Cash transfer programs have increasingly become the strategy of choice for poverty alleviation in middle and low-income regions such as Latin America and Caribbean countries (LAC), Asia, and Africa [1, 2]. Many of these programs have been found to be effective in improving child outcomes such as learning outcomes, child growth and nutrition. However, several of the child cash transfer programs that have been evaluated and rolled out at scale are conditional cash transfers (CCTs). Conditionality refers to post-grant conditions that require recipients to change their behaviour for purposes of human capital development. Very few developing countries have unconditional child cash transfer programs although they are common in developed countries such as the United Kingdom and several other European Union countries. In Africa, there are a number of unconditional cash transfer programs that exist in countries such as Zambia, Malawi, Ghana, and Kenya but these are either small scale (often pilot programs covering less than 100 000 beneficiaries) or they are not exclusively targeted at children .
Debates on conditional and unconditional cash transfers centre on two main contending arguments. Proponents of conditional cash transfers argue that conditioning transfers on behavioural change helps to address not only immediate poverty but long-term poverty through its insistence on human capital investment . However, advocates of unconditional cash transfers believe that human capital investment in beneficiaries can be enhanced without enforcing conditionality. This group assert that conditionality is a violation of social protection as a human right since it interferes with beneficiaries’ right to choose on what and how the transfer should be spent .
CCTs which have garnered world-wide praise and great interest are from the LAC countries, specifically Bolsa Familia in Brazil and Opportunidades in Mexico (formerly called Progresa). Both programs are targeted and non-contributory, focusing on the health, education and nutrition of children from the poorest households in the two countries [4, 6–8]. The two CCTs have been associated with high rates of school enrolment and attendance, improved child growth (lower prevalence of stunting), increased utilisation of health care services, and in the case of Bolsa Familia, contributing to a reduction in inequality [7, 8].
South Africa is unique among developing countries for establishing a large scale cash transfer program, the Child Support Grant (CSG), for children of poor families. While the CSG is not conditional on behavioural change it does have requirements, which need to be met by prospective recipients. These are: possession of a birth certificate for the child, an identity document for the mother, hospital card, Road to Health Card (infant health record), and a parental income that is currently set at less than R2800 (US$340) per month for single parents, and R5600 (US$680) for married couples. At the time of the study eligibility was below R1100 parental income per month for urban areas and below R800 for rural areas. Recently other requirements for school enrolment and attendance for children between the ages of 7 and 18 years have been added. This new amendment to CSG legislation emphasises that proof of school enrolment and attendance is not a condition for continued receipt of the CSG, but is there to help identify and help children who are struggling to remain in the school system . The CSG was introduced 14 years ago as a response to childhood poverty and it constitutes the largest cash transfer in the continent, both in terms of coverage ( over 10 million children) and the state budget allocated to it (US$695 million per annum) . Over the years, the age limit for eligibility has been repeatedly extended, most recently to 18 years of age. The target set by the Department of Social Development is to reach 100% of all eligible children in the country.
During the early stages of its implementation the CSG was plagued with roll out challenges such as low uptake rates, which have since improved . More recently there have been other debates around conditionality and targeting, with some advocating for continued receipt of the grant to be tied to conditions, and others arguing for universal access instead of means testing for eligibility [12, 13]. The discourse on conditionality in South Africa has been spurred in part by the success of conditional cash transfer programs in LAC countries.
There has been a general paucity of empirical evidence on the performance of the CSG. The few studies that have been conducted have looked at the grant’s reach, utilisation and impact. A national survey conducted by Delany and colleagues in 2008 with some 2700 households in South Africa showed that the CSG is reaching 80% of its intended beneficiaries among all eligible children 0–14 years, constitutes 40% of the household income in poor families, and that 80% of it is used for food, clothing and school related costs . Additionally, more recent evidence shows that take up rates of the CSG are highest between the ages of 7 to 10 years and are lower for infants and adolescents, and that early receipt of the grant is associated with improved child height for age for children whose mothers have higher education levels; and more grades in school for girl children whose mothers have lower education attainment, as well as reduced risky behaviours amongst adolescents . Another study showed that the CSG is positively correlated with improved child nutritional status, and that early receipt of the grant in the first few months of life is critical to achieving this outcome . These studies validate the importance of CSG access and timing of receipt in maximising the benefits of the grant for each child. The study by Delany and colleagues while showing that receipt of the CSG may be high at a national level, conversely highlights the 20% of eligible children who are not receiving the grant, and hides the variations in take up rates present at the provincial level and within age categories [17, 18].
In the absence of strong evidence on the effectiveness of unconditional cash transfers on poverty alleviation and human capital development, there has been a significant move towards replicating the LAC model of conditional cash transfer programs in developing countries all over the world, including Sub-Saharan Africa [2, 13]. The CSG thus presents a unique opportunity to further our understanding of how an unconditional cash transfer works in a developing country context. This paper presents findings on the factors associated with receipt of the unconditional CSG across three diverse settings in South Africa.