Even if conditionalities work, do women pay the price?

Conditional cash transfer programmes often transfer cash to women, on condition that they meet the health, education and nutrition targets for their children. Evidence from Nicaragua suggests that the Red de Protección Sociale programme may not have had sustainable impacts, and may even have negatively affected women participants.

Research from Middlesex University, in the UK, and the Centro de Información y Servicios de Accesoria en Salud, in Nicaragua, explores the extent to which social protection programmes such as conditional cash transfers (CCTs) benefit poor people, particularly women. The authors use the Nicaraguan Red de Protección Sociale (RPS) as a case study.


Nicaragua’s RPS began as a pilot project in 2000, expanding to cover more than 22,000 families through 2006. Cash transfers were made for three years to the mothers of the children enrolled in the programme, conditional on the fulfilment of targets related to child health and nutrition.

Key findings include:

• The pilot RPS met its goals for education, with increases in enrolment, particularly among the poorest groups, but there was no specific focus on girls’ education.
• Other studies warn against over optimism about long-term impacts, citing drops in school attendance after CCT programmes end and a lack of employment opportunities.
• Academic performance did not improve among RPS children, and the programme seemed to have created social divisions by the exclusion of ineligible children. • In terms of health, achievements included a 5 percent decline in the number of children with stunted growth.
• It was assumed that cash transfers were used to improve child nutrition, though this was not tested, and reports suggested that the extra food was not always of ‘ideal’ quality.
• Health services were contracted out to private providers, who met the 98 percent coverage target, perhaps influenced by the Pay for Performance basis of the contracts. Use of services remained high once RPS ended.

It is unclear whether lasting changes were achieved in household behaviour, or if providing services without imposing conditions would be sufficient. Whilst one evaluation finds that RPS had a profoundly positive impact on women and their children, they have had to bear the burden of programme implementation.

• Women had to ensure that their children attended school and met health targets.
• Women had to attend awareness sessions on health, though it is unclear whether they benefited, and their attendance may have been at the expense of other activities.
• The active role of the promotoras – local female community facilitators – cast doubt on the autonomy of women in the programme.
• RPS changed how women see themselves and their ability to manage money, but its short-term nature undermined their ability to fulfil their increased responsibilities.
• RPS reinforced and drew on the idea of ‘traditional’ family values, including women’s assumed altruism towards their families.

Sarah Bradshaw and Ana Quirós Víquez

Sarah Bradshaw
Middlesex University, The Burroughs,
Hendon NW4 4BT, UK
T +44 20 8411 6438
s.bradshaw@mdx.ac.uk