CTs and Early Childhood Development

CTs and ECD outcomes

CTs and early childhood development outcomes

Evaluations of CTs with early childhood objectives have had important, although not universal, success related to intermediate health outcomes, such as young children’s attendance at medical check-ups. The effect is not clearly related to relative transfer size. Impact on immunization rates is similarly mixed, and may depend on initial immunization levels: lower levels may benefit from greater impact.

Final health outcomes, such as height-for-age or weight-for-height, tend to show the best results for the youngest children. Nicaragua’s RPS increased height-for-age in children under the age of 5 (Maluccio and Flores 2005), and Colombia’s Familias en Acción improved z-scores in children under 2 years old only (Attanasio et al. 2005). Although Mexico’s Oportunidades increased height-for-age for some young children (12-36 months old (Gertler 2004, Berhman and Hoddinott 2001, 2005), under 6 months old (Rivera et al. 2004)), it is not clear this increase was maintained over time (Neufeld et al. 2005). South Africa’s Child Support Grant increased height-for-age of children who received the grant for the first 3 years of life (Agüero, Carter, and Woolard 2007). In Burkina Faso, unconditional transfers given to fathers, as well as conditional transfers given to either parent, increased children under 5’s weight-for-age (Akresh, de Walque, and Kazianga 2012). CTs’ impact on anemia has been large in some cases, but negligible in others.

On the education side, CCTs have been shown to increase enrollment in early childhood education: Galasso (2006) determined that Chile Solidario increased preschool enrollment by approximately 4-5 percentage points, a promising result considering the known benefits of preschool attendance on future success in life, particularly among the worst-off children.

Some of the most encouraging research on CTs is related to their ability to affect young children’s cognitive development, particularly since CCTs’ impact on older children’s final learning outcomes has been muted. Mexico’s Oportunidades appears to have improved motor development (endurance but not skill), cognitive development (long-term memory, short-term/working memory, and visual integration), and receptive language (Fernald, Gertler, and Neufeld 2008). Ecuador’s Bono de Desarrollo Humano had a positive impact on long-term memory for young rural children in the poorest income decile, although other cognitive measures were not affected and no impact was seen for better-off children (Paxson and Schady 2008). Nevertheless, these results suggest a CT can improve cognitive development in the worst-off children. In Nicaragua, the Atención a Crisis CCT had significant, positive impacts on language and personal-behavioral skills, but not on short-term memory or behavioral problems, of young children (Macours, Schady, and Vakis 2008).

While the Ecuadorean and Nicaraguan programs were technically CCTs, the requirement that young children be taken to health centers for well visits was not monitored in either program, effectively rendering this component unconditional. Both CTs utilized social marketing components that encouraged households to make key investments in young children. Further analysis of the results shows that the increase in young children’s cognitive outcomes is not entirely attributable to a pure income effect (Paxson and Schady 2008, Macours, Schady, and Vakis 2008), suggesting household behaviors changed as a result of the transfer. In the Nicaraguan case, households shifted purchases in favor of higher quality foods. They also were more likely to have pen and paper and books, and to read more frequently, or tell stories or sing to children than control households. Unfortunately, it is not clear whether the households changed their behavior because the cash was given to female adults in the household or due to the social marketing campaign.

Their analysis suggested that mothers- in lieu of siblings-may have been providing more care for these young children, implying that they received higher quality care.

Finally, in a meta-analysis of early childhood interventions, Nores and Barnett (2010) find that cash transfers, along with other early childhood development programs with educational, nutritional, or mixed goals, have a positive impact on children’s cognition, behavior, health, and schooling levels. Cash transfers alone were not as effective as educational or mixed interventions on children’s cognition, suggesting the potential for complementarities between CTs and additional interventions, or the importance of including additional early childhood-focused components within CTs to achieve early childhood development outcomes.

These results highlight important points about CT features that should be considered. See Knowledge and programming gaps for more details.