BRIEF

Burkina Faso: Can Cash Transfers Help Children Stay Healthy and Go to School?

Problem
Even when compared with other developing countries in Sub-Saharan Africa, Burkina Faso’s some 15 million people have very poor health and economic opportunities and outcomes. Close to 50 percent of people live at or below the national poverty line; per capita GDP is below the average for developing countries in the region; and life expectancy is 55 years. Health care is likewise poor. Some 35 percent of children under the age of 5 are malnourished based on height for age and when the pilot cash transfer program was implemented, only about half of primary school-aged children actually attended classes.

Intervention
The Nahouri Cash Transfers Pilot Project, a two-year program, used conditional and unconditional cash transfers to encourage poor families to send children aged 7 to 15 to school and to take children under the age of six for quarterly health monitoring.  The pilot was implemented in the country’s south, about 100 miles from the capital.

Evaluation design
A randomized control trial was used to evaluate the relative effectiveness of the different cash transfers. Seventy-five villages with primary schools within a five-kilometer radius were randomly allocated to one of five groups using a lottery system. In the first group, fathers received the conditional cash transfer; in the second group, mothers received the conditional cash transfer; in the third group, father received an unconditional cash transfer; in the fourth group, mothers received it; and the fifth group was the control group. About 3,200 households took part. The impact evaluation ran from 2008-2010

Eligibility
Only poor households qualified for the transfer program, and their eligibility was determined using a combination of Burkina Faso national household data and a survey that looked at asset ownership, education, living conditions, and economic activities.

Results
For health, conditional cash transfers boosted preventive health care visits for children by more than 40% regardless of the gender of the child or which parent received the money. Unconditional cash transfers did not have the same effect. The increase in checkups was greatest for children aged 24 to 59 months. For education, both unconditional and conditional cash transfers had a similar impact increasing enrollment of children traditionally favored by parents for school, including boys, older children, and higher ability children. However, conditional transfers were significantly more effective than the unconditional transfers in improving enrollment of "marginal children" who are initially less likely to go to school, such as girls, younger children, and lower ability children.

The Impact
The impact evaluation results contributed to the design of the national safety net program in which some 40,000 poor households will receive direct cash transfers. The scale-up of the social safety net cash transfer program is being evaluated through a SIEF grant.