Abstract #88  -  The scientific evaluation of a cash transfer pilot project to support orphans and vulnerable children in Manicaland, Zimbabwe: A trial design
Authors:   Presenting Author:   Ms Laura Robertson - Imperial College London
Additional Authors:  Dr Constance Nyamukapa, Ms Phyllis Mushati, Ms Shungu Munyati, Prof Simon Gregson,
Aim: High prevalence of HIV across sub-Saharan Africa has led to an increase in adult mortality and consequently to a rise in the number of orphans. Cash transfers provided to households may improve the wellbeing and development of orphans and vulnerable children. Conditions can be attached to the transfers whereby households must invest in human capital, e.g. sending children to school, but there is debate regarding the appropriateness of imposing conditions on poor families. Conditional cash transfer programmes have been rigorously evaluated in several Latin American countries. They have increased school enrolment rates and improved access to preventive healthcare. We have designed a study to investigate the effects of cash transfers – unconditional and conditional – on children in the context of an advanced HIV epidemic in southern Africa, specifically Manicaland, eastern Zimbabwe.
Method / Issue: A review of scientific and “grey” literature on the evaluation of cash transfer programmes in middle and low-income countries was conducted. A feasibility study, which involved meetings and interviews with key stakeholders, including service providers and local community members/potential beneficiaries was also carried out. Analyses of cohort data from Manicaland and national, cross-sectional data from Zimbabwe were performed. A combination of information from these sources was used to develop a suitable study design for the evaluation, including sample size calculations, primary outcome indicators and data collection methods. This process also informed various aspects of the programmatic design; in particular, the identification of important indicators of child vulnerability has guided the development of household eligibility criteria and appropriate conditions.
Results / Comments: Our programme will be delivered by a local NGO. A community-randomised controlled trial design was selected to ensure a rigorous evaluation of the programme. Thirty communities will be randomised to receive a conditional transfer programme, an unconditional transfer programme or to be a control community. The primary objectives/outcomes are: 1. To determine whether cash transfers can increase the percentage of vulnerable children aged 0-4 years with a birth certificate; 2. To determine whether cash transfers can increase the percentage of vulnerable children aged 0-4 years with up-to-date vaccinations; and 3. To determine whether cash transfers can increase the percentage of vulnerable children aged 6-12 years attending primary school at least 80% of days per month. Data will be collected on primary outcomes using rapid baseline and follow-up surveys. Elderly headed and child headed households, the poorest 20% of households in the area and households containing orphans, disabled or chronically ill members will be eligible for inclusion in the study if they contain children aged under 18 years. Eligible households in intervention communities will receive bimonthly cash payments. Households in the conditional transfer communities will be monitored for their compliance with various conditions, which relate to birth registration; school attendance; access to routine, preventive health services; and attendance of parenting skills classes.
Discussion: .
Go Back