Acceptability of conditions in a community-led cash transfer programme for orphaned and vulnerable children in Zimbabwe

Morten Skovdal; Laura Robertson; Phyllis Mushati; Lovemore Dumba; Lorraine Sherr; Constance Nyamukapa; Simon Gregson

doi:10.1093/heapol/czt060

Acceptability of conditions in a community-led cash transfer programme for orphaned and vulnerable children in Zimbabwe

Health Policy Plan. 2014 Oct;29(7):809-17. doi: 10.1093/heapol/czt060. Epub 2013 Sep 9.

Authors

Morten Skovdal¹, Laura Robertson², Phyllis Mushati², Lovemore Dumba², Lorraine Sherr², Constance Nyamukapa³, Simon Gregson³

Affiliations

¹ Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK, Save the Children, 1 St John's Lane, EC1M 4AR, London, UK, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Praed Street, W2 1NY, London, UK, Biomedical Research and Training Institute, No. 10 Seagrave Road, Avondale, Harare, Zimbabwe, Catholic Relief Services, 95 Park Lane, Harare, Zimbabwe and Department of Infection and Population Health, Royal Free Hospital, Rowland Hill Street, NW3 2PF, University College London, London, UK Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK, Save the Children, 1 St John's Lane, EC1M 4AR, London, UK, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Praed Street, W2 1NY, London, UK, Biomedical Research and Training Institute, No. 10 Seagrave Road, Avondale, Harare, Zimbabwe, Catholic Relief Services, 95 Park Lane, Harare, Zimbabwe and Department of Infection and Population Health, Royal Free Hospital, Rowland Hill Street, NW3 2PF, University College London, London, UK m.skovdal@gmail.com.
² Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK, Save the Children, 1 St John's Lane, EC1M 4AR, London, UK, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Praed Street, W2 1NY, London, UK, Biomedical Research and Training Institute, No. 10 Seagrave Road, Avondale, Harare, Zimbabwe, Catholic Relief Services, 95 Park Lane, Harare, Zimbabwe and Department of Infection and Population Health, Royal Free Hospital, Rowland Hill Street, NW3 2PF, University College London, London, UK.
³ Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK, Save the Children, 1 St John's Lane, EC1M 4AR, London, UK, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Praed Street, W2 1NY, London, UK, Biomedical Research and Training Institute, No. 10 Seagrave Road, Avondale, Harare, Zimbabwe, Catholic Relief Services, 95 Park Lane, Harare, Zimbabwe and Department of Infection and Population Health, Royal Free Hospital, Rowland Hill Street, NW3 2PF, University College London, London, UK Institute of Social Psychology, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK, Save the Children, 1 St John's Lane, EC1M 4AR, London, UK, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Praed Street, W2 1NY, London, UK, Biomedical Research and Training Institute, No. 10 Seagrave Road, Avondale, Harare, Zimbabwe, Catholic Relief Services, 95 Park Lane, Harare, Zimbabwe and Department of Infection and Population Health, Royal Free Hospital, Rowland Hill Street, NW3 2PF, University College London, London, UK.

Abstract

Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash transfers is an issue of controversy. Contributing to policy debates on the appropriateness of conditions, this article sets out to investigate the overall buy-in of conditions by different stakeholders and to identify pathways that contribute to an acceptability of conditions. The article draws on data from a cluster-randomized trial of a community-led cash transfer programme in Manicaland, eastern Zimbabwe. An endpoint survey distributed to 5167 households assessed community members' acceptance of conditions and 35 in-depth interviews and 3 focus groups with a total of 58 adults and 4 youth examined local perceptions of conditions. The study found a significant and widespread acceptance of conditions primarily because they were seen as fair and a proxy for good parenting or guardianship. In a socio-economic context where child grants are not considered a citizen entitlement, community members and cash transfer recipients valued the conditions associated with these grants. The community members interpreted the fulfilment of the conditions as a proxy for achievement and merit, enabling them to participate rather than sit back as passive recipients of aid. Although conditions have a paternalistic undertone and engender the sceptics' view of conditions being pernicious and even abominable, it is important to recognize that community members, when given the opportunity to participate in programme design and implementation, can take advantage of conditions and appropriate them in a way that helps them manage change and overcome the social divisiveness or conflict that otherwise may arise when some people are identified to benefit and others not.

Keywords: Cash transfers; community acceptability; conditions; orphaned children; social protection.

Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Child Welfare / economics*
Child, Orphaned*
Female
Focus Groups
Humans
Interviews as Topic
Male
Public Policy
Reimbursement Mechanisms* / economics
Reimbursement Mechanisms* / organization & administration
Vulnerable Populations
Zimbabwe

Grants and funding

Wellcome Trust/United Kingdom