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492125116586000Graduate School of Development Studies15875281305Cash Transfers and Human Development Outcomes: Tackling Child Poverty in Zimbabwe00Cash Transfers and Human Development Outcomes: Tackling Child Poverty in ZimbabweA Research Paper presented by:Hilton NYAMUKAPA(Zimbabwe)in partial fulfillment of the requirements for obtaining the degree ofMASTERS OF ARTS IN DEVELOPMENT STUDIESSpecialization:Children and Youth Studies (CYS)Members of the examining committee:Dr Auma OKWANY Dr Loes KEYSERS The Hague, The NetherlandsNovember, 2011.Disclaimer:This document represents part of the author’s study programme while at the Institute of Social Studies. The views stated therein are those of the author and not necessarily those of the Institute.Research papers are not made available for circulation outside of the Institute.Inquiries:Postal address:Institute of Social StudiesP.O. Box 297762502 LT The HagueThe NetherlandsLocation:Kortenaerkade 122518 AX The HagueThe NetherlandsTelephone: +31 70 426 0460Fax: +31 70 426 0799AcknowledgementsI would like to extend my appreciation to the Netherlands Fellowship Programme for the generous funding support that made this research study a reality. Furthermore, this research paper would not have been a success without the timely and professional academic guidance of Dr Auma Okwany and Dr Loes Keysers. To all my fellow students I would like to thank you for your constructive comments from the proposal stage up to the presentation of the paper. Special recognition goes to the Department of Social Services through the office of the National Coordinator of NAP for OVC, and the Catholic Relief Services for giving me access to their programming documents and field information. My Zimbabwean professional colleagues you are not forgotten but your technical and academic support was very much appreciated. Lastly, I would like to thank my wife and the greater family for their overwhelming emotional support during my absence.Contents TOC \o "2-3" \h \z \t "Heading 1,1,Heading 1 not chapter,2" Acknowledgements PAGEREF _Toc309303190 \h iiiList of Tables PAGEREF _Toc309303191 \h viList of Figures PAGEREF _Toc309303192 \h viList of Pictures PAGEREF _Toc309303193 \h viList of Appendices PAGEREF _Toc309303194 \h viList of Acronyms PAGEREF _Toc309303195 \h viiAbstract PAGEREF _Toc309303198 \h viiiChapter 1Introduction PAGEREF _Toc309303199 \h 11.1Research Objectives and Questions PAGEREF _Toc309303200 \h 21.2The Importance of focusing on Children Human Development PAGEREF _Toc309303201 \h 31.3Research Methods and Data Collection PAGEREF _Toc309303202 \h 4Document Review PAGEREF _Toc309303203 \h 4Semi-structured Interviews PAGEREF _Toc309303204 \h 5Data Analysis PAGEREF _Toc309303205 \h 7Chapter 2Conceptualising CT and Child Poverty PAGEREF _Toc309303206 \h 92.1Cash Transfer: Understanding the Concept PAGEREF _Toc309303207 \h 92.2Understanding Child Poverty PAGEREF _Toc309303208 \h 112.3Household Dynamics: Transforming Income into Living Standards PAGEREF _Toc309303209 \h 162.4Human Development status of Zimbabwean Children PAGEREF _Toc309303210 \h 17Chapter 3Tackling Child Poverty in Zimbabwe: The Case of Cash Transfers PAGEREF _Toc309303211 \h 213.1National Action Plan for Orphans & Vulnerable Children PAGEREF _Toc309303212 \h 223.2The NAP 2 and CRS-BRTI Cash Transfer Programmes PAGEREF _Toc309303213 \h 233.3Programme Implementation PAGEREF _Toc309303214 \h 253.4Programmatic Implications PAGEREF _Toc309303215 \h 26Targeting Precision PAGEREF _Toc309303216 \h 26‘Trickle down’ Effect PAGEREF _Toc309303217 \h 27Full Employment PAGEREF _Toc309303218 \h 27Dependency Load PAGEREF _Toc309303219 \h 28The Nature of Poverty PAGEREF _Toc309303220 \h 28Perfect Supply PAGEREF _Toc309303221 \h 283.5Programme Evaluation Results PAGEREF _Toc309303222 \h 29Chapter 4 The ‘Story’ Behind Zimbabwe CT and Analysis of Outcomes PAGEREF _Toc309303223 \h 304.1 The Stories of Most Significant Change PAGEREF _Toc309303224 \h 30The Story of Caregivers PAGEREF _Toc309303225 \h 30The Story of Children PAGEREF _Toc309303226 \h 334.2 CT and Children Human Development Outcomes PAGEREF _Toc309303227 \h 36Access to food PAGEREF _Toc309303228 \h 37Access to education PAGEREF _Toc309303229 \h 37Promotion of Child Health PAGEREF _Toc309303230 \h 39Chapter 5 Conclusion PAGEREF _Toc309303231 \h 40References PAGEREF _Toc309303232 \h 43Appendices PAGEREF _Toc309303233 \h 49List of Tables TOC \h \z \t "table title,2" Table 1: Definitions of Child Deprivation. PAGEREF _Toc309234663 \h 13Table 2: HDI and its Components PAGEREF _Toc309234664 \h 17Table 3: Nutritional Status Zimbabwe 2009 PAGEREF _Toc309234665 \h 18Table 4: Health Status Zimbabwe 2009 PAGEREF _Toc309234666 \h 18Table 5: Education Status Zimbabwe 2009 PAGEREF _Toc309234667 \h 19Table 6: Cost Breakdown for NAP 2 Programme PAGEREF _Toc309234668 \h 23List of Figures TOC \h \z \t "Figure title,2" Figure 1: Elements of Poverty PAGEREF _Toc309234681 \h 12Figure 2: The Ecological Systems Theory PAGEREF _Toc309234682 \h 14Figure 3: NAP 2 Targeting PAGEREF _Toc309234683 \h 24Figure 4: Most Significant Change Stories (caregivers) PAGEREF _Toc309234684 \h 31List of Pictures Most Significant Change Approach 6List of AppendicesAppendix A: HDI Dimensions and Indicators 50Appendix B: Zimbabwe Monthly Inflation year 2009 and 2010 51Appendix C: Response Matrix Caregivers 52Appendix D: Response Matrix Children 53List of AcronymsADB African Development BankAIDS Acquired Immune Deficiency SyndromeBEAM Basic Education Assistance ModuleBRTI Biomedical Research and Training InstituteCHIP Child Poverty Research and Policy CentreCPRC Chronic Poverty Research CentreCRS Catholic Relief ServicesCT Cash TransferFACT Family Aids Caring TrustFBO Faith Based OrganisationGoZ Government of ZimbabweHDI Human Development IndexHDR Human Development ReportIILS International Institute of Labour Studies ILO International Labour OrganisationHIV Human Immunodeficiency VirusMoHCW Ministry of Health and Child WelfareMoPSLSW Ministry of Public Service, Labour and Social WelfareMSC Most Significant ChangeNAP National Action PlanNDHS National Demographic Health SurveyNGO Non-Governmental OrganisationOAU Organisation of African UnionOVC Orphans and Vulnerable ChildrenUNDP United Nations Development ProgrammeUNESCO United Nations Education Scientific and Cultural OrganisationUNFPA United Nations Population FundUNICEF United Nations Children’s FundUSD United States DollarWFP World Food ProgrammeWHO World Health OrganisationAbstractChild poverty is a phenomenon of concern in Zimbabwe. Exacerbated by an escalating population of orphans and other vulnerable children, child poverty has been a major blow to the development of children. Its effect manifests in deprivation of basic necessities among children. There are several efforts being made by the government and other independent civil bodies to improve the general welfare and development of children countrywide. Among the recent programmes to alleviate child poverty are the household income support interventions in form of Cash Transfers. This research paper is an inquiry into the effectiveness of cash transfers in improving children human development outcomes in the context of fighting child poverty in Zimbabwe. Access to food, health and education services is the dimensions of analysis. Two cash pilot projects are being focused on: the NAP 2 and the Manicaland OVC Pilot Cash Transfer Programmes. An analysis of the Information drawn from the programmes formulation and implementation documents together with semi- structured interviews from children and caregiver beneficiaries suggests the potential for income support to be instrumental in child poverty alleviation. However, there are inherent design and practical limitations to the approach. Coupled by socio-economic household resource allocation challenges, the amount of disbursements were generally smaller to cater for the often gendered and aged based requirements of children. This makes cash transfers inadequate to be used as a stand-alone intervention to improving the general welfare of children. A more comprehensive approach focusing more on the ends and flexible to use several means is required in order to have an impact on the development of children. KeywordsChild Poverty, Cash Transfer, Human Development.Introduction Tackling poverty associated with childhood in Zimbabwe has been on the national agenda since colonial independence in 1980. Children are recognised as a special population in Zimbabwe which requires specialised attention. The population of children across the county do have varying degrees of exposure to poverty and deprivation of essential commodities required for their development. Orphans (mainly HIV/AIDS related) and other vulnerable children living in poor households is the most common targeting criteria. The term ‘Orphans and Vulnerable Children’ (OVC) has therefore become the widely used targeting context in Zimbabwe. Several other combinations of strategies are employed by several government and non- government organisations who engage in child poverty interventions. There are quite a number of national policy instruments for child protection in Zimbabwe such as the Orphan Care Policy, and the Children’s Act.Zimbabwe is a state party to the Convention on the Rights of Children (United Nations 1989) and the African Charter on the Rights and Welfare of Children (OAU 1999). As such, it is expected to take steps towards ensuring that minimum rights of children are met through both local and international resources at its disposal. Even though to date there are no legislative articles in the Zimbabwean constitution that hold the government accountable for non-fulfillment of children’s rights, social protection for children is embraced in the national objectives. Apart from efforts to protect children, child poverty is still considered very high in the country (UNDP 2010).Currently the Government of Zimbabwe (GoZ) through the Ministry of Public Service, Labour and Social Welfare (MoPSLSW) is implementing the National Action Plan for Orphans and Vulnerable Children Phase Two (NAP 2) (MoPSLSW 2010) . This intervention focuses on providing income support to households in which children live in anticipation of improvement of children human development. Other non-governmental civil organizations are also complementing government’s effort through similar programmes. Notable organizations are the Catholic Relief Services, Help Age Zimbabwe and UNFPA. Most programmes are still in their pilot phase. At the moment the major question being asked in the local development circles is whether this approach will have positive effects on the development of children.In this paper, the search for the answer to the question starts from closely looking at the two concepts: ‘Child Poverty’ and ‘Cash Transfer’. A theoretical understanding of child poverty and cash transfer is sought followed by an understanding of the concepts’ relationship to the socio-economic mechanisms of the household and beyond. The approach taken in this study goes beyond the boundaries of the household to look at the totality of the environment surrounding it. This is because a household is not an isolated entity but it constantly interact and transact both socially and economically with other institutions such as schools, health centres and markets. Based on the understanding of household mechanisms and the wider institutional framework, and with children at the core, the potential for children human development within the households receiving Cash income support is discussed against some evidence gathered from implementing agencies and beneficiaries. This research study is based on the National Action Plan for OVC 2 and the CRS-BRTI Manicaland non- conditional Cash Transfer Pilots Projects carried out in Mashonaland East Province and Manicaland Province respectively. Research Objectives and QuestionsThis research study seeks to establish the extent to which children human development needs are being addressed in the era of household cash income support as ascertained by access to food, health and education services. The focus is on the impact (effectiveness) and design and technical issues (efficiency) surrounding the cash transfer programming. The efficiency of the programmes, in terms of how the processes, as reflected in programme design and implementation of converting the inputs (cash) into outputs (improved children human development) are relevant and adequate towards the realisation of child poverty alleviation as an ultimate goal. The study therefore seeks to answer the following specific question and sub questions: To what extent has the Cash Transfer Programmes addressed the issue of children’s access to food, health and education?How efficient has been the Cash Transfer Programmes in terms of their design and implementation? What outstanding impacts have been made by the Cash Transfer Programmes from the perspective of the caregivers and children? Two non- conditional pilot cash transfer programmes; the NAP Pilot Cash Transfer Programme in Goromonzi District (implemented by MoPSLSW in February 2011) and the Manicaland Pilot Cash Transfer Programme carried out by CRS between the period December 2009 and February 2011 are looked at. A higher order term, Child Poverty, is used here to encompass the need to enhance the survival and development of children outside the boundaries of targeting strategies used by development agencies such as ‘OVC’. Thus, involving all children in a holistic approach without necessarily discriminating through categorisation. The Importance of focusing on Children Human Development The concept of Human Development was brought to the fore since the publication of the first Human Development Report (HDR) in 1990 (UNDP 1990). In this report Human Development was defined as:[…] a process of enlarging people’s choices. The most critical ones are to lead a long and healthy life, to be educated and to enjoy a decent standard of living. Additional choices include political freedom, guaranteed human rights and self-respect (UNDP 1990: 10).This definition has three elements, Human Development as a process, with some dimensions constituting the process, and presented as outcomes. The outcomes are given as an index and the revised dimensions as per the HDR of 2010 are shown in Appendix A. Human Development is a broad concept and share some similar characteristics and objectives with concepts such as Poverty and Citizenship to be discussed in Chapter 2 and 3. Human Capital Development is a concept usually related to the education part of human development. It is basically associated with equipping one with education, skills and competencies necessary for productive purposes.Understanding the need for households to provide opportunities for human development; that is, ensuring that children have access to basic needs (food, education and health) during the formative years is essential for their well-being and as potentially productive adults. This understanding is entrenched and made a pillar of the United Nations Convention on Child Rights of 1989 (United Nations 1989). Accordingly, every member state including Zimbabwe should ensure attainment of such through its policies and legislation. Focus on childhood poverty is not to overshadow experiences of poverty of other vulnerable people within households but an observation that children represents a special niche that is itself worth of consideration in the policy making processes. This will go a long way in informing policy on child welfare in Zimbabwe and help generate some new perspectives on the relationship between cash transfers and the development of children.In previous years interventions meant to promote children human development were mainly in form of supplying the children with commodities such as food (e.g. infant supplementary and school feeding schemes), uniforms and stationary. A shift in policy and programming objectives in Zimbabwe towards income support represents a major issue of concern to the development of children. First, there is growing evidence that poverty is itself exacerbated by a number of intersecting variables which are not all linked to income (e.g. Sen 1999); even though there is no consensus on how to measure them. For example, only one out of the five poverty traps in the Chronic Poverty Report of 2008 is income related (CPRC 2008). Others were insecurity (war and violence), limited citizenship, spatial disadvantage (related to one’s location) and social discrimination. Cash transfers as a demand side intervention alone cannot end problems of access because supply factors are also at play. For example, clinics may not be accessible because of distance. Secondly, the experience of poverty is felt differently by status such as age, gender, location etc. (Holmes and Jones 2009). Under such situations, children living in extremely poor household are much more likely to carry the burden (costs) of poverty and become vulnerable to deprivation in terms of access to health, education and nutrition than adults. This is exacerbated by their structural powerlessness. The position of children cannot therefore be completely rationalized at family levels. Anticipating that children will always benefit from family wide interventions might not necessarily suit every situation in which children are found in.Addressing child poverty is a long term measure in breaking the intergenerational transmission of poverty in developing countries. Efforts towards human capital development such as the provision of adequate food health, education and living standards ensure that children grow into adulthood with the capacity for economic productivity. The incidence of poverty as measured by the HDI suggests that a growth in GDP, associated growth in income per capita leads to a high HDI and a general reduction in poverty levels. Apart from improvements in Gross National Income per Capita, tackling child poverty also has the effect of improving other indicators of HDI: life expectancy at birth, mean years of schooling and expected years of school (ADB 2010: 10, 15).Research Methods and Data CollectionThis study is a retrospective approach to gathering past and present information on Cash Transfer Programming and Child Poverty alleviation. It combines a programme document review and semi-structured interviews with beneficiaries. A retrospective approach was used because of the unavailability of specific knowledge or any documented baseline information on each household that took part in the research. As a result, the research process was meant in a way to generate information about the situation that prevailed before and after the intervention. Two forms of data were collected; programming information of the 2 pilot projects (mainly Project Proposals and Implementation and Evaluation Reports) and stories of most significant changes from project beneficiaries. Document ReviewThe programming and implementation information was mainly gathered from Project Proposals and Implementation and Evaluation Reports. These documents were obtained from both published and unpublished sources including the internet with full citation. Data concerning the NAP 2 cash transfer pilot project was mainly gathered from the Social Services Department and the NAP for OVC website and also from websites of its partners (e.g. UNICEF Zimbabwe). Data on the Manicaland Province (Makoni District) Pilot Cash Transfer Programme was mainly obtained from CRS. An analysis of the two Pilot Programme documents and relevant reports was made to establish the motivation behind their formulation, to describe the programme’s design and implementation, and to determine the presence and or absence of adequate measures that ensure changes and impacts on households and children in particular. Some references were sought from the preceding programmes like the NAP 1, and other projects that were carried out by independent NGOs who shared the similar vision of Child poverty alleviation. Some informal interviews and communication was continually made with program officials from both the MoPSLSW and CRS to seek clarifications and further information on the pilot cash projects during the entire research period. Secondary data was gathered from textbooks, journal articles, government publications, and newspaper sources. Other relevant sources such as reports published by development bodies such as the World Bank, UNICEF, UNDP, and local newspapers were used among others. The purpose was mainly a review of relevant literature on the interventions on child poverty in the era of cash based social protection.Semi-structured InterviewsSemi-structured interviews were carried out with systematically selected samples of households in each of the districts. Seven households in Goromonzi District of Mashonaland East Province and eight in Makoni District of Manicaland Province were selected at systematic interval from the sampling frame (list of beneficiaries) obtained from the implementing agencies. Due to time and cost constraints, only one administrative ward (relatively smaller in terms of geographical coverage) in each district was considered for sampling. The two samples were only a smaller percentage of the total number of beneficiaries and this may limit generalisation of findings; but basically, emphasis was more on collecting dependable and transparent data that give an insight into the cash transfer programming and its contribution towards tackling child poverty in Zimbabwe. The semi-structured interviews with beneficiaries of the cash transfer programme were aimed at gathering information on the impact of the cash income projects from the beneficiary’s viewpoint.The ‘Most significant Change’ approach was employed as a tool for gathering data during the interviews. Most significant changes are the outstanding changes that happen or are realized by the beneficiaries as a result of an intervention (Davis and Dart 2005). The motive behind the approach was that any intervention is done to bring particular positive impacts to the target population. It is therefore reasonable to assess or evaluate a project in terms of the changes reported by the beneficiaries themselves rather than only focusing on whether the project objectives have been met or not by using indicators only, which they may also fail to understand.MSC ApproachSource: MSC Manual (Davis and Dart 2005: i)Obviously Indicators are important in quantifying the reported changes but may limit the focus in project evaluation within preconceived boundaries, failing to capture unintended benefits and shortcomings. Although this approach cannot be used alone, it provides quick indications of trends especially in projects that tend to have relatively long periods to show actual changes such as escaping from poverty. Its use in this research has a lot of potential to help improve the analytical power and quality of results obtained through other methods that were used in the evaluation done by the programme implementers. Significant changes reported are also essential because sometimes the complexity of the development environment in terms of intersecting benefits from several donor agencies affect the quality of attribution made to any one project. Under such circumstances, beneficiaries are likely to be in a better position to establish and differentiate boundaries of several other interventions in which they are also beneficiaries. Equally important is also the fact that giving the evaluation function to beneficiaries is probably suitable in programmes that have several expected outcomes. For example, in this case children’s welfare is not the only or explicit objective but falls within the overall sphere of interest of the project, that include strengthening of the household economy. On the other hand, the perceptive nature of poverty as a concept makes a qualitative approach more suitable. Poverty is a subjective concept, often perceived differently in different localities and over time. This calls for an approach that actively engage beneficiaries in evaluating projects such as cash transfers (Adatto 2008). In summary, the qualitative nature of this research gave the caregivers and children the opportunity to participate through giving their opinion, expressing their attitude and feeling towards the intervention as well as a chance to be heard. Involving beneficiaries to express their opinion on the impacts they feel are most significant provide much informative feedback for policy and future planning. Semi-structured interviews were done to collect the most significant change stories. Beneficiaries were asked to give an account of the most significant changes that have occurred to their livelihood and standard of living as a result of the cash income intervention without given any particular domain of change to talk about. Afterwards, some follow-up and probing questions relating to children access to health, education and food were then asked. This helped in capturing the most important effects of cash transfers to families and an indication of how children have benefited. The interviews also gathered stories of most significant change that have resulted from the intervention from a gendered perspective, and also recognition was given to the differences in needs according to the age of the children. A total of 22 beneficiaries from 15 households were interviewed. They include 9 beneficiaries of the NAP 2 cash transfer pilot project from 7 households (Goromonzi District): 2 male caregivers, 3 female caregivers, 3 boys (1 in primary and 2 in secondary school) and 1 girl (a primary scholar). Another set of interviews was carried out with 13 beneficiaries from 8 households of the CRS-BRTI beneficiaries in Makoni District: 3 male caregivers, 3 female caregivers, 4 boys (2 primary and 2 secondary) and 3 girls (1 in primary and 2 in secondary school).It was made clear to participants that the research and the researcher are not part of the Monitoring and Evaluation process of neither the NAP 2 Programme nor the CRS-BRTI Programme, but the research outcome aims to provide information that may guide the development and design of future cash transfer programmes. All the beneficiaries were recipients of non- conditional transfers whose households had at least one child. This preference was made in recognition of the household approach in targeting children as opposed to explicit targeting of children within households which is often the case in conditional cash transfers. Due ethical considerations were observed throughout the research process. After a full introduction of the researcher, the purpose of the research was made clear, willingness to participate was sought while emphasizing on the respondents’ right to withdraw from participation at any point during the interview should he or she feels so. For child interviewees, consent from both the child and the parent/guardian was obtained. However, obtaining consent form either the children themselves or their parents or guardians was problematic especially for primary school going and female children. This resulted in fewer female children taking part in the research. In all cases, protection of privacy was guaranteed, that is, the information collected from the research participants can only be used for purposes mutually agreed with the researcher. Data AnalysisSeveral literature do agree that human development is the foundation to ending poverty and is associated with adequate access to proper nutrition, education and health (e.g. World Bank 1990 and UNDP 1996 ). Three domains of change: access to health, education and nutrition form the basis of analysis of the interviews. In other words, categories if significant changes reported by the respondents were defined and grouped as food, health or education related. The magnitude of change reported and other demographical data are summarised in Appendices C and D. The operational definitions of deprivation as described in the Bristol Deprivation Approach (Table 1) were used as guidelines to ascertain the level of deprivation before and after the cash interventions. However, the understanding of the beneficiaries’ changes in levels of access and deprivation was largely taken into account. For example, mild food deprivation was considered to be ‘at least having something to eat’ rather than determining the nutritional value of the food. Similarly, severe food deprivation was taken to be cases were daily routine are affected by hunger, for example, when children miss school because of unavailability of food. Though sometimes the definitions of change cited by the beneficiaries could not be easily interpolated into a before and after category, the level of impact and/ or non- impact could be explained form the stories collected from the beneficiaries. Stories of significant change from caregivers and children were in each case categorised in to seven groups. These groups were exhaustive of the responses given; the final grouping was for those data that cannot be classified because no significant change could be reported. Translation of the research questions into the local language and translation of the answers into English was done with the help of colleagues with academic teaching experience and also reviewed by peers in the development sector. The next chapters in this paper are an elaborate account of the research experience.Conceptualising CT and Child PovertyThere are quite a number of research activities that were carried in Zimbabwe concerning Cash Transfers and poverty alleviation (e.g. Mushunje and Mafico 2010, WFP and Concern Worldwide 2010) that have made several different recommendations towards the approach. At the same time, some reported cases of success of cash transfers in child poverty alleviation in other countries cannot be dismissed as an influence to the adoption of the approach in Zimbabwe. The meeting point of how cash transfers are theoretically and practically understood and how child poverty is conceptualised in the Zimbabwean context is important in providing a prognosis of the effects of the income support intervention. This chapter begins by separately examining the two concepts: Cash Transfer and Child Poverty then bring them together in an analysis of their relationship and compatibility within the context of the household (as the household is a point of focus in child poverty alleviation in Zimbabwe); followed by a presentation of the human development status of the Zimbabwean children.Cash Transfer: Understanding the Concept Cash transfers are a non-contributory (social assistance) grant such as child grants, foster care grants and scholarships (OXFAM 2003). This form of income based support is currently a popular strategy in poverty reduction. Originally introduced in the humanitarian sector as an intervention strategy under famine and emergency conditions, cash transfers have now been applied as a broad spectrum instrument in poverty reduction including children’s welfare. The intervention is basically aimed at stimulating demand for services through distributing cash to poor households. Amartya Sens’ Entitlement Approach is considered the basis of the theoretical underpinning of cash transfers in the development sector (ibid). Sen (1981) used the Entitlement Approach to explain the famine that occurred in Bengal in 1943. According to Sen (ibid), people did not die because of lack food but “lacked the ability [...] to command food through the legal means available in the society” (ibid: 167), referred to as Entitlement failure. Two types of entitlement failure were described, ‘pull’ and ‘response’ failures. Pull failures represents inability to demand, for example through wage loss in unemployment. Response failures represent inability to supply to meet demand, i.e. the unavailability of food on the market. The cash transfer approach is basically a demand -side intervention aimed at mitigating the pull failures. In other words, the approach assumes that children needs are not being met because necessary commodities cannot be adequately demanded due to lack of the means of exchange, the Entitlement. The entitlement approach consists of three related concepts; the Endowment set, Entitlement mapping, and the Entitlement set.The Endowment set is defined as resources owned by a person (legal) both tangible and intangible for example land, knowledge/skill and labour power. It is these resources that either through exchange or production enables a person to obtain other commodities needed for survival through means that are considered legal by the society in which one is part of. Entitlement mapping refers to the process of converting ones endowment into means possible to obtain commodities bundles of one’s choice. Thus, labourers’ sale their labour to obtain wages for buying commodities while farmers sells their produce to get cash for exchange with other commodities. Social insurance and social assistance falls within this process. Entitlement set (or commodity bundle), refers to the actual commodities which people chose to have for satisfying their needs. The entitlement set also includes goods and services obtained through public provisioning such as free education ((Osmani 1993: 3). Several literatures discuss and argue for the potential of cash transfers in improving children’s access to education, health and nutrition (e.g. Chapman 2006, Bassett and Adatto 2009). To date, a variety of Cash transfer strategies have been used in children human development through promoting access to health, nutrition and formal education. Conditional cash transfer based programmes such as The Red de Protección Social Programme in Nicaragua was reported to have resulted in an average increase of 18 percentage points in enrolment and 23 percentage points in attendance (against a baseline of 70% enrolment in the target population) between 2000 and 2003 (Maluccio 2005). The Bolsa Familia Programme in Brazil to reduce child labour by increasing the income of households has shown a decrease in school dropout and an increase in enrolment even though the amount of the cash transfer was less than that realised from child labour (Cardoso and Souza 2003). Access to food improved and absenteeism declined by 16% during the first 9 months in Kalomo district Zambia where unconditional cash transfer was implemented (Wietler 2007). However, the need to consider adopting the income support strategy to child poverty alleviation at a more local level remains important. The socio-economic and political situation in Zimbabwe is different from that of the countries where the programme was a success; chances are that these countries have different challenges in terms of demand and supply factors related to children human development. The entitlement approach is a plausible conceptualisation of poverty and fits suitably well with how child poverty is viewed in Zimbabwe as reflected in government and other donor funded programmes to overcome it. Logically, disbursement of cash to provide or augment family income will translate to the ability of a household to command more commodities in the entitlement set, probably more for children. There are also logistical reasons for the widespread use of cash transfers in social protection. They include reduced response time, flexibility and expanded choices for beneficiaries and cost effectiveness in term of absence of procurement costs as noted by OXFAM (2003).Another variation of cash resource support which is more of a sectorial approach is to improve access through wavering of fees and subsidies. Instead of distributing cash to households, several programmes are carried out to make sure that service providers are ready to deliver through capacitation. For example, since independence the government of Zimbabwe through the Ministry of Health and Child Welfare’s Maternal Child Health Care Programme has been offering free medical services to children under the age of five who abides by the mandatory monthly child development and growth monitoring ( ‘Maternal and Child Health’, MoHCW 2011). The rest of the citizens including older children can have assisted access to health care under the Welfare Assistance Act. However, health care hasn’t been at zero cost at the point of delivery. Hospitals and clinics often have shortages of drugs and essential medicines which patients need to purchase on the market. In the Zimbabwean education sector, education is not free but tuition fees in government schools are subsidised, strategically lower and affordable than in private schools. However, other additional levies charged are out of reach for the majority of caregivers. The situation has been made worse by the collapse of the Zimbabwe education system due to inadequate government funding; which has led to a de facto privatisation scenario in the education system. Understanding Child PovertyChild poverty is itself a concept that emerged out of social and scientific discourses on poverty. There are several definitions of poverty in use depending mainly on the motive of the users. The UN Programme of Action of the World Summit for Social Development summarily considered poverty as:[…] lack of income and productive resources sufficient to ensure sustainable livelihoods; hunger and malnutrition; ill health; limited or lack of access to education and other basic services; increased morbidity and mortality from illness; homelessness and inadequate housing; unsafe environments; and social discrimination and exclusion. It is also characterized by lack of participation in decision making and in civil, social and cultural life (UN 2005: paragraph 19).Definitions of poverty are largely subjective; people living in different localities usually have their own conceptions and definitions of poverty which are relative to their way of living (relative definitions of poverty). This complicates the understanding of poverty and makes its measure more diverse, resulting in widely diversified policies to eradicate it. Several approaches to measuring poverty are in use today. They range from more absolute measures defined by the Poverty Datum Line to multi-dimensional archetypes (Boyden 2006). Several dimensions of human life (economic, social, environmental etc.) are used to ascertain how poor people are, and several combinations of these dimensions can be used to summarize poverty levels. The Human Development Index is typical of such and it combines life expectancy, education and Gross Domestic Product (GDP). Figure 1 below depicts the multi-dimensionality of poverty and provides a graphical summary of the elements of poverty as reflected in several definitions.Figure 1: Elements of PovertySource: Understanding Multidimensional Child Poverty (John 2011: 23)Put simply, child poverty refers to poverty experienced by children. It differs from adult poverty in terms of causes and effects; in which the impact of the effects during childhood are more permanent (CHIP 2002). Apart from mainstream definitions of poverty, child poverty is also considered to be a form of multi-dimensional deprivation of basic necessities among children. This is probably because children are considered as lacking the capacity to accumulate resources necessary to avoid poverty on their own. But such orientation may risk undermining the resilience within children living in poverty. A working definition presented by UNICEF in 2005 is in line with multi dimensionality of child poverty: poor children are considered to be “[those who] experience deprivation of the material, spiritual and emotional resources needed to survive, develop and thrive, leaving them unable to enjoy their rights, achieve their full potential or participate as full and equal members of the society” (UNICEF 2005). This is a quite broad definition which recognises the development and functionality of children in the society on condition of the availability of an appropriate environment. A need based Bristol Deprivation approach is one of the popular assessment instruments for child poverty and it recognizes the multidimensionality of child poverty and builds upon the CRC’s basic needs that children require to survive and develop (Gordon et al. 2003a). The basic needs are: food, safe drinking water, sanitation facilities, healthcare facilities, shelter, education and information. Deprivation of the basic needs is rated on a continuum with a condition of no deprivation at one end through mild, moderate, and severe to extreme deprivation (definitions in Table 1 below). Table 1: Definitions of Child Deprivation.Deprivation Mild Moderate Severe Extreme Food Bland diet of poor nutritional valueGoing hungry on occasionMalnutrition Starvation Education Inadequate teaching / learning due to lack of resourcesUnable to attend secondary but can attend primary educationChild is 7 or older and has received no primary or secondary education.Prevented from learning due to persecution and prejudiceHealth Occasional lack of access to professional medical care due to lack of money.Inadequate medical careNo immunisation against diseases. Only limited non-professional medical care available when sickNo medical careSource: The Distribution of Child Poverty in the Developing World (Gordon et. al. 2003b: 8).The multi-dimensionality of child poverty is not only in the form of deprivation as postulated by the Deprivation Approach. The sources of the poverty itself are multi-dimensional. Child poverty is propagated by several factors found in the environment in which children live. As such, a closer understanding of the whole environment surrounding children is also important in understanding their experience of poverty and possible intervention strategies. In 1974 Brofenbrenner theorized the ecological setting or framework under which human development happens; the Ecological Systems theory (Brofenbrenner 1979, 1989). Structures influencing the development of a person are arranged from the most immediate, the microsystem which includes the family and school, through the mesosystem which interconnect the structures of the microsystem; the exosystem which includes the community and communally owned family resources. The macrosystem comprises of laws, cultural values and norms that govern the relationships of actors within the ecological system. For example, some cultural values may direct the way in which parents view and provide for their children. The choronosystem is the influence of time on the development of children, their needs are not static and their relationship with the ecological system is somehow time bound, for example the aging of their parents. Figure 2 below is a graphic summary of the Ecological System Theory.Figure 2: The Ecological Systems TheorySource: The Ecological Systems Theory (Bronfenbrenner 1989).Cash Transfer programming mainly targets the households in which children live. Such an ecological model of intervention embeds the welfare of children into the welfare of the household, which is outwardly moulded by the community structures and national policy frameworks. Such an overlapping relationship may complicate the relation between income and access to services essential for the development of children. For example, access can be governed by: Access to user feesDistance of households from service centresAvailability of quality services andConducive environment e.g. regulations. Targeting households through income support has the potential to make user fees available but fall short on addressing the other three. This means that addressing children’s access to basic commodities requires a multi-pronged approach, not necessarily income based alone. The other 3 factors may be tackled at a higher level, usually through the local or national government commitment. Overall efforts to promote child poverty alleviation should therefore focus also on policies and undertakings that generally create a favourable environment for the development of children (Waddington 2004). Economic commitment for child development is seen in public finance policies of governments, for example, by sufficient budgetary allocation to improve availability and access to education and primary health care as well as investments in improving the infrastructure of such. Child poverty and deprivation can be define at a more locally at the level of gender and age. Research has found some significant influence of gender and age of children towards the access to food, education and health services (DFID 2005a). These occurrences are usually driven by cultural and social beliefs. Cultural beliefs and values may have a bearing on how household income is spent to meet the needs of individuals within it. In patriarchal societies for example, it is often the case that women and girl children are of lower status than boys and man. In such cases investment in girls in terms of health (including maternal health) and education might not be sufficient enough to lift them out of poverty. For example, Zimbabwe is a patriarchal society were male children are often considered as assets in a family because of their potential to become future breadwinners, unlike girls who will leave their family upon wedlock. As such, in a situation of limited resources boys are more likely to be given first priority. Still on the issue of gender, there are some needs that are based on physiological make-up. Unlike boys, girls have reproductive related needs such as sanitary ware. Girls might also need nutritional support to guard them against iron-deficiency anaemia that is exacerbated by menstruation (Sridhar 2008:2). Another interesting gendered dimension important in designing cash transfer projects was reported by Slater and Mphale (2008). In their research on gendered aspects on cash income support (ibid.), they found that cash transfers disbursed to female caregivers were seen to be more likely to yield benefits that improve the development of children (especially girls) as compared to those handled by their male counterparts. The age of children is also significant variable in determining their development needs. Children of different age groups have different education, information, nutritional and medical needs. For example, infants require immunisation and more regular medical check-ups than adolescents. The needs-timeline relationship therefore means that the needs of children are not static, but are constantly changing as they move from one age group to another. It is therefore important for any intervention which aims to alleviate child poverty to seriously consider the gender and aged based factors in order to come up with effective programmes. The effects of non-income factors to child poverty do potentially have varying degrees in relation to the level of distributable income available. While it may seem obvious that households above the poverty threshold affords to meet the needs of children, occurrences of deprivation in such cases cannot be ruled out. On the other hand, poor households with very limited resources have a lot to consider in terms of choices, exacerbating the influence of non-income factors to take precedence in coming up with decisions on how resources are spent. Most children live in households and households are an important institution in providing children with primary needs and access to basic rights. However, a household is not an unproblematic unit; several processes shape the household-child relationship, an important factor in children human development.Household Dynamics: Transforming Income into Living StandardsHolding other factors constant and assuming a perfect supply side, there are several economic and socio-cultural factors that affect the efficiency of households in converting income into living standards. Thus, a trickle-down effect of household income into the benefit of children is not always obvious. Cash transfers are a way of giving households capacity to demand services. Households make choices or ‘map’ on the services depending on their needs. The process of entitlement mapping at the household level determines whether children’s needs are considered to be part of the entitlement set. What is important is how resources or income is appropriated within the household, that is, who gets what and when and how.Traditional micro-economic models assume that households consist of individuals who are utility maximising (Thomas 1993, Cornia and Steward 1995). The Unitary Model holds that households make collective decisions and income is allocated in the best way to meet the needs of every individual within the household. A household is only limited by the total budget at its disposal under this model (Vermeulen 2002). Under the unitary model, even if the cash is disbursed to a household without any specific targeting, every member is assured of a fair share from the collective appropriation process. However, in reality individuals within the household naturally have different preferences or at least differ in priorities. Samuelson (1956) made an attempt to explain the inevitability of individual preferences and suggest that at least household members argue for their own personal preferences and reach a consensus to aggregate their utilities. Becker (1974) unlike Samuelson, suggest the existence of a benevolent household head through which collective utility is achieved. On the other hand, the bargaining model assumes a bargaining process among the household members. The ultimate allocation of resources depends on the bargaining power of each individual or groups within the household (Cornia and steward 1995). In the Bargaining Model, children are expected to bargain for resources in order to meet their needs such as education and health. These primary household models are an important step in understanding household economic behaviour and the politics of resource allocation, how income is transformed into living standards, and how children resource requirements stand a chance to be addressed at household level. In reality, household resource allocation is a complicated system. There are other several socio-cultural, legal, and tempo-spacial mechanisms of exclusion and inclusion that affects resource allocation to children within the ecological system. These are propagated by a combination of influences from the household itself and the community at large. For example, the relationship between the household in which children live and the school or a health centre is made possible by the availability of user fees and the distance between the two. In this case cash transfers have a possibility to contribute towards user fees but little to do with distance especially in areas without road networks. On 20 April 2011 UNICEF featured a story of a beneficiary of the Zimbabwe Expanded Immunisation Programme who had to walk 15 kilometres to the nearest immunisation point, the journey he (the beneficiary) reported to afford once a year and which his wife could not take because of ill health (UNICEF 2011).Having discussed the complexities involved in understanding and addressing child poverty through cash transfers within the context of a household, the following section highlights the current condition of child poverty based on food availability, access to health and education services. Human Development status of Zimbabwean ChildrenLiterature surrounding child poverty in Zimbabwe shows a continued downward trend on opportunities for human development among children. The Human Development Report of 2010 shows a more recent comparative position of Zimbabwe in terms of Human Development Index and its indicators (see Appendix A). Zimbabwe is the least ranked among United Nations countries (UNDP 2010: 146). This position has been maintained since 2009 (UNDP 2009: 146). Table 2 below show a summary of Zimbabwe HDI status as reported by the UNDP. Table 2: HDI and its ComponentsRankCountryHDILife expectancy at birthMean years of schoolingNon income HDI1Norway0.93881.012.60.954168DR Congo0.23948.03.80.390169Zimbabwe0.14047.07.20.472Source: Human Development Report (UNDP 2010: 143)Other countries have been included in the table for a quick comparative glance. Norway is ranked first and its HDI status can be considered much closer to the ideal situation. DRC falls within almost the same progressive ranking category with Zimbabwe. However, it can be noted that the HDI as a summary can be representing a skewed balance of the individual factors that forms its components. For example the HDI for Zimbabwe is lower than that of DR Congo but looking at the mean years in schooling, Zimbabwe is far much ahead, and much closer to the number one ranked Norway. This trend suggests that deprivation of human development factors might not be necessarily equal in all dimensions and easily predictable. Thus, it is possible for children living in households surviving above the poverty line to be deprived in terms of health services, food or education.The statistics based on survey data produced by UNICEF (2009) on the status of Zimbabwe’s children’s nutrition, health and education are shown in Tables 3, 4 and 5 below. This information was a more reliable status of children during the formulation phase of the NAP 2 and Manicaland Cash Transfer Pilot Programmes. There are other several sources of varying levels of credibility who publish similar reports but they often rely on trend data interpolated from other secondary sources. Table 3: Nutritional Status Zimbabwe 2009Basic IndicatorsPercentage % of under-fives suffering from moderate to severe underweight (WHO)12% of under-fives suffering from moderate to severe underweight (NDHS- WHO)16% infant with low birth weight11Source: Country Statistics (UNICEF Zimbabwe 2009).Underweight in children is largely a result of food shortage and malnutrition and is associated with a weak immune system which makes victims susceptible to diseases and ailments. This is a huge threat to early childhood development. The percentage of underweight children represents potential or already existing health (both physical and mental) deficiencies. Children born to undernourished mothers are also likely to be underweight themselves. This trend may justify the targeting of households with food relief efforts rather focusing on children only. Table 4 below show the health status of children in Zimbabwe. Table 4: Health Status Zimbabwe 2009Basic IndicatorsPercentage % of under-fives with suspected pneumonia taken to an appropriate health care provider25% of under-fives with suspected pneumonia receiving antibiotics16% of under-fives with Diarrhoea receiving oral rehydration and continued feeding35Source: Country Statistics (UNICEF Zimbabwe 2009).A considerable percentage of children under the age of five are failing to get professional medical attention. Most of physical and motor skills development as well as neurological maturation happen under the age of five. Therefore, poor nutrition coupled with untreated illnesses is likely to negatively impact on the children’s human development. Despite infant mortality, children who do not receive proper medical attention are most likely to grow up with underdeveloped and retarded physio-motor and intellectual abilities.In Table 5 below, a discrepancy in enrolment versus attendance ratio for both primary and secondary school going children can be noted. Table 5: Education Status Zimbabwe 2009Basic IndicatorsPercentageMaleFemalePrimary school enrolment ratio8991Primary school attendance ratio9092Secondary school enrolment ratio3939Secondary school attendance ratio4643Source: Country Statistics (UNICEF Zimbabwe 2009).Unlike situations were children are totally out of school, this gap represents potential factors that affect access to education even in cases where there is a desire to be educated. Access to education is very low in secondary education. Factors leading to these phenomena might be an area that requires further research as these are crucial factors that need not be ignored in designing interventions to fight child poverty. The basic requirements for human development (food, health and education services) are not totally independent of each other but are interdependent to a greater extent. Some empirical evidence shows a correlation between availability of food (nutrient supply) and human development in terms of physical and cognitive maturation. Children with a history of malnutrition were seen to have a low IQ and scored less in other cognitive competence tests as compared to matched groups although it is believed that the social environment in which the under nutrition has occurred also contributes to the condition (Pollitt 1990). More recent studies also suggests that Poorly nourished children and or those who are often sick are likely to have their learning capabilities affected, resulting in poor grades in school (Gani and Prasad 2007). Even children who are well nourished but have missed vaccinations are also prone to diseases like polio, measles and Tuberculosis which may make them miss school or lead to drop-outs in extreme circumstances. A study done by Miguel and Kremer (2004) in Kenya revealed that deworming of children increased school attendance by a significant percentage. Other elements postulated to be essential on human development outcomes such as the availability of portable water and proper sanitation facilities at home and in schools also go a long way in preventing children from diseases. Communicable diseases like cholera are a major threat to children’s education especially in urban areas in Zimbabwe. Thus tackling deprivation cannot be an effort directed to a single or particular factor but an approach that fulfils the backward and forward linkage relationships among adequate nutrition, access to health services and education. It may also require different targeting combinations that include households and general public provisioning.This chapter has shed more light on the concept of cash transfer and child poverty and how these concepts relate to each other in the context of a household, followed by the current status of childhood poverty in Zimbabwe. In summary, the ecological approach to child poverty recognises that child poverty is embedded within the structures of a household, thus, efforts to alleviate child poverty should target the household. However several issues have been discussed to highlight problems associated with this kind of conceptualisation, which range from the multi-dimensionality of forms of child poverty to the multi-dimensionality of the sources of child poverty. The next chapter presents, examines and discusses the formulation and design of the two pilot OVC cash transfer programmes in Zimbabwe in light of the accumulated understanding of cash transfers and child poverty.Tackling Child Poverty in Zimbabwe: The Case of Cash Transfers Cash transfers based social protection for children is not a new concept in Zimbabwe. During the colonial period, some form of social protection in form of social assistance and occupational pensions were in place even though they were much limited to the minority European population (Kaseke 1988). After the country got its independence in 1980, issues to do with general protection of children have received recognition by the legislature but enforcement has always been a problem. To date, efforts to promote children’s access to basic rights are not constitutionalised and have been largely implemented as part of national policy objectives. This means that the government has no budgetary obligation for the promotion of children’s rights but can do so if funds permit. The government through the MoPSLSW manages social insurance and provide social assistance to citizens but shortage of funds has made the programmes inadequate, with social assistance (mainly cash transfers) almost non-existent.Interventions and policy around child poverty in Zimbabwe seems to Centre on two main viewpoints or varying combinations of both. The first is that children are poor because they live in income poor families (Income approach), and secondly, children are poor because of unavailability or scarcity of resources required for their survival and development both within and outside the family or household (Deprivation approach). Hence, Schubert (2010) argued that a child sensitive social protection approach in Zimbabwe does not have to ignore the needs of other categories of people in the household such as the elderly and the unemployed. As such, using Orphans and Vulnerable Children as the main targeting priority ignores the importance of the role of caregivers as essential, and blocks a comprehensive social security program. Such kind of an orientation point to the fact that poverty of the household has some direct impact on the well-being of children, and that efforts to tackle child poverty should be directed towards the household. Under the two approaches, it means that children are not directly engaged as independent agents but rather indirectly considered through their membership to households. Contrary to this, contemporary social theory advocates for the recognition of children’s citizenship in development. Janoski (1998: 9) defined citizenship as “passive and active membership of individuals in a nation state with certain universalistic rights and obligations at a specified level of equality”. This definition recognises agency, personhood (as opposed to belonging) and equality of persons within a state. Universal rights involves the realisation of civil (legal), political (associated with political participation such having influence on policy), and social rights (welfare and security provided through schools and health, social services) (Marshal 1950). Recent positive developments include the recognition of limited citizenship as one of the five major poverty traps in the Chronic Poverty Report of 2008 (CRCP 2008). Earlier in 2005 the UN Programme of Action of the World Summit for Social development included an aspect of limited citizenship in its Characteristics of poverty as “[…] lack of participation in decision making and in civil, social and cultural life” (UN 2005: paragraph 19). Going back to the definition of Human Development in Chapter One, the concept of citizenship is therefore closely tied to the political freedoms and human rights necessary for the attainment of human development.Considering children’s rights as not paternalistically conferred, but realising children’s passive and active citizenship is another lens for conceptualising child poverty and deprivation and visualisation of an alternative approach to interventions. From this view, there is need for the fulfilment of children’s rights (including the right to food, education and health services) on the part of the state regardless of household economic status, but by virtue of passive membership to a nation. Even though children have limited active participation in politics (lack voting rights), there are various ways in which they can be consulted on issues of policies affecting them, and the concept of Junior Parliaments is one. Efforts should also be made to address all forms of political, social, and economic resource inequalities that inevitably affect citizenship. National Action Plan for Orphans & Vulnerable ChildrenOne of the major nationally coordinated interventions on disadvantaged children of the 21st Century in Zimbabwe was the National Action Plan for Orphans and Vulnerable Children (NAP for OVC). In 2005 the NAP for OVC was tabled (MoPSLSW 2005). Its core activity areas were: Coordination of effort, Child Participation, Birth Registration, Formal Education, Social Services, Extra Curricular Education and Livelihoods and Child Protection. The first phase took off in 2008 and ended in 2010 under the Ministry of Public Service, Labour and Social Welfare, National Aids Council, and UNICEF. Implementation was basically strengthening the supply side through non-cash resource transfers and executed through a network of civil society organisations countrywide. The second phase ( NAP 2) led by the GoZ and mainly funded by UNICEF, and governments of The Netherlands, United Kingdom, Sweden and the European Commission was launched in 2011 and is expected to run up to the year 2015. It is basically focusing on strengthening the household economy, child protection, access to basic services, and programme coordination and management (MoPSLSW 2010). In May 2010, a study on Child Protection and Development commissioned by UNICEF made recommendations to move from the supply side (NAP 1) to demand side interventions towards addressing child poverty (NAP 2). Cash transfers are a growing social protection strategy as several governments and the donor community moves from the traditional supply side and charity based interventions. The report of the study entitled “Child-Sensitive Social Protection in Zimbabwe” by Schubert (2010: 6) pointed out that 55% of Zimbabweans live in extreme poverty and half of them are children, who are living under extreme deprivation. The first proposed action was redirecting the Program of Support for the NAP 1 from directly targeting OVC towards targeting approximately 1 250 000 food poor households and lifting them from extreme poverty through cash transfers, while also preventing those vulnerable from falling into extreme poverty. There are two pilot programmes carried out to date: The NAP 2 under the GoZ through the MoPSLSW and the Manicaland OVC Cash Transfer Pilot Programme carried out by Catholic Relief Services (CRS) an independent faith based organisation together with the Biomedical Research Technical Institute (BRTI). This study is drawing conclusions from the information gathered on these two programmes.The NAP 2 and CRS-BRTI Cash Transfer ProgrammesThe NAP 2 Programme main objectives are to improve household incomes and access to nutrition, health and education for orphans and vulnerable children. The programme also aims to create a protective environment for children whilst coordinating all efforts directed at promoting children’s well-being nationally. This is translated into four strategic pillars (and key result areas) namely: Strengthening of the household economyChild protectionAccess to basic servicesProgramme coordination and management.The key result areas of the second phase of the NAP are very broad and are expected to be staggered between the periods from 2011 to 2015. Table 6 below shows the estimated cost breakdown of the NAP 2 Programme. Table 6: Cost Breakdown for NAP 2 ProgrammeStrategic PillarShare in TotalCost, USDStrengthening the household economy30%101,520,000Child protection17%58,570,000Access to basic services48%162,500,000Programme coordination andmanagement4%13,750,000Total Budget100%336,340,000SOURCE: NAP 2 Programme Document (MoPSLSW 2010: VIII)Strengthening of the household’s economy is meant to make households more resilient and respond positively to meet the needs of children within them. This is expected to be achieved through disbursement of cash income beginning with approximately 250 000 poor families and expected to spread across all the poor households countrywide. Access to services for children will also be further strengthened through Assisted Medical Treatment and the Basic Education Assistance Module (BEAM). These strategies are used separately or in combination depending on the situation befalling the households and or children. The results of this study shows that it is possible for a single household to benefit from both income support and assisted access or from only one of them, with different impacts on the welfare of children.The targeting categories of the NAP 2 are shown in Figure 3 below. They are intersecting between the level of household poverty and the availability of economically active people within the household.Figure 3: NAP 2 TargetingConsumption per person225552027940001409692794000 14097014541400 Absolute poverty line 78% 400 000 Households 100 000 Households 14097013652500 Food poverty line 55%1 250 000 Households 250 000 Households Eligible for cash transfer1409708127900Low dependence ratio High dependency ratio dependence (Households with labour) (Households without labour) ratio Source: Request for Proposals, Child Protection Fund for NAP 2 (MoPSLSW and UNICEF 2011: 12).It is estimated that about 55 per cent of Zimbabwean households live below the food poverty line of which about three million are children (MoPSLSW 2010). Assuming a dependency ratio of 3, this suggests a figure of about 3 million severely food and services deprived children living in between 1 200 000 and 1 250 000 households. About one fifth of the households are labour constrained and qualifies for income support (ibid.).The cash transfer programme undertaken by CRS-BRTI had similar objectives and it also aimed at adding knowledge to cash transfer programming in tackling child poverty prior to the launch of a nation-wide programme. Its specific objectives were to:Improve personal identity and access to services, that is facilitating birth registration for the under 5 from 38% to 63%,Reduce infant mortality through scaling up immunisation/vaccination from 54% to 84%,To increase school attendance of children aged from 6 to 12 from about 72% to 89% (CRS 2009).The objectives were going to be attained by cash transfers to 2 846 households (reaching 5 771 OVC) and distribution of agricultural inputs to 1423 households housing 2 886 children. The cash income and food production support had different beneficiaries in order to capture differences in the outcomes. This study focused only on the cash transfer programme. The targeting (beneficiary selection) criteria of the Manicaland Cash Transfer Programme showed some great resemblance to the NAP 2 strategy. It was based on household demographic and wealth index data produced from a baseline census conducted by CRS in 2009 and reflects some preference of labour constrained households. Those who qualified met the following criteria:The poorest households falling within the last 20% at baseline (Wealth Index)Households with at least one orphanHouseholds whose head is above age 60Child headed household at project inceptionHousehold headed by a chronically ill person, and Household with a disabled member.The selected beneficiaries are households with very low endowment in terms of productive resources. A prior household economic survey used to select the beneficiaries of the Manicaland Programme revealed that these households lacked capital assets such as labour, livestock and a reliable and stable income for their upkeep. This condition justified the need for social assistance in the form of income support directed to these households.Programme ImplementationThe NAP 2 pilot programme was implemented in a single ward in the Goromonzi District of Mashonaland East Province. It began in February 2011 and was expected to run for six months until July of the same year but abandoned before the planned end date due to undisclosed reasons. Efforts to get official information about the implementation plans and evaluation reports through the MoPSLSW were fruitless. A formal application to access the documents was turned down. A field visit revealed that only a single transfer was made even though the beneficiaries had a lot to say about the project. The Manicaland Cash Transfer Pilot Programme was implemented from December 2009 to February 2011and managed to assist 12 155 OVC from 4 083 households in three districts of Manicaland province: Nyanga, Makoni and Mutasa (CRS 2011). The disbursement per household was between USD 22 (a fixed amount of USD 18 plus USD 4 per child) and USD 30 (a maximum of 3 children based on the dependency ratio of 2.26 children) made after every two months. The amount of money given was uniform irrespective of whether the child is in primary or in secondary school or whether he or she is disabled or not. It was not mentioned in the Programmes whether the amount of monthly disbursement was indexed on general prices of commodities at current rate of inflation or not. According to government statistics, the annual rate of inflation (consumer prices) for the year 2010 has been 4.2 on average (Reserve bank of Zimbabwe 2011: 22). Inflation has been generally stable since the adoption of the USD as the official currency. Month to month inflation rates for the year 2009 and 2010 are shown in Appendix B (Reserve bank of Zimbabwe 2010 and 2011).Apart from the cash support project, there were other forms of assistance already going on in the areas of study (Mutasa District). The BEAM programme being the one with national coverage. In a survey carried out in May 2010 by the Manicaland HIV/AIDS Prevention Project, it was revealed that there were nine NGOs, 4 community based FBOs and one United Nations agency providing HIV/AIDS related services only in Mutasa District (Manicaland HIV/AIDS Prevention Project 2010).Programmatic ImplicationsThe design and implementation specifications of the two cash transfer programmes have got both implicit and explicit assumptions which have a bearing on the efficiency of the programmes. These assumptions are an important factor in the success or failure of the project in terms of the impact on the development of children. Explicit assumptions among others are that the programmes will obtain the budgeted funding in time and that suitable personnel are available. If these assumptions hold true, then the project will be on the road to success. However, looking at the intervention framework and targeting criteria of the two programmes, there are other implicit (hidden or made operational by adopting other options) assumptions that are also important for the success of the programmes. This section will look at the targeting assumptions looking at their major likely positive and negative implications on programming and subsequent impact on children and households. Targeting PrecisionThe major advantage of a Proxy-means testing (using household characteristics which are indicative of poverty such as productive assets) and Categorical (e.g. based on physical status and age) targeting criteria have a higher likelihood of identifying the poor and deserving. Holding other factors constant, the household survey data used in both programmes coupled with community participation in identifying the beneficiaries used in the Manicaland Cash Transfer Project is mostly likely to have resulted in the selection of needy beneficiaries. These approaches are more transparent and are likely to receive public support. However, the selective versus universal targeting strategies debate is an on-going one, especially in situations where the prevalence of those falling in the eligible group is high. The major debate mainly centres on the cost of targeting (associated with identifying the eligible beneficiaries and monitoring), the risk of improper inclusion or exclusion in either case, and the prevalence of the considered factor in the target population (Kakwani, Soares and Son 2005: 34). In this case, considering that more than 78% of the Zimbabwean live below the absolute poverty line (MoPSLSW and UNICEF 2011: 12), there is a greater likelihood that most children are surviving under deprivation. Under high poverty prevalence the proxy indicators becomes weaker. The general observation by experienced practitioners is however that targeting errors of inclusion and exclusion are inevitable in development interventions, but effort should be made to keep them minimal (Taylor and Seaman 2004).‘Trickle down’ EffectThe most important and open assumption is the trickle-down effect of the household income towards improving the welfare and development of children. In the previous chapter it was highlighted that there are several socio-political and economic complexities in the entire ecological system in determining the benefits derived by children from household income. This makes such a prognosis to be not always obvious. Apart from factors within the household, the targeting criteria/strategy of NAP 2 (Figure 3) is also a potential source of exclusion. While this type of proxy-means testing targeting is very good in identifying the poor, the multi-dimensionality of poverty is relatively compromised. In other words, concentrating on economic indicators alone leaves a host of socio-political factors that influence household resources allocation.Full EmploymentChildren living in households with economically active unemployed breadwinners are likely to be left out as beneficiaries, whilst they may be equally deprived as those in labour constrained households. The targeting approach assumes that the economically active population are able to engage themselves in productive wage employment or informal income generating activities. This assumes the availability of jobs and income opportunities and unemployment is basically seen as voluntary. However, the availability of formal or informal employment opportunities or other income generating activities is limited especially in the rural areas where most of the population live. The formal unemployment rate in Zimbabwe is estimated to be above 80 per cent (IILS 2008: 121). With increasing informal unemployment often characterised by low wages and lack of social insurance, even households that are not labour constrained are finding it difficult to have enough income to sustain their requirements. While extending assistance to the economically active population may potentially create a dependency syndrome, the economic standing of Zimbabwe cannot guarantee employment to those who qualify to be employed. This situation therefore means that the cash transfers might not actually be a supplement but may be all the income that a household get: a fact not compatible with the CRS’s line of reasoning which states that the cash extended to beneficiaries should be limited enough so that no dependency is created, and should be treated as a supplement (CRS 2009:11).Dependency LoadAnother potential source of exclusion is the assumption of a uniform dependency across the target population. In cases where all children (including beyond number 2.29) in a household are likely to be equally deprived, limiting the number of children who can benefit within a household greatly affects the effectiveness of the intervention because of exclusion. Some households who took part in the research exercise had up to 5 children. The overall effect is most likely to be a decline in the per capita benefit of the children because the income will be spread among several children beyond the limit set in the programmes. This will result in a diluted impact of the intervention. The Nature of PovertyAnother factor that cans potential propagates exclusion and subsequent threats to programme efficiency is the inconsistent and cyclical nature of being poor and poverty. Households and children may become poor at any moment, for example, due to the loss of a breadwinner or unemployment. On the other hand, household economic status also evolves over unpredicted time periods, which can also be characterised by alternating bouts of extreme to mild poverty. For example, poverty can be seasonal in the sense that farming communities may only have enough food during the harvesting periods but suffer greatly off-season. Considering that assessment surveys and beneficiary selection committee meetings (made up of implementers and villagers) are occasional events, households and children who fell into poverty in between these events are excluded from the assistance sometimes with grave consequences. Recognising children’s citizenship in a rights based approach for example, will to a large extent ensure that children will continue to go to school and seek medical treatment irrespective of the economic status of their households. Despite all the efficiency factors discussed so far in this section, let’s assume that income is available in households that are not labour constrained and that cash transfer are disbursed to labour constrained households with fair distribution among members; the important questions to ask whether there are sufficient and suitable commodities on the market to meet the human development needs of children.Perfect SupplyThe Second Phase of the NAP focuses on improving access to commodities for children through stimulating the demand side. Household income support, medical and education assistance enables households to demand more services for their children. This approach however, works well where there is a corresponding supply side capable of handling the level of increased demand. The beneficiaries of the Cash Transfer programmes who were interviewed during the research indicated that sometimes services centres could not be accessible due to bad road networks and expensive transport fares. Shortage of medicines and understaffed schools are also a characteristic of the health and education service delivery in Zimbabwe. A Zimbabwe daily newspaper reported that the Zimbabwe Ministry of Education, Sports, Arts and Culture officials have confirmed that there are 15 000 vacant teaching posts in government schools countrywide. Of the 111 000 teaching posts filled, 96 000 are occupied by qualified teachers while the remainder manned by unqualified personnel, in worst case by people who do not even have the minimum five ordinary level passes. The shortage of teachers was said to be worse in rural areas (The Herald 2011). This brings in the issue of quality and adequacy of services. Such response failures (in Sen’s terms) suggest some potential threats to the efficiency and effectiveness of the demand based cash transfer programming aimed at promoting children human development.Programme Evaluation ResultsIn the face of a number of programming issues discussed above, the Evaluation report of the CRS reported some success of the Pilot Cash Transfer Project. The following are some of the major outcomes that were observed:Children from benefiting households were likely to have a birth certificate (from 46% to 85% of 0-4 aged children), been vaccinated (from 64% to 94% had taken required doses), regularly attend school, and have school uniforms;Some households managed to buy small livestock such as pigs and chicken (CRS 2011: 9)The report concluded that cash transfers are “…a practical and effective strategy for improving child well-being and development in a holistic manner amongst OVC in Zimbabwe.” (ibid: 10). Despite the convincing prima facie evidence of success in this programme and those carried out in other countries, there is need to gather more evidence on the advantages and disadvantages as well as cost effectiveness of cash transfers over the conventional supply side strategies like food distribution. The use of conditional versus unconditional cash transfer also remain controversial as some evidence suggest that despite conditions, general improvement in human development factors are visible under the free reign approach (Schubert and Slater 2006). Other evidence gaps include the impact of the cash transfer approach on the local and national markets and the overall economic related growth; and how such support can be mainstreamed into social protection mechanisms of developing states such as Zimbabwe. The next chapter presents and discusses the findings gathered from the beneficiaries (caregivers and children) of the cash transfer pilot projects. Chapter 4 The ‘Story’ Behind Zimbabwe CT and Analysis of OutcomesThis chapter presents the beneficiary’s account of the two cash transfer programmes. These are stories of most significant changes that resulted from the income support from the perspectives of the caregivers and children. It provides a critical analysis and discussion aimed at establishing the impact of the cash transfer programmes on households, and the extent to which they have gone towards children human development through improving children’s access to education, health and nutrition. 4.1 The Stories of Most Significant ChangeThe Story of CaregiversThe most significant change stories reported by the caregivers are presented in seven categories as shown in Figure 4 below. The age range of respondents is 25 to 60 years and each had between one and five children under their custody. The response and demographic data of the caregiver households is given in Appendix C.The cash pay-outs of an average of USD26 were made after every two months in Manicaland translating to about USD13 per month for a household with an average of 4 people including children. A single payment of a similar amount was disbursed in Goromonzi District. The significant stories (probably tangible or distinct benefits of the income) show mainly a use of resources towards commodities of a collective benefit to the household such as food, repaying debts, and blankets. This suggests an economic household model that cannot be truly unitary, where all individual need receive a fair share or bargaining, where each individual bargain for a share to meet his or her needs. This poses some challenges on the trickle-down assumption in which needs of children will be met at an individual level under the cash programme. Three out of eleven caregivers specifically mentioned the ability to purchase foodstuffs as their story of most significant change, while the remainder also mentioned varying degrees of improvement in food availability. In other words, all the caregivers who took part in the research reported that they were able to buy foodstuffs in some way with the money they received, especially those foodstuffs that are not available in their gardens (mainly groceries). The groceries included maize meal, cooking oil, laundry soap, salt, and wheat flour. As one elderly woman in his early 60s put it, “putting food before the children is the only way from keeping them away from staring at you”. Figure 4: Most Significant Change Stories (caregivers)While the caregivers reported that the money enabled them get commodities they could not necessarily afford before, the majority (7 out of 11) indicated that the money is insufficient to meet the basic household requirements between disbursement periods. This figure includes 3 who could not specifically zoom in to what they can call significant changes but do appreciate that the money they receive from the programme as better than nothing. The insufficiency of money disbursed under cash transfer programmes was also reported in Kenya’s pilot cash transfer program that commenced in three districts in December 2004 ( Bryant 2009: 68). Under this program households were given an equivalent of USD6.5 per month (ibid.). Some households showed some preference for spending the money in productive activities rather than only on consumption. Maize is the staple food in Zimbabwe and most families targeted by the income support programme dot not often have the capacity to produce enough to meet their needs. They often lack inputs such as seed and fertilizer. In as much they want to buy school equipment for the children with the money they got, they still feel that there is need to invest in food production rather than relying on buying from the market. One family reported that it was able to hire labour for weeding a maize field. “[…] we always rely on what we harvest (maize) for our livelihood, it’s better to exchange maize for other food products because monetary prices are always changing” said a 60 year old grandmother who looks after two grandchildren and her husband. This shows beneficiaries concern on building their own sustainable endowment in order to strengthen their livelihood. It therefore seems equally important to consider an intervention that also improves the productive assets of poor households such as arable land and farming inputs. Such an intervention is potentially effective in the long run as households may be able to handle economic risks such as inflation because the produce can serve as a store of value as suggest by a women interviewee quoted in a few sentences above. Prioritising and investing in food production was also the case observed in an independent evaluation of an emergency cash transfer programme of Kalomo District in Zambia (Harvey and Marongwe 2006: 28). Apart from buying food, beneficiaries in Kalomo used some of the transferred money for land clearing and cultivation and labour costs for harvesting. Investments in other productive assets such as goats for breeding were also reported as a positive impact in Kalomo District (DFID 2005b: 18).The disbursements also significantly helped caregivers meet other household requirements. As shown in Figure 4 above. A female beneficiary pointed out that she was able to service her debts with the local schools and a grocery shop while the other was able to buy blankets. One interviewee pointed out that cash income has enabled her to choose among several priorities because money is actually a medium of exchange for most of her monthly household requirements; “[…] if I have cash I can keep it [or save it] and use it for any need that arises in future”. In her narration the women said that she always do piecework but paid in form of cash approximately 50 per cent of the time. Another caregiver said that the cash transfer was useful for seeking medical attention for his diabetic wife. The most significant changes raised by the respondents might be in another perspective seen as burdens which worries them; probably areas important for their survival which they always strive to fulfil. A probe for further information related to children’s human development elements revealed that almost all caregivers (10 out of 11) manage to send children in their custody to school even though some confirmed that their children’s attendance is not consistent due to failure either to pay tuition fees in time or afford other extra levies. In one of household a boy aged 16 who was supposed to be in secondary school had dropped out to pursue some kind of paid work. Five households in the research had some of their children on BEAM while the remainder had to pay tuition fees for children on their own. About half of the respondents did manage to buy some stationery for their children; but this does not include textbooks which were reported to be expensive and not always enough especially in secondary schools. Only a few (about one third) of the caregivers have sought professional medical attention for children under their custody during the span of the cash transfer programmes. Visits to health centres were mainly for regular vaccination and children monthly growth monitoring and health check-ups. For those who had illness related consultations, some reported that they couldn’t afford to buy the prescribed medicines. A grandfather said he could not afford regular check-ups at the provincial hospital for his asthmatic granddaughter. The majority of the caregivers (three quarters) have treated their children at home. The children could have suffered some mild to moderate ailments with some reported to be chronic such as asthma. The major reason attributed to home treatment has been unavailability of transport fares to referral hospitals as the local clinics could only provide limited services and sometimes have insufficient or inappropriate drugs. There were no major differences in the ideas of change and opinions observed between responses from the two Districts studied except that the programme in Goromonzi district made only one disbursement covering two months compared to the Mutasa District programme which covered 14 months. As the period covered increases, the households were able to transact on a bigger variety of commodities. A look at the response matrix suggest that female caregivers in the research showed much concern on food security, for example by buying or by hiring labour to work in the fields, while their male counterparts also considered other needs such as blankets and medical services. One female caregiver reported to have experienced some challenges on how to use the money she got from the programme. The issue was mainly on differences in food related priorities with other male adults in the household. The cash transfers were not the only source of income for most of the households. Apart from piecework, it was noted that other sources of income for the poor and labour constrained households include occasional remittances from relatives and other members of the household who work elsewhere. There are also occasional donations from other villagers and the church. Technically this introduces a margin of error in the changes that can be attributed sorely to the cash programme. Involving the beneficiaries in the study was part of measures to minimise this error as respondents were asked to focus only on changes they feel are related to the cash transfer programme. Generally, the cash transfer programme has brought hope to the beneficiaries because of its reliability than other sources. However, the beneficiaries are sceptical about the continuity of the project. The income support project has also been generally welcomed by the interviewees as an addition to other support packages (e.g. Home Based Care for HIV/AIDS patients) offered by other donor agencies in the districts studied. The Story of ChildrenThe children living in beneficiary households shared almost similar sentiments as caregivers. The children interviewed largely measured the success of the cash projects based on the availability of food and how the households have been able to respond to their educational needs. Figure 5 below shows a summary of the children’s stories of most significant change. The demographic data and response matrix of the children is attached as Appendix D.There were only seven major categories of the stories told by 11 children. As seen in Figure 5 below, household food status was among the leading concerns of children. Three children pointed improvement availably as their most significant change story. Food availability has been reported in three forms as shown in Appendix D. First, four of the children interviewed said that they are getting enough food in the sense that food is not an issue of immediate concern to them and their households. These children can be described as mildly deprived and looked satisfied by the amount of food available to them though it is difficult to objectively attribute the adequacy of the food sorely to the cash intervention. A second sub-category concerning food is comprised of 5 children who reported that food availability has improved in the household since the inception of the cash transfers although they have not yet achieved mild deprivation level but mostly fit into moderate to severe deprivation. One 12 year old girl showed some appreciation in the improvement of food availability in her story: “…on that day [one of the day the household received the cash] my aunt bought peanut butter and dried carpenter fish for us […] yes its better”. The third sub-category is composed of three children who could not particularly comment on changes in the food status within their household prior and after the income support programme. Another considerably larger proportion of children failed to actually pinpoint at least one significant change that has occurred in their lives as a result of the cash income intervention. One interviewee, a secondary school going boy aged 17 narrated his ordeal with a tone showing doubt and hopelessness after failing to point any significant change he realised from the program; “…my life hasn’t been the same [since mother’s death two years ago] I got assistance from other 2 organisations that come and go. The family don’t have enough to eat, and clothes, sometimes we fail to go to school because we don’t have soap to wash our clothes...”Figure 5: Most significant change stories (children)Out of the three cases that did not have a story of most significant change, two were not aware of the programme and its aims. This suggests that there were very few if not zero chances that they would have been consulted on how the income was to be distributed. This limitation to children’s right to participation in matters affecting them is often a result of their relatively low structural power in households. Actively engaging children (through awareness and participation in beneficiary selection) in the programme might improve their position as bargaining partners in household resource allocation.Of the 7 major categories of children’s stories of significant change, 3 were related to education. One primary school child reported to have a school uniform purchased for her, a 17 year old secondary school pupil managed to pay his exam fees while other managed to secure stationery. The school stationery acquired was mainly exercise books, pens, and other accessories but excluded text books. Of the total children interviewed only one was out of school, and 4 of those in school were on BEAM. The other 4 had their school fees paid by their parents/guardians. The majority of secondary school children were not receiving any form of assistance from outside the household. There were no significant differences in the stories of significant changes from children between boys and girls, although secondary school going children were much worried about getting school material such as textbooks and exam fees than their primary school counterparts.None of the most significant changes reported had anything to do with the children’s health. However, a further probe revealed that although none of the respondents had been hospitalised during the period of the programme implementation, at least two had sought some professional medical assistance and treatment while 3 (and in about 3 thirds of the caregiver households: Appendix C) had been treated for minor to average ailments such headaches, stomach pains and fever at home. The research showed that health concerns are of a little worry to caregivers and children. What makes health look unimportant is not clear but the low incidences of ill-health among the children is a plausible factor to attribute such a trend. A scan of the available information on the state of primary health care in Zimbabwe showed that immunisation against diseases has increased by 11 per cent since 2005-6; with at least 62.1 per cent of children aged between 12-23 months who lives in the rural areas having received all major vaccines (Zimbabwe National Statistical Agency 2011:14). The Demographic Health Survey (ibid: 16) also showed that an average of 35.6 per cent (of the total cases covered in the survey) of children of up to age 59 months sought treatment from a health facility for diarrhoeal infections within two weeks prior to the survey. Despite improvements in vaccination against diseases and low illness rates among children of school going age, the prevalence (including an unknown number of those infected but did not seek treatment) of diarrhoea in rural areas signifies low sanitation standards and presence of health risks, a major threat to the development of children.The children showed concern for their individual wellness and their current personal development opportunities as they believe it will translate them to being productive adults. This suggests the children’s concern over breaking the poverty cycle by growing up normally and being educated so as to get well-paying jobs in their adult years. Children’s concern for human capital development is also reflected in the findings of an earlier research (Figure 6 below) done in Zimbabwe in 2005 which was investigating the major worries of OVC (FACT and UNICEF Zimbabwe 2005). Figure 6: What worries OVC most?Source: Baseline Operation: Community Based Support to Orphans and other Vulnerable Children (FACT 2005)Generally being orphaned is a major concern to most children. Orphan hood is a major threat to their access to food, education, shelter and health. Children understand that this deprivation propagates poverty and affects their present status while reducing their prospects to grow as productive adults. In this research, the importance placed by the children on education and educational accessories, food and clothes probably suggests that the absence or lack of one of these variables is most likely to be interpreted among them as a state of being poor and poverty. 4.2 CT and Children Human Development OutcomesThe information gathered in this study has shown that cash programmes are a potentially viable strategy towards child poverty alleviation. Caregivers, who in most cases are also household heads, show some concern on keeping the households going in terms of making food available, making sure that children are healthy and do attend school. Children on the other hand, were seen to be concerned about getting enough food and attending school as well as school accessories such as stationery and school uniforms.This section revisits child poverty alleviation in the era of cash transfers in light of the practical programming implications together with the viewpoint of the beneficiaries in Zimbabwe. This tri-aspect analysis provides an insight into the extent to which Cash Transfers have improved children’s access to food, education and health services. Access to FoodIn this study both caregivers and children have reported food availability as the most significant change that has occurred since the inception of the cash transfer programmes. There were basically two ways that emerged from the interviewees through which household food availability have improved; either through investing in production, or buying the food from the market. At national level programming, differences in soil types, amount of average annual rainfall and other weather related factors among regions are crucial to food production and need to be embraced in planning.Food procurement seems to be among the top ranking household priorities and tends to correlate positively with an increase in disposable income. Despite the fact that the benefiting households were already considered to be food poor, this trend suggests that food may be readily available to children as the household income increases. Improvements in food availability as measured by amount and number of meals per day among OVC were also noted in Kenya and Zambia under cash transfer programmes carried out in 2004 and 2005 respectively (DFID 2005b: 15, 18). While improvements in quantity does not necessarily mean improvement in nutritional value of the food, further research is needed to determine whether the children do get enough combinations of nutrients and minerals that promote their physical and mental growth.The dependency ratio of 2.29 used in the programme design may not be a true reflection of the composition of rural households. This is because in some cases the income will be far much stretched by the size of household members as shown in the demographic data in Appendices C and D. Some households had more than 4 children, excluding adults. However as much as it looks obvious that the size of the households affect food adequacy considering the limited amount of food the disbursement can buy, caution is given on this proposition as different methods on estimating consumption per person yields different results (Lanjouw and Ravallion 1994). Looking back to some nutritional statistics in Table 3, it might also be important to take into cognisant the prevalence of underweight children in the target population. With a national prevalence rate of 12-16 per cent, it is most likely that the majority of underweight children are found within the programme’s target of food poor households. Using a uniform dependency alone might lead to exclusion of some underweight children form benefiting. The general food security situation in participating households as presented by the beneficiaries suggests a moderate deprivation. Food is undoubtedly a major factor in the development of children as it is linked to improved health, school attendance and learning abilities. Therefore, food security should be given much priority in improving children human development and poverty alleviation in general. Access to EducationEducation, probably the second human development concern after food availability in households, can potentially be responsive to an increase in income as revealed. But in this research study some children from benefiting households were on BEAM. Their significant change stories were not directly related to actual tuition fees which will allow them to enrol into school. The situation can be expected to have different results if prior assistance was not available. Nevertheless, the rate of school enrolment in both primary and secondary level among the interviewees was impressive. Education is not only viewed as a consumption good but also as an investment (future employment prospects and better income) by both caregivers and children. However, caregivers from households seem to be preoccupied much by making sure that the household survives through the availability of food before turning to such needs. Generally, the condition of deprivation in terms of education can be considered to be minimally moderate as some children still fail to secure schooling equipment such as stationery. Educational needs of children are aged based as the research suggest. This means that individual education needs are ever evolving. The interviews established that the difference between household compositions of children in terms of age has a bearing on the adequacy of the transfer amount. For example, those households whose children are in secondary school require more in terms of school resources (notably textbooks and exam fees) as compared to those with children in primary school. On the other hand, younger primary school going children may face difficulties in travelling long distances to school. Thus, affordable, accessible, and better equipped schools (e.g. where textbooks are available) are likely to sustain attendance and offer better learning opportunities for children. Acquiring education during childhood in poor households may depend on how households arrange their labour according to information gathered from the interviews. Labour is the major economic resource usually held by poor families to be readily exchanged for an income in times of need. Children as young as 15 years old may be active in casual employment to augment household income. This may affect their development in terms of learning; although some may still recognize the importance of education and by paying for their education with income they get from employment. A female caregiver admitted that children sometimes miss school not because she can’t pay for their tuition fees but the children had to work to earn money for survival. A 17 year old boy doing his last year in secondary school said that the cash transfer scheme has helped him add to what he had already earned to pay for his examination fees as his most significant change. He however said that earning money is seasonal as children always do jobs that are associated with the rainy season such as herding cattle and weeding people’s fields. Some evidence from the research also pointed out that children do not always look up to their parents or guardians for their development needs but can also try to engage in employment at their own will. In both cases, it can be seen that although child labour defies the norms of the traditional models of childhood, it is prevalent as a way of coping with poverty in low income households especially were adult labour is limited. Thus, holding other ecological factors constant, an injection of income up to a certain level into the households will see children having more time to go to school than engaging in paid employment. This triangular relationship of child labour, household income and education is consistent with findings of researches carried out in Brazil in 2003 and in 2008 on the effects of household income on child labour and education (Cardoso and Souza 2003, de Carvalho 2008). Brazil’s Bolsa Escola (now Bolsa Familiar) Conditional Cash Transfer Programme was nationalised in 2000 aimed at reducing child labour whilst increasing school attendance. Apart from some positive results recorded, it was also noted that the amount of income forgone by children was actually more than that received form the programme (Gustafsson-Wright and Pyne 2002), suggesting that it is possible for household income support to reduce child labour and make improvements in school attendance even where no conditions exist.Promotion of Child HealthThe absence of disease and illness is undoubtedly a requirement for human development. While the income under cash transfers went a long way in augmenting household food availability, the study revealed that it has not significantly improved access to health services, especially in terms of affordability of drugs. There are also challenges of supply and adequacy of medical services and medicines. The information drawn from the interviews also suggests that service fees are not the only expenses incurred; exorbitant transport fees charged by operators to the provincial hospital also hinders access to health facilities. The majority of caregivers who took part in the research reported to have treated their children at home for some minor to average non-chronic ailments, while the minority remainder had sought professional medical attention for their children during the period the programme was being implemented from either a clinic or a hospital. As shown in Figure 5 above, little mention was given to the health needs as most significant changes by the children. The incidences of failure to access medical treatment show that diseases and general illness are most likely to put children at risk of malfunctioning. Children are likely to miss school or succumb to treatable diseases, a major drawback in human development.To conclude this chapter, lack of sufficient access to services such as education, health care and other social services contributes to low children human development outcomes in Zimbabwe. The overall observation is that in a monetised economy, cash is the main driver of human livelihood and development. Social assistance in form of income support is essential to households who are labour constrained including those who cannot earn up to the minimum living standard. This study has shown that both caregivers and children are much concerned about children human development. However, in spite of the cash intervention, their demand capability and access to food, education, and medical services is still inadequate on average. Chapter 5 ConclusionThe Zimbabwe’s second phase of the NAP for OVC dubbed ‘Child Sensitive Programming’ puts the family at the core of tackling child poverty and vulnerability. Income and economic strengthening of households through Cash Transfers to the households where OVC are found is one of the major interventions in the programme. As such, this research aimed at examining human development outcomes by specifically looking at the extent to which the design and implementation of the National Cash Transfer Progammes has addressed issues of children’s access to food, education, health services. Other aspects included an efficiency analysis, which is the programmes potential to achieve intended goals by looking at its overall design, as well as examining the overall impacts on the livelihoods of households. This study draws conclusions from two pilot cash transfer programmes carried out between December 2009 and February 2011: the NAP 2 Pilot Cash transfer Programme and the CRS Manicaland Pilot Cash Transfer Programme. The programme information as well beneficiary’s views in this research suggests that the cash transfers had some mild to moderate impact on children access to food, health and education services. Improving the demand capability of households living in poverty is a promising sustainable strategy towards addressing deprivation of essential needs of children in Zimbabwe especially the availability of food within the benefiting households. In most cases, food availability is often prioritised over other household requirements. Therefore, it is reasonably evident that food requirements of children can be met with increased income more than their education and health requirements. Similar outcomes were also evident in African countries like Kenya (Bryant 2009) and Zambia (Wietler 2007). However, there is also evidence to suggest that cash transfers alone are not sufficient or comprehensive in addressing child poverty. According to the households who took part in this research, the amounts of disbursements are not enough to cover the monthly food requirements or other non-food expenses such as education and health especially towards children. The account of the beneficiaries showed that not all children deserving professional medical attention received it. Among those who manage to seek professional medical assistance, a considerable percentage is failing to afford or procure prescribed medication. Access to education is significantly high among the benefiting households. However, attributing this status to cash transfers is largely problematic due to the presence of the BEAM programme in which several households were also beneficiaries. Even though, most parents and other caregivers are still failing to provide other educational accessories such as uniforms, text books and exam fees especially for secondary school children. Thus, disbursements based on realistic food, health and education requirements at prevailing costs will tangibly improve the human development of children. As with the availability of food and health services, the quality of education is what really matters in human development. A further inquiry to determine the quality of services available is essential. Economic hardships always forces caregivers to put household survival as first priority before attending to children individual needs. This does not however mean that income is the only good measure of household’s ability to achieve minimum human development formation. The findings here suggest that in most cases food security receives priority over the education and health of children. Literally translating to the fact that besides other ecological factors, households (considering their size) are more likely to escape the scourges of poverty and be able to meet the children human development needs when they attain a certain level of economic endowment and disposable income. In such scenarios children may also afford to forgo work to attend school. Income support programming should therefore adopt a more discretionary approach to determining the size of disbursements made to households. Wealth Index based and a participatory approach targeting used has great potential in identifying the poor. However, there are some negative applied technicalities that pose efficiency threats. These factors are mainly assumptions embedded in programme’s design strategies or challenges imposed on these strategies by the local political and socio-economic environment. The potential for the success of income support as revealed suggest that sometimes it is not that inputs are not capable of producing the desired outputs but it may be the flaws in the process of converting those inputs into outputs or outcomes: a problem of programme efficiency. Fore mostly, while labour is an asset abundant among the poor, its effectiveness relies heavily on the opportunities provided by the greater community to exchange it for income. With unemployment level as high as 80 plus percent, there are high chances that there are deprived children living in non labour constrained households who were excluded from the support. Another clear threat to success is the use of a standard dependency ratio of 2.29. Imposing a ceiling to support given to households is not practically effective. It has been seen in this research that some households far much surpass the dependency limit. The situation in those families is not likely to improve considering the amount of the cash allocation and number of people it caters for. Therefore, it is reasonable to base the disbursement on the actual number of children per household.Child poverty is multi-dimensional, it occurs in a broad environment. It is not only the way the target households are characterised economically but also how their interaction is regulated by complex inter-linkages of the prevailing norms, culture, age and gender only to mention but a few; a fact that need consideration in designing an intervention. These are some important aspects that potentially affect household resource distribution. For example, information gathered in the research revealed a difference in human development requirements based on age. In a nutshell, the caregivers and children indicated some concern especially for failing to afford educational material (text books) and fees for secondary than for primary education. There are also differences in health requirements; immunisation and medical consultation (including treatment when available) for children under five is free of charge while health services for those beyond is expensive. It is evident therefore that future cash transfers for OVC should minimally take into account the age of the children within the households eligible for support. Apart from the demographic characteristics and relationships of members within a household, the other important factor is the availability of opportunities for furthering the development of children from other structures and institutions outside the household.Cash transfers are in nature biased towards improving the household demand for services. However, this approach works well when the services can be legally and adequately available and accessible. Focus should not be only on improving demand but also an equal amount of effort is needed to make sure that services of reasonable quality are made available. This implies an investment in essential services such as food security, health and education delivery system. The beneficiaries of the cash transfer programme (caregivers and children) cited shortages of medicines in local clinics, textbooks in schools and exorbitant transport fees. This scenario obviously stretches the household income available. There should be improvements in doctor-patient ratios and availability of medicine, proper and well equipped schools as well as a good road infrastructure linking the communities with the service centres to mitigate these response failures. Such large scale developments often require coordination at a higher level (sectorial or ministerial level) than the community level. It is therefore practical not to view cash transfers as a panacea to child poverty but focus should be more on how cash transfers can be effectively implemented alongside other development interventions. Hence, ‘Child Sensitive Programming’ should be not only confined to the micro-economics of the households but should be also reflected in national socio-political and macro-economic policies. A rights based approach to child poverty as opposed to a need based approach seems to be comprehensive in terms of dealing with issues of accessibility. Such an approach will ensure equality; the availability of equal opportunity access to food, education and health services for all children as well as increasing government’s accountability towards the development of children thereby enhancing and preserving children’s citizenship.The Cash Transfer programme has been generally welcomed by the people. Apart from direct uses towards the needs of children, the income has been instrumental in helping households on other requirements such as medication for caregivers and hiring of labour. 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Harare: Zimbabwe National Statistics Agency.AppendicesAppendix A: Human Development Index: Dimensions and Indicators.Source: UNDP Human Development Report 2010 (2010:13) Appendix B: Zimbabwe monthly Inflation (based on Consumer Price Index) 2009 and 2010. Year 2010 Year 2009 Note: the monthly inflation average is depicted by the green line.Source: Monetary Policy Report 2009 and 2010 (Reserve Bank of Zimbabwe 2010: 22, 2011: 23).Appendix C: Response Matrix Caregivers.Caregiver StatusFood StatusEducation StatusHealth Status(last 6 months)Other Income SourcesCaseAgeChildrenMost Significant Change Story Could buy foodstuffsFood not enoughChildren on BEAM or other assistanceChildren in schoolAffords stationaryChildren treated at homeProfessional Medical attention Can’t afford drugsCan’t afford transportMoney insufficientRemittances/ donationsvendingCasual labour including childrenFemale255-603Could hire labour to work in the fields√√33√635-403Could buy foodstuffs√√3√√√1040-454No significant change√√14√√√1325-301Could buy foodstuffs√1√√√1540-455Could repay debts√√4√1825-302Freedom to choose what to buy√2√√√Male530-352Could seek medical attention for his wife√2750-554No significant change√√24√√√√√√845-502Could buy foodstuffs√22√√√1145-504No significant change√√14√2235-403Could buy blankets and clothes√√3√√√Appendix D: Response Matrix Children.Child StatusFood StatusEducation StatusHealth StatusCaseAgeOther children in householdChild aware of the programmeMost Significant Change StoryCould get enoughfoodFood availability has improvedFood availabilityhasn’t changedChild out of schoolChild on BEAM or other assistanceCaregiver afford tuition fees Could get stationery excluding text booksChildren treated at homeProfessional medical assistance Can’t afford drugsgirls4162yesImproved food availability√√√√9121noMore than one (food, school equipment etc.)√√162noGot school uniform√√√193noNo significant change√√√Boys1141yesNo significant change√√√3112noCould get clothes√√√12172yesCould pay exam fee√√14101noNo significant change√√√√17160yesImproved food availability√√√200noCould get stationery√√211yesImproved food availability√√ ................
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