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Ministry of Community Development, Mother and Child Health REPUBLIC OF ZAMBIA MINISTRY OF COMMUNITY DEVELOPMENT, MOTHER AND CHILD HEALTH SOCIAL CASH TRANSFER SCHEME 24-Month Impact Report for the Child Grant Programme September 2013 Principal investigators: Dr. David Seidenfeld, Dr. Sudhanshu Handa, and Dr. Gelson Tembo American Institutes for Research 1000 Thomas Jefferson Street NW, Washington, DC 20007-3835 | 202.403.5000 | TTY 877.334.3499 | www.air.org Contents Contributors .................................................................................................................................................. 2 Acknowledgments ......................................................................................................................................... 3 Acronyms ...................................................................................................................................................... 4 Executive Summary ....................................................................................................................................... 5 I. Introduction ............................................................................................................................................. 10 II. Conceptual Framework ........................................................................................................................... 12 III. Study Design ........................................................................................................................................... 14 IV. Attrition.................................................................................................................................................. 16 V. Operational Performance ....................................................................................................................... 19 VI. Consumption Expenditures ................................................................................................................... 22 VII. Poverty and Food Security .................................................................................................................... 28 XIII. Young Child Outcomes ......................................................................................................................... 35 IX. Children Over 5 Years Old ...................................................................................................................... 40 X. Women .................................................................................................................................................... 43 XI. Birth Outcomes ...................................................................................................................................... 46 XII. Economic Impacts ................................................................................................................................. 48 XIII. Discussion and Conclusion ................................................................................................................... 63 Annex 1: Prices in the CGP Evaluation Sample ........................................................................................... 67 Annex 2: Difference-in-Differences Estimation .......................................................................................... 69 Annex 3: Mean Differences at Baseline for Attrition Analysis .................................................................... 71 Annex 4: Additional Results on Economics Impacts ................................................................................... 75 Annex 5: The Local Economy-wide Impact Evaluation Model for the CGP ................................................ 76 Annex 6: Community Profile ....................................................................................................................... 77 1 Contributors The evaluation of the Child Grant Program is being conducted by American Institutes for Research (AIR) for the Ministry of Community Development, Mother and Child Health in Zambia, under contract to UNICEF, with funding from the Cooperating Partners— DfID, and Irish Aid. The Principal Investigators for the overall evaluation are David Seidenfeld (AIR) and Sudhanshu Handa (University of North Carolina at Chapel Hill). The Zambia-based Principal Investigator is Gelson Tembo of Palm Associates and the University of Zambia. The FAO (Principal Investigator Benjamin Davis) was contracted by DFID-UK to provide the analysis of the economic and spillover effects of the CGP. The overall team leaders of this report are David Seidenfeld (AIR), Sudhanshu Handa (UNC), and Benjamin Davis (FAO), but many others made important contributions and are listed below by institutional affiliation and alphabetical order within institution: AIR: Cassandra Jessee, Leah Prencipe, Dan Sherman Palm: Alefa Banda, Liseteli Ndiyoi, Nathan Tembo FAO: Silvio Daidone, Joshua Dewbre, Mario Gonzalez-Flores UC-Davis: Ed Taylor, Karen Thome UNC: Amber Peterman The suggested citation for this report is: American Institutes for Research. (2013). Zambia’s Child Grant Program: 24-month impact report. Washington, DC: Author. Contact information: David Seidenfeld Sudhanshu Handa Benjamin Davis [email protected] [email protected] [email protected] Gelson Tembo [email protected] 2 Acknowledgments This evaluation report has been drafted by American Institutes for Research (AIR) on behalf of the Ministry of Community Development, Mother and Child Health. AIR recognizes the contributions of many individuals and organizations without whom it would not have been possible to complete this study. Our thanks go to the Zambian Ministry of Community Development, Mother and Child Health (MCDMCH); the Department for International Development (DfID); the United Nations Children Fund (UNICEF); Irish Aid; and Palm Associates for the opportunity to carry out this study and for the financial and technical support that they rendered. Our special thanks go to Dr. Gelson Tembo (Palm Associates) for carrying out the data collection and Mr. Paul Quarles van Ufford (UNICEF) and Ms. Kelley Toole (DfID) for their technical support during the design and fieldwork. The value of the logistical support obtained from Mr. Stanfield Michelo, the Director of Social Welfare at the MCDMCH; the staff in the cash transfer unit at the MCDMCH, Lusaka; and the district social welfare officers (DSWO) in Shangombo, Kaputa, and Kalabo also cannot be overemphasized. Everyone at the ministry provided valuable logistical support during data collection in the three districts, including program background information. Our acknowledgments would be incomplete without mentioning our team of very able research assistants in Zambia. Specifically, we acknowledge the input of the team of enumerators and supervisors from Palm Associates, whose dedication during data collection ensured that the data collected were of high quality. The highly competent team of data entry personnel at Palm Associates is also greatly acknowledged. The patience exercised by the Zambian households, community leaders, and community members during interviews are also greatly acknowledged. It is our hope that the insights from the information that they provided will translate into valuable interventions in their communities. David Seidenfeld, Ph.D. 3 Acronyms AIR American Institutes for Research ARI Acute Respiratory Illness CGP Child Grant Social Cash Transfer Program CWAC Community Welfare Assistance Committee DD Differences-in-differences ECD Early Childhood Development FANTA Food and Nutrition Technical Assistance Project FAO Food and Agricultural Organization of the United Nations HDDS Household Dietary Diversity Score IYCF Infant and Young Child Feeding LCMS Living Conditions Monitoring Survey LEWIE Local Economy-wide Impact Evaluation MCDMCH Ministry of Community Development, Mother and Child Health (MCDMCH) MICS Multiple Indicators Cluster Surveys RCT Randomized Controlled Trial UNICEF United Nations Children's Fund ZDHS Zambia Demographic and Health Survey ZMW Zambian Kwacha ZOI Zone of Influence 4 Executive Summary Background In 2010, the Government of the Republic of Zambia through the Ministry of Community Development, Mother and Child Health (MCDMCH) began implementing the Child Grant social cash transfer program (CGP) in three districts: Kalabo, Kaputa, and Shangombo. The CGP targets households with children under age 5 living in program districts and provides each household with 60 kwacha (ZMW), or roughly U.S. $12, a month, regardless of household size. Payments are made every other month, and there are no conditions to receive the money. An impact evaluation was conducted as the program was implemented to learn its effects on recipients and provide evidence for deciding the future of the program. American Institutes for Research (AIR) was contracted by UNICEF Zambia in 2010 to design and implement a randomized controlled trial (RCT) for a 3-year impact evaluation of the program and to conduct the necessary data collection, analysis, and reporting. 1 This report presents findings after 24 months of program implementation, including impacts on expenditures, poverty, food security, children under age 5, children older than 5, and the economy. Study Design We implemented an RCT to estimate program impacts after 2 years. This study includes 2,515 households in 90 Community Welfare Assistance Committees (CWACs) that have been randomly assigned to treatment or control conditions. As shown in the baseline
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