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Progresa | Oportunidades a Pioneering National Program Incentiving School Attendance and Healthcare Through Conditional Cash Transfers

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Progresa | Oportunidades a Pioneering National Program Incentiving School Attendance and Healthcare Through Conditional Cash Transfers Contents Full Report Case Studies Summary + Findings Stakeholder Map View Alphabetically P Timeline View Geographically Process Diagram View by Discipline Evidence in Appendices Practice Print MEXICO | ECONOMIC DEVELOPMENT Progresa | Oportunidades A pioneering national program incentiving school attendance and healthcare through conditional cash transfers. By Victor Cervantes and María del Mar Gutiérrez Contents Full Report Case Studies Page 02 of 27 Summary + Findings Stakeholder Map View Alphabetically P Timeline View Geographically Process Diagram View by Discipline Evidence in Appendices Practice Print Progresa | Oportunidades Evidence in Practice Introduction 03 Table of Contents Part I: The Progresa Story 04 The Story of Progresa: The Program and its Objectives 04 Initial Design, Pilot Project + Poverty Measurement 05 Launching the Program 08 Implementing the Program 10 Evaluating the Program 10 The New Federal Administration: 2000-2006 13 Part II: Evidence in Practice: Key Themes + Insights 15 Evidence Definition, Creation, + Use 15 Definition of Evidence 15 Evidence Creation 15 Uses of Evidence 16 Incentive Alignment Among Actors 17 The Role of Timing in the Incorporation of Evidence into Practice 18 Need to Devote Exclusive Time and Resources to Learn About and Operationalize Evidence 18 Importance of Building Trust and Forging Relationships Among Stakeholders 19 The Role of Funders | Shielding the Program 20 Conclusion 20 Image Credits Cover: Bud Ellison Page 5: Enrique Saldivar Part III: Resources Page 7: Eli Duke Stakeholder Map 21 Page 9: Son of Groucho Timeline 22 Page 11: Darij + Ana Page 12: Doris Hausen Process Diagram 23 Page 18: Kashfi Halford Appendices 24 evidenceinpractice.yale.edu Contents Full Report Case Studies Page 03 of 27 Summary + Findings Stakeholder Map View Alphabetically P Timeline View Geographically Process Diagram View by Discipline Evidence in Appendices Practice Print The Evidence In Practice directors. Second, we conducted a matched the complex relationship between “evidence” comparison of eight cases of development and “practice.” These representative research project at the Yale programs or interventions where rigorous stakeholder groups are: Researchers, School of Management, evidence was integrated with varying degrees Funders, Influencers 2, Intermediaries, funded by the William and of effectiveness. This case study is one of Policymakers, Implementers, and Flora Hewlett Foundation, the eight produced by the project. The third Beneficiaries3. was conducted from January component, conducted in parallel to the eight case studies, consisted of interviews Each of the cases thus contains a map of the See the relationship 2016 to January 2018 in with prototypical representatives of each of specific organizations (and individuals) that between the the stakeholder groups, or individuals who defined its evolution, their structural affiliation stakeholders in order to better understand this project in the the conditions under which could clearly describe the typical experience to a stakeholder category (in some cases, stakeholder map. of enacting a particular stakeholder role. organizations played more than one formal, rigorous evidence can be Our synthesis analysis is presented in the structural role), the informal roles that certain effectively integrated into public accompanying report.1 individual actors played, as well as the key policies and non-governmental relationships between these individuals and Stakeholder Characterization organization (NGO) practices organizations. Based on our research, we have found it in the field of international useful to think of the flow of evidence into development. policy and practice as an “ecosystem” in 1 Please see the appendex for a detailed description on Data and Methods. which a set of archetypical stakeholder The Evidence in Practice project followed a groups interact. This set of stakeholder 2 While some of our interviewees identified rigorous methodology comprised of three categories was described and reinforced “Influencers” (such as the media, the general public, lobbyists, and influential individuals) as playing an broad elements: First we conducted an initial by our interviewees throughout the project. important role in the evidence-to-practice eco-system, round of expert interviews with individuals While this is not a perfect description (e.g., this group did not play an explicit role in the narrative who have spent a significant portion of their some organizations fall within more than one of any of the case studies. So we have included the category here, though it does not appear in the professional lives attempting, researching, stakeholder group and individuals often shift stakeholder maps of the individual case studies. or promoting the integration of evidence into across stakeholder groups or play roles that development practice, including academics, effectively span categories), it can help frame 3 We use the term “beneficiaries” to indicate those whom a specific policy or program is intended to government officials, foundation program the conversation to identify the critical roles, help. Different analytic frameworks use various terms to officers, NGO practitioners, and think-tank incentives, and relationships that animate describe this group, including clients, users, recipients, etc. Contents Full Report Case Studies Page 04 of 27 Summary + Findings Stakeholder Map View Alphabetically P Timeline View Geographically Process Diagram View by Discipline Evidence in Appendices Practice Print Part I: The Progresa Story In 1994, presidential elections were held in Mexico. That year, Mexico The Story of Progresa: The Program and its Objectives experienced its highest level of income inequality in the past 30 years.4 Shortly after the winner of the elections, Dr. Ernesto Zedillo, assumed office, The program’s main objective was to disrupt the intergenerational transmission of poverty a profound economic crisis struck the Mexican economy. The crisis had an by encouraging and supporting household especially large impact on the poor. The extreme poverty rate grew from investments in child education. In particular, 21.4 percent to 37.4 percent between 1994 and 1996.5 the program combined health, education, and nutrition elements into a single intervention, At that time, most poverty alleviation programs in which barriers that tend to inhibit the Dr. Ernesto Zedillo creating reinforcing effects between the three. consisted of food subsidies. In 1996, roughly integration of evidence into practice can be In essence, the program consisted of a cash two thirds of the subsidies were untargeted, overcome. First, it demonstrates the ways in transfer to eligible households conditioned generalized price subsidies and more than which embedding evidence into the fabric on continued and demonstrable school three fourths of the subsidies went to urban of a program from the beginning can align attendance by the family’s children, coupled areas, leaving rural areas—where extreme the (often conflicting) incentives of different with routine health and nutrition checkups for poverty was more prevalent—underserved.6 stakeholders and overcome issues related all household members. During the checkups, Food subsidies were expensive, did not to discordant decision-making timelines. nutritional supplements were provided for reach the poor, and were routinely abused as Second, it shows that developing deep children under the age of five and pregnant or tools of political manipulation—for example, relationships with, and engaging a diverse nursing women.7 The cash transfer was given exchanging subsidies for votes. The crisis group of stakeholders can be critical to to the female head of the household, seeking prompted the urgency of supporting the poor developing trust—necessary to implement a to improve the allocation of resources within more effectively within the added constraints rigorous evidence-based program. the family. of a reduced budget. A body of academic literature had been generated before 1995 advocating for a paradigm shift in anti-poverty policy. Building on this literature, Progresa 4 Esquivel, Gerardo, Nora Lustig, and John Scott, 6 Levy, Santiago. “Progress against poverty.” (“Prosperous”) marked a notable departure (2010). “A decade of falling inequality in Mexico: Washington DC: Brookings Institute (2006). from existing social policy in Mexico, market forces or state action?.” Declining inequality in developing a groundbreaking program based Latin America: A decade of progress. 7 Ibid. on targeted, conditional cash transfers. 5 Cortés, Fernando, and Rosa María Rubalcava, (2012) Progresa (later renamed Oportunidades, or El PROGRESA como Respuesta a la Crisis de 1994. “Opportunities”) illustrates several key ways International Policy Centre for Inclusive Growth, No. 169. Contents Full Report Case Studies Page 05 of 27 Summary + Findings Stakeholder Map View Alphabetically P Timeline View Geographically Process Diagram View by Discipline Evidence in Appendices Practice Print Progresa marked a dramatic departure from trade, and development. In the early 90’s, he existing social policy in Mexico. It was the was hired as a consultant for the World Bank first program in Mexico to explicitly combine to evaluate anti-poverty programs in Mexico. the three elements of healthcare, nutrition, In his work, he questioned the effectiveness and education. Progresa was targeted to of traditional programs, such as the tortilla specific families according
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