When Damien de Walque started working on a trial of cash transfers in rural Burkina Faso, some of his colleagues at the World Bank were sceptical. “People were saying, are you just crazy?” he recalled. “How are you going to distribute cash in remote villages without a banking system?”
But de Walque and his team didn’t only manage to successfully run their trial. The work they did has since been instrumental in the design of a nationwide cash transfer program.
Although research increasingly shows that intervening early in life can bring big benefits, it’s proved difficult to build national policies that reproduce the effects of small, labour-intensive pilots. It’s particularly challenging in low-income countries where kids could be helped most.
That makes the scaling-up of the Burkina Faso trial an instructive success story. The way the pilot generated not only useful research, but also practical policy insights and a team of locals ready to work on a national scale, has valuable lessons for early childhood programs across the world.
Cash transfers have become a widespread tool in development economics. They’re seen as a simple and cost-effective way of helping families tackle whatever problems are most pressing in their particular circumstances. But there are still plenty of questions about the design details that can make them most effective.
De Walque and his team designed their trial, which ran from 2008 to 2010, to help answer two of those questions: whether it matters which parent cash is given to, and how much behaviour change can be induced by making the transfers conditional.
Their results disrupted the conventional wisdom that cash should be given to mothers rather than fathers, on the basis that they were more likely to prioritise children.
“It’s a more complex relationship,” de Walque said. Transfers to mothers were more effective at promoting educational outcomes, but cash for fathers made a bigger difference to nutrition — possibly because, in the rural society where the study was conducted, men are socially responsible for providing food.
The research also found subtle results around the effects of making transfers conditional — only giving cash to families which perform desired behaviours, like sending children to school. It’s been controversial in the development community whether conditions matter, or if boosting financial resources alone can change behaviour.
In Burkina Faso, according to de Walque, it’s a little of both. The conditions didn’t matter for favoured children. “Parents would like to enrol the boys, the older kids … and if they get more money, whether it’s conditional or not, they do,” he said.
But it did matter for more marginal children. “If they’re not the priority for the household when it comes to school enrolment, then you need the conditionality,” de Walque explained.
They’re nuanced findings, reflecting the careful design of the trial. But the same care had an even bigger impact in a different way — by making the pilot a useful resource for the development of a scaled-up national program.
The major challenge for scaling in early childhood is implementing a scheme nationally with the same attention to detail it enjoyed as a small, closely supervised pilot.
Perhaps the most widely replicated early childhood intervention is Reach Up, a Jamaican home visiting program to improve the way mothers played with their children. But while many of the imitations have produced benefits, they’ve rarely been of the same size — or at large scale.
“Maybe it’s because we had a very intense model,” said Sally Grantham-McGregor, who headed the original Reach Up program. That makes it very difficult to reproduce nationwide, she explained. “Even if I could do exactly what I wanted with the health service and everyone would listen to me, I think it would be challenging.”
Larger schemes, of necessity, omit some of the details present in pilots and evaluations. In Burkina Faso, the government’s national program didn’t even incorporate the subtle lessons about gender and conditionality that were the trial’s most important academic implications — because they would have introduced too much complexity.
But the World Bank evaluation did make an important difference to the design of the national policy. One valuable factor was the way the trial involved the government from the beginning, creating expertise among local officials before the national program was launched.
That’s quite unusual, de Walque said. “What you find often is it’s done by some local or international NGO,” he explained, which means the government is less familiar with the program it’s trying to implement.
In Burkina Faso, the cash transfer trial was organised by a senior government official. “The scaling up is more likely to be successful if people from the government use the pilot as a training ground,” de Walque suggested.
As well as involving senior figures from an early stage, the trial created a pool of qualified employees for the early stages of the national program. Local workers who were hired and trained to implement the pilot were top candidates to help launch the policy at scale.
Creating this kind of ownership and involvement is valuable because of the way governments inevitably leave out some details from a pilot. “Obviously when you go to a larger scale governments, and probably rightly so, at least in the first attempt, choose more simple programs,” de Walque said.
If the officials in charge have direct experience from the trial stage, they’re more likely to know which simplifications are feasible and which could seriously undermine the program.
Piloting new waters
Apart from the advantages of government involvement, de Walque said, just running a national pilot at all is vital. Too often, policymakers rush to implement a program that’s been successful elsewhere, without a trial stage in their own area.
But even tried-and-tested interventions — conditional cash transfers have been implemented in dozens of countries — will need adaptation to new countries. So careful piloting and assessment is needed before large-scale implementation is considered.
De Walque’s trial, for example, helped figure out how cash transfers could be delivered to rural villages in Burkina Faso without banking services or much contact with government officials. That’s the kind of hurdle that could cripple a scaling-up effort if it’s not identified in advance.
“What we found was that it is actually feasible, and with basically simple, practical solutions,” de Walque said. “There really is a benefit of having a prior pilot evaluation.”
The early stages of the pilot also informed the government’s choices about conditionality in the program. Fully implementing conditions, it was decided, would be too complex.
But a “contract” model, in which communications about the transfer focus on its intended use for children’s health and education and recipients sign an agreement to that effect, was an effective replacement, based on lessons from the pilot.
Burkina Faso’s program is still expanding, region by region, towards a full national scale. De Walque is leading a new evaluation, concentrated in two regions, to assess the impact of the full program as it’s rolled out.
Already, though, the researchers’ work has been invaluable in the country — and in the lessons it offers for efforts to scale up childhood policies around the world. — Fergus Peace
(Picture credit: TK)