Thursday, October 31, 2013

Cash Transfers Mixed Results on Height

Giving money to directly to the poor has become such a widely popular policy tool it is harder to find a country that is not doing it than one that is. One choice that policy makers face is if to put conditions on the money they send. The Economist has an excellent article that compares conditional to unconditional programs. Conditional cash transfers pay money to mothers conditional on their children attending schooling and going in for regular health checkups. Despite conditionality on regular health checkup and growth monitoring there are mixed results of conditional transfer programs to improve children's height and the new study on an unconditional transfer shows no impact on height. I use children's height because it is one of the better indicators of long term human capital development.

I make this claim of mixed results of cash transfer performance on height based on a meta-analysis I co-authored with James Manley and Vanya Slavchevska published in World Development. We find conditional and unconditional cash transfer programs have only small and statistically not significant impacts on height when aggregated across programs.  We find similar results when we look at only Latin American conditional cash transfers. I have also heard reports of a few cash transfer programs collecting height data but not reporting them in their impact evaluations, so the small impacts are likely an overestimate.

The economic development blogosphere has been talking about a recent study (David McKenzie,Chris Blattman, Brent Keller; Amanda Glassman)  of a program called Give Directly where you can as the website suggests make donations directly to Kenyan families. The study find a lot of positive effects: household eat more food, were happier and accumulated assets.
On thing I did notice is that Give Directly had no impact on children's height (see Table 6 in the study link).Amanda Glassman in her post highlights some of success of cash transfer programs, which include reducing stunting (that is helping the most malnourished). She pointed to a study of a conditional cash transfer program in the Philippines that reduced stunting, however like Give Directly it did not seem to increase overall height.

My take it seems cash transfers are doing a decent job in some cases of reducing the worst forms of malnutrition (stunting), the other results are little less clear if there are any impacts. It seems from reading several pieces that we understand cash increases food intake however is not leading to the nutrition gains expected. Like others I think understanding the pathways that cash leads to improved height increases needs more study. What I would like to see is (and perhaps I'm just not finding them) is more nutritionists participating in the discussions and thinking carefully about how to adapt programs so cash actually leads to human development with stronger results.

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