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Conditional Cash Transfer (CCT) programs, started in the late 1990s in Latin America, have become the antipoverty program of choice in many developing countries in the region and beyond. This paper reviews the literature on their long-term impacts on human capital and related outcomes observed after children have reached a later stage of their life cycle, focusing on two life-cycle transitions. The first includes children exposed to CCTs in utero or during early childhood who have reached school ages. The second includes children exposed to CCTs during school ages who have reached young adulthood. Most studies find positive long-term effects on schooling, but fewer find positive impacts on cognitive skills, learning, or socio-emotional skills. Impacts on employment and earnings are mixed, possibly because former beneficiaries were often still too young. A number of studies find estimates that are not statistically different from zero, but for which it is often not possible to be confident that this is due to an actual lack of impact rather than to the methodological challenges facing all long-term evaluations. Developing further opportunities for analyses with rigorous identification strategies for the measurement of long-term impacts should be high on the research agenda. As original beneficiaries age, this should also be increasingly possible, and indeed important before concluding whether or not CCTs lead to sustainable poverty reduction.

This article assesses the role of conditionality in cash transfer programs using a unique experiment targeted at adolescent girls in Malawi. The program featured two distinct interventions: unconditional transfers (UCT arm) and transfers conditional on school attendance (CCT arm). Although there was a modest decline in the dropout rate in the UCT arm in comparison with the control group, it was only 43% as large as the impact in the CCT arm at the end of the 2-year program. The CCT arm also outperformed the UCT arm in tests of English reading comprehension. However, teenage pregnancy and marriage rates were substantially lower in the UCT than the CCT arm, entirely due to the impact of UCTs on these outcomes among girls who dropped out of school.

When potential beneficiaries share their knowledge and attitudes about a policy intervention, their decision to participate and the effectiveness of both the policy and its evaluation may be influenced. This matters most notably in integrated social policies with several components. We examine spillover effects on take-up behaviors in the context of a conditional cash transfer program in rural Mexico. We exploit exogenous variations in the local frequency of beneficiaries generated by the program’s randomized evaluation. A higher treatment density in the areas surrounding the evaluation villages increases the take-up of scholarships and enrollment at the lower-secondary level. These cross-village spillovers operate exclusively within households receiving another component of the program, and do not carry over larger distances. While several tests reject heterogeneities in impact due to spatial variations in program implementation, we find evidence to suggest that spillovers stem partly from the sharing of information about the program among eligible households.

This study looks at the effect of welfare programs on work incentives and the adult labor supply in developing countries. The analysis builds on the experimental evaluations of three programs implemented in rural areas: Mexico's Programa Nacional de Educación, Salud y Alimentación (PROGRESA), Nicaragua's Red de Protección Social, and Honduras' Programa de Asignación Familiar. Comparable results for the three countries indicate that the effects that the programs have had on the labor supply of participating adults have been mostly negative but are nonetheless small and not statistically significant. However, the evidence does point to the presence of other effects on labor markets. In the case of PROGRESA, there is a small positive effect on the number of hours worked by female beneficiaries and a sizeable increase in wages among male beneficiaries and a resulting increase in household labor income. Moreover, PROGRESA seems to have reduced female labor-force participation in ineligible households. These results imply that large-scale interventions may have broader equilibrium effects.

Under the administrations of Fernando Henrique Cardoso (1995–2002) and especially President Lula (2003–), conditional cash transfer (CCT) programmes have become adopted as mainstream social policy in Brazil. This follows a marked trend since the 1990s in Latin America towards the setting up of targeted safety nets to alleviate poverty. Lula consolidated and expanded CCTs, firstly under Fome Zero and later Bolsa Família, now the largest such scheme in the world. Its four sub-programmes (educational stipends to boost school attendance, maternal nutrition, food supplements and a domestic gas subsidy) benefit some 30 million of Brazil's poorest people, with a target of 44 million by 2006. Since 2003, spending on Bolsa Família has risen significantly to consume over one-third of the social assistance budget for the poorest sectors and it remained a flagship policy in the run-up to the presidential elections of October 2006. Although coverage of Bolsa Família is impressive, however, systematic evaluation of its social and economic impacts is still lacking. Evidence from other CCT programmes in Latin America suggests that positive results may be achieved in terms of meeting some immediate needs of the poor. However, there have been many implementation problems. These include poor beneficiary targeting, lack of inter-ministerial coordination, inadequate monitoring, clientelism, weak accountability and alleged political bias. Given the heightened profile of cash transfers in Brazil's social policy agenda, key questions need to be asked. These concern, firstly, the extent to which Bolsa Família does indeed contribute to poverty alleviation; and secondly, whether it creates greater dependence of the poor on government hand-outs and political patronage at the expense of long-term social investment for development.

How do cash transfers conditioned on health clinic visits and school attendance impact health-related outcomes? Examining the 2010 randomized introduction of a program in Tanzania, this paper finds nuanced impacts. An initial surge in clinic visits after 1.5 years—due to more visits by those already complying with program health conditions and by non-compliers—disappeared after 2.5 years, largely due to compliers reducing above-minimal visits. The study finds significant increases in take-up of health insurance and the likelihood of seeking treatment when ill. Health improvements were concentrated among children ages 0–5 years rather than the elderly, and took time to materialize; the study finds no improvements after 1.5 years, but 0.76 fewer sick days per month after 2.5 years, suggesting the importance of looking beyond short-term impacts. Reductions in sick days were largest in villages with more baseline health workers per capita, consistent with improvements being sensitive to capacity constraints. These results are robust to adjustments for multiple hypothesis testing.

Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women.

The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18–25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9 % for the monthly model, and 80.4 % for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$ 288 per person per year, but it was lower for MSW: USD$ 156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM and MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average WTA estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model to targeted HIV/STI prevention.

Conditional cash transfers have come to play a prominent role in the social policy landscape in Latin America and especially in Brazil in recent years. Evaluations of their impacts, however, have focused on limited short-term outcomes, particularly consumption and school enrolment and attendance rates. Long-term outcomes have received comparatively little attention. This article reviews the existing evidence on the long-term impacts of CCTs, focusing on the underlying assumptions in the CCT model for intergenerational poverty reduction. In doing so, it questions the notion that CCTs can indeed interrupt the intergenerational cycle of poverty through human capital investments that are thought to lead to expanded opportunities in the labour market. Moreover, it highlights the need for more research on the social processes that may influence young beneficiaries’ life trajectories and experiences in poverty.

The World Health Organization recommends four antenatal visits for pregnant women in developing countries. Cash transfers have been used to incentivize participation in health services. We examined whether modest cash transfers for participation in antenatal care would increase antenatal care attendance and delivery in a health facility in Kisoro, Uganda. Twenty-three villages were randomized into four groups: 1) no cash; 2) 0.20 United States Dollars (USD) for each of four visits; 3) 0.40 USD for a single first trimester visit only; 4) 0.40 USD for each of four visits. Outcomes were three or more antenatal visits and delivery in a health facility. Chi-square, analysis of variance, and generalized estimating equation analyses were performed to detect differences in outcomes. Women in the 0.40 USD/visit group had higher odds of three or more antenatal visits than the control group (OR 1.70, 95% CI: 1.13-2.57). The odds of delivering in a health facility did not differ between groups. However, women with more antenatal visits had higher odds of delivering in a health facility (OR 1.21, 95% CI: 1.03-1.42). These findings are important in an area where maternal mortality is high, utilization of health services is low, and resources are scarce. (Afr J Reprod Health 2015; 19[3]: 144-150). l'Organisation mondiale de la Santé recommande quatre consultations prénatales pour les femmes enceintes dans les pays en développement. Les transferts de fonds ont été utilisés pour encourager la participation à des services de santé. Nous avons examiné si les transferts de fonds modestes pour la participation à des soins prénatals pourraient augmenter la fréquentation aux services des soins prénatals et d'accouchement dans un établissement de santé à Kisoro, en Ouganda. Vingt-trois villages ont été randomisés en quatre groupes: 1) pas d'argent; 2) 0,20 dollars américains (DA) pour chacune des quatre visites; 3) 0,40 DA pour une seule visite du première trimestre seulement; 4) 0,40 DA pour chacune des quatre visites. Les résultats étaient trois consultations prénatales ou plus et l'accouchement dans un établissement de santé. Nous avons mené une analyse de la variance Chi-carré et d'équations d'estimation généralisées pour détecter les différences dans les résultats. Les femmes du groupe de visite de 0,40 DA étaient plus susceptibles de trois consultations prénatales ou plus que le groupe de témoin (OR 1,70, IC à 95%: 1,13 à 2,57). Les chances de l'accouchement dans un établissement de santé ne sont pas différentes parmi les groupes. Cependant, les femmes avec plus de visites prénatales étaient plus susceptibles d'accoucher dans un établissement de santé (OR 1,21, IC à 95%: 1,03 à 1,42). Ces résultats sont importants dans une région où la mortalité maternelle est élevée, où l'utilisation des services de santé est faible, et les ressources sont rares. (Afr J Reprod Health 2015; 19[3]: 144-150).