Exploring the Health Outcomes of Conditional Cash Transfer Program in Rural Philippines

Abstract

The Pantawid Pamilya Pilipino Program (4Ps), the first conditional cash transfer (CCT) program of the Philippine government, has become a popular approach aimed at improving the health and educational status of disadvantaged households. Its implementation is expected to advance the government’s health agenda, particularly in terms of child mortality reduction and maternal health improvement. Despite the growing evidence on the positive health outcomes resulting from the implementation of CCT programs, evidence remains limited to the qualitative evaluation of health care service utilization among beneficiary households. In this regard, by employing key interviews and focus group discussion, this study aims to examine the impacts of 4Ps on health and nutrition as experienced and perceived by beneficiaries at a community-level implementation. After subjecting the interview transcripts to thematic network analysis, the results reveal six dominant themes: enhanced health practices, improved uptake of health care services, increased awareness on health issues, improved living conditions, responsive program implementation, and persisting implementation challenges. While it is evident that the positive impacts are reflective of the beneficiaries’ strict compliance to meet the program conditionalities, there is still much to be done to ensure the sustainability of the program. The provision for adequate health care should then be supplemented with reinforced delivery of the program’s learning component (family development session) and support mechanism to the implementers.

Examining the Association Between Household Enrollment in the Pantawid Pamilyang Pilipino Program (4Ps) and Wasting and Stunting Status Among Children Experiencing Poverty in the Philippines: A Cross-Sectional Study

“…9 The 4Ps conditionalities include attending maternal and child health care services, as well as participation in monthly Family Development Sessions that cover topics on health, wellbeing, family dynamics, and parenting. [9][10][11] Upon completion, participants are entitled to cash transfers and food subsidies that could support food security and improvements to housing conditions. 9,10 Overall, a combination of both the conditionalities and entitlements are expected to provide families with the resources to create healthy environments that are supportive of children's nutritional status.…”

Limits to Transformational Potential: Analysing Entitlement and Agency within a Conditional Cash Transfer Program in the Philippines

“…Despite the institutionalisation of 4Ps and its positive evaluations, the program has also faced criticism for design and implementation challenges (Tabuga and Reyes, 2012;Peñalba, 2019). For example, the periodic targeting strategy of 4Ps may exclude newly eligible households from the program (Albert and Dacuycuy, 2017;Economic Policy Research Institute, 2019;Dadap-Cantal et al, 2021).…”

“…Others have noted the small size of the cash grant relative to the income of poor households is not enough to result in meaningful impacts (Tabuga and Reyes, 2012;Economic Policy Research Institute, 2019). Concern has also been raised over the capacity of partner institutions to implement the program; for example, some health facilities serving 4Ps beneficiaries have limited capacity, making it challenging to monitor compliance with health-related conditionalities (Fernandez and Olfindo, 2011;Peñalba, 2019). Additionally, an evaluation of the outcomes of 4Ps by the Institute of Family Life and Children's Studies (2016) found that 4Ps may contribute to community division in settings where there is confusion or mistrust in the identification and inclusion of 4Ps beneficiaries (Institute of Family Life and Children's Studies, 2016).…”

“…Additionally, an evaluation of the outcomes of 4Ps by the Institute of Family Life and Children's Studies (2016) found that 4Ps may contribute to community division in settings where there is confusion or mistrust in the identification and inclusion of 4Ps beneficiaries (Institute of Family Life and Children's Studies, 2016). 2 More broadly, there are concerns that recent social policy reforms under the Duterte administration promote and entrench a residualist approach to social policy References: Fernandez and Olfindo, 2011;Orbeta et al, 2014;Acosta and Velarde, 2015;Conchada and Tiongco, 2014;Peñalba, 2019;Saguin and Howlett, 2019. that favours poverty targeting over universal or more inclusive policies and programs (Ramos, 2020).…”

“…Characteristics and conditionalities of the Pantawid Pamilyang Pilipino Program (4Ps) Notes. Conversions between Philippine Pesos (PHP) and US Dollars (USD) are based on the exchange rate on January 1, 2020References:Fernandez and Olfindo, 2011;Orbeta et al, 2014;Acosta and Velarde, 2015;Conchada and Tiongco, 2014;Peñalba, 2019;Saguin and Howlett, 2019.…”