"In many developing countries, household conditional cash transfers (CCTs) produce positive public health results". So said Marcos Vera, Professor at University College London, who recently presented at the 4th Development Week, organized by the Navarra Center for International Development of the University of Navarre at IESE Business School in Madrid. This type of policy, CCTs, consist of completing periodic transfers of money to poor households—often to mothers directly—in exchange for children’s school attendance or bringing children to health centers for vaccination, for example. 

In 2010, there were already at least 19 countries, and are possibly 20 today with such policies, according to Professor Vera. However, despite affirming that in the majority of these cases the data reflect positive results, “it remains difficult to identify an exact recipe”: “[CCTs] aim to eliminate barriers, but in each country and context, the challenge changes and it is difficult to find any universal policy that could work in every place.”

The University College London professor recommended analyzing where are the restrictions and impediments to design better policies.  “It could be, for example, that the household would not have incentives to search for healthcare, or equally that the quality of service would be so bad that it would bring them nothing to demand it,” he clarified.

The use of health services is quite sensitive to the price paid,” Vera stated, but also added that while healthcare is viewed as an expense for governments, in reality is a long-term investment in their human capital. “There is evidence on the importance of healthcare in the first years of childhood, including during pregnancy. Access to it increases life expectancy and cognitive function of individuals”, he said. “In Colombia, we have seen that extending health insurance coverage to the poorest corresponded with increases in doctor visits, preventative care, and overall reduction of hospitalizations…”.

Soften the Social Norms

With respect to changing public behavior through this type of programs, Vera added that “we have to see if they really change habits or social norms, or if to the contrary, they only improve an economic aspect and the effect will only occur while they maintain the economic incentive, in which case they have still at least served to improve household income”.

As an example of the former case, he cited a CCT program in Mexico that managed to change men’s attitudes on letting women get tested for cervical cancer. “It is interesting to see how said transfers permitted them to change social norms and improve the balance”.

Marcos Vera presented the results of a study of schools in rural China, where anemia rates are very high. He verified that giving monetary incentives to school directors to reduce anemia is effective. The University College London expert presented his work at the 4th edition of Development Week, a conference on development economics, hosted annually by the NCID.