As a result of conditional cash transfers school enrollment is up and stunting in recipient communities is down. But doubts remain: is this the best route to development?
Despite its long experience in implementing different types of programmes to combat poverty, the Philippines is finding it to be a persistent scourge, with an estimated 28% of its population living in poverty in 2012. In recent years though, ineffective programmes have given way to a large-scale conditional cash transfer scheme that is proving to be modestly successful where other programmes have failed.
The Pantawid Pamilyang Pilipino started as a pilot programme in 2008 covering just 6,000 households, but within a year its results were impressive enough for the president to instruct the social welfare and development department to rapidly expand it. Now it covers over 3.93m households across all 17 regions and by the end of 2013 will have been funded to the tune of 120bn pesos (£1.73bnor $2.79bn), making it by far the largest social development programme in the country.
"We used to provide in-kind subsidies, eg, cheap rice to poor communities, but they were very poorly targeted, presented a lot of challenges to deliver and there were a lot of observed 'leakage' [misappropriation]," says Rodora Turalde-Babaran, national programme manager for Pantawid Pamilyang Pilipino. "Based on the experience of other countries we could see that a conditional cash transfer programme was easier to administer. It also minimised [funds going to groups other than those targeted by the programme]: this was one of the biggest differences to what we'd done in the past."
Eligible families are screened into the programme though a proxy means test using a survey, the national household targeting system for poverty reduction. Children up to the age of 14 or a pregnant woman were part of the criteria for eligibility. Recipients also had to agree to several conditions: 85% school attendance and twice-yearly deworming for six to 14-year-olds, 85% preschool attendance for three- to five-year-olds, regular health checks from birth to age five and for pregnant women, attendance at pre- and post-natal check-ups and birth attended by a skilled attendant or health professional. In addition, recipient parents are required to attend monthly family development sessions, a unique feature of the Philippines conditional cash transfer model.
The grant, worth 500 pesos (£7.19) a month per child has two aims: to provide a modest but stable source of income for the poorest families, (accounting for approximately a fifth to a quarter of total family income) and to interrupt the cycle of intergenerational poverty by keeping children healthy and in school for longer.
The scheme was set up to run for five years. Now five more years of extension is sought to cover children from high school to their graduation, which would bring it more in line with similar schemes in Latin America such as Brazil's Bolsa Familia and Opportunidades in Mexico.
"Five years on it is already a very accepted programme nationally but it's also controversial. Some politicians still call it a dole-out, encouraging dependency. It's not an easy sell," says Turalde-Babaran. "People are so used to requesting favours from elected politicians who give patronage in return for votes. We believe one reason why local politicians are sometimes opposed to it is because it's breaking that patronage."
The programme is supported by the Asian Development Bank, the World Bank, AusAID and the Japan Fund for Poverty Reduction. "We are very proud to be among the development partners supporting the Philippines government initiative," says Chris Spohr, senior education economist with the Asian Development Bank.
A 2012 impact evaluation by the government and aid partners found that Pantawid is reaching most of its key objectives, to an extent comparable with similar programmes in Latin America, eg, 10% higher pre-school enrollment for three- to five-year-olds and 4.5% higher enrollment for six- to 11-year-olds compared to non-recipient households. Severe stunting, which afflicts 24% of children aged six to 36 months (pdf) in non-recipient neighbourhoods was reduced to 14% in recipient neighbourhoods. Use of antenatal and postnatal services also increased among Pantawid recipients, which should go some way towards addressing the country's high maternal mortality rate (221 maternal deaths per 100,000 live births).
The monthly family development sessions cover a wide range of subjects, including parent effectiveness training, disaster risk reduction and livelihood development skills, but the most popular sessions are those covering family planning and reproductive rights, says Turalde-Babaran.
Each neighbourhood, or barangay, has to deliver up to 60 modules and they have been of varying quality so far. The ADB is working with the social welfare and development department to better screen and select organisations that deliver some of the modules. Sessions that are well-run have proven extremely popular with recipient parents.
"During site visits beneficiaries told me without exception, and even unprompted, that they really value the family development sessions," says Spohrhe. "They have an important role with marginalised populations, to have a formal body with parent leaders who are themselves beneficiaries with facilitation from local municipal [agencies] and civil society organisations is very unique for them. There is of course variation in quality but that is the price of innovation."
Opposition from local politicians is not surprising, but Pantawid has come under fire from other quarters, including the non-government organisation Kalipunan ng Damayang Mahihirap (Kadamay, or Militant Centre of the Filipino Urban Poor) which criticised the programme for diverting funds that could be used for job creation and for racking up more external debt via development bank loans.
A study by national policy thinktank the Philippines Institute for Development also criticised the programme's rapid expansion and 29% 'leakage' rate, and pointed out that Pantawid has not helped children aged 12-14 stay in school. The Institute instead recommends (pdf) improving the targeting of recipients and extending the programme to cover existing recipients through to high school graduation, as only this level of education can have an impact on future earning ability.
As the Pantawid programme matures, other countries in the region are looking to learn from the Philippines' experience either in terms of improving their own cash transfer programmes, in the case of Indonesia and Pakistan, or as they begin to develop social safety nets, such as in Burma. The key is to see conditional cash transfers in perspective, says Spohr. "I never argue that [it] is a magic bullet, but it's a potentially important, effective tool that works best as a complement to broader poverty eradication programmes."
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