Long-Term Effects of a Conditional Cash Transfer Program in Nicaragua

Last registered on December 25, 2019

Pre-Trial

Trial Information

General Information

Title
Long-Term Effects of a Conditional Cash Transfer Program in Nicaragua
RCT ID
AEARCTR-0001572
Initial registration date
September 04, 2018

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
September 05, 2018, 10:34 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
December 25, 2019, 5:14 AM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Primary Investigator

Affiliation
Paris School of Economics

Other Primary Investigator(s)

PI Affiliation
Middlebury College
PI Affiliation
University of Colorado, Boulder

Additional Trial Information

Status
On going
Start date
2000-05-01
End date
2020-12-31
Secondary IDs
Abstract
CCT programs have become the anti-poverty program of choice in many developing countries. Numerous evaluations, often based on rigorous experimental designs, leave little doubt that such programs can increase enrollment and grades attained––in the short term. But evidence is notably lacking on whether these short-term gains translate into longer-term benefits. This project uses the randomized phase-in of the RPS CCT program in Nicaragua to estimate the long-term effects on cognitive development, educational attainment, learning, labor force participation and earnings, measured 10 years after the start of the program. The empirical analysis focuses on specific cohorts of boys and girls, for whom the program’s eligibility criteria and the randomized timing of the program imply differential exposure in early versus late treatment group.

For boys exposed to the early treatment when they were 9-12 years old. The short-term program effect of a half grade increase in schooling for boys was sustained after the end of the program and into early adulthood, and results indicate significant and substantial differential gains in both math and language achievement scores. Importantly, these coincide with positive labor market returns including higher earnings, and demonstrate important long-term returns to CCTs (study 1).

For girls in the same age cohort, CCTs not only provide incentives and means to remain in school longer, but also may affect fertility outcomes through improved nutrition (with implications for the onset of puberty) or provision of reproductive healthcare information. For the cohort of girls 9-12, differential exposure to the CCT does not lead to long-term differences in grades attained or learning, but does lead to differential impacts on the age of menarche, young adult Body Mass Index, fertility, and subsequent labor market outcomes and income (study 2).

Focusing on exposure very early in life, we also test the hypothesis that intervention starting in utero and continuing in the first two years is critical. At age ten, boys exposed to the program during this period had better cognitive, but not anthropometric, outcomes than those exposed in their second year of life or later. The lack of a differential effect on anthropometrics was due catch-up growth (study 3).

This trial registry is for the 10-year follow-up of the trial AEARCTR-0003243

Registration Citation

Citation
Barham, Tania, Karen Macours and John Maluccio. 2019. "Long-Term Effects of a Conditional Cash Transfer Program in Nicaragua." AEA RCT Registry. December 25. https://doi.org/10.1257/rct.1572-2.1
Former Citation
Barham, Tania, Karen Macours and John Maluccio. 2019. "Long-Term Effects of a Conditional Cash Transfer Program in Nicaragua." AEA RCT Registry. December 25. https://www.socialscienceregistry.org/trials/1572/history/59586
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Experimental Details

Interventions

Intervention(s)
In 2000, the government of Nicaragua launched a national CCT program, called Red de Protección Social (RPS), that incentivized parents to invest in their children's health, nutrition and education. The program lasted six years and reached approximately 30,000 poor rural families. The CCT had two core components: 1) education; and 2) food security, nutrition, and health. Corresponding to these, transfers for each component were conditional on household education and health behaviors, with conditionalities monitored by teachers and specially contracted healthcare providers. Education transfers were contingent on enrollment and regular school attendance of children aged 7–13 years who had not yet completed the fourth grade of primary school. Food security, nutrition and health transfers were contingent upon the household representative attending bimonthly health education workshops and bringing children under age five for scheduled preventive healthcare appointments that included routine vaccinations. Reproductive health information sessions and services were added at a later stage of program implementation and included adolescents. The transfers were for three years with no recertification possible.
Intervention (Hidden)
Intervention Start Date
2000-11-01
Intervention End Date
2005-12-31

Primary Outcomes

Primary Outcomes (end points)
Study 1 and 2: Educational attainment, Learning (achievement tests), Reproductive health outcomes, labor market status/participation, earnings
Study 3: Cognitive and Anthropometric measures
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The 42 targeted localities were randomized into one of two equally sized treatment groups, the early or late group, at a public lottery carried out by the Government of Nicaragua in July 2000. To improve the likelihood that the selection of localities in the experimental groups would be well balanced in terms of poverty levels, a marginality index was used to classify the 42 localities into seven strata of six localities each. From each stratum three localities were randomly selected as early treatment and three as late treatment.

A program census, was implemented in May 2000 and and the 21 early treatment localities received their first transfers in November 2000. They were eligible to receive three years’ worth of cash transfers and received the last transfer in late 2003. Households in the late treatment localities were informed that the program would start in their localities later. The 21 late treatment localities were phased-in at the beginning of 2003. They were also eligible to receive three years’ worth of cash transfers. At the end of 2005, all program benefits were discontinued and the program no longer operated in these municipalities.

(In 2002, the study selected 21 localities in nearby municipalities as a non-experimental control group interviewed in 2002 and 2004.)

Between November 2009 and November 2011, i.e., between 9 and 11 years after the start of the program for the early-treatment group, researchers conducted a long-term follow-up survey (the 2010 survey). In this survey, researchers included all households in the original short-term evaluation survey, as well as a sample of additional households who, according to the 2000 program census, had children of ages critical to the long-term evaluation. Specifically, researchers oversampled households with children born between January and June 1989 and as well as households that, according to the RPS administrative data, had children born during the six months after the start of the transfers in 2000. The 2000 program census is used to obtain baseline information. The target sample has a total of 1,330 households from the early-treatment group and 1,379 households from the late-treatment group. In 2010, data was collected using an expanded household survey instrument, including new modules on labor market history and economic activities. In addition, a separate, individual-level instrument was designed to measure individual cognition, achievement levels and reproductive health outcomes of each child and young adult born after January 1, 1988. Respondents who could not be found in their original locations were tracked to new locations in Nicaragua and Costa Rica. Attrition ranges between 6 and 22% (depending on the cohort and the outcome).

(The target sample in the comparison group was 757 households.)

The main focus of the analysis of the 10-year differential effects on outcomes for young adults (study 1 and 2) is on the cohort aged 9–12 years at the start of the program in 2000. For this cohort, the combination of program eligibility, age at exposure, pre-program educational patterns, and age-of-menarche (for girls) suggest the CCT could have different effects in the early versus late treatment groups.

The analysis of the 10-year differential effects on anthropometrics and cognition (study 3), focuses on boys exposed to the program in utero and very early in life in the early treatment group, i.e. those born in the first year after the start of the transfers.

All analyses are carried out on an intent-to-treat (ITT) basis.
Experimental Design Details
Randomization Method
Public Lottery
Randomization Unit
Locality
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
42 localities
Sample size: planned number of observations
10,121 households in census of program area prior to randomization The target sample for the long-term evaluation has a total of 1,330 households from the early-treatment group and 1,379 households from the late-treatment group, as well as any split-off households of children below age 22 at follow-up.
Sample size (or number of clusters) by treatment arms
early-treatment group: 21 localities; late-treatment group: 21 localities
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Middlebury College
IRB Approval Date
2009-11-10
IRB Approval Number
9341
IRB Name
Johns Hopkins University
IRB Approval Date
2009-12-10
IRB Approval Number
2009102

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
December 31, 2005, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
November 30, 2011, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
42 localities
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
The 2010 sample includes all households that contain the original bene ficiary of the program. In addition, if an original panel household member under 22 (in 2010) had moved out of the household by 2010, their new household (the split-off household) was
added to the sample. During the follow-up the survey team interviewed 2,505 original households and 1,375 new households, including both local and long-distance migrants
Final Sample Size (or Number of Clusters) by Treatment Arms
early-treatment group: 21 localities; late-treatment group: 21 localities
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
CCT programs have become the anti-poverty program of choice in many developing countries. Numerous evaluations, often based on rigorous experimental designs, leave little doubt that such programs can increase enrollment and grades attained––in the short term. But evidence is notably lacking on whether these short-term gains translate into longer-term educational benefits needed to fully justify these programs. This paper uses the randomized phase-in of the RPS CCT program in Nicaragua to estimate the long-term effects on educational attainment and learning for boys, measured 10 years after the start of the program. Researchers focus on a cohort of boys aged 9–12 years at the start of the program in 2000 who, due to the program’s eligibility criteria and prior school dropout patterns, were likely to have benefitted more in the group of localities that were randomly selected to receive the program first.

Researchers find that the short-term program effect of a half grade increase in schooling for boys was sustained after the end of the program and into early adulthood. In addition, results indicate significant and substantial gains in both math and language achievement scores, an approximately one-quarter standard deviation increase in learning outcomes for the now young men. Hence in Nicaragua, schooling and achievement gains coincided, implying important long-term returns to CCT programs.
Citation
Barham, Tania, Karen Macours, and John A. Maluccio. "More Schooling and More Learning? Effects of a Three-Year Conditional Cash Transfer Program in Nicaragua after 10 Years." IDB Working Paper Series No. IDB-WP-432, July 2013.
Abstract
In the 1990s Mexico launched a new social program—PROGRESA (now known as Oportunidades). As a conditional cash transfer program, PROGRESA integrated investment in human capital with access to a social safety net. From 1998 to 2000, the International Food Policy Research Institute (IFPRI) assisted in evaluating the program. Much of the ensuing research is summarized in IFPRI Research Report 139 by Emmanuel Skoufias. Since the inception of PROGRESA, several countries, particularly in Latin America, have implemented similar programs. One reason for the growing popularity of these programs is that, by encompassing various dimensions of human capital, including nutritional status, health, and education, they are able to influence many of the key indicators highlighted in national poverty reduction strategies. One of these pilot programs, the Red de Protección Social (RPS), modeled after PROGRESA, was begun in Nicaragua in 2000. IFPRI conducted a quantitative impact evaluation of this program. Findings show that the program was effective in several domains, largely erasing differences in health-care and schooling outcomes across expenditure groups. Moreover, the program overcame obstacles found in the lower-income settings of Nicaragua, compared to Mexico, Colombia, or Brazil. One unique aspect of RPS was its approach to health-care supply. Government-contracted private providers supplied the services rather than the Ministry of Health. The results show that such an approach can be an effective delivery mechanism in areas where government provision might prove difficult. In late 2002, based in part on the positive findings of the various evaluations, the government of Nicaragua and the Inter-American Development Bank agreed to a continuation and expansion of a modified program for three more years. IFPRI remained involved in the evaluation of that second phase, including a qualitative evaluation, and the results continued to show that the program was effective in a number of important areas. Nevertheless, at this writing the future of the program is uncertain. Rigorous evaluations are important components of the policymaking process, but they are not the only ones.
Citation
Maluccio, J. A., and R. Flores. 2005. “Impact Evaluation of a Conditional Cash Transfer Program: The Nicaraguan Red de Protección Social.” Research Report 141. Washington, DC, United States: International Food Policy Research Institute

Reports & Other Materials