Columbia International Affairs Online: Working Papers

CIAO DATE: 05/2008

Performance-Based Incentives for Health: Conditional Cash Transfer Programs in Latin America and the Caribbean - Working Paper 120

Marie Gaarder, Amanda Glassman, Jessica Todd

April 2007

Center for Global Development


Poor families in the developing world often lack the resources to take advantage of healthcare. Distance to health facilities, lost wages due to illness, the costs of care-taking and care-seeking, facility fees and other out-of-pocket costs limit access and can threaten to drive poor families deeper into poverty. Conditional Cash Transfer (CCT) programs--which transfer cash to poor mothers for use of health services and education--are one of the strategies to create incentives for the poor to use preventive health care services. Evaluations show that CCT programs work, and their use is spreading rapidly throughout the developing world. Since 1997, seven countries in Latin America and the Caribbean have implemented and evaluated CCT programs with health and nutrition components, and other countries are in the process of developing programs.

This paper analyzes key features of CCT programs and offers practical advice for the design of future CCT programs. Recommendations include:

This paper is one in a series of four CGD working papers written in conjunction with the Performance-Based Incentives Working Group (Working Paper Nos. 119 – 122).