start of a major so?
programs "administratively
offered an "effective means" for promoting the cial experiment. In considering the theoretical
of human conventions that have built up around CCT

accumulation capital by poor house?
holds. In a more recent for the Interna? in Latin America, we may
study programs distinguish
tional Development Bank, Bouillon & Tejerina 10 salient features, which not necessar?
though
(2006) concluded that in evaluations done be? ily shared by all promoters of CCT programs
tween 1997 and 2003 (in Costa Rica, Ecuador, are nonetheless present inmost theoretical and
and Honduras as well as in Brazil, Mexico, technical discussions about them.
Nicaragua, and Colombia), cash transfer pro? First, although CCT programs entail pub?
are
grams were found to be
"very effective tools" lic interventions on the demand side, they
for reducing poverty and inequality "in the long more of market
generally respectful princi?
term" and the relief of poverty "in the short ples than the usual supply-side interventions
term." (Levy 1991, Levy & Rodriguez 2005, Braun &
In its Annual Report for 2005, the Inter Chudnovsky 2005, Rawlings 2005, Bouillon &
American Development Bank (LADB) (2006) Tejerina 2006, Cohen & Franco 2006a,World
47'8 Valencia Lomelt

Bank In a very real sense, CCT the nutrition, health, and educa?
2007). programs determining
represent
a continuation of broader economic tionof children (Morley& Coady 2003). Itwas
reformsinLatin America during the 1980s and not
immediately obvious in early discussions of
which have to instru? conditional transfers, however, that this focus

1990s, sought develop
ments of social that would be would emerge. At least inMexico, itwas taken
policy "compati?
ble with the logic of the market" and to under? after considerable debate and tied to
up only
take interventions that would avoid "distortions concrete put forward
proposals by government
in relativeprices" (Levy& Rodriguez 2005). demographers such as Jos? G?mez de Le?n
Second, a
key premise
of CCT programs is (L?pez & Salles 2006, Rubalcava 2007).
that "a fundamental reason for the reproduc? Fifth, CCT programs concentrate their in?
tion of poverty over various is the terventions at chosen points in the

generations carefully
lack of investment in human in the areas life cycle, on nutrition and
capital focusing particularly
of education, health and nutrition" (Villatoro health pregnancy and the first years of
during
2004). In other words, deficiencies in health, life, on the continuation of education during
and nutrition interact to a vi? transitions from primary to secondary school
education, yield
cious of poverty within which individuals and, at least in Mexico, from to
cycle secondary
and familiesbecome enmeshed (Levy 1991). In preparatory school (Levy & Rodriguez 2005,
essence, children from poor households are as? Cohen & Franco 2006a). To encourage educa?
sumed to additional tion, programs generally offer extra cash trans?

experience disadvantages
fers or educational con?
above and beyond their immediate material de? grants when children
because the low quality and limited tinue in school. To promote better nutrition and
privation
leads to low worker cash to promote the
amount of schooling pro? health, they also transfer
and incomes in the future education of mothers and enable the purchase
ductivity depressed
of certain nutritious food items. In some coun?
(Morley&Coady2003).
CCT combine the tradi? tries, programs offer participating households a
Third, programs
tional role of social assistance in standard package of medical care and nutrition,
public pro?
grams with the newer role of social investment which includes food supplements for small,
(Morley& Coady 2003, Lindert et al. 2006). In undernourished children, pregnant women,
the short term, they
raise the income of poor and nursing mothers (Rawlings & Rubio
households transfers of cash, 2003).
through goods,
and and, in the long-term,
services Sixth, programs seek to the behavior
encourage change
investments in human of poor households the receipt
capital formation by of? by conditioning
economic incentives and conditional re? of transfers, goods, and services on
fering specific
wards for continued among children. behavioral outcomes, such as continued school
schooling
In doing so, they combine the three classic com? enrollment, rates of school attendance
regular
ponents of human capital?education, health, (generally at least 80%), participation in
and nutrition?into a courses on health and nutrition, and the receipt
single package, although
some programs emphasize education whereas of periodic health checkups. The conditional
others focus on the interaction between all three nature of the transfers is hypothesized to
components (Rawlings& Rubio 2003) and as? be "likely

to lead households to make more
sume strong between them efficient educational decisions" &
complementarities (Morley
(Levy 1991). Coady 2003) by transforming them into
Fourth, CCT theorists argue that house? rational cost-benefit calculations (Braun &
holds and families are central
to the 2005). enables the
reproduc? Chudnovsky Conditioning
tion of poverty from one generation to the next programs to "address market failures" as well as
and that interventions can break the to "internalize the positive externalities accrued
strategic
vicious circle of deprivation (Cohen & Franco increased investments in health and
through
2006b). focus on mothers as actors education among the young" 2005).
They key (Rawlings
? Conditional Cash
www.annualreviews.org Transfers 47c

CCT seek to promote are to female householders to
Seventh, programs paid directly
education not the direct costs avoid "intermediate local leaders or corpora?
only by covering
of schooling but also the oppor? tive groups that might commitments
by offsetting require
costs children to other than those established in the program or
tunity generated by having go
school insteadofwork (Rawlings 2005),while at wish to seize them for other purposes" (Levy &
the same time seeking "to avoid eroding the in? Rodriguez 2005).
an eval?
centive for self-help or enhancing the incentives Finally, CCT usually have
programs
for higher fertility"(Morley & Coady 2003). uation design built into their operation from the
some cases
CCT theorists assume that the benefits of edu? very start, in embracing experimen?
cation "are permanent" because chil? tal or quasi-experimental
features (Rawlings
they give
dren the tools they need "to earn their way out & Rubio 2003, Bouillon & Tejerina 2006,
of poverty" later in life(Morley& Coady 2003). Cohen & Franco 2006a). According
to one
was a
They argue that more education means greater study by theWorld Bank, Mexico pio?
future productivity and higher adult incomes. neer in this regard, and the evaluation of the
Children with better health and nutrition program went well

per? Progresa-Oportunidades
form better at school and achieve fu? the simple construction of summary in?
higher beyond
ture earnings from their labor (Cohen & Franco dices and concentrated instead on real "mea?
2006a). suresof impact" (World Bank 2004). According
Eighth, because social programs are

always
to Behrman & Skoufias (2006), the evaluation
subject
to
budget constraints, CCT programs of PROP inMexico underscored the gains of
channel their benefits to the needi? a serious evaluation over a reliance on
generally making
est cases in order to "achieve the greatest ef? a and "vested interests,"
"myths," priori beliefs,
fectwith the budget on a determined reliefof biases that all too often predominate
in deter?
or to use alternative terms, to pro? the effectiveness of social programs.

poverty, mining
duce a determined effect at the lowest budget
cost" et al. 2004). use a combina?
(Coady They
to
ASSESSMENT OF PERFORMANCE
tion of approaches identify needy households
et al. 2004), a proxy means
AND ACHIEVEMENTS
(Coady including
test to collect information about household It thus appears, based on the large research lit?
characteristics (Chile was first to use this ap? erature that has now that important
developed,
of poverty, and sectors of academia and key of
proach), geographic clustering representatives
in some cases and international financial are now
community-based targeting organizations
self-selection(Morley& Coady 2003, Rawlings convinced of the social relevance, administra?
& Rubio 2003, Britto 2004, Braun & Chud tive efficiency, theoretical relevance, and finan?
novsky 2005, Rawlings 2005,Villatoro 2005b, cial viability of CCT programs. Nonetheless,
Bouillon & Tejerina 2006, Lindert et al. 2006, it remains important
to evaluate their perfor?
mance a decade a
Cohen & Franco 2006a). The most commonly after their initiation. Does
used mechanism is the proxy means-testing of balanced assessment of their pros and cons ac?
often codified as a cord with the enthusiasm of CCT

living standards, point system promoters
(World Bank 2007). and support their theoretical justifications?
Ninth, resources
by transferring directly
to specific households, national governments
to establish
Performance in Education
attempt direct relationships with
individuals rather than on bureau? Table 2 summarizes the results of studies eval?
relying
cratic intermediaries 2005), a re? the effect of CCT on educa?
(Rawlings uating programs
that is in theory structured to be tional outcomes. These evaluations
lationship generally
"apolitical" (Britto2006) and "nonparty" (Levy conclude that CCTs are successful in achieving
& 2005). In most cases, transfers their explicit of increasing rates of school
Rodriguez goal
480 Valencia Lomel?

Table 2 Effect of CCT programs on educational outcomes in Latin America
School attendance General increase RPS-Nicaragua (up to 30 percentage Less inBF-BrasilandPROP-M?xico

(Explicitgoal) points),FA-Columbia(up 5% rural, (inprimaryeducation)because subsidies
13% urban).In variousage groupsin are concentrated on groups that already
FA-Columbia, PRAF Honduras, and attend school

SUP-CostaRica
School enrollment General increase RPS-Nicaragua (22%, cohort aged inPRAF-Honduras

Not significant
(Explicitgoal) 7-13),PROP-M?xico (12% in
transition to secondary, more for girls
andfor high school),BE-Brasil,
SUP-Costa Rica, RS-E1 Salvador.
Effect of increasing average schooling
inPROP-M?xico (0.66-1year inrural
s),RPS-Nicaragua (0.45 years)
School leaving Some positive results PROP-M?xico (reductioninruralprimary
(Not explicitgoal) schoolsand high schooleducation;
reduces dropout .rate but increases grade
repetition)_"
School learning No positiveeffect No effects for BA-Brasil, BDH-Ecuador,
FA-Colombia, PRAF-Honduras,
PROP-M?xico, RPS-Nicaragua_
Sources: Behrman et al. (2000), Bouillon & Tejerina (2006), Braun & Chudnovsky (2005), Britto (2004, 2007), Cohen et al. (2006a), Cruz et al. (2006),
De Janvry& Sadoulet (2006), Draibe (2006), Duryea & Morrison (2004), Largaespada Fredersdorff (2006), Levy & Rodriguez (2005),Morley & Coady
(2003), Nunez & Cuesta (2006), Ponce (2006), Rawlings (2005), Rawlings & Rubio (2003), Reimers et al. (2006).
enrollment and attendance, and that these out? & Coady (2003) point out repeatedly, it is not
comes translate into higher levels of to raise enrollment and atten?
average enough simply
schooling among children in families receiving dance rates; the quality of education must also
aid. Moreover, in at least some cases, CCT pro? be improved because without good classroom
grams have contributed to dif? instruction CCT programs cannot be consid?

reducing gender
ferentials in educational attainment. They also ered to be efficient.To be fair, improving the
show some
positive effects in quality of education is not an explicit objec?
reducing dropout
rates, this is not an tive of most CCT programs in Latin America,
although explicit objective
in many programs. Some authors, such as De which focus more on enrollment and atten?
Janvry& Sadoulet (2006), go so far as to con? dance rates (Morley & Coady 2003). As a re?
clude that conditions with the trans? sult, issues such as and the quality of
imposed learning
fers have yielded effects thatwould not have education are often
ignored
in evaluations.
been achieved To the quality of education has

by the transfers alone, especially date, gen?
inMexico but also inBrazil. erallybeen taken forgranted and has not been
As Table 2 indicates, however, results are
incorporated into thedesign ofCCT programs,
not as with to effects on ac? which constitutes a serious Reimers
promising respect deficiency.
tual learning.According toVillatoro (2005a), et al. (2006) severelycriticize thisomission and
learning is one of the "least clear aspects" of conclude that,at the end of theday, the implicit
and most are unable is that the accumula?
CCT programs, studies theory of these programs
to document results et al. tion of human is the same as the accu?
positive (Behrman capital
2000, Draibe 2006, Levy & Rodriguez 2005, mulation of years of schooling. They question
Ponce 2006, Reimers et al. 2006). As Morley this assumption and point out that educational
? Conditional Cash
www.annualreviews.org Transfers 481

quality for the poor is often substandard and Table 4 show,CCT programs inLatin America
that years of schooling do not the same also yield in nutrition and con?
yield improvements
benefits for poor as privileged children.They sumption (Levy& Rodriguez 2005, Bouillon &
criticize CCT enthusiasts for treating instruc? Tejerina 2006, Britto 2006, Cohen et al. 2006b),
tion as a black box. In sum, an essential aspect nutrition results are somewhat mixed.
although
for evaluating the effectiveness of CCT pro? Most studies show in the variety
improvements
grams is left in doubt: whether or not
they
re? of food consumed, greater height and weight
ally succeed in improvingthe scholarlyabilities among participating children, and reduced mal?
of the poor students who participate. nutrition inCCT families,but many analyses
found no improvement with respect to anemia.
Moreover, evaluations in Honduras found no

Health, Consumption, and Nutrition on outcome:
positive influence any nutritional
Table 3, which summarizes studies
evaluating Neither the amount of food consumed, the va?
the influence of CCT programs on a
variety riety of comestibles, the pace of physical de?
of health outcomes, a nor exposure to anemia showed a
generally suggests posi? velopment,
tive influence on the receipt of preventive infant influence. In fairness, however, these
positive
care (checkups during pregnancy, after birth, negative results probably reflect the small size
and early
in childhood), vaccinations, visits to of the transfers(Cohen et al. 2006a)
health care centers, and illness rates (Villatoro One case that stands out isNicaragua's RPS
2005a). In some cases, they also find a re? program, duringwhich a drop in the price of
duction in maternal and infant mortality and coffee and a serious about a
drought brought
improved knowledge of health among partici? severe reduction in consumption among house?
pants. In addition, as the studies summarized in holds in the control group but not those in
Table 3 Effect of CCT programs on health outcomes in Latin America
medical checkups
Having regular General PROP-Mezico
Receiving prenatal, natal, and General increase PJ-Per?, PRAF-Honduras,
postnatal
care PROP-M?zico, RS-E1 Salvador
Care of growth
for children General increase FA-Golombia, PRAF-Honduras,
PROP-Mezico, RPS-Nicaragua,
PJ-Per?
Vaccination General increase FA-Colombia, PRAF-Honduras,
RPS-Nicaragua, PJ-Per?
Mortality PROP-Mezico: 11% reductionin

maternal mortality, 2% in infant
mortality_
Incidenceof illness General reduction PROP-M?zico: 12% forchildren PRAF-Honduras: increase in
<5,20%-22% in rural areas; for children<5

diarrhea
FA-Colombia: 5% reductionin
diarrhea
for ruralchildren<5,
10%for urbanchildren<5
Knowledgeofhealthcare PROP-M?zico: iincrease among on risky
PROP-M?zico: no effect
women sexual practices among adolescents
Sources: Bouillon & Tejerina (2006), Braun & Chudnovsky (2005), Britto (2007), Cohen et al. (2006a), Cruz et al. (2006), Francke & Mendoza (2006),
Largaespada Fredersdorff (2006), Levy & Rodriguez (2005), N??ez & Cuesta (2006), Rawlings (2005), Rawlings & Rubio (2003).
482 Valencia Lomel?

Table 4 Effect of CCT programs on nutritional outcomes in Latin America
Consumption General increase RPS-Nicaragua: protected purchasing

power during economic crisis
provokedby fallingcoffeeprices
Spendingon food General increase PRAF-Honduras: no effect
Food supplements No effect PROP-M?xico: supplements only consumed

by 50% of targetpopulation,problemwith
iron content of formula
Diet General FA-Golombia, PROP-M?xico, and PRAF-Honduras: no effect on

variety of diet
improvement RPS-Nicaragua: improved diet
Infant
weightand Mixed effects FA-Colombia: ruralchildren<2 PRAF-Honduras: No effect on retarded infant
height 0.78 cm tallerand0.22 kgheavier; growth;PROP-M?xico: 20%-30% of

PROP-M?xico: ruralchildren2-6 childrenaged 2-6 stillofpoor stature
0.67 cm taller, urban children 1 cm
tallerand 0.5 kgheavier;
RPS-Nicaragua: retarded growth
loweredby 7% for children<5
Malnutrition BF-Brazil: reduction in northeast BA-Brazil: increase in northwest
Anemia No effect PRAF-Honduras: continued prevalence of

anemia; PROP-M?xico: 20%-30% rural
children1998-2003with anemia;
RPS-Nicaragua: no
effect_
Infant cognitive PROP-M?xico: no effect
for childrenaged 2-6
development
Sources: Bouillon & Tejerina (2006), Braun & Chudnovsky (2005), Britto (2006), Cohen et al. (2006a,b), Cruz et al. (2006), Draibe (2006), Largaespada
Fredersdorff (2006), Levy & Rodriguez (2005), Neufeld et al. (2005a,b), N??ez & Cuesta (2006), Rawlings & Rubio (2003), Villatoro (2005a).
the treatmentgroup (Rawlings& Rubio 2003). in

nearly
a quarter of the program participants
Despite this salient example, results are still aged 2-3 in 2004. Nor did the program have
mixed forNicaragua as well asMexico. Indeed, a effect in anemia
significant reducing among
Neufeld et al. (2005a) concluded that for the urban children (Neufeld et al. 2005b). The per?
period 1998-2003 "itwas not possible to detect sistence of anemia despite the cash transfers is
an on a serious concern
impact from Oportunidades the preva? because it is well established
lence of anemia or on to ratios" that iron deficiencies can de?
weight height impede cognitive
among ruralchildrenaged 2-6.They found that velopment and thereby undermine the learning
anemia continues to be a serious with and long-term human of ane?
problem, capital formation
20%-30% of children showing iron deficiency mic children.
and low stature. The evaluators also pointed
out seriousproblems in thedistributionof food
supplements, in that "the typeof iron [used] is Poverty Reduction
not properly absorbed," indicatingproblems in The balance of results in poverty reduction
their formulas. from CCT program evaluations, summarized
Neufeld et al. (2005a) also documented se? inTable 5, offers only tempered conclusions. In
rious with respect to nutritional ed? the size of poverty-reducing effects is
problems general,
ucation and in urban areas ane?
showed that quite small. A short-term reduction in poverty is
mia continued to be a severe to be of course, the size of most
problem, present expected, given
? Conditional Cash

Table 5 Size of cash transfers by CCT programs in Latin America
BF-Brazil $91 (PPP*) per familyinextremepoverty 2003 20%-21% of family

consumption
CHS-Chile S33 (PPP) per familyinextremepoverty 2004 18%-50% of povertyline
during first six months of
program_
FA-Colombia 9%-29% of povertyline
PJ-Per? 88% of incomeforfamiliesinextremepoverty
PROP-M?zico S239 (PPP) maximumper family withhigh 2005 20%-21% of family
consumption;15%-98%
$24 (PPP) infood
school students; ofnutritional
povertyline
assistance for eligible
households_
PS-Republica Dominicana 20%-21% of family
consumption
RPS-Nicaragua 20%-21% of family
consumption;70% of
poverty line_
RS-E1 Salvador SI5 average per family, $20 maximum per 2007 37%-50% of ruralpovertyline
family_
aPPP, purchasing power parity.

Sources: Cohen et al. (2006b), Cohen & Villatoro (2006), Britto (2007), Draibe (2006), Francke & Mendoza (2006), Largaespada Fredersdorff (2006),
Morley & Coady (2003), Nunez & Cuesta (2006), Presidencia de laRep?blica Dominicana (2006), Skoufias et al. (2001), and Soares et al. (2007).
transfers in comparison to in rural Mexican

family income. The poverty communities between
key issue is how to measure the longer-term ef? 1997 and 1999 and a 36.1% reduction in the
fects on the incidence and intensity of poverty. size of the rural poverty gap, other
confirming
The debate has generally concluded that the appraisals by Skoufias et al. (2001), Levy &
effects of CCT programs are greater in reduc?
Rodr?guez (2005) and Cohen et al. (2006b). In
more recent
ing the intensity than the incidence of poverty. calculations, Alvarez (2006), using
That is, transfers succeed in the gap the latest data from the International
lowering Develop?
between a household's income and the poverty ment Bank, found thatbetween 1997 and 2003
thresholdbut generally do not lifthouseholds changes
in the incidence of poverty were lim?
above this line (Draibe 2006, Cort?s et al. 2007). ited,with only 9% of the rural poor managing
Morley & Coady (2003) argue, however, to rise above the poverty line.
that it is wrong to assess the effect of CCT At the national level, evaluations inMexico
programs measures of that PROP transfers made a

simply by comparing suggest signif?
poverty before and after their icant contribution to poverty reduction dur?
implementa?
tion. They argue that the comparison should ing 2000-2002 (World Bank 2004, Villatoro
contrast treatment and control groups and 2005a); but according to Cort?s et al. (2007),
that in the absence of such a re? the transfers
comparison, produced only modest improve?
searchers should compare the cost of the pro? ments in national poverty rates (pobreza de ca?
gram with the size of the post-transfer poverty pacidades) thereafter, with reductions of 3.6%
gap. Putting thisproposal into effect,theyfind in 2002, 3.6% in 2004, and 5.1% in 2005,
a reduction in the overall level of poverty of effects were in rural than ur?
though greater
3.0%-3.9% inMexico and Brazil, with a reduc? ban areas. They based their analysis on esti?
tion of around 14% of the povertygap in rural mates calculated from the National Survey of
areas. However, the decline in poverty was Household Income. With to
only respect general
0.4% and 0.8% in Honduras and rates, the reduction was
Nicaragua, poverty only around
In their of treatment 1% per year. In terms of over time (the
respectively. comparison change
and controlgroups in
Mexico, Morley & Coady difference between instantaneous poverty rates
(2003) found a 17.4% reduction in the rate of in the years 2002 and 2005), the contribution
484 Valencia Lomel?

of transfers was calculated to be even less? In terms of poverty reductions, of
long-term
in the poverty rates de the effects of CCT
just 0.22% (pobreza course, programs obviously
Nonetheless, these authors cannot yet be measured. Children from the first
capacidades). agree
with other studies that the effect of PROP was households to receive transfers in the 1990s are
in reducing the intensity than the inci? now to leave school and enter
greater only beginning
dence of poverty, the size of the gap the workforce, and the really massive CCT in?
lowering
by 11.5%, 9.7%, and 12.1% during2002, 2004, terventions only occurred within the past five
and 2005, years. Even those who accept the conventional

respectively.
This conclusion is consistent with the re? thinking about CCT programs agree that there
sults of studies, which after five are no answers to about

qualitative questions "long-term
years of fieldwork confirmed that although impactson welfare" (Rawlings& Rubio 2003).
PROP did reduce the economic vulnerability The only evidence
we have to base con?
of households inMexico, the reduction was not clusions on at this are simulations of
point
to do or "erad? future incomes. In the initial evalua?
enough away with deprivation possible
icate poverty" (Gonz?lez de la Rocha 2006b). tion of PROP inMexico, for example, simula?
Other factors tended to dominate in generat? tions that an increase of 0.66 years
suggested
in as a result of transfers would ulti?
ing poverty, and, compared with these, transfers schooling
appeared "to acquire a

secondary role." More mately yield 8% higher futurewages, and that
factors included "the domestic cy? as a result of food future earnings
important supplements,
cle, the structure of the households and the op? would be 2.9% higher (Skoufias et al. 2001).
tions for generating resources
by
means of man? In theiranalysis,Morley & Coady (2003) esti?
power" (Gonz?lez de laRocha 2006b). mated the future incomes of workers who re?
Other studies agree that CCT programs ceived grants in Nicaragua's transfer program
do not go very far in reducing poverty rates. would be 9% greater to increased time
owing
et al. (2003) estimate a reduction in school. Of course, these estimates do
Bourguignon spent
of only 4% in Brazil in 1999, but like other not address whether future earners will actually
a in be able to emerge from poverty,
investigators they report larger effect only whether
the gap between household income future earnings are
to be as a result
reducing likely higher
and the poverty threshold (9.8%). According of the additional time spent in school, leaving
toMorley & Coady (2003), themodest results the critical question of poverty alleviation unad
of Bourguignon et al. reflect the fact that the dressed. InMexico in 2002, a third of all house?
of the program in Brazil was to holds income were and

goal improve earning only wage poor
education rather than reduce poverty per se, 22% experienced poor nutrition (Cort?s 2006).
so that amounts transferred were the assumptions
very small. Moreover, made byMorley
Likewise, Argentina's program had a minor & Coady (2003) in theirsimulations are largely
effect on the overall poverty rate but amajor ef? untested. Growth in the number of workers
fect in reducing the rate of indigence (Braun & with more years of does not nec?
schooling
Chudnovsky 2005); and inUruguay theCitizen essarily translate
into greater future income
Income transfer program achieved a 1.4% as & them?
producing capacities, Morely Coady
reduction of poverty in 2006, and reduced the selves admit. In this regard, Villatoro (2005a)
povertygap by 7.8% (Arim& Vigorito 2006). speaks of growing uncertainty surrounding the
In sum, recent studies conclusions effect of education on wages, levels
yield given rising
close to what Skoufias et al. (2001) of schooling Latin America. The
originally throughout
observed: "Targeted programs, such as PRO? implicit assumption of most CCT evaluations
GRESA, may be quite successful at is that in the future better educated workers
reducing
the poverty gap or the
severity of poverty, but will find sufficientdemand in the labormarket
may have a negligible impact
on the headcount for their services, an
assumption that Duhau
ratio." (2000) calls heroic. Even Levy (2007), a strong
? Conditional Cash

of PROP-Mexico when it started, the capacities of poor households from employ?
promoter
who defined
the original as "trans? ment In the absence of meaningful
program policy. job
fers of income linked to investment in human creation, the future social effectiveness of CCT
capital today, and higher personal

income to? programswill be limited.
morrow," now concludes, 10 years later,
nearly
that PROP workers will not achieve higher
incomes if they have access to small Efficiency of Programs
personal
of poor areas or
land in rural In terms of efficiency?reaching targeted popu?
parcels quality
are in the streets of urban areas, lations effectively at low cost?evaluations gen?
self-employed
that CCT do manage
even if
they
are
employed
in microbusinesses. erally conclude programs
that have more to serve intended with a
"Without businesses capital and populations positive
are in? benefit-cost often with substan?
larger," he says, "'the higher personal ratio, although
comes tomorrow' will not
happen. Where
are tial leakage (defined below). Whether or not
in fact, reached
the companies that are going to hire, and regis? targeted groups are, by cash
terwith the social security institute, the millions transfer was the subject of a vigor?
programs
of workers from Oportunidades?" ous early debate inLatin America (Raczynski
According to Cohen & Franco (2006a), 1998, Boltvinik & Cort?s 2000, Barba Solano
the connection between transfers and et al. 2005, Engel Aduan 2006). The debatewas
receiving
of
"the insertion of the worker in a decent job is
fueled by the simultaneous implementation
full of questions." Certainly the critical nexus? the social investmentfunds (Schteingart 1999).
investment in human In their analysis of CCT be?
capital today for produc? program targeting
tive work in the future?is far from assured, for tween 1985 and 2002, based on studies con?
it requires a socioeconomic context in which ducted by the IFPRI, Coady et al. (2003, 2004)
abilities can be realized and skills can be trans? found a high degree of efficiency, which they
lated into higher earnings (Gendreau 2000). measured as the ratio between the percentage in
Without new the poorest segment of the nation's

population
generating productive employ?
ment, CCT in Latin America can be to the percentage of transfers going to this seg?
programs
expected to have limited effectson the future

ment. As shown inTable 6, this ratio generally
and poverty of poor families. From the between 1.56 and 2.08 and was always
earnings ranged
point of view of public policy, in the long-term above the mean for performance of 85 programs
it is not possible to separate actions in favor of the authors. to their

analyzed by According
Table 6 Effectiveness of targeting and errors of inclusion for CCT programs in Latin America
CHS-Chile 40% 83.0% 2.08 None reported
PRAF-Honduras 40% 79.5% 1.99 20% of households in program were not poor
PROP-M?xico 40% 62.4% 1.56 did not go topoorest

16.3% of transfers
households;4% went torichestquintile
RPS-Nicaragua 40% 80.9% 2.02 11.4% of transfers did not go to poorest
households
BE andBF: Brazil 40% 80% 2.00 15% of transfers went to richest
quintile; 24%
inclusion errors
FA-Colombia 21% of families served are in the top segment of

the beneficiary classification
system_
Sources: Coady et al. (2004, 2006a), Draibe (2006), Lindert et al. (2006), N??ez & Cuesta (2006), Soares et al. (2007).
486 Valencia Lomel?

the transferred re? tances and on
calculations, programs spend money transport, thereby
sources with an efficiencyof 108% in Chile, yielding elevated levels of self-exclusion (Armas
102% in Nicaragua, 99% in Honduras, and D?vila 2004). Likewise, Colombia's transfer
56% inMexico, more than expected under uni? program excludes locations with?
automatically
form or random assumptions.
out banks (N??ez & Cuesta 2006), thereby
Other writers confirm the thrust of 12% of the nation's poorest areas
general eliminating
these conclusions. Soares et al. (2007) confirm et al. 2004). Peru's program
(Coady Similarly,
these results forChile (2003) and place results encountered problems because many mothers
from Brazil at a similar level, with 80% of the do not have the required identification docu?
transfers to 40% of the poorest house? ments (Francke & Mendoza 2006). In Mexico,
going
holds in 2004, comparedwith 80% of the trans? PROP similarly excludes locations lacking ed?
fersgoing to 40% of thepoorest households in ucation and health services within a radius of
Mexico. Lindert et al. (2006), Draibe (2006), 2 to 15 km, thus disenfranchising those places
and theWorld Bank (2007) find programs in that suffer the most severe
problems of poverty
Brazil, Chile, Argentina, and Mexico to be well and isolation (Valencia Lomeli 2003).
targeted, as do Villatoro (2005a) inColombia Coady
et al. (2004) note that, in Mex?
and Chile; Cohen & Villatoro (2006) inChile; ico, community-based targeting under is used
Cohen et al. (2006b) inMexico; Cort?s et al. PROP's rules of operation but that several eval?
Mexico; andCohen et al. (2006a)

(2007) in rural uations reveal these rules to have been over?
inHonduras. Finally, inArgentina 96% of the looked in practice, with many selected to re?
households that received transfers were poor in ceive an invitation the results
simply ratifying
2002 (Braun & Chudnovsky 2005), and trans? (Adato 2004,Gonz?lez de laRocha 2006a). The
fers were found to reach 72% of the unem? BE in Brasil allows
program targeting of munic?
ployed (Golbert 2006b). ipalities, but officials have not been able to reach
of should also an on the to im?
Any analysis efficiency agreement specific procedures
include an assessment of the selection, room
leakages (resources plement targeted leaving
that go to outside of the for significant and
people targeted political patronage leakage
in this case those who are not poor) (Britto2004).
population,
as well as errors of exclusion With to the administrative costs of
(missing people regard
who should be served). As Table 6 indicates, poor families, a of evaluations
reaching variety
some of the findingswith regard to leakage conclude that the CCT programs are
quite effi?
are
unexpected. Boltvinik (2004), for example, cient (Morley& Coady 2003, Coady et al. 2004,
emphasizes that the IFPRI itselffound that the Behrman& Skoufias 2006). Lindert et al. (2006)
of program were minimal conclude that the ratio of cost to transfer for
advantages targeting
with other service BF was in 2005, com?
compared delivery methods Brazil's program 2.7%
inMexico. In this sense, it is surprising that pared with 6.4% forMexico's PROP program
Coady
et al. (2004) estimate an
efficiency
in 2003, and 11.7% forColombia's FA program
rating for Mexico's program of milk subsidies 2000-2004. pro?
during Getting far-reaching
to those with incomes two
(targeted below grams started implies very high initial costs, as
minimum greater than that of PROP, was the case inMexico, whose PROP
wages) program
with a ratio of 1.60 of the transfers had a ratio of 106.3% in 1997, that in
(64% meaning
to the poorest 40% of households). its first year administrative costs exceeded the
granted
Studies have also uncovered value of all transfers made.
design prob?
lems that generate errors of exclusion. there is no perfect method of
Ultimately,
Ecuador's program, for example, delivers trans? selection or have some
targeting?all degree
fers its Network of Private Banks, of error, whether of inclusion or of exclusion.
through
which are in cities, thus In the methods used
mostly forcing eligi? evaluating by CCT pro?
ble rural participants to travel considerable dis grams Latin America, the overall
throughout
? Conditional Cash

assessment is reasonably positive but nonethe? work interaction.Adato (2004) also found that
less reveals of inclusion in communal activities and meet?
significant problems participation
execu? social rela?
and exclusion deriving from design and ings with promoters strengthened
tion.The studies listed inTable 6 show that tions, a finding that appears to
prevail
in
also
of inclusion a range of 15% Ecuador, where women made new contacts with
problems occupy
cannot be considered each other as from normal rou?
20%, which minor, any they departed
more than problems of exclusion tines to travel to cities in order to withdraw
by design.
In terms of inequality, Soares et al. (2007) transfers (Armas D?vila 2004). Women also
that the methods of selection used in formed new ties through cocontributions
suggest they
Latin America small effects were to make under the program in
generally produce required
on income redistribution. They calculate just Argentina (Kessler& Roggi 2005) and through
a 5% reduction of inequality inMexico during attendance at
training workshops, meetings
1996-2004 and 5% inBrazil during 1995-2004, with promoters, and municipal activities in
with no effectinChile during 1996-2003. The Colombia (Largaespada Fredersdorff 2006,

actual contribution of CCT programs to reduc? Villatoro 2005b,N??ez & Cuesta 2006).
tions inMexico and Brazil was estimated to be In one suppose that receiv?
theory, might
an overall on a certain so?
21%, yielding impact equality of ing income transfers could confer
1% the periods covered. The clear cial on

program but this
just during stigma participants,
implication is that theCCT programs do not does not appear to be the case. When
targeted
constitute a solution to the enormous programs are, in fact, universal, does
problems "stigma
of inequality in these countries. not to be a because entire
appear problem"
groups share the same fate (Kessler &
Roggi
2005).Nonetheless, bothGonz?lez de laRocha
Effects on Social Relations
(2005) and Adato (2004) agree that social ten?
on sions are often created in?
Evaluations of the effect of CCT programs by decisions about
social relations outside the home or in the com? clusion and exclusion, in rural ar?
especially
results eas. The selective of outside resources
munity yield contradictory (Amagada granting
& Mathivet 2007). On the one hand, studies to
targeted communities and families gener?
indicate that some actors network ates new resentments that exacerbate
strengthen previous
ties as a result of participation in CCT pro? interpersonal conflicts. According
to Behrman
grams and that they are

empowered by
trans? & Skoufias (2006), this possibilityneeds to be
fers. On the other hand, other studies report taken into account in program
explicitly design.
rising conflict as a result of program targeting, In other words, before doing anything else,
CCT
with disputes between those included and those administrators should study the risk of
excluded from participation and conflicts be? new conflicts or exist?
unchaining exacerbating
cause or in
of the certification responsibilities ing tensions because of the targeting method
the program. used (Amagada & Miranda 2005, Bebbington

Gonz?lez de laRocha (2005) argues thatpar? 2005). In addition to
exacerbating community
ticipation in networks of solidarity and reci? tensions, CCT programs may also unleash pro?
not trust but also en? cesses of isolation. & Serrano (2005)
procity only requires Raczynski
tails certain costs. Recent economic crises have found that theCHS program inChile did not
weakened the ability of social to pro?
networks strengthen family and community networks be?
vide support to their members, and in this con? cause it linked families to public social services
text, monetary transfers have "strengthened the promoters and thus worked "with the
through
capacity of the families receiving benefits to es? familyin isolation" (Palma & Urz?a 2005).
tablish and maintain social relations" in rural For Adato (2004), one critical issue is how
areas. Likewise, in urban areas the net result the selection process is interpreted those
by
is positive with regard
to the
capacity for net who are included and excluded. Although
488 Valencia Lomel?

use state-of-the-art statistical sion of labor that confines women to
programs may strictly
methods to and the not-so-poor domestic roles (Cohen & Franco 2006a, Garcia
identify poor
households, people who
live in targeted com? Falconi 2004).
munities are not aware of these fine As noted, most CCT programs
necessarily already
distinctions. In an environment characterized in Latin America women a central
grant
and a his? role funds
by widespread illiteracy, clientelism, by design, transferring directly
to to mothers on the that are
tory of cacique rule, it is difficult for people assumption they
selection methods based on better administrators of family resources than
comprehend digital
media and advanced statistical models (Valencia fathers (Serrano 2005, Fonseca 2006). This
Lomeli 2003, Amagada & Miranda 2005). In design feature generated considerable debate
such a context, are when the programs were first

interpretations inevitably implemented
constructed among community members about (see Rubalcava 2007) and when the firsteval?
the reasons for selection (chance, fate, luck, fa? uations were done Fern?ndez 2000).
(Riquer
voritism), annoyance in Nonetheless, the conventional theory that
thereby fueling general
the community. Even in literate societies, the from this early work confirmed that
emerged
of understanding a selec? women were instrumental in program success
problem point-based
tion system exists (Coady et al. 2004). (Skoufias et al. 2001). Given an balance
unequal
How, then, to advance in of power within the household, conditional
transparency?
the is that social work? an commit?
Part of problem transfers gave mothers "effective
ers (Soares et al. 2007), municipal contacts, ment device" with which to defend thewelfare
persons certifying responsibilities (Valencia of children (De Janvry& Sadoulet 2006).
Lomeli 2003, Zamora 2007), and pro? Women are thus central to the accumula?
Anaya
moters (Raczynski & Serrano 2005) may be tion of human capital. The longer
a mother
interested as much in power stays in school, the other members of

accumulating longer
as in administering programs and her stay in school. Moreover, if girls
alleviating family
poverty, choices at var? from poor families stay in school in
yielding discretionary longer,
ious of than own
stages program implication rather the future they will keep their children
transparency. All these elements make itwrong in school down?

longer, yielding significant
to label CCT programs as "conditional stream effects on the health and nutrition of
simply
transfers for the accumulation of social and children (Morley & Coady 2003). Indeed, the
human capital" (Amagada & Mathivet 2007). first program evaluations in Mexico empha?
They inevitably have broader social and eco? sized the positive effectof CCT programs in
nomic consequences for community relations. male recog?
empowering women?improving
nition of their importance in family welfare and
differentials in education while
reducing gender
Influence on Gender Relations
not time burden
increasing mothers' (Skoufias
The balance of findings with respect to gender et al. 2001, Adato 2004). These themes were
relations also yields contradictory conclusions. repeated in later assessments (Villatoro 2005a),
studies reveal that CCT programs even programs did not
Although though many incorpo?
the position of women in rate an focus in their design or
usually strengthen explicit gender
the influ? N??ez &
participating households?increasing implementation (e.g., Colombia?see
ence of mothers within the family, raising their Cuesta 2006).
self-esteem, and reducing educational gaps be? Despite these positive effects, there is a
tween men and women?they also document a downside to transfers on
potential focusing
of women with new re? women alone. & Mathivet
frequent overloading Amagada (2007),
sponsibilities emanating from the program it? in their comparison of Mexico's PROP pro?
self, and many studies find that cash transfers gram with Chile's CHS program, along with
to mothers
simply reinforce a traditional divi Molyneux (2007) in her analysis of PROP,
? Conditional Cash
www.annualreviews.org Transfers 48c

concluded that CCT reinforced the welfare of their families, but only
programs proving
traditional roles by emphasizing the within the restrictions of traditional re?
gender gender
maternal role of women as "who lations, thus raising about the extent
people questions
live for others." Fredersdorff to which these relations limit the potential of
Largaespada
(2006) also found that traditionalgender roles women to break
the intergenerational cycle
of
a that con?
were
strengthened
in Nicaragua. Nonethe? poverty. Without program design
less, Molyneux (2007) out that Mexico's fronts and overcomes maternalism and famil
points
PROP was not to deal with ism, women will continue to have serious diffi?
program designed
"the specific needs and vulnerabilities of women culties themselves into productive
integrating
on whom the Garcia in less precarious ways that are
program depends." employment
Falconi (2004) and Gonz?lez de la Rocha less conducive to
continuing the reproduction
that women became over? of poverty.

(2006b) argued
worked because of conflicts between program
and their normal productive
responsibilities
reflects a "rancid
CONDITIONAL CASH
and reproductive work, which
but still current social division of labor." De?
TRANSFERS AS SOCIAL POLICY
studies generally The review several
spite these potential problems, foregoing supports gener?
find that CCT programs more involve? alizations about the influence of conditional
yield
ment women in household decision cash transfers in Latin America. CCT pro?
by making,
self-esteem, and grams have acted to increase school
improved greater knowledge generally
about health and nutrition (Villatoro 2005b). enrollment and attendance (though
not in ev?
Despite their limitedgender focus,CCT pro? ery case), raised years of schooling completed,
grams do appear to increase the relative power and in some cases lowered the rate of school
of women (Molyneux 2007) by giving them leaving. CCTs

have increased access to preven?
control of transfer income, which opens limited tive medical care and vaccinations, raised the
for renegotiating the balance of gen? number of visits to health centers, and reduced
options
der relationswithin the family (Gonz?lez de la the rate of illness while raising overall consump?
Rocha In Ecuador, for example, Armas tion and food with re?
2006b). consumption, positive
D?vila found that transfers made it pos? sults on the growth and weight of children, es?
(2004)
sible for women to be economic in the smallest. With respect to
providers pecially among
addition to men, with positive effects inside the poverty, the consensus is that, in the short term,
home. CCT have a effect in reduc?

programs greater
In some programs, however, elevated levels ing the intensity of poverty than in lowering its
of familial violence have also been detected as a incidence. the gap between a fam?
By narrowing
result of program usu? resources and the poverty
participation by women, ily's threshold, they
wives and slightly lower overall
ally violence by angry husbands against reduce vulnerability
from disputes over the management levels of income
stemming inequality.
of transfer income (Armas D?vila 2004, Cohen CCT transfer programs appear to be rela?
et al. in
2006a). Recent quantitative research tively efficient in reaching targeted populations,
Mexico that participant as those in extreme
concluded, however, typically defined poverty,
families less overall
violence and not without certain problems of design
experienced though
less psychological violence with con? and implementation. limited, inter?
compared Although
trol groups (Rivera et al. 2006). Nonetheless, vi? actions between CCT program re?
participants
olence women was social
against quite high whether inforce community social relations, and
were in CCT programs (34.5%) or not networks are income transfers
they empowered by
(40.4%). that raise the security of households and the
In sum, CCT programs do appear to en? of participating in networks. Evi?
possibility
courage women to become active in im dence that the standing of women is
agents suggests
49 o ValeficiaLomeli

which enhance the intergenerational transmission of
improved by CCT programs, breaking
female self-esteem, promote relationships with poverty. Although empirical support for points
other women, and reduce gaps in edu? 1-3 is fairly clear, the evidence is weak or un?
gender
cation. Transfers made to mothers also certain for points 4-6. conventional
directly Although
help them negotiate a stronger

bargaining po? CCT theorists have tended to highlight the
sition within made to date, in
patriarchal households. great progress reality they have
these benefits, however, the forego? been around for a decade, and it is too
Despite only early
to know their ultimate
ing review also highlights several limitations of effects.
CCT In to have The desire of CCT theorists to show pos?

programs. general, they appear
little or no effect on performance in school, itive results and the urgency with which they
on the amount learned in school, or on cogni? promoted these social experiments
seem to have
tive development and their effects on a in constructing a very

generally, played key role opti?
rates of anemia have been limited. The mistic vision. Nonetheless, the "pyramid of sup?
persis?
tence of anemia among children in most CCT upon which CCT programs are con?
positions"
programs suggests the possibility of long-term structed leaves many uncertainties (Villatoro
cognitive impairment. In the end, the long 2005b). Although it is clearly a good thing that
term effects of CCT programs are still un? children consume more food and
experience
known. Despite simulations suggesting that ac? less illness and that
inequality
are
and poverty
cumulations of human capital will improve the reduced, if only by a little, these outcomes do
future it is not clear that more years not mean that CCT programs are the best strat?
earnings,
of schoolingwill necessarilyyield improvedhu? egy for dealing with poverty or that they con?
man and higher incomes. The cur? stitute "the cornerstone of the national
capabilities strategy
rent link between education and may for welfare in each 2005).
earnings country" (Rawlings
not in the future as levels of education It is still too to determine their effects on
prevail early
rise, especially in the absence of significant either at the individ?
job long-term development
creation. ual or national level (Soares et al. 2007), and
With to social relations, in the doubts that have accumulated in 10 years
regard people
targeted populations often do not understand of research must be addressed by farther
re?
themethods by which CCT participants are search and independent, multiple evaluations.
selected, which gives rise to tensions in the Even Rawlings (2005) recognizes that CCT
between those selected for partic? programs are limited in scope as instruments
community
and those not. conventional of national and must be set in a broader
ipation Although policy
program designs emphasize the role of women framework of social welfare and economic
in the way that transfers are
fomenting change, development.
made also reinforces the traditional household The current debate must therefore widen
division of labor and at times increases the work its horizons to embrace a more vi?
general
burden of mothers them. sion, with interventions that focus not
receiving public
Thus, a careful and balanced evaluation of on the demand side but on the
only supply
the accumulated research conclusions side as well (Gendreau 2000, Barba Solano
yields
that are more muted than the tri? et al. Bouillon & Tejerina Par?
notably 2005, 2006).
umphal proclamations of ideological boosters, with respect to education and health,
ticularly
who generally
rest their case on six pillars: the search for interventions that do not dis?
(1) CCT programs attend to the poorest of tort markets has obscured the need for reforms
the poor; (2) they are administratively efficient; on the supply side and
paradoxically have lim?
(3) they reduce inequality; (4) they reduce ited the scope of possible actions on the de?
poverty in the short and long term; (5) they mand side. A false
dichotomy between targeted
are effective at the accumulation and universal it impossible to
encouraging coverage makes
of human and (6) are of understand that CCT are embedded
capital, they capable programs
? Conditional Cash

within institutions that are universal in charac? mentation (Valencia Lomel? 2007). The key is?
ter (Gendreau How can the capacities of sue, then, is how to CCT programs
2000). integrate
so as
the poor be improved without substantial im? within existing social security institutions
in the quality of health and educa? to overcome traditional pressures for segmen?
provement
tion services more tation of Latin America. An view
generally? integrated
The answer to this leads of social would incorporate the objec?
question inevitably policy
to about the reform of social tive of social more
larger discussions strengthening citizenship
institutions and the character of welfare regimes generally (Barba Solano et al. 2005, Palma &
more
generally
in Latin America (Filgueira Urz?a, 2005, Serrano 2005, Barba Solano 2007,
2005, Huber 2006, Barba Solano 2007). Given CEPAL 2006). Under present conditions,CCT
theminimalist view of social policy (De Ferranti programs cannot be expected
to contribute to
et al. 2000) that has become in the re? the construction of integrated citizenship if
possible
sense to focus are not as vehicles for guaran?
gion, itmay make public action they thought of
on the limited reach of CCT programs; but teeing rights and if they do
not increase the civil
to do so still leaves enormous gaps in cover? and political participation of those included
age because it excludes broader social institu? (Irarr?zaval 2005).
tions and concerns itself only with protecting Whereas CCT programs partially fortify
the poor (Huber 2005, Serrano 2005). A more the access of the poor to basic services, they do
is required, not see themselves as vehicles for exercising a
comprehensive approach seeking
to connect on behalf of the poor an
equity actions right, but simply instrumental administra?
with reform of the basic institutions of social tive action 2008). As an administrative
(Sottoli
to is temporary"
security. action, "any entitlement rights
International financial organizations and (Fonseca 2006), and their enjoyment is left
now that the CCT pro? to the of politics and subject to the
governments recognize vagaries
grams will last longer than originally nature of selection criteria (World
expected arbitrary
and that the problems of chronic or structural Bank 2007). Civic participation by citizens
poverty will require both long- and short-term within CCT programs is generally limited
actions (Alvarez 2006). social to for with a
Unfortunately, requirements coresponsibility,
coverage in Latin America few notable exceptions that demand greater
security dropped
from 61.2% in 1980 to 52.4% in 2000 (Mesa civic action (in particular in
PJJ-Argentina;
see
Lago 2005), and this fracturingof public wel? Golbert 2006a,b) or some
changes in account?
fare systems in the region yields bleak eco?

ability.The idea of coresponsibility is assumed
nomic down the road: high poverty at to social with
prospects strengthen citizenship, rights
the regional level, weak reductions in chronic and duties shared between authorities and
poverty,high and rising inequality,weakened citizens (Palma & Urz?a 2005); but it can also
social institutions, and be seen as the coercive of individuals
growing sociopolitical tutelage
resistance to
dealing with these problems. If by authorities demanding the strictfulfillment
these trends continue, then the current seg? of within a context of frank
responsibilities
mentation of social institutions could become inequality between officials and presumed ben?
more marked, with some of people eficiaries, a kind of Social
categories yielding Taylorism.
being well insured, others only temporarily pro? The debate should not be limited to a
tected, and most a no-man's-land of of extremes?either a neoliberal
occupying comparison
complete exclusion from public insurance and welfare of programs or a
regime targeted
social protection (Lautier 2004). universal system with a minimum
guaranteed
In societies with two-track sys? income (see Lindert et al. 2006)?but should
emerging
tems of social welfare, such as Brazil and rather include a consideration of the variety of
Mexico, this dualism could become permanent, Latin American in-between

regimes (Filgueira
us to of institutionalized seg 2005, Barba Solano 2007). There is no reason
enabling speak
49 2 Valencia Lomeli

that nations cannot advance toward a of the population excluded from
recogni? traditionally
tionand validation of social rights(Sottoli 2008, public attention is itself a positive initiative,
CEPAL in ways that are sustainable so? broader reforms are needed to promote
2006) equity
cially,politically,and financially (Filgueira et al. and coverage, financial ca?

strengthen program
2006, Townsend 2007). According to Sim?es pacities, and consolidate a broader network for
(2006), CCT programs represent instruments social security. Paradoxically, further enhancing
that in practice can confront the denial of basic the effectof targetedCCT programs inLatin
social while to promote America now the state
rights endeavoring requires reinvigorating
an of conditions for exercising one's institutions that offer basic services,
"equality especially
social attention to segments those pertaining to education and health.
rights." Although
DISCLOSURE STATEMENT
The authors are not aware of any biases that might be perceived as the objectivity of this
affecting
review.
ACKNOWLEDGMENTS
This reviewwas translatedfrom theoriginal Spanish byNicholas J.Barrett and edited byDouglas
S. Massey. The version can be found online at
original Spanish http://www.annualreviews.
org/go/E ValenciaLomeli.
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Conditional Cash Transfers as Social Policy in Latin America: An Assessment of Their

Contributions and Limitations

This content downloaded from 200.89.67.10 on Wed, 16 Apr 2014 22:34:51 PM

Enrique Valencia Lomeli

Anno. Rar. Sociol. 2008.34*75-99

This content downloaded from 200.89.67.10 on Wed, 16 Apr 2014 22:34:51 PM

erage, these programs have been for

Argentina Plan JefasyJefes(PJJ) 2002 0.80% (2003) 1991persons(2003)

476 Valencia Lomel?

This content downloaded from 200.89.67.10 on Wed, 16 Apr 2014 22:34:51 PM

This content downloaded from 200.89.67.10 on Wed, 16 Apr 2014 22:34:51 PM

scored the connection between research successful" in oflevels

by PROP inMexico and PRAF inHonduras. "their demonstrated impacts

of human conventions that have built up around CCT

47'8 Valencia Lomelt

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which have to instru? conditional transfers, however, that this focus

tion of poverty over various is the terventions at chosen points in the

sumed to additional tion, programs generally offer extra cash trans?

components (Rawlings& Rubio 2003) and as? be "likely

This content downloaded from 200.89.67.10 on Wed, 16 Apr 2014 22:34:51 PM

Children with better health and nutrition program went well

2006a). suresof impact" (World Bank 2004). According

Eighth, because social programs are

or to use alternative terms, to pro? the effectiveness of social programs.

often codified as a cord with the enthusiasm of CCT

480 Valencia Lomel?

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School attendance General increase RPS-Nicaragua (up to 30 percentage Less inBF-BrasilandPROP-M?xico

FA-Columbia, PRAF Honduras, and attend school

School enrollment General increase RPS-Nicaragua (22%, cohort aged inPRAF-Honduras

grams have contributed to dif? instruction CCT programs cannot be consid?

been achieved To the quality of education has

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Moreover, evaluations in Honduras found no

Table 3 Effect of CCT programs on health outcomes in Latin America

Mortality PROP-Mezico: 11% reductionin

<5,20%-22% in rural areas; for children<5

482 Valencia Lomel?

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Consumption General increase RPS-Nicaragua: protected purchasing

Food supplements No effect PROP-M?xico: supplements only consumed

Diet General FA-Golombia, PROP-M?xico, and PRAF-Honduras: no effect on

height 0.78 cm tallerand0.22 kgheavier; growth;PROP-M?xico: 20%-30% of

Anemia No effect PRAF-Honduras: continued prevalence of

the treatmentgroup (Rawlings& Rubio 2003). in

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BF-Brazil $91 (PPP*) per familyinextremepoverty 2003 20%-21% of family

aPPP, purchasing power parity.

transfers in comparison to in rural Mexican

programs measures of that PROP transfers made a

484 Valencia Lomel?

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and 2005, years. Even those who accept the conventional

sults of studies, which after five are no answers to about

appeared "to acquire a

of the program in Brazil was to holds income were and

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capital today, and higher personal

Without new the poorest segment of the nation's

expected to have limited effectson the future

it is not possible to separate actions in favor of the authors. to their

CHS-Chile 40% 83.0% 2.08 None reported