Evaluating the Ability of Conditional Cash Transfers to Promote Human Capital Through the Protection of Health

Evaluating the Ability of Conditional Cash Transfers to Promote Human Capital Through the Protection of Health

by Harvard T.H. Chan School of Public Health, Esther Velasquez, Harvard University

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Conditional cash transfer programs have diffused rapidly across the world since the mid- 1990s and have been adopted as a poverty-reduction tool in the majority of Latin American countries. This dissertation focuses specially on the Colombian conditional cash transfer program, Familias en Acción, and examines the relationship between social welfare policy and health in the Colombian context. The work is divided into three separate papers. Paper 1 assesses the impact of Familias en Acción on adult health outcomes that capture disruptions in daily life due to health conditions. The analysis utilizes data collected by the Colombian National Department of Planning for program evaluation purposes and employs a differences-in-differences approach specifying mixed effects logistic models to examine the impact of the program on impairment, bedridden status, and hospitalization among individuals 18 years of age and older. Paper 2 explores the impact of Familias en Acción on mortality assessing the possibility of differential impacts by age group and cause of death. The work pools program evaluation data with vital statistics and census data to create a dataset of municipal population, municipal death, and municipal exposure to the anti-poverty program. The analysis uses a differences-in- differences approach specifying mixed effects negative binomial regression models. Paper 3 is a qualitative political economy project and draws from both primary as well as secondary data. Familias en Acción was modeled after the Mexican conditional cash transfer program, and the two programs are nearly identical in terms of programmatic components with one major exception which is in the area of health programming. The Mexican program is more comprehensive in the area of health, targeting all ages and offering a more comprehensive package of health services. The work examines the political and economic reasons that led to the adaptation of the Mexican conditional cash transfer program in the Colombian context.

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