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Can ”active” welfare work? A review of implementation problems in welfare programmes tied to active requirements

Einar Overbye

Einar.overbye@hioa.no

Paper presented at IPSA’s 23rd World Congress of Political Science, July 19-24, Montréal.

Abstract

The introduction of activation requirements (“conditionalities”) in welfare programmes is a global trend. It is tied to recent ideas about social investment - welfare states, as well as older ideas about developmental states. Active conditionalities come in three main types. First, benefits can be conditioned on work or on active job-search (prevalent in OECD coun-tries but also many non-OECD, e.g. India's Rural Employment Guarantee). This represents a work-first approach. Eventual training takes place on the job, if at all. “Work” means sheltered or subsidized employment, or low-wage temporal work. The second type represents a qualifi-cations-first approach. Benefits are conditioned on following qualification programmes, aimed at achieving a higher level of human capital. The third type represents a long-run human in-vestment approach. Benefits are linked to children attending regular health checks, be given special nutrients, or attending school regularly. Initiated by Mexico's 1997 Progresa (later Oportunidades), such conditional cash transfers have been very influential in Latin American as well as Asian and African countries. A shared communality of all three types is a sanction-ing regime that is supposed to reduce or cut benefits if requirements are not fulfilled. Another communality is the attempt to deliver work or services of an acceptable quality to those who follow the programme. The article uses Carol Weiss’ distinction between implementation the-ories and programme theories to identify the critical junctures where such programmes can go wrong, and reviews the literature concerning each ”schwerpunkt” based on existing pro-cess evaluations.

Introduction

The purpose of this paper is twofold. First, to illustrate the global rise in active requirements with regard to tax-financed welfare benefits. Second, to review the literature investigating under which circumstances active requirements work as suggested.

Increased emphasis on active requirements

Active requirements come in three main types. First, receipt of welfare benefits can be condi-tioned on work or on active job-search. This represents a work-first approach. “Work” usually means sheltered or subsidized employment, or low-wage temporal work. The second repre-sents a qualifications-first approach. Claimants are channeled into qualification programmes

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aimed at increasing their human capital and hence their future earnings. To attend the pro-gramme is a condition for receiving benefits. The third type, Conditional Cash Transfers (CCTs), represents a long-run human investment approach. They aim to intervene already in childhood or early adolescence. Families (usually mothers) receive benefits conditioned on children attending school, doing regular health checks etc. Figure 1 sums up the three main types of active conditionalities.

Figure 1. Different types of active conditionalities in welfare schemes, with examples

Conditioned on work or active job-search

Workfare (US), Rural employment guarantee (In-dia)

Conditioned on retraining, reeducation, occupational rehabilitation etc

Qualification and integration programmes (Swe-den, Norway)

Conditioned on children’s use of nutri-tion, health and education services

Conditional cash transfers (Mexico, Brazil)

The diffusion of such activation requirements is a global trend. The US is known for its work-fare-approach to social assistance. The major overhaul of tax-financed welfare benefits un-der the Clinton administration sharpened active conditionalities, and emphasized a work-first approach. The main US social assistance scheme is targeted is the 1997 Tanf (Temporary assistance for needy families) scheme1. It targets poor families with children.

Mexico introduced the Progresa scheme the same year. Progresa (later Oportunidades) is also a Conditional Cash Transfer (CCT) reserved for families with children. Unlike US Tanf, Oportunidades requires claimants to ensure their children fulfill active requirements, rather than to meet active requirements themselves. This implies ensuring that children get regular health check-ups and attend school.2 Brazil’s fairly similar Bolsa Familia scheme is a CCT even more widely distributed than Oportunidades. Some CCTs condition benefits only on nu-trition and health follow-ups (Malawis CCT pilot programme). Others include educational con-ditionalities (Mexico, Brazil). Some only include educational conditionalities (Bangladesh’ Pri-mary Education Stipends Programme).

Many programmes blur the lines between the three types of conditionalities in Figure 1. For example, some Latin American CCTs extend conditionalities from children to include manda-tory training or work by parents.

European welfare schemes also increasingly install activation requirements in order to claim benefits (Bonoli 2012). Increased emphasis on active requirements is evident in the German Hartz IV-reform, conditioning unemployment benefits on activation requirements (Knuth 2007). The French Revenu minimum d'insertion was redesigned in 2004 as Revenu mini-mum d'activité. In Britain, Tony Blair’s New Labor streamlined British welfare schemes along activation lines, and active requirements have been strengthened further under David Cam-eron. Scandinavian countries emphasize active labor market policies, which constitute a broad set of policy interventions, including activation requirements in welfare schemes. Scandinavia operate means-tested social assistance schemes, where able claimants can be required by local governments to work for benefits. Scandinavian countries have also intro-

1Replacing the earlier AFDC (Aid for Families with Dependent Children) scheme. 2The Mexican scheme has later introduced some limited conditionalities also concerning parents’ behavior, making the scheme more similar to US Tanf.

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duced higher-benefit integration programmes (for recent immigrants) and qualification pro-grammes. These higher benefits are conditioned on attending such programmes. Failure to attend means that benefits are scaled back or lost.

India’s version of workfare takes the form of a National Rural Employment Guarantee for the rural population, conditioning benefits (i.e. a low wage) on work in public projects (Raghben-dra et al 2009). Such Employment-Intensive Programmes (EIPs) attempt to self-select poor recipients, assuming that only the poorest will find such work attractive. India’s EIP pro-gramme is the biggest in the world. EIPs, like CCTs, are widespread in low- and middle in-come countries (Ginneken 2003).

This paper provides a review of the evaluation literature with a primary focus on Conditional Cash Transfers, since CCTs have been evaluated more extensively than other activation schemes. The focus is on process evaluations, identifying the various “links in the chain” from the launch of the programme till eventual effects materialize. The paper further investi-gates if the implementation theories and programme theories that can be identified with re-gard to CCTs can be generalized to activation schemes more generally. The general re-search question can be stated as follows: What are necessary and sufficient conditions for “active welfare systems” to work?

The global reach of Conditional Cash Transfers (CCTs)

The diffusion of conditional cash transfers is impressive. Since Mexico’s 1997 Pro-gresa/Oportunidades programme, similar programmes have been introduced in Brazil (Bolsa Alimentaco/Bolsa Familia), Colombia (Familias en Acción), Honduras (Programa de Asigna-cion Familiar), Nicaragua (Red de Protección), Paraguay (Tekopra), Panama (Red de Opor-tunidades), Equador (Bono de DesarrolloHumano),Guatemala (Mi Familia Progresa), Peru (Juntos),Chile (Solidarito) Argentina (Asignación Universal por Hijo) and are under imple-mentation in El Salvador.3 Outside Latin America, the Mexican innovation has inspired similar schemes in many countries, including Jamaica (Program Advancement Through Health and Education), Turkey (Şartlı NakitTransferi), Indonesia (Program Keluarga Harapan and Pro-gram Nasional Pemberdayaan Masyarakat-Generasi Sehatdan Cerdas), Nepal (Safe Deliv-ery Incentive Programme), Philippines (Pantawid Pamilyang Pilipino Program), Bangladesh (Primary Education Stipends Programme and Female Secondary School Assistance Pro-ject), Cambodia (Cambodia Education Sector Support Project) and Malawi (Diffusion and Ideational Change Project). Similar programs are under implementation at least in Egypt, Kenya and Zambia.4

The diffusion of this innovative Mexican welfare design illustrates that policy learning increas-ingly takes place between middle-and low income countries, rather than originating in high-income countries and then being adopted in middle- and low income countries.5

High-income countries also struggle to come to terms with social changes that have long characterized several Latin American countries; such as high income inequalities, a large in-formal sector, deindustrialization and ethnic heterogeneity. Identifying policy options that

3 Chiles and Ecuadors programmes differ from the others in that the cash transfer is not conditioned on any health – or nutrition related behavior. 4Gaarder et al 2010 supplemented by other sources. 5 The Brazilians can argue that they were the true innovators of CCTs. Two Brazilian municipalities initiated con-ditional cash transfers already in January 1995: Bolsa Escola in Distrito Federal and Guaranteed Minimum Fam-ily Income Program in Campanias, initiated by Governor Buarque (Worker’s Party PT) and Mayor Teixeira (Bra-zilian Social Democratic Party PSDB) respectively.

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work reasonably well in post-industrial social environments is increasingly commanding inter-est in high-income countries. The attempt – albeit aborted –to introduce an Oportunidades-inspired CCT in New York City in 2006 illustrates the point (Peck and Theodore 2010). More generally, the global diffusion of “active” welfare schemes, i.e. welfare schemes with active requirements, represent a similar-type response to social changes that are identifiable both in low, middle and high income countries.

Do active requirements work?

Conditional welfare benefits, i.e. benefits that encompass active conditionalities, are more complex to deliver that unconditional welfare benefits. The delivery relies on two, rather than one, delivery systems: one system concerned with delivering the cash benefit, and another system concerned with delivering the services claimants are compelled to (actively) use in order to claim the benefit. Following Weiss (1998, 59), a distinction can be drawn between problems related to implementing a policy program (implementation theory), and problems related to how users respond to the program (dubbed “program theory” by Weiss). Figure 2 provides a general illustration of how implementation theory and program theory interact in (eventually) producing positive outcomes for recipients as well as for the broader society. Links (1) – (5) are common for both unconditional and conditional welfare benefits; links (6) – (9) (grey area) are particular for conditional benefits (benefits that include active require-ments). The point to emphasize is that “more things can go wrong” in conditional than in un-conditional benefit systems, since the government not only has the challenge to deliver the benefit – it also has the challenge to provide the services the claimants are required to use, to ensure that they hold and acceptable quality, plus to monitor compliance and sanction non-compliance.

In the following, each link in the implementation – and programme chain spelled out in Figure 2 is scrutinized based on the available evaluation literature. What can go wrong, or what of-ten goes wrong, with regard to each link?

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Figure 2 primarily relates to CCTs, but is also a relevant way to present the linkages in quali-fication programmes more generally. In both CCTs and qualification programmes, recipients (or their children) must attend public-sponsored institutions such as health stations, schools and training facilities in order to receive either a cash benefit or in-kind benefits (food stamps etc). The state not only provides the benefit but also sponsors the training/schooling/health care that claimants are required to use.

Some modifications of figure 2 are necessary to present the corresponding linkages in work-fare-schemes, including EIPs. In EIPs and workfare schemes, link (8) [service personnel re-ceive recipients] should be replaced with: street-level administrators put claimants in work placements (or not)? Link (9) [recipients fulfil active requirements] should be: Claimants ac-tually work (or not), and (7) [administrators monitor compliance and sanction non-compli-ance] should be: Supervisors monitor if work requirements are fulfilled, and sanction shirkers (or not). All links in the chain must work in order for “active” welfare to work. In the following, each link in Figure 2 is discussed in turn.

Figure 2 (1): Politicians pass program legislation, allocate funds and pass instructions to administrators (or not)

In all tax-financed welfare systems, the choice of targeting principles is crucial. There are four main types of targeting principles: 1) proxy targeting (usually in the form of geographical or demographic criteria), 2) means-testing (individual assessment), 3) community targeting and 4) self-selection (Ginneken 2003).

Targeting principles can be decided at a central, regional or local political level (or a mix of all three). The precise choice of targeting criteria can also to a varying extent be is delegated to local (street-level) administrators, or to the formal or informal leaders in a community (com-munity targeting). Sometimes, the choice of targeting principles and how they should be op-erationalized are determined solely at the central political level. Thus in Mexico deciding tar-geting criteria for Oportunidades is solely in the hands of central- level politicians, plus ad-ministrators employed by the central government. In other countries, local politicians and local administrators can have some influence over targeting criteria. In Brazil, local mayors have indirect influence through their administration of the Unified Registry, from which claim-ants are identified (Fenwick 2009, see also Ansell and Mitchell 2011,308). Most European social assistance-schemes benefits devolve operationalization of targeting criteria even fur-ther. These systems are usually discretionary means-tested, implying that the legal texts leave a wide scope for street-level administrators (such as social workers) to use their pro-fessional discretion when deciding who qualifies for social assistance, and how large the benefit should be in each case.

If targeting principles should be decided at the central or local political level, with or without some leverage for administrators in how they should be operationalized, raises problems re-lated to risks such as cream-skimming and “benefit capture”. We discuss these problems further below.

Figure 2 (2-3): Administrators make information about the program available (or not); Information is received by target groups (or not), target groups understand the infor-mation (or not); and respond by applying (or not)

Link (2-3) relates to the take-up problem in welfare schemes. If adequate resources are not used on informing potential claimants, if claimants fail to understand the information, or if they none the less fail to apply (due to cumbersome registration procedures), targeting pro-

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cedures fail to adequately reach the targeted group. In a review of take-up of social assis-tance and housing benefits in OECD countries, Hernandez et al (2006) estimated take-up rates between 40 and 60 percent of the eligible population.6

Governments do not necessarily regard maximum take-up as a policy goal worth spending resources to achieve. In the early days of Progresa, Mexican public relations campaigns were minimal to avoid raised public expectations. However since 2006 the public profile of the program has been raised through radio and television advertisements. 7

A quasi-experimental Israeli study by Dahan and Nisan (2006) found that minority language groups were less aware of welfare programmes than majority language groups, suggesting that minority ethnic groups, including indigenous populations, have particular problems un-derstanding social assistance rules and regulations. This is a shared problem in conditional as well as unconditional welfare systems.

Conditional benefit systems (CCTs) create added take-up problems. A government that pro-vides conditional benefits must not only find ways to finance the cash; it must also find ways to ensure there are sufficient acceptable-quality services in the areas where the poor live.8 Mexico’s Progresa initially had to leave out extremely poor populations not because they were unwilling to apply, but because they lived in areas where there were too few health and education services of an acceptable quality they could be compelled to use (Calvo 2011, 62).9

Yet another complexity specific for conditional benefits concerns if claimants understand the active conditions. In a Brazilian study, Morris et al 2003 (quoted in Gaarder et al 2010,26) found a reduction in the rate of weight gain among Bolsa Familia preschool children relative to a control group. They argued that some parents (wrongly) thought that good performance in growth monitoring would lead to expulsion from the programme, prompting them to feed their children less rather than more (see also Bradshaw 2008, 199).10

A final reason why potential applicants may decline is because they fear being socially stig-matized. Stigma can be a problem in unconditional as well as conditional welfare systems. However stigma is not necessarily a “problem” in all conditional welfare schemes. The self-selection targeting strategy almost presume that stigma is associated with applying. Self-se-lection occurs if benefits are so low, and the accompanying conditionalities so unpleasant,

6 Following van Oorschot (1996), Hernandez et al differentiated between primary or secondary non take-up. The most common type of non take-up was when eligible individuals do not claim their benefit. (link (2-3) in Figure 2). In other cases, eligible people apply for benefits but have their application rejected In this second case, non take-up is said to be “secondary” (this would be link (4) in Figure 2). 7 Another example: In the mid-1980s, the Norwegian Department of Social Affairs printed a folder meant to be widely distributed to Norwegian households, informing them of the right to social assistance. At the last mi-nute the initiative was quenched and the folder never distributed. No reasons for pulling the folder was given. But perhaps Norwegian politicians, on second thoughts, decided that although social assistance is a legal right for people in dire circumstances, it is not necessarily to shout about it. 8 The lack of social infrastructure in areas where the poorest target groups live may be one reason why African-type social assistance schemes, where they exist, seldom include a similar number of conditionalities as Latin-American schemes.

9 In addition, the environment did not have the presence of banks that could accept the deposits; a problem also for unconditional cash transfers, to the extent that the government prefers to deliver the money directly rather than through local administrators on the spot (Calvo op.cit). Problems were similar in the Columbian CCT (ibid). 10 In a Turkish CCT, researchers found no effect on preventive services utilization and only an effect on immun-

ization, which was ascribed to many beneficiaries not understanding that the scheme had health check-up con-ditionalities, and those who knew (wrongly) believed they were related to immunization (Gaarder op.cit.).

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that only the truly needy will apply. Self-selection is administratively cheap and has been the targeting principle in many rural employment guarantee programmes (EIPs). Targeting through self-selection is often used in countries with limited administrative capacity for other types of targeting (Reinecke 2005). Providing EIPs through self-selection illustrates that low take-up, at least if it is due to stigma, is not always a “problem” in this type of conditional ben-efit schemes.11 Or, more precisely put: it is a problem that is associated with the targeting strategy itself.

There are stronger reasons to worry about the poor not taking up benefits if the scheme not only aims to provide poverty relief (the main motive behind unconditional benefits), but also to foster social investment (often a motive behind conditional benefits). If the poor abstain from applying for unconditional benefits because they deem that benefits are too small or too stigmatizing, one may argue that this is simply their choice. But if they decline to apply for schemes aimed at increasing their or their children’s human capital, low take-up implies that the “nudge” to get them to attend school or go to the health station is too weak. If health care, schooling and training is something also others than the poor themselves desire – such as a government interested in increasing its citizens’s future productive potential in order to in-crease the nation’s future power – low take-up of conditional benefits is a problem also for others than the poor themselves.

Figure 2 (4): Administrators accept applications (or not), evaluate applicants accord-ing to the proper criteria (or not), and allocate funds accordingly (or not)

Good implementation implies that administrators accept all correctly filed applications, evalu-ate them according to the proper criteria, and allocate available funds accordingly. That can be more difficult to bring about in conditional than in unconditional welfare systems. We dis-cuss two groups of implementation problems in this section. First, the problem of deciding the proper entitlement criteria when distributing conditional welfare benefits; second, how to counter the risk of benefit capture (familism and clientilism).

1) Help the poorest, do triage, or do cream-skimming?

An ethical imperative underlining tax-financed, unconditional welfare benefits is to target these benefits on those with the most severe problems and least resources on their own: “Help first those most in need.” However, this is less obvious in conditional welfare systems, since they often have social investment-purposes alongside poverty alleviation. A tension arises since one may argue that social investments should be spent where they have maxi-mum improvement impact: “Help first where help yields the largest effect.” The tension arises because the weakest and most destitute that are necessarily best able to utilize social invest-ments. Having some initial resources of one’s own can give a better capacity to utilize further investments. This is the idea behind triage, and old idea in the distribution of scarce (medical and social) resources. Triage can come in conflict with the “help the most destitute first” prin-ciple.

Triage implies to give priority to claimants with fairly serious problems who have some re-sources of their own, since they are the most likely to successfully utilize health, school and training services. Claimants with fairly light problems and quite extensive own resources should be rejected, or get much less help, as they are likely to get on by their own devices

11 There is a trade-off between giving many access to meager benefits, or giving fewer access to generous ben-efits. Politicians may sometimes prefer to provide a widely distributed meager benefit, even if this means that some will not bother to apply. Low take-up of the very meager Nepalese (unconditional) old age benefit is a case in point (Chandra 2012)

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anyway - added resources help them only marginally. Those with very severe problems and few if any also have limited benefit from social investments, as they are less able to put acti-vation services to effective use. They should rather get only poverty relief (unconditional ben-efits).12 If “triage” makes sense from a social investment perspective, there is a tension be-tween the social investment-purpose of conditional welfare benefits, and the poverty relief-purpose of such benefits.

There is also a third possibility: That those selected for conditional welfare benefits will tend to be those able to get by perfectly well even without the benefits and the accompanying acti-vation services. Lipsky [1980] (2010, 107 ff) argues that street-level administrators are likely to prioritize those likely to succeed anyway, at the expense both of those with middle-level problems and those with very severe problems. The reason for this inefficient selection is partly that it makes their job easier, partly because service personnel often prefer to interact with people similar to themselves (i.e. the most resourceful of their clients), and partly based on more-or-less conscious biases about the “worthiness” of claimants. Plus, if the wages of street-level administrators are linked to successful activation, they have an economic incen-tive to pick the applicants most likely to succeed – and those most likely to succeed are those who would probably succeed even without extra help.

Figure 3. Three theories about who gets – or should get - priority in welfare programmes conditioned on using health, education and/or training services

Claimant group: Aim at maximum poverty relief

Aim at maximum so-cial investment ef-fect of available means

Aim at maximum activation success

Limited problems, and sufficient own re-sources to solve them

Give priority to this group (cream-skim those most likely to succeed)

Fairly severe problems, some resources

Give priority to this group (do triage)

Very severe problems, few resources

Give priority to this group (help the most destitute first)

The choice between “aim at maximum poverty relief” and “aim at maximum social investment effect” represents an ethical dilemma when providing welfare benefits. Cream-skimming rep-resents no similar dilemma, but is an ever-present danger since those who fund and adminis-ter conditional welfare systems will normally be eager to demonstrate that the programmes are successful – and the safest way to do that is to grant conditional welfare benefits to those likely to succeed even without the benefit.

Hossain (2010, 1273-4) illustrates both implicit triage and cream-skimming in his analysis of Bangladesh’ Primary Education Stipends Programme, a CCT conditioned only on education. Quote:

12 Triage stems from the Napoleonic wars. The idea, which revolutionized the treatment of battle wounded in its day, was to sort the wounded in three groups: Those with light wounds, those with severe but not life-threatening wounds, and those with wounds beyond hope of recovery. To provide efficient use of limited medi-cal services, “triage” dictates that priority should be given to the middle group.

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“…interpretations of the programme goals and target group by those tasked with its imple-mentation create a situation where it is entirely legitimate...to exclude poor students. First, …officials at the frontline appear to see the programme as supporting “meritorious” students who struggle to cover their education costs…The archetypical “meritorious” student is almost by definition the “middle class poor”…There are incentives to do so: …the poorest students are pre-excluded because they are unlikely to meet attendance and performance criteria, on grounds it is better to select someone who will not ultimately lose their entitlement…This logic emerges out of a programme rule that students are paid on the basis of their attend-ance record…[Second,] teachers selected “meritorious” students…in order to maintain school eligibility for the stipend project”.

The quote illustrates why those selected for investment-type welfare programmes are not necessarily the claimants with least resources of their own. It also illustrates that if schools (or, more generally, the institutions which provide activation services) receive payment based on the number of claimants that are successfully activated and/or pass required exams, they have an incentive to pick the claimants most likely to succeed anyway.

An often used counter-measure to deter cream-skimming is to place claimants in different categories depending on how difficult it is likely to be to achieve successful activation. Street-level administrators are then awarded extra bonuses (or extra renumeration) for achieving success with hard-to-activate claimants relative to easy-to-activate claimants. This attempt to discourage cream-skimming has merits, but increases administrative complexity. It requires a separate set of administrators who are able to categorize claimants according to the odds that each of them can easily be activated. Even if done professionally, such categories tend to be rather broad and leave some room for cream-skimming within each category. The dif-ferentiation-and-bonus apparatus requires added administrative resources to run the pro-gram. It can also lead to creative book-keeping (aka gaming), since administrators have an incentive to categorize claimants in harder-to-activate categories, further implying that admin-istrative resources are needed to supervise how administrators use such a differentiated sys-tem. In short, this type of conditional welfare system needs a variety of highly professional, differentiated and sophisticated administrators at several administrative levels, and such ad-ministrators are in short supply in many countries. Plus, they are expensive.

2) Benefit capture (bribery, familism, patronage)

A different type of implementation problem concerns the risk that benefits are not allocated according to formal programme rules at all. Administrators sometimes misplace programme rules, or use irregular discretion when judging applicants (Hernandez et al, op.cit). Reasons for misplaced rules can be arbitrary or systematic. Systematic misplacement of pro-gramme rules is a possible indicator of benefit capture. Benefit capture means that the bene-fit is directed to serve the interests of administrators or politicians rather than claimants. Ben-efit capture comes in several versions. They can be subsumed under headings such as fami-lism, bribery, and clientilism. Familsm chacterises a mindset where the interests of the family assumes a position of as-cendance over individual or state interest. In the context of benefit capture, familism implies that administrators use their control over resources made available by the state (such as control over welfare benefits) to favor their own family. Either directly (awarding welfare ben-efits to family members) or indirectly (awarding welfare benefits to families one owes favors, or to families one wants to forge connections with). This type of benefit capture takes place within a network of local, informal debts and obligations, where a family member’s control over state resources can strengthen the resource-base of one family in its dealings with other families. An example concerns the distribution of school stipends to girls in rural Pakistan,

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where girls allegedly got stipends depending on the relationship between their families and the family of the street-level administrator.13 Bribery – i.e. giving the street-level administrator a cut to gain access to a welfare benefit – represents another form of benefit capture, and must be considered a rather crude form compared to familism. Familism as a form of benefit capture often creates dependencies resembling those arising from mutual gift-giving, where the members of families create a web of implicit debts which can be called upon at a later date. Compared to familism, clientilism represents a more hierarchical form of benefit capture (MacLean 2011, 130-2). Within a patron-client relationship, welfare benefits can be used by local patrons to strengthen loyalty among clients. Formal eligibility criteria are set aside. In-stead, benefits are distributed to those loyal to the local patron. Benefit capture is made eas-ier if eligibility criteria allow politicians or administrators a high degree of discretion in deter-mining who is eligible for benefits.14 Ansell and Michell (2011) make a useful further distinction between corporatist clientilism and bossist clientilism. Bossist clientilism is typically local. The local boss (mayor, alderman, landowner) procure resources from higher-ups, and selects some clients (as opposed to oth-ers) to personally receive them. Bossist clientilism can shade over into familism. Corporate clientilism is more remote, and does not necessarily imply bending or tweaking the formal rules. Corporatist clientilism typically takes place at the state or federal level, and is more about making the formal rules than tweaking them. Corporate clientilism shades over into “or-dinary” populist politics. The corporate patron (a vertically integrated party or a bureaucratic organization, such as a trade union) earns loyalty by dispensing organizational resources (union benefits, cheap food programmes, infrastructure) to people who express loyalty to the larger organization. Clients express loyalty to corporate patrons by purchase of their branded commodities, by attending their strikes and rallies, by voting for the party that sup-ports them and by turning a blind eye to corruption by “their” patron.15

13Information given in a NORAD debate on evaluation challenges in development aid, Oslo autumn 2011. 14 Discretion can be used to make the application procedure can be made pleasant and fast for friends/family

members/clients, and not-so-pleasant for everyone else (Willmore 2003)Willmore’s reference to the process when Mauritius decided to scrap means-testing of their tax-financed, unconditional social pension and go for an administratively simpler flat-rate benefit instead is worth quoting: “A major complaint against the means test...was the power that it gives bureaucrats, and the corruption that sometimes accompanies this power...When an applicant has a right to a pension simply by submitting proof of age, the government official has little power. When an official is asked to certify the income of an applicant, he obtains power, which pro-vides opportunity for corruption and abusive invasion of privacy. The government minister Mr Raoult made the point this way [in a 1958 Parliamentary debate]: “[W]e know that if an unfortunate person applies for the old age pension it would take months...[to] obtain the old age pension...Once [the means test] is got rid of, every person who is entitled to receive an old age pension would be able to apply for it and, as a matter of law, as a matter of right, be entitled to it. It will not be a question of whether one member of the House or some of his friends happen to be persona grata with certain officers...This is one way in which power has been obtained in certain quarters of this country."

15 A further specification can be warranted. Terms like “patronage” and “clientilism” are sometimes evoked to

describe all policy proposals that aim to boost the popularity of politicians among specific groups of voters. If so, hardly any public spending programme, in any country, can escape the label clientilist. However there is a difference between public spending aimed at boosting the popularity of a political party or politician, and spending which can be arbitrarily withheld if the receiver is not displaying loyalty. The first is an ingredient of competitive politics everywhere; the latter is an ingredient in maintaining a dominance-subordination relation-ship. A grey area exists, but the label “clientilism” should arguably be reserved for relationships where trans-fers are used to build up debts of gratitude, including the threat that benefits can be arbitrarily withdrawn if loyalty is not demonstrated.

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Benefit capture can be a problem both in conditional and unconditional welfare programmes. However in conditional welfare systems there are “more things to capture” than in uncondi-tional welfare systems. In unconditional systems, only the cash benefit itself can be captured by administrators or patrons. In conditional systems tied to the use of subsidized health and education services, one may in addition capture the subsidized service itself, i.e. be able to influence who gains employment providing the service in question. Employment in state-sub-sidized health and education services is often an attractive, limited good. With regard to Em-ployment-Intensive Programs (EIPs) the government usually provides equipment of various sorts – for example shovels and machinery for road-building – meant to be used by those who receive cash benefits through the programme. This equipment, often in the form of “stuff that fell off a lorry”, can be re-directed to others than the formal benefactors.

Are conditional welfare benefits exposed to benefit capture? Fried (2012) finds few indica-tions that Brazil’s Bolsa Familia is used for corporate patronage, noticing that political criteria do not explain the difference between the number of poor families that live in a municipality and the number of families that receive support. Fenwick (2009) further argues that Bolsa Familia is unlikely to be exposed to state (as opposed to both federal and local) patronage, since state governors have no influence over any element in the implementation of Bolsa Fa-milia. Giraudy (2006) refer studies indicating bossist clientilism in the distribution of Argentin-ian emergency employment programs (workfare) between 1993 and 2002. Programs were sometimes allocated discretionally, preventing the neediest from gaining access to benefits; the targeted population was not always informed about the communal projects in which ben-eficiaries were to engage; and periodic oversights by responsible control agencies was not always carried out. In an Indian context, Raghbendra et al (2009 462-3) find indicators of bossist clientilism in the distribution of the National Rural Employment Guarantee Pro-gramme in Andrah Pradesh, but less so in Rajastan. Local politicians in Andrah Pradesh were more involved in the programme, using it as an opportunity for advancement of their fol-lowers. Interestingly, one of the indicators was a higher stipulated programme wage in An-drah Pradesh, making the programme attractive for others than the very poorest (implying that targeting through self-selection of the poor broke down).

The fear of benefit capture is a possible reason why conditional cash transfers in Mexico are administered at the central rather than the local level, and according to rigid eligibility criteria which leave little room for professional discretion by street-level administrators. Benefits are means-tested, but not discretionary means-tested; i.e. benefit levels are pegged to different levels of registered economic means. On the other hand, Fenwick (2009) reports increasing influence of Brazilian local majors (but decreasing influence of state governors) in this policy field since local governments were granted increased power and autonomy in the 1987-88 Constitutional Assembly.

In countries where the perceived risk of benefit capture is low, one may expect that condi-tional welfare benefits are less controlled from above, and leave more room for local politi-cians and/or street-level administrators to allocate resources. This may possibly imply that conditional welfare systems in high-income countries leave a larger scope for local political decision-making and street-level professional discretion than in middle - and low income countries. High-income countries presumably experience less risk of benefit capture than middle- and low-income countries. 16 However this is an impressionistic impression, and an area for further research. Figure 4 provides an example.

16 Or perhaps not. Baldacci and Santis (2002) studied the distribution of unconditional disability benefits in

Southern Italy. They found that in the 1980s benefits were sometimes distributed to US-Italian immigrants who had resided in Italy for very short time periods. The professional discretion involved in determining disability allowed local patrons to use this Italian social insurance-scheme to reward family members and associates, ra-ther than for intended purposes.

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Figure 4. Who controls operational targeting criteria, illustrated with examples

Who determines targeting criteria

Solely determined at the central political level

Co-determined by the regional and/or local political level

Do targeting criteria leave room for dis-cretion by street-level administra-tors?

Yes Norwegian social assistance (national framework law stipulating universal right to apply, some leverage for local gov-ernment interference, and discretionary means-testing by street-level adminis-trators)

No Mexico’s Oportunidades (central level proxy tar-geting plus means-test-ing without discretion)

Brazil’s Bolsa Familia (proxy targeting with local government influence, plus means-testing without discretion)

Figure 2 (5-6): Recipients collect benefits (or not) and fulfill active requirements (or not); administrators monitor compliance with active requirements (or not) and sanc-tion non-compliance (or not)

With regard to conditional benefits, the question is not only if the delivery system for the cash benefit operates as intended. The question is also if the services claimants are obliged to seek out, operate as intended – and if claimants respond to the services as they are sup-posed to. With regard to workfare, the corresponding issue is if acceptable-quality work-places are offered, and if claimants actually work.

Related to this issue is the question of how large the cash benefit must be to provide an in-centive for fulfilling the active requirements. Fernald et al (2008) found that a doubling on the CCT benefit resulted in better policy outcomes with regard to child development in Mexico.17 But in a study of the Cambodian conditional cash transfer programme, Fimer and Scandy (2001) found that families receiving modest benefits fulfilled active requirements to the same extent as families receiving larger benefits18.

Determining the size of the benefit necessary to ensure compliance with active requirements further illustrates the ethical tension between the poverty relief and social investment-aim of conditional welfare benefits. From a poverty relief perspective, the benefit should be suffi-cient to bring recipients out of poverty. For this purpose, a higher benefit will usually be more helpful than a lower benefit. But from a social investment perspective it may be sufficient if

17Five year follow up study, child development operationalized as prevalence of wasting and stunting, over-weight, motor development, cognitive and language development. 18 The Cambodian study suggests that a sanction in the form of a benefit reduced gradually in several succes-

sive steps towards nothing would still retain an incentive to fulfill the active criteria, until parents receive rock-bottom nothing. But the Mexican study suggests that a high benefit confer indirect advantages on the children, in addition to advantages related to the services they are conditioned to use. Perhaps households with more money simply take better care of their children than households with less money.

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the benefit is large enough to make recipients fulfill the active requirements. From this per-spective, a small benefit is better than a large benefit if the larger benefit does not result in higher compliance with the active requirements.

Monitoring of compliance is costly. It commands resources that could otherwise be used to increase benefits or improve service quality. However without monitoring, there is the possi-bility that the conditional welfare benefit over time de facto becomes an unconditional welfare benefit. 19

In cases with effective monitoring (Colombia, Mexico, Nicaragua and Jamaica) compliance is generally extremely high. In cases without extensive monitoring, results are mixed. Schandy and Araujo 1996 (quoted in Gaarder 2010, 24) found that in Equador the mere announce-ment of conditionality, even if not enforced, was the main reason behind a large and signifi-cant change in school attendance. However, Morris et al (2004) found zero effects in the Honduran programme when conditionality was not enforced (also quoted in Gaarder et al op.cit). It appears that cultural context influences the likelihood that conditionalities are met.20

There is little point in monitoring compliance unless sanctions are enforced for non-compli-ance. To provide a credible threat that sanctions will be applied, benefits must be lower, or be lost altogether, if active requirements are not fulfilled. However this creates an ethical di-lemma, particularly acute in conditional welfare programmes benefiting families with children. As Calvo (2011, 65) point out: “The critical issue is why a child should be deprived of essen-tial resources just because a targeted family member fails to meet the behavioral conditions”.

The core question is how rigid the sanctioning system should be in conditional welfare pro-grammes. How many instances of non-compliance are necessary to cross the threshold be-fore sanctions are applied? Zero tolerance? Or a point system? How about legitimate ex-cuses, and who in the system has the decision-making authority to decide if excuses are le-gitimate or not? Is there, or should there be, room for professional discretion on behalf of street-level administrators or local political elites in determining how and when sanctions ap-ply? These factors add complexity to the administration of conditional welfare benefits com-pared to unconditional welfare benefits.

Figure 2 (7): Service personnel receive recipients (or not) and perform their work with an acceptable quality (or not)

If active conditionalities are not followed up by increased budgets for the services claimants are compelled to use (education, health and so forth), the quality of services is likely to de-cline. Besides, health, education and related social services are not necessarily of high qual-ity in the first place – in particularly not in areas where the poor live.

19Lax monitoring of active criteria may also take place for political reasons. An often-heard argument for active

criteria is that it is likely to increase the willingness of middle-class taxpayers to fund such schemes. If legiti-macy in the eyes of taxpayers is the main purpose of active criteria, then these mainly have a symbolic func-tion. If so, it makes limited sense to ardently monitor fulfillment. This would represent a form of “Machiavellian altruism” on behalf of ruling politicians: perhaps their primary aim is to serve the poor (or their poor constitu-encies), and they add conditionalities only as a deceptive ploy to dupe middle-class voters.

20 As Giraudy (op.cit.) argues in the Argentinian case, administrators are not likely to monitor compliance with

conditionalities at all if benefits are used as patronage.

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With reference to Indian primary schools, Banerjee and Duflo (2011, 81 ff) argue that public education services are often dominated by rôte learning, and that teachers often neglect pu-pils who are not among the upper-half in their class:

1“We have seen countless examples of...elite bias among teachers in developing countries... [in an experiment], teachers who...were assigned to the bottom track [of pupils] were upset, explaining that they wouldn’t get anything out of teaching and would be blamed for their stu-dent’s low scores. And they adjusted their behavior accordingly: During random visits, teach-ers assigned to the bottom rack were less likely to teach, and instead more likely to have tea in the teacher’s room, than those assigned to the top rack...Many teachers are anxious to avoid being posted in remote or “backward” villages. One reason is the inconvenience or commuting, or living in a remote village with poor facilities...Another common reason is alien-ation from the local residents...who are sometimes said...to have no potential for educa-tion...A young teacher simply told the team that it was impossible to communicate with “chil-dren of uncouth parents”” (op.cit, 90-1)

In some cases, teachers seek favors in return for preferential treatment or good grades, or dole out arbitrary punishments. Also, parents may be reluctant to send pupils, in particular girls, on long walks to school, if the environment is unsafe. If employment in health and edu-cation services is awarded due to family connections or patronage rather than merit, the ser-vice quality is likely to deteriorate further. In short, parents as well as pupils can sometimes have good reasons for declining an offer of publicly sponsored services. If so, active require-ments that compel them to do so (under threat of losing benefits) may lead to worsened, ra-ther than improved, life quality.

The problem of poor service quality may be softened by providing recipients with vouchers they can use to access competing health, education and training facilities, rather than to have to rely on (monopolistic) providers of such services (le Grand 2007). However this as-sumes that benefactors are able to distinguish between high and low quality service provid-ers, which is not always the case (see below).

Figure 2 (8): Recipients of services understand and appreciate the services provided (or not), and modify/change their behavior accordingly (or not)

Weiss (1998) as well as Gaarder et al (op.cit.) point out that evaluating the impact of activa-tion requirements often end by investigating policy outputs – if claimants use the prescribed services or not. What really matters, however, is policy outcomes – if use of services improve the situation of those who use them. This is not necessarily the case. Even if services are provided according to acceptable standards, claimants do not always understand and appre-ciate the services, or they may appreciate the services for different reasons than the program designers had in mind. Bradshaw (2008, 198) notices that Mexican mothers participating in Oportunidades wanted to educate their daughters not because of the assumed higher in-come it would bring, but because it would make them better able to look after themselves and not be “taken in or fooled by others”, i.e. by men.

Banerjee and Duflo (op.cit) provide more extreme examples from the Indian subcontinent. In one study, Indian mothers who went to the local health clinic with children suffering from diar-rhea were annoyed by being given cheap packets of iodized salt (effective treatment) rather than a more dramatic and costly treatment, such as a shot with antibiotics (ineffective treat-ment). In another study, parents perceived the primary education system as an opportunity for their children to get a future office job. They wanted teachers to help their children suc-ceed in passing entry exams to higher education, and were annoyed if teachers instead fo-

15

cused their teaching on practical topics (presumably of greater benefit to most of the chil-dren). In such circumstances, the problem is not on service providers or the quality of their services, but on how these services are perceived by recipients.

Another problem concerns locating the relevant decision-maker in recipient households. In the Bangladeshi Integrated Nutrition Project, young mothers in rural Bangladesh received food supplements (in-kind benefits) combined with nutritional information at health stations. They were informed of what vegetables to grow in their garden to provide balanced nutrients, and how to wash, cut and prepare vegetables to preserve maximum nutrient value. However what the designers of the program had failed to consider was who make decisions about what to grow, and how to prepare food, in rural Bangladeshi households. It is certainly not young mothers. It is fathers-in-law, husbands and brothers (what to grow) and mothers-in-law (how to prepare food) (White 2009).

Finally, even if knowledge provided through health and education services is acknowledged, it does not necessarily result in changed behavior. This is a common finding across studies from high-middle and low income countries (Lindstrand et al 2006). For example, knowledge about the benefits of preventive health interventions does not necessarily result in changed health behavior: avoid junk food, exercise more, cut down on cigarettes, alcohol and illicit drugs, abstain from unsafe sex and so forth. The spirit is willing, but the flesh is weak (Mat-thew 26:41).

Examples of the above abound, and as the wisdom of Matthew certify, this is a problem shared across national borders.

Figure 2 (9-10): Short and/or long term outcomes improve for claimants and for the broader society (or not)

Many CCTs have been rigorously evaluated, with randomised or quasi-randomised control groups. They reduce poverty when the control group gets nothing at all. Positive effects on nutrition, health development (e.g. measured as prevalence of stunting and wasting) and ed-ucational attendance are also reported, although here results are more mixed. Gaarder et.al. (op.cit. 29) conclude their review of long-term outcomes as follows:

“Based on evidence from Latin America, Africa, Asia and the Middle East, ...financial incen-tives work to increase utilization of...key health services...as long as the beneficiaries have knowledge of the programme requirements. The mixed picture with respect to outcomes – nutritional status, and...morbidity and mortality – suggest that encouraging utilization when the pertinence of services is unknown or of poor quality may not produce the expected ef-fects...mixed results suggest that assumptions about need, household decision-making, and causal relationships might not be entirely correct and thus our expectations for im-pacts....may be incorrect....while paying poor households to use preventive services works at increased utilization, it is still unclear what happens at the health post. If quality decreases, or non-beneficiaries are crowded out,....negative spillovers in service quality...may be greater than the net gain to beneficiaries. On the other hand, increased demand and more informed users...may encourage improvements in efficiency and quality”.

Gaarder complains that few of the experimental or quasi-experimental evaluations of CCTs use unconditional cash transfers as a counterfactual. New studies rapidly fill the gap here. Banerjee and Duflo (2011,80) refer African studies where groups that received transfers con-ditioned on school enrollments were compared to groups that received unconditional trans-fers. School enrollment in both groups went up relative to a control group that did not receive any transfers at all, suggesting that the transfer, rather than the conditionality, was the main

16

factor in boosting school enrollment. Brauw and Hoddinott (2011) however found that condi-tional cash transfers were more effective than unconditional cash transfers in boosting school enrollment in Mexico.21 Thus here also results are mixed.

CCTs are usually given to the mother in the household, on the assumption that poor mothers are less irresponsible than poor fathers. Experimental studies that randomly assign the bene-fit to mothers and fathers, to see if this uncharitable view of poor males holds true, have not yet been conducted.

Some studies claim that CCTs influence the power balance within households, by giving women control over their own money (see Leroy et al 2009 for a review). Given the weak ne-gotiating position of women in male-earner families this should probably be regarded as a positive effect. However it is questionable if the qualitative evidence that typically underline such conclusions can be generalized beyond the case studies. Bradshaw (op.cit) remain skeptical if money really changes household power relations, and even claims that domestic violence may increase (presumably in situations where women will not let go of the money). However, this evidence appears anecdotic.

How about negative effects? Several studies investigate if CCTs reduce work effort. None of the randomized control trials referred so far report reduction of informal work effort by the pri-mary beneficiaries, i.e. women.22 Some studies report a reduction of child labor, which must count as a beneficial effect. Bradshaw (2008) quotes anecdotic evidence that CCT money to women may have led their husbands to scale down work effort, but such indirect employment effects have not been systematically studied.23 A related worry is that CCTs, since they are means-tested, stimulate the informal economy and the expense of the formal economy. Re-cipients (and their husbands) have an incentive not to report their incomes, in order to con-tinue to receive benefits. This possible effect has not yet been studied empirically.

What about broader societal effects? Some claim that CCTs reduce community tensions, but others claim that community tensions are sometimes enhanced, in particular if community targeting is used. An even broader societal effect would be the creation of a more pleasant and/or less threatening “social space”, which represents a classic collective good.24 If CCTs are limited to some communities and/or geographical areas one could in principle set up a controlled design to investigate such broader effects. So far no such studies exist. In short, we still lack outcome-studies that investigate a variety of possible outcome-measures of such welfare schemes.

Apart from CCTs, randomized control trials to investigate the effects of conditional welfare schemes are few and far between. A Campbell review of 46 mainly US welfare-to-work pro-grammes found effects in the expected direction, but the average effect was small. An aver-age of 33 welfare recipients had to receive one of the work programmes in the review in or-der to predict that one more of them would become employed (Smedslund et al 2006).

21Brauw and Hoddinott took advantage of a glitch in the early implementation of Progresa which meant that not all beneficiaries were initially exposed to conditionalities. 22Most CCTs deliberately give money to women rather than their husbands, unless in the few cases where men are sole providers of their children. 23In a study of the unconditional South African old-age benefit, Bertrand et al 2003 (quoted in Skovseth 2010, 27) found indicators that the benefit led to reduced work effort among prime-age members of the pensioner’s household; admittedly relying only on survey data. 24It is impossible to exclude someone from “consuming” a pleasant social space (less crime and begging in city streets and other public access-venues) once it has been “produced”, and consumption of a pleasant social space is non-rival.

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Conclusion

Unconditional welfare systems are controversial in many countries because of a widespread opinion that claimants spend the money on booze and bling. Conditional welfare systems en-joy higher political support as long as many voters and taxpayers believe this to be true, re-gardless of whether it is true or not. If one welcomes higher spending on tax-financed bot-tom-floor welfare benefits, conditional welfare benefits is a way to broaden support for such benefits.

From an empirical perspective there is a global trend in the direction of conditional welfare systems. As stated in the introduction this trend is discernible in high- middle- and low in-come countries alike. This shift to conditional welfare benefits may possibly reflect deeper structural changes, such as postindustrialisation and the rise of a large low-paid service economy. In a situation where the formal sector is contracting, or providing too low earnings to include social insurance contributions, tax-financed conditional welfare systems represent a strategy for extending social security coverage – admittedly at minimum levels. There is also an emerging consensus among multilateral institutions that such schemes are a legiti-mate way to spend limited tax resources. The ILO launched its social protection floor initia-tive in 2011, emphasizing basic health care and minimum income benefits (Cichon 2014). And the World Bank is a sponsor of Conditional Cash Transfers in many middle- and low in-come countries.

However as this review has shown, conditional welfare programmes are more complex than unconditional programmes. Being more complex means that more things can go wrong. Not only must the government get the information, administration and delivery of the cash benefit right: it must also get the accompanying subsidized health, education and training services (and/or workfare) right. This implies to ensure acceptable service quality, avoid cream-skim-ming, ensure efficient monitoring and sanctioning of non-compliance, and avoid the risk of benefit capture by administrators, families or patrons. It further implies to handle the ethical tension between an imperative to help the most destitute first, versus to spend activation re-sources to maximize the “return” on social investments. It also necessitates an awareness of who are the decision-makers in recipient households (not necessarily the recipient of the welfare benefit), and how to deal with recipients who have ill-informed or counterproductive ideas about what constitutes high-quality services. In short, “getting it right” implies continu-ous awareness of the many schwerpunkte in the implementation – and programme chain, from the allocation of policy inputs to the policy outputs that may materialize if all links in the chain perform adequately. The program’s overall efficiency will be no higher than the effi-ciency in the weakest link in this chain.

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