A Bargain or a Burden? How Conditional Cash Transfer (CCT) Program Design Affects the Women Who Participate in Them

Conditional cash transfers (CCT) play a central role in the anti-poverty strategies of low- and middle-income countries around the world, and at the center of these programs stand some of the world’s neediest women. Designed to improve the health and education of economically deprived children, break the intergenerational cycle of poverty, and alleviate immediate economic distress, CCTs differ in detail but share many common features. Prominent among them is the policy decision to place major responsibility for achieving program goals on the wives and mothers–often themselves uneducated and socially subservient—of very poor households.

This choice produces an array of effects, which vary according to features of program design. On the one hand, women’s central role in CCTs appears to contribute strongly to meeting program goals. Numerous studies document favorable outcomes for the low-income children who are CCTs’ main targets and nearly all families eligible for the programs participate. CCTs achieve their aims by giving poor families regular, fixed, cash stipends in return for particular actions intended to better children’s life chances. These include assuring that they attend school regularly and that they, as well as pregnant and nursing women, receive specified health and nutrition care. Results for children include higher school enrollment and attendance, more balanced and nutritious diets, and less illness. Family incomes rise and birth outcomes improve thanks to increased prenatal care, skilled birth attendance and family planning.