Migration and Fuel Use in Rural Zambia.

What is the effect of migration on fuel use in rural Zambia? Opportunities to increase income can be scarce in this setting; in response, households may pursue a migration strategy to increase resources as well as to mitigate risk. Migrant remittances may make it possible for households to shift from primary reliance on firewood to charcoal, and the loss of productive labor through migration may reinforce this shift. This paper uses four waves of panel data collected as part of the Child Grant Programme in rural Zambia to examine the connection between migration and the choice of firewood or charcoal as cooking fuel and finds evidence for both mechanisms. Importantly, this paper considers migration as a process, including out- as well as return migration, embedding it in the context of household dynamics generally. Empirical results suggest that while migration helps move households away from firewood as a fuel source, return migration moves them back, but because firewood is more common, the overall effect of migration is to shift households away from primary reliance on firewood towards charcoal.

A Cash Plus Program Reduces Youth Exposure to Physical Violence in Zimbabwe.

Violence against children and adolescents, a highly prevalent problem, is a clear violation of child rights and has detrimental effects on later life outcomes. Programs that alleviate poverty address a structural determinant of child vulnerability and can thereby reduce child abuse. This paper investigates whether the Government of Zimbabwe's Harmonized Social Cash Transfer (HSCT) Program, which combines cash transfers with complementary services, affects youth exposure to physical violence. The analysis uses data from a non-experimental impact evaluation and a difference-in-differences approach. Results show a 19-percentage point decline in the incidence of physical violence among youth four years into the program. HSCT-induced enhancements in beneficiary households' purchasing capacity and food security, improvements in caregiver subjective well-being, and reductions in youth participation in economic work for pay could be mediating the program's effects on youth abuse. This paper adds to the relatively scarce evidence on the impacts of anti-poverty policies on young people's susceptibility to physical violence in developing countries.

Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia.

Cash transfer programs are rapidly becoming a key component of the social safety net of many countries in Sub-Saharan Africa. The primary aim of these programs is to help households improve their food security and smooth consumption during periods of economic duress. However, beneficiary households have also been shown to use these programs to expand their microentrepreneurial activities. Cluster-randomized trials carried out during the rollout of large-scale programs in Malawi and Zambia reveal that children may increase their work in the household enterprise through such programs. Both programs increased forms of work that may be detrimental to children, such as activities that expose children to hazards in Malawi and excessive working hours in Zambia. However, both programs also induced positive changes in other child well-being domains, such as school attendance and material well-being, leading to a mixed and inconclusive picture of the implications of these programs for children.

The household and individual-level productive impacts of cash transfer programs in Sub-Saharan Africa.

Silvio Daidone is a economist and Benjamin Davis is a Strategic Program Leader, both with the Food and Agriculture Organization of the United Nations, Rome, Italy. Sudhanshu Handa is a professor at the University of North Carolina at Chapel Hill. Paul Winters is the Associate Vice-President of the Strategy and Knowledge Department, International Fund for Agricultural Development, Rome, Italy. The research presented in this article has been carried out under the auspices of the "From Protection to Production" (PtoP) project, a collaborative effort of the United Nations Children's Fund, the United Kingdom Department for International Development (DFID) and the Food and Agriculture Organization of the United Nations (FAO). The project has received funding from the DFID Research and Evidence Division, the European Union through the "Improved Global Governance for Hunger Reduction Programme", and the FAO Regular Fund. The authors would like to thank the following: two anonymous reviewers and the journal editor, who have provided excellent comments and significantly contributed to the improvement of the article; Alejandro Grinspun, Fabio Veras Soares, and Marco Knowles for technical review of previous drafts; Ervin Prifti and Noemi Pace for their useful suggestions and comments. The authors are also grateful to participants at the following conferences and workshops: 2017 APPAM International Conference, Brussels; 2016 Transfer Project workshop, Addis Ababa; 2016 IFAD-3IE Designing and implementing high-quality, policy-relevant impact evaluations, Rome; 2015 SASPEN Conference on Social Protection, Johannesburg; 2015 Global Food Security Conference, Ithaca; 2014 IPEA International Seminar "Social protection, entrepreneurship and labor market activation - Evidence for better policies", Brasilia; 2014 University of Florence, Department of Economics & Management Seminars, Florence; 2014 Africa Community of Practice (CoP) on Conditional Cash Transfers and Cash Transfers; 2014 African Union Expert Consultation on Children and Social Protection Systems, Cape Town; 2014 IDS Graduation and Social Protection Conference, Kigali. The authors would also like to remember Josh Dewbre, a founding member of the PtoP team, who passed away in April 2015, who had participated in the fieldwork and in the analysis of several programs included in this study. All mistakes and omissions are those of the authors.

CASH TRANSFERS ENABLE HOUSEHOLDS TO COPE WITH AGRICULTURAL PRODUCTION AND PRICE SHOCKS: EVIDENCE FROM ZAMBIA.

Climate change is projected to dramatically disrupt rainfall patterns and agricultural yields in Sub-Saharan Africa. These shocks to food production can mire farming households in poverty traps. This study investigates whether unconditional cash transfers can help households cope with agricultural production and price shocks. We find that cash empowers poor, rural households facing these negative shocks to employ coping strategies typically used by the non-poor and enables them to substantially increase their food consumption and overall food security. Extending relatively small cash payments unconditionally to the rural poor is a powerful policy option for fostering climate-resilient development.

List randomization for soliciting experience of intimate partner violence: Application to the evaluation of Zambia's unconditional child grant program.

Social scientists have increasingly invested in understanding how to improve data quality and measurement of sensitive topics in household surveys. We utilize the technique of list randomization to collect measures of physical intimate partner violence in an experimental impact evaluation of the Government of Zambia's Child Grant Program. The Child Grant Program is an unconditional cash transfer, which targeted female caregivers of children under the age of 5 in rural areas to receive the equivalent of US $24 as a bimonthly stipend. The implementation results show that the list randomization methodology functioned as planned, with approximately 15% of the sample identifying 12-month prevalence of physical intimate partner violence. According to this measure, after 4 years, the program had no measurable effect on partner violence. List randomization is a promising approach to incorporate sensitive measures into multitopic evaluations; however, more research is needed to improve upon methodology for application to measurement of violence.

Cash Transfers, Early Marriage, and Fertility in Malawi and Zambia.

There is increasing interest in the ability of cash transfers to facilitate safe transitions to adulthood in low-income settings; however, evidence from scaled-up government programming demonstrating this potential is scarce. Using two experimental evaluations of unconditional cash transfers targeted to ultra-poor and labor-constrained households over approximately three years in Malawi and Zambia, we examine whether cash transfers delayed early marriage and pregnancy among youth aged 14 to 21 years at baseline. Although we find strong impacts on poverty and schooling, two main pathways hypothesized in the literature, we find limited impacts on safe transition outcomes for both males and females. In addition, despite hypotheses that social norms may constrain potential impacts of cash transfer programs, we show suggestive evidence that pre-program variation in social norms across communities does not significantly affect program impact. We conclude with policy implications and suggestions for future research.

Examination of performance of the Center for Epidemiologic Studies Depression Scale Short Form 10 among African youth in poor, rural households.

BACKGROUND: Youth mental health has emerged as a pressing global issue. However, to advance research gaps in low-income settings, we need valid measures of common mental health disorders. Using primary data collected in five countries (Kenya, Malawi, Tanzania, Zambia, and Zimbabwe), this study aims to assess the psychometric properties of the commonly used 10-item Center for Epidemiological Studies Depression (CES-D 10) scale among poor, disadvantaged youth populations in sub-Saharan African (SSA). METHODS: Youth samples from each country (sample sizes ranging from 651 to 2098) come from large household surveys with youth modules, collected for impact evaluations of cash transfer programs targeted to poor families. For each sample, we assessed internal consistency (alpha), conducted factor analysis, and then examined construct validity and measurement invariance. We performed both exploratory (EFA) and confirmatory factor analysis (CFA) to examine and confirm the structure of the CES-D 10 for each country and then used multigroup CFA to assess measurement invariance across gender and age. Multivariate analyses were conducted to assess construct validity via test of the relationship between CES-D 10 and background characteristics. RESULTS: Results show the CES-D 10 had strong psychometric properties and was a reliable measure of depressive symptoms among disadvantaged youth in SSA. Across countries, there was high internal consistency (Cronbach alphas = 0.70-0.76) and the traditional two-factor solution showed good model fit. Full measurement invariance of the CES-D 10 was supported across gender. Consistent with previous literature on risk factors for depressive symptoms, the CES-D 10 was associated with increasing age, and female gender and being out of school in some locations. CONCLUSIONS: Results from this study support broad use of the CES-D 10 among poor youth populations in SSA. Between one-third and two-thirds of our samples demonstrated depressive symptoms as classified by recommended cut-offs for the CES-D 10, indicating a high burden of mental illness in disadvantaged youth populations. This tool can be used in future efforts to study prevalence and dynamics of depressive symptoms in this population, as well as effectiveness of policies and interventions to improve the mental health of youth in SSA.

Paying for Happiness: Experimental Results from a Large Cash Transfer Program in Malawi.

This study analyzes the short-term impact of an exogenous, positive income shock on caregivers' subjective well-being (SWB) in Malawi using panel data from 3,365 households targeted to receive Malawi's Social Cash Transfer Program that provides unconditional cash to ultra-poor, labor-constrained households. The study consists of a cluster-randomized, longitudinal design. After the baseline survey, half of these village clusters were randomly selected to receive the transfer and a follow-up was conducted 17 months later. We find that the short-term impact of household income increases from the cash transfer leads to substantial SWB gains among caregivers. After a year's worth of transfers, caregivers in beneficiary households have higher life satisfaction and are more likely to believe in a better future. We examine whether program impacts on consumption, food security, resilience, and hopefulness could explain the increase in SWB but do not find that any of these mechanisms individually mediate our results.

Can unconditional cash transfers raise long-term living standards? Evidence from Zambia.

In Africa, state-sponsored cash transfer programs now reach nearly 50 million people. Do these programs raise long-term living standards? We examine this question using experimental data from two unconditional cash transfer programs implemented by the Zambian Government. We find far-reaching effects of the programs both on food security and consumption as well as on a range of productive outcomes. After three years, household spending is on average 67 percent larger than the value of the transfer received, implying a sizeable multiplier effect, which works through increased non-farm activity and agricultural production.

The Effect of Cash Transfers and Household Vulnerability on Food Security in Zimbabwe.

We study the impact of the Zimbabwe Harmonized Social Cash Transfer (HSCT) on household food security after 12 months of implementation. We investigate determinants of food security as measured by a well-known food security scale - the Household Food Insecurity Access Scale (HFIAS) - and as measured by value of household food consumption composed of own-production, market purchases and gifts received. We find that several dimensions of household vulnerability correlate more strongly with the food security measure than with food consumption. Labor constraints, which is a key vulnerability criterion used by the HSCT to target households, is an important predictor of the food security score but not food consumption, and its effect on food security is even larger during the lean season. Impact analysis shows that the program has had statistically significant impacts on Food Security and Diet Diversity scores but null to low impacts on food consumption. However aggregate food consumption hides dynamic activity taking place within the household where the cash is used to obtain more food from the market and rely less on food received as gifts. The cash in turn gives beneficiaries greater choice in their food basket, which improves diet diversity.

The role of productive activities in the lives of adolescents: Photovoice evidence from Malawi.

Adolescence is an important transitional period, separate from both childhood and adulthood. Critical physical and mental development occurs during adolescence, including emotional skills, physical, and mental abilities. Behaviors adopted during this lifecourse period have critical implications for adolescents' future health and well-being. The main research question of the present study is: what is the role of productive activities in the lives and development of adolescents in rural Malawi? As part of this study, selected adolescents from poor rural households were asked to take photographs of their daily (productive) activities. These photographs served as a starting point for focus group discussions. In addition to including adolescents, we conducted qualitative interviews with caregivers and teachers to triangulate and obtain a more holistic understanding of adolescent engagement in productive activities. The main themes that emerged were that 1) the work that is conducted by adolescent boys and girls inside and outside the household is not only perceived by adolescents as a product of poverty, but as a point of pride, as well as a potential means of providing for one's future, 2) there is a tension between the needs of the family and schooling, and 3) adolescent productive activities are associated with minor although not negligible hazards and injuries. We discuss that these qualitative findings help to better understand how social protection interventions, such as Malawi's Social Cash Transfer Program, may affect adolescent engagement in work and adolescent wellbeing more generally.

One plus one can be greater than two: Evaluating synergies of development programmes in Malawi.

This paper investigates the interplay between the Social Cash Transfer Programme (SCTP) and the Farm Input Subsidy Programme (FISP) in Malawi. We take advantage of data collected from a seventeen-month evaluation of a sample of households eligible to receive SCTP, which also provided information about inclusion into FISP. We estimate two types of synergies: i) the complementarity between SCTP and FISP, i.e. whether the impact of both interventions run together is larger than the sum of the impacts of these interventions when run separately, and ii) the incremental impact of receiving FISP when a household already receives SCTP, as well as the incremental impact of receiving SCTP when a household already receives FISP. The analysis shows that there are synergies between the two policy interventions, mainly in terms of incremental impact of each programme over the other, in increasing expenditure, agricultural production and livestock.

Cash for Women's Empowerment? A Mixed-Methods Evaluation of the Government of Zambia's Child Grant Program.

The empowerment of women, broadly defined, is an often-cited objective and benefit of social cash transfer programs in developing countries. Despite the promise and potential of cash transfers to empower women, the evidence supporting this outcome is mixed. In addition, there is little evidence from programs at scale in sub-Saharan Africa. We conducted a mixed-methods evaluation of the Government of Zambia's Child Grant Program, a poverty-targeted, unconditional transfer given to mothers or primary caregivers of young children aged zero to five. The quantitative component was a four-year longitudinal clustered-randomized control trial in three rural districts, and the qualitative component was a one-time data collection involving in-depth interviews with women and their partners stratified on marital status and program participation. Our study found that women in beneficiary households were making more sole or joint decisions (across five out of nine domains); however, impacts translated into relatively modest increases in the number of decision domains a woman is involved in, on average by 0.34 (or a 6% increase over a baseline mean of 5.3). Qualitatively, we found that changes in intrahousehold relationships were limited by entrenched gender norms, which indicate men as heads of household and primary decision makers. However, women's narratives showed the transfer increased financial empowerment as they were able to retain control over transfers for household investment and savings for emergencies. We highlight methodological challenges in using intrahousehold decision making as the primary indicator to measure empowerment. Results show potential for unconditional cash transfer programs to improve the financial and intrahousehold status of female beneficiaries, however it is likely additional design components are need for transformational change.

Short-term Impacts of an Unconditional Cash Transfer Program on Child Schooling: Experimental Evidence from Malawi.

This study analyzes the impact of a positive income shock on child schooling outcomes using experimental data from an unconditional cash transfer program in Malawi. Since households receive the cash and parents are responsible for making spending decisions, we also examine the intervening pathways between cash transfers and child schooling. Data comes from a cluster-randomized study of Malawi's Social Cash Transfer Program (SCTP). After a baseline survey, households in village clusters were randomly assigned to treatment and control arms with treatment villages receiving transfers immediately and control villages assigned a later entry. We test for treatment impacts on a panel of school-aged children (6-17) using a differences-in-differences model. After a years' worth of transfers, we find the Malawi SCTP both improves enrollment rates and decreases dropouts. The main intervening pathway between the program and schooling is education expenditures, suggesting that the cash improves the demand for education by reducing financial constraints.

Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia.

There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambia's Child Grant Program on a range of maternal health utilization outcomes using a randomized design and difference-in-differences multivariate regression from data collected over 24 months from 2010 to 2012. Results indicate that while there are no measurable program impacts among the main sample, there are heterogeneous impacts on skilled attendance at birth among a sample of women residing in households having better access to maternal health services. The latter result is particularly interesting because of the overall low level of health care availability in program areas suggesting that dedicated program design or matching supply-side interventions may be necessary to leverage unconditional cash transfers in similar settings to impact maternal health.

Is Graduation from Social Safety Nets Possible? Evidence from Sub-Saharan Africa.

In the last decade social cash transfer programmes have become extremely popular in sub-Saharan Africa, and often portrayed as an instrument that can facilitate graduation out of poverty. The evidence on whether social cash transfers have had actual effects on graduation, however, is limited. This paper provides a cross-country reflection of the potential effects of social cash transfers on graduation, drawing from impact evaluation results of cash transfer programmes in Ghana, Kenya, Lesotho and Zambia. We analyse whether social cash transfers have improved the likelihood of graduation, through increased productivity, income generation and resilience to shocks. We identify which factors in terms of programme implementation and household characteristics can increase the likelihood of cash transfer programmes facilitating graduation from poverty.

The impact of a national poverty reduction program on the characteristics of sex partners among Kenyan adolescents.

Cash transfer programs have the potential to prevent the spread of HIV, particularly among adolescents. One mechanism through which these programs may work is by influencing the characteristics of the people adolescents choose as sex partners. We examined the four-year impact of a Kenyan cash transfer program on partner age, partner enrollment in school, and transactional sex-based relationships among 684 adolescents. We found no significant impact of the program on partner characteristics overall, though estimates varied widely by gender, age, schooling, and economic status. Results highlight the importance of context in exploring the potential HIV preventive effects of cash transfers.

Cash transfer programme, productive activities and labour supply: Evidence from randomized experiment in Kenya.

This paper reports analysis of the impact of Kenya's Cash Transfer for Orphans and Vulnerable Children Programme on the household decisions on productive activities using data from a randomized experimental design. Results show that the programme had a positive and significant impact on food consumption coming from home production, accumulation of productive assets, especially on the ownership of small livestock and on formation of nonfarm enterprise, especially for females. The programme has provided more flexibility to families in terms of labour allocation decisions, particularly for those who are geographically isolated. The programme was also found to have reduced child labour, an important objective of the programme. However we find very little impact of the programme on direct indicators of crop production.

Impact evaluation of a quality improvement intervention on maternal and child health outcomes in Northern Ghana: early assessment of a national scale-up project.

OBJECTIVE: To evaluate the influence of the early phase of Project Fives Alive!, a national child survival improvement project, on key maternal and child health outcomes. DESIGN: The evaluation used multivariable interrupted time series analyses to determine whether change categories tested were associated with improvements in the outcomes of interest. PARTICIPANTS: The evaluation used program and outcome data from interventions focused on health-care staff in 27 facilities. SETTING: Northern Ghana. INTERVENTION: The project uses a quality improvement (QI) approach whereby process failures are identified by health staff and process changes are tested in the health facilities and corresponding communities to address those failures. MAIN OUTCOME MEASURES: The maternal health outcomes were early antenatal care attendance and skilled delivery, and the child health outcomes were underweight infants attending child wellness clinics, facility-level neonatal mortality and facility-level infant mortality. RESULTS: Postnatal care changes for the first 1-2 days of life (ß= 0.10, P = 0.07) and the first 6-7 days of life (ß = 0.10, P = 0.07) were associated with a higher rate of visits by underweight infants to child wellness clinics. There was an association between the early pregnancy identification change category with increased skilled delivery (ß = 1.36 P = 0.07). In addition, a greater number of change categories tested was associated with increased skilled delivery (ß = 0.05, P = 0.01). CONCLUSION: The QI approach of testing and implementing simple and low cost locally inspired changes has the potential to lead to improved health outcomes at scale both in Ghana and other low- and middle-income countries.