Mudanças e continuidades entre o Chile Solidario e o Ingreso Ético Familiar / Cambios y continuidades entre el programa Chile Solidario e Ingreso Ético Familiar / Change and continuity between Chile Solidario and Ingreso Ético Familiar

Resumo Este artigo apresenta e discute os programas de transferência monetária condicionada implementadas no Chile, o Chile Solidario (2002-2013) e o Ingreso Ético Familiar (2013-presente), procurando identificar continuidades e diferenças entre as duas iniciativas. Tendo por base a literatura sobre mudanças em políticas públicas e, em particular, a tipologia proposta por Howlett e Cashore (2009), que distinguem entre fins e meios, faz-se uma comparação entre os dois programas, de modo a identificar objetivos e mecanismos que se mantêm, quais se alteram, bem como as novidades introduzidas. Argumenta-se que, apesar de ter sido apresentado como um programa inovador em relação ao seu antecessor, o Ingreso Ético Familiar, o Chile Solidario mantém os atributos daquele, aos quais se adicionam alguns novos elementos. O artigo traz contributos em duas áreas: traça a evolução da política de transferência condicionada no Chile nas duas últimas décadas e dialoga com a literatura sobre mudança em política social.

Resumen El artículo presenta y discute los programas de transferencia condicionada chilenas - el Chile Solidario (2002-2013) y el Ingreso Ético Familiar (2013-presente) - y busca identificar continuidades y diferencias entre las dos iniciativas. Teniendo como base la literatura acerca de cambio en políticas públicas y, en particular, la tipología propuesta por Howlett y Cashore (2009) que distingue entre fines y medios, se realizar un análisis comparado entre ambos programas, buscando identificar los objetivos y mecanismos que persisten, los que se modifican y si se introducen innovaciones. Como resultado, pese a que haya sido presentado como un programa innovador en relación al anterior, el Ingreso Ético Familiar mantiene los principales atributos de Chile Solidario, a los cuales son añadidos algunos nuevos elementos. El artículo busca hacer contribuciones en dos áreas: (1) mapear la evolución de los programas de transferencia condicionada en las dos últimas décadas y (2) dialogar con la literatura sobre cambios en política social.

Abstract This article presents and discusses the two conditional cash transfer initiatives implemented in Chile - Chile Solidario (2002-2013) and Ingreso Ético Solidario (2013-present) - and aim at identifying continuities and change between the two. A comparison of the two programmes, based on Howlett and Cashore's (2009) tipology for analysing policy change that distinguished between ends and means, allows the identification of continuities and changes regarding the goals and mechanisms present in the two programmes. The article argues that despite being announced as an innovative measure in regard to the previous programme, Ingreso Etico Familiar maintains the core characteristics of Chile Solidario and includes some additional elements. This article makes two different contributions: (1) it traces the evolution of conditional cash transfers programmes in Chile over the past two decades and (2) it establishes a dialogue with the literatures on changes to social policy.

¿Cuál es el impacto de la implementación de bonos de impacto social en programas y servicios sociales?: síntesis rápida de evidencia / What is the impact of implementing social impact bonds in social programs and services?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO Un bono de impacto social es un mecanismo de financiamiento innovador en que los gobiernos establecen contratos con proveedores de servicios sociales, tal como empresas sociales u organizaciones sin fines de lucro, y con inversionistas, para pagar por el logro exitoso de determinados resultados del ámbito social. Debido a esto la División de Cooperación Público-Privada del Ministerio de Desarrollo Social de Chile solicita esta síntesis de evidencia con el objetivo de sintetizar la información sobre los efectos de la implementación de los bonos de impacto social en el mundo, y de esta manera informar a la toma de decisiones. METODOLOGÍA Utilizando palabras clave como "conditional cash transfer", "social bonds", "pay for performance" y "pay for success financing", se buscó en las bases de datos Web of Science, Social System Evidence, MedLine, Embase, Scopus, HealthSystemsEvidence, HealthEvidence, Epistemonikos, la Biblioteca Cochrane, y PubMed, con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Los criterios de inclusión contemplaron mecanismos de financiamiento que incluyeran los tres actores principales de un Bono de Impacto Social: inversionista, institución privada e institución pública que ejecutará la intervención social. Se excluyeron artículos de revisiones, editoriales, comentarios, modelos matemáticos y otros que no incluyeran la evaluación del efecto de los BIS y mecanismos de pago basados en desempeño individual. RESULTADOS -No se encontró evidencia sobre el efecto de bonos de impacto social.

Household characteristics, housing profile and diet diversity of Pantawid Pamilyang Pilipino Program (4Ps) beneficiaries and non-beneficiaries in Lucena City, Quezon, Philippines

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The Philippines adopted the Conditional Cash Transfer (CCT) program as the Pantawid Pamilyang Pilipino Program (4Ps) that serves as the government's flagship social assistance program for the poor. This provides short-term income support to poor families while investing on health and education to overcome future poverty.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to characterize the beneficiary and non-beneficiary households and evaluate the impact of 4Ps program on housing facilities and diet diversity.</p><p style="text-align: justify;"><strong>METHODS:</strong> Quasi-experimental design was used to evaluate survey outcomes between 91 randomly sampled beneficiaries and 91 completely enumerated non-beneficiaries (incoming grantees). FANTA Household Dietary Diversity Score (HDDS) was used as an indicator for dietary diversity while structured questionnaire on housing profile was based on BIDANI and CEM-UPLB tools.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The 4Ps beneficiaries had significantly higher maternal education, household size (?=0.038), and improved water source (?=0.004) than non-beneficiaries. Cash transfer among 4Ps households provided 11% increase in the average monthly income of P7,324 pre-transfer. Diet diversity using FANTA scoring (0-12) showed that nonbeneficiaries were significantly lower by 0.4 than 4Ps score of 7.9 (?=0.003). Maternal education was found to have significant positive correlation with diet diversity. Both groups had high cereals and fats intake (>90%) while low in complex carbohydrates and legumes (<31%).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The 4Ps had positive correlation on housing profile and diet diversity among beneficiaries. Family Development Session should integrate practical methods on improving variety of foods, specifically, the low consumption food groups. Additionally, a review on the selection criteria based on the provincial poverty threshold vis a vis income of grantees must be implemented to accurately target intended beneficiaries.</p>

Los efectos de los programas sociales en la salud de la población en condición de pobreza: evidencias a partir de las evaluaciones de impacto del presupuesto por resultados a programas sociales en Perú / Effects of social programs on indigent population health: evidence from results-based budgeting’s impact evaluations to social programs in Peru

Este artículo describe la experiencia en la gestión de evaluaciones de impacto del Ministerio de Economía y Finanzas (MEF) como uno de los instrumentos del presupuesto por resultados, y documenta el diseño de las evaluaciones de impacto a tres programas sociales emblemáticos y los resultados obtenidos, haciendo énfasis en aquellos vinculados a la salud de su población objetivo. Estos son el Servicio de Acompañamiento a Familias (SAF) del Programa Nacional Cuna Más, el Programa Nacional de Apoyo Directo a los Más Pobres JUNTOS y el Programa Nacional de Asistencia Solidaria Pensión 65. Los resultados muestran que el SAF generó mejoras en el desarrollo cognitivo y de lenguaje en los niños mas no en las prácticas de cuidado infantil de las madres, ni en el estado nutricional de los niños. JUNTOS logró incrementos en el gasto per cápita, gasto en alimentos, disminución de la severidad de pobreza y mejoras en el logro educativo. Sin embargo, no se encontraron resultados significativos en la mayoría de indicadores de salud prenatal ni estado nutricional infantil. Pensión 65 mejoró la salud emocional del adulto mayor (depresión, autovaloración), pero no se evidenció aumentos en el uso de servicios de salud por parte de los adultos mayores ni mejoras en su salud física. Se recomienda que dichos programas fortalezcan sus diseños y acciones de articulación con el Ministerio de Salud y entre diferentes niveles de Gobierno, cuando corresponda, a fin de mejorar la oferta y contenidos de las prácticas saludables y optimizar la prestación de los servicios de salud.

This article describes the experience of the MEF’s impact evaluation management as one of the RBB instruments and documents the design and results obtained from three impact evaluations of the most emblematic government social programs. The Service of Visiting Families (SAF) of the National Program "Cuna Mas", conditional cash transfer Program "JUNTOS" and National Program "Pension 65" focusing on objective population’s health the outcomes. Among the main results, it was found the SAF generated improvements in cognitive and communication development in children, but had no impact on mothers’ child care practices or children’s nutritional status. In the case of JUNTOS, there were increases in per capita spending, food expenditure, decreases in severity and poverty gap, increases in school attendance and reductions of school dropout. However, no significant results were found in most indicators of prenatal health, child health, or chronic malnutrition. In the case of Pension 65, there were increases in household consumption and improvements in elderly’s emotional health (depression, self valoration); but there was no evidence of increases in the use of health services by the elderly or improvements in their physical health. Therefore, it is recommended that such programs boost their designs and inter-sectoral coordination with MINSA and subnational institutions, in order to improve contents of healthy practices and child care, and optimize the provision of health and education services, in order to meet the demands of their users.

A next generation of conditional cash transfer programs / Una próxima generación de programas de transferencia condicionada de ingreso / Uma próxima geração de programas de transferência de renda condicionada

Abstract This article evaluates the role of the Brazilian federal Conditional Cash Transfer programs (CCTs) such as Bolsa Família and Bolsa Escola during the past recent years and discusses their future. Based on previous empirical evidence based on my own work, I propose an integrated framework with two complementary perspectives. The first perspective is a goal approach based on the short term aggregated influences exerted by these programs, organized under four headings, namely: equality, prosperity, stability and sensibility. The emphasis here is to compare the results of Bolsa Família with other official programs such as BPC and Social Security benefits. The second perspective follows a means approach inspecting the microeconomic mechanisms through which CCTs operate, comparing the impacts on CCTs beneficiaries versus non-beneficiaries. Such perspective helps in dialoguing about the relevance of different CCTs attributes, and to discuss possible desirable upgrades.

Resumen Este artículo examina el papel de las políticas de transferencias condicionadas de ingreso (CCT's en Inglés) como Bolsa Familia y Bolsa Escuela, su reciente expansión y su futuro. Organizamos la evidencia empírica de nuestros trabajos, propongo un marco integrado desde dos perspectivas complementarias. La primera utiliza un enfoque-final desde una gama de influencias macroeconómicas a corto plazo ejercidas por esos programas a través de cuatro componentes: equidad, prosperidad, estabilidad y sensibilidad. El énfasis es en la comparación de los resultados del Bolsa Familia con otros programas, como las prestaciones de la Seguridad Social y BPC. La segunda utiliza un enfoque-medio a través de la inspección de los mecanismos por los que las CCT's operan mediante la comparación de los impactos sobre los beneficiarios vis-à-vis aquellos que no son. Esto ayuda en el diálogo sobre la relevancia de los diferentes atributos de las CCT's y posibles mejoras.

Resumo Este artigo avalia o papel de programas de transferência de renda condicionada (sigla CCTs em inglês) como o Bolsa Família e o Bolsa Escola federais, sua expansão recente e discute o seu futuro. Organizamos evidências empíricas de trabalhos anteriores, propondo um arcabouço integrado a partir de duas perspectivas complementares. A primeira utiliza abordagem-fim via influências agregadas de curto prazo exercidas por esses programas por meio de quatro componentes: equidade, prosperidade, estabilidade e sensibilidade. A ênfase é sobre a comparação dos resultados do Bolsa Família com outros programas, como o Benefício de Prestação Continuada (BPC) e a Previdência Social. A segunda perspectiva segue abordagem-meio inspecionando os mecanismos microeconômicos pelos quais os CCTs operam, comparando os impactos sobre os indivíduos beneficiários desses programas vis-à-vis aqueles que não o são. Essa segunda perspectiva ajuda no diálogo sobre a relevância dos diferentes atributos dos CCTs e a discutir possíveis melhorias.

Dietary diversity of Pantawid Pamilyang Pilipino Program beneficiary and non-beneficiary households in selected barangays in San Pablo City, Laguna, Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> The study aimed to analyze the household dietary diversity of beneficiary and non-beneficiary households of Pantawid Pamilyang Pilipino Program (4Ps) in selected barangays in San Pablo City, Laguna, Philippines and determine the nutritional status of children (6-60 months old) within these households.<br /><strong>METHODS:</strong> Household dietary diversity score (HDDS) was used as an indicator for the households' dietary diversity. The nutritional status of children was determined using anthropometric data from the Barangay Health Centers. A total of 270 households was randomly selected through stratified random sampling with equal allocation.<br /><strong>RESULTS:</strong> Findings showed that beneficiary households had higher HDDS compared to the non-beneficiary households. The results also suggest that beneficiary households with larger household size, higher income, who were living in rural areas and who have female as well as more educated financial managers, tend to have a more diverse diet. On the other hand, a higher prevalence of malnutrition was observed among children in beneficiary households.<br /><strong>CONCLUSION:</strong> Beneficiary households of 4Ps had better diet quality in terms of diversity than non-beneficiary households. However, the advantage of having a more diverse diet has not fully addressed the malnutrition problem among children as it was still widely prevalent in beneficiary households.</p>

A study on utilization of Janani Suraksha Yojana and its association with institutional delivery in the state of West Bengal, India.

Background: India launched the Janani Suraksha Yojana (JSY) on the principles of conditional cash transfer providing monetary incentive to needy women to improve access to institutional childbirth. Objectives: This study was conducted among JSY-eligible women who delivered between April 2012 and June 2012 to assess the utilization of cash incentives toward institutional delivery, along with other associated factors influencing institutional delivery. Methods: It was a cross-sectional, descriptive study conducted between July 2012 and May 2013 on 946 women selected through stratified random sampling of subcentres from better and worse performing districts of West Bengal. Results: 74.7% of the study population was JSY-eligible. 90.2% of those who took three antenatal check-ups (ANCs) and 36.8% JSY-noneligible women received cash. Government institutions were preferred for childbirth among all groups irrespective of JSY eligibility, receipt of cash, and number of antenatal visits. Overall, 78.8% opted for institutional delivery if they had received cash, which was significantly more than those who did not (64.5%). JSY-eligible women were 1.5 times more likely to deliver in government institutions compared to JSY-noneligible women. With no incentive, the likelihood of institutional delivery was halved. The distance of a 24 Χ 7 delivery hub beyond 5 km (74.8% vs. 81.8%), the religion of Islam (62.7% vs. 83.2%), and multiparity (63.9% vs. 83.6%) were significant deterring factors. Conclusion: Despite some inclusion and exclusion errors, cash incentive under JSY was associated with increased institutional delivery, especially in government institutions though there were other factors influencing the decision as well.

Programa Bolsa Família e o acompanhamento das condicionalidades na área de saúde / Family Allowance Program and the follow-up of the conditions related to the health field

Resumo: Este artigo consolida resultados de uma pesquisa realizada em dez municípios brasileiros, que buscou analisar a dinâmica de acompanhamento das condicionalidades de saúde do Programa Bolsa Família. A ideia central consistiu em abordar variáveis que poderiam afetar o desempenho municipal na gestão do programa, tais como: porte populacional e magnitude da população a ser coberta; estrutura e capacidade técnico-gerencial dos municípios; oferta e organização da Atenção Básica em Saúde e arranjos intersetoriais.

Abstract: This article consolidates results from a research carried out in ten Brazilian cities. The research analyzed the dynamic of the follow-up of the conditions related to the health field of the Family Allowance Program. The central idea was to approach the variables that could affect the City Hall performance in managing the program, such as: population size, magnitude of the population to be attended, the structure and both the technical and managing capacity of the each one of the City Halls analyzed, the offer and organization of the Primary Health Care and sector arrangements.

Avaliação das condicionalidades em saúde do Programa Bolsa Família / Conditionalities health evaluation of the Bolsa Família Program

Os programas de transferência condicionada de renda estão disseminados em países em desenvolvimento na América Latina com ênfase no Brasil como um novo paradigma nas políticas sociais para erradicação da pobreza. Consistem no repasse de recusros monetários de renda do governo diretamente para familias pobres mediante cumprimento das condicionalidades em educação e saúde. Na saúde, memos com variçãoes entre os países as condicionalidades tem como público alvo gestantes e crianças com vistas à redução de indicadores de saúde da criança, como cescimento e desenvolvimento, mortalidade infantil e incemento do pré-natal. Os objetivos deste trabalho são comparar o programa de transferencia condicionada de renda brasileiro, o Bolsa Familia e os programas semelhantes na América Latina em relação aos seus efeitos no crescimento e desenvolvimento de crianças até 7 anos de idade e avaliar a prevalencia das condicionalidades em saúde da mulher e da criança entre usuárias dos serviços de saúde brasileiros cujas equipes aderiram ao Programa de Acesso e Qualidade da Aenção Básica (PMAQ). Para o primeiro objetivo foi realizada uma revisão sistemática onde selecionaram-se dez artigos entre mais de mil encontrados nas bases de dados Embase, Pubmed, Scopus, Scielo e Lilacs. Os artigos são estudos epidemiológicos observacionais dos tipos descritivos transversais e analíticos de coorte e casos-controle. Para o estudo de prevalencia, análise estatística utilizou a regressão de Poisson com variância robusta para investigar como a prevalência do cumprimento das condicionalidades na área de saúde foi influenciada pelas diversas variáveis explicativas.

Foram estimadas razões de prevalências brutas e ajustadas, com seus respectivos intervalos de confiança de 95%. O cadastro no programa bolsa família foi considerado como principal variável de exposição. As variáveis de confundimento foram: idade da mãe, escolaridade, raça/cor, saber ler, viver sozinha e região de moradia. Na análise dos dados foi utilizado o software R 3.0.1 (RDevelopment Core Team, 2013). Em relação a comparação do Bolsa Familia com demais programas da América Latina, a revisão mostrou resultados semelhantes quanto ao efeito positivo dos programas de transferência de renda no estado nutricional de crianças beneficiárias, sendo que estes efeitos são mais evidenciados em crianças menores de dois anos de idade, bem como pertencentes às famílias de mais baixo nível socioeconômico. Para a prevalencia das condicionalidades entres os diferentes grupos de usuárias do Bolsa Família e não usuárias Os resultados apontaram que não houve diferença estatística significativa entre respondentes (com filhos menores de dois anos) cadastrados e não cadastrados no PBF quanto às questões referentes aos seguintes aspectos: cumprimento do calendário vacinal da criança, realização de pelo menos sete consultas de pré natal, realização do acompanhamento do crescimento e desenvolvimento da criança e receber orientação da equipe de saúde quanto a alimentação da criança. Conlui-se de um lado que aumento de renda mínima para familias de exterma pobreza mostrou impacto possitivo na saúde das cranças no Brasil e América Latina. Do outro não confirmou, no Brasil, uma incremento das condicionalidades expressas numa utlização dos serviços de atenção básica por parte das usuárias do Bolsa Familia. (AU)

The programs of conditional cash transfer are widespread in developing countries in Latin America with emphasis on Brazil as a new paradigm in social policies for poverty eradication. Consist of transferring monetary funds from the government directly to poor families by fulfilling the conditionalities on education and health. In health, even with variations between countries, conditionality targeting public pregnant women and children with a view to improving health indicators maternoinfantil as growth, infant mortality and prenatal care. The objectives of this study are to compare the transfer program conditional Brazilian income, the Family and similar programs in Latin America in relation to its effects on growth in children, and to evaluate the effect of Bolsa Família in the prevalence of use of services (conditionalities) of prenatal care in Brazilian health services whose teams joined the Programa de Acesso e Melhoria da Qualidade da Atenção Básica (PMAQ-AB). For the first objective a systematic review , we selected ten articles between 1007 (one thousand and seven) found in the databases Embase, PubMed, Scopus, Scielo and Lilacs databases was performed. Articles are observational epidemiological studies of transverse descriptive and analytical types of cohort and case - control. For the second objective, for it is a prevalence study, a statistical analysis using Poisson regression with robust variance was performed to investigate how the prevalence of compliance with conditionalities on health was influenced by various explanatory variables. Ratios, crude and adjusted prevalence, with their respective confidence intervals of 95 % were estimated. The family joined the scholarship program was considered as the main exposure variable. Confounding variables were: maternal age, race / color, paid employment , marital status and region of residence. In data analysis software R 3.0.1 (RDevelopment Core Team 2013) was used . Regarding the comparison of the Bolsa Família with other programs in Latin America, the review found similar results regarding the positive effect of income transfer in the nutritional status of beneficiary children programs, and these effects are more evident in children under two years old and belonging to families of lower socioeconomic status. For the prevalence of conditionalities entres different groups of users of the Bolsa Família and nonusers results showed no statistically significant difference between respondents (with children under two years) registered and not registered in PBF on issues relating to: meet at least six prenatal visits, meet and participate in health education activities. It follows from side to increase minimum income for families in extreme poverty showed positive impact on children's health in Brazil and Latin America. The other is not confirmed in Brazil, an increase in conditionality expressed in use of primary care by the users of the Bolsa Família services. (AU)

A gestão das condicionalidades de saúde do Programa Bolsa Família: relações intergovernamentais e intersetoriais / \" The health conditionalities of the management of the Bolsa Família Program: intergovernmental and intersectoral relations \"

O Programa Bolsa Família (PBF) é um programa nacional de transferência de renda com condicionalidades, destinado às famílias em situação de pobreza ou extrema pobreza. O recebimento do benefício monetário está vinculado ao cumprimento pelas famílias de condicionalidades nas áreas de educação, saúde e assistência social. As condicionalidades do programa têm suscitado um amplo debate, com posicionamentos contrários e favoráveis à sua existência. As condicionalidades de saúde se referem a ações básicas (imunização, pré-natal, acompanhamento do crescimento e desenvolvimento infantil) que já deveriam ser garantidas no âmbito do Sistema Único de Saúde (SUS). A pesquisa desenvolvida teve como objetivo analisar a gestão das condicionalidades de saúde do PBF no contexto do município do Rio de Janeiro,considerando os propósitos e diretrizes da política nacional e as relações intergovernamentais e intersetoriais na gestão local do programa. A metodologia utilizada foi um estudo de caso, que envolveu revisão bibliográfica, análise documental, análise de bases de dados secundários e realização de vinte entrevistas semi estruturadas com dirigentes e profissionais envolvidos na gestão do PBF. A pesquisa demonstrou que o desenho dos programas próprios de transferência de renda implantados na esfera estadual (Renda Melhor) e municipal (Cartão Família Carioca) incorporou inovações relevantes. Além disso, constataram-se diferenças na lógica subjacente às condicionalidades entre esses dois programas. As relações intersetoriais na gestão local das condicionalidades da saúde do PBF demonstraram-se frágeis no que concerne à interação entre a saúde e a assistência social...

The Program Bolsa Família (PBF) is a Brazilian national conditional cashtransfer program aimed at families in poverty or extreme poverty. Receiving thefinancial benefit is dependent on meeting conditionalities in the areas of education,health and social assistance, which constitutes a controversial aspect of the program.The health conditionalities refer to basic actions (immunization, prenatal care,nutritional monitoring of children) that should already be ensured under the UnifiedHealth System (SUS). This study aimed to review the management of the PBF healthconditionalities in the context of the municipality of Rio de Janeiro, considering theobjectives and guidelines established by national policy and the relations betweendifferent levels of government and different sectors in the local management of the program. The methodology employed was a case study, involving bibliographic review,documental analysis, analysis of secondary data and twenty semi-structured interviewswith managers and other staff involved in PBF management. The study showed that cash transfer programs implemented at a state level (Renda Melhor) and municipal level(Cartão Família Carioca) have incorporated important innovations. Furthermore, differences were found in the underlying logic of the conditionalities between these two programs. The cross-sectorial relations in the local management of the PBF health conditionalities were found to be fragile in terms of the interaction between health and social assistance...

Evaluation of Janani Suraksha Yojana (JSY) in Maharashtra, India: Important Lessons for Implementation.

Aims: The study was conducted to estimate the proportion of eligible women for Janani Suraksha Yojana and to understand the factors affecting receipt of benefits in Maharashtra State, India. Methodology: It was as comparative observational study conducted in Maharashtra State having a population of 112.37 million. Each district was divided into five strata tribal, rural, Municipal Council, slum and non-slum in Municipal Corporation. In each district about 2400 household were surveyed comprising proportionate quotas from each stratum. Surveying unit from each stratum was randomly selected. The study population consisted women delivered in 2008-2009 year. Firstly Head of household was interviewed for confirming child delivery in the reference period. Then delivered woman was interviewed for checking eligibility to JSY and then details of receipt of benefits were obtained from her. Receivers and non-receivers of benefits were compared with respect to some variables. The study was undertaken with the help of Community Medicine Department from Government Medical Colleges. Results: In the reference period 4,544 women delivered children and 41.15% were found eligible for the scheme. But only 52.57% certainly received cash benefits. About 24% surely did not receive and 23% were not sure about receipt or the scheme and hence included in non-receiver group for further analysis. Non-earning women, not delivered in public health care institutions and un-aware about the scheme were unlikely to receive the benefits. Ante Natal Care visits, immunization, receipt and consumption of Iron and Folic Acid tablets were better among beneficiaries then non-receivers of the benefits. The benefits were not received immediately after delivery. About 10% women had problems in receiving the benefits, particularly requirement of certain certificates. Conclusion: The uptake of the scheme may be slightly higher than 53% and there are many factors responsible for not reaching to entire eligible population. Modifiable risk factors like delivery in government health institution and awareness about the scheme are playing major role in receiving the benefits.

El resurgir de viejos fantasmas: política asistencial y mundo del trabajo / The resurgence of old ghosts: social assistance policy and labor world

Desde fines de los años 90 en América Latina la política asistencial se ha ampliado e institucionalizado, asumiendo principalmente la forma de Programas de Transferencia Condicionada. También en el Uruguay, desde el 2005 se ha consolidado esta línea de actuación pública. Uno de los principales aspectos desde los que han sido discutidos estos programas, refiere al vínculo con el trabajo. Las transferencias desalentarían a los beneficiarios a trabajar, aumentando la dependencia del Estado. A partir de la experiencia uruguaya este trabajo analiza la relación entre inserción en el mundo del trabajo y transferencias condicionadas, observando que no se verifican esas preocupaciones. Estas, son estructurantes del campo de la asistencia que resurgen en la actualidad como viejos fantasmas.

Since the end of the nineties, Latin America has widened and institutionalized its social assistance policies, mainly by the implementation of Conditional Cash Transfer Programs. In Uruguay, these programs have been implemented since 2005. One of the more debatable topics regarding these programs has been their impact on work and whether transfer programs would not incentive beneficiaries to work and promote their dependency with the State. This paper presents the Uruguayan case analyzing Conditional Cash Transfer Programs and the world of work stating there is no such impact of these programs on adult work. Rather, these concerns are old ghosts which have always been present in the social assistance arena.

Los Programas de Transferencia de Renta Condicionadas como gestión neoliberal de la cuestión social / The Programs of Conditional Cash Transfer as a neoliberal way to manage the social issue

El neoliberalismo continúa demostrando su manifiesta incompetencia a la hora de plantear una pauta razonable de integración social. Los Programas de Transferencia de Renta Condicionada implementados en Uruguay, a partir de la creación del Ministerio de Desarrollo Social (Mides) en el año 2005 se diseñaron con el explicito objetivo de combatir la pobreza extrema, consecuencia directa de la aplicación de las políticas neoliberales desarrolladas en el Uruguay. El artículo busca demostrar que la paradoja contenida en el propio dispositivo, es que esta búsqueda se realiza rindiendo culto a los límites impuestos por la retórica neoliberal.

Neoliberalism continues to demonstrate its incompetence when considering a reasonable standard of social integration. The Programs of Conditional Cash Transfer implemented in Uruguay from the creation of the Ministry of Social Development (Mides) in 2005 were designed with the explicit objective of combating extreme poverty, a direct result of the application of neoliberal policies developed in Uruguay. The article shows that the paradox in the device itself is that it attempts to perform within the limits imposed by the neoliberal rhetoric.

El desarrollo del capitalismo y la nueva configuración de la protección social: la Asignación Universal por Hijo en Argentina / The development of capitalism and the new configuration of social protection: the Universal allocation per child in Argentina

En este trabajo señalamos el contexto político, económico y social en que surge y se implementa la Asignación Universal por Hijo en Argentina como un programa de "Transferencias Monetarias Condicionadas" aprobado a fines del año 2009. Caracterizamos este programa a partir de un conjunto de dimensiones de análisis, desde una perspectiva amplia y compleja sobre la política social, e identificamos problemas en relación a la orientación y sentido ético político que persigue. En relación a estos interrogantes colocamos algunas tensiones centrales que hacen al desarrollo del capitalismo y a la implementación de políticas: la relación de las condiciones y formas de organización del trabajo y las desigualdades contemporáneas con las formas de protección social; el papel de las condicionalidades y las tensiones con perspectivas universalistas. De este modo damos cuenta de la configuración de un nuevo sistema de protección social acorde con las transformaciones del capitalismo contemporáneo.

In this paper we pointed out the economic, political and social context that arises and implements the Universal allocation per child in Argentina as a program of "Conditional Cash Transfers" adopted at the end of the year 2009. We characterize this program from a set of dimensions of analysis, from a broad perspective and complex on social policy, and identify problems in relation to the orientation and sense of ethics that aim. In relation to these questions we put some tensions that make central to the development of capitalism and to the implementation of policies: the relationship of the conditions and forms of work organization and inequalities with contemporary forms of social protection; the role of the conditionalities and tensions with universalist perspective. In this way do we account for the configuration of a new system of social protection in line with the contemporary transformations of capitalism.

Impact of Conditional Cash Transfers on Maternal and Newborn Health.

Maternal and newborn health (MNH) is a high priority for global health and is included among the Millennium Development Goals (MDGs). However, the slow decline in maternal and newborn mortality jeopardizes achievements of the targets of MDGs. According to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50%. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in maternal and newborn health interventions in low- and middle-income countries. Conditional cash transfer (CCT) programmes have been shown to increase health service utilization among the poorest but little is written on the effects of such programmes on maternal and newborn health. We carried out a systematic review of studies on CCT that report maternal and newborn health outcomes, including studies from 8 countries. The CCT programmes have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers and reduced the incidence of low birthweight. The programmes have not had a significant impact on fertility while the impact on maternal and newborn mortality has not been welldocumented thus far. Given these positive effects, we make the case for further investment in CCT programmes for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programmes. We recommend more rigorous impact evaluations that document impact pathways and take factors, such as cost-effectiveness, into account.

Lucha política y des-politización: nuevos dispositivos tecnocratizantes / Political struggle and depoliticization: technological new devices

El documento que se presenta busca tematizar el surgimiento y características que adquieren los Programas de Transferencia de Renta Condicionada. Se busca describir las condiciones societarias que los generan, tratando, asimismo, de partiendo de la reflexión lukacsiana sobre la crisis de la filosofía burguesa y su expresión apologética, iluminar en este complejo proceso de conflicto distributivo. Su objetivo es demostrar que la incorporación de tecnología en los programas sociales puede ser analizada con los mismos énfasis que en la reestructuración productiva. En este sentido, se puede considerar como un complemento a la ofensiva de la economía política burguesa sobre la economía política de los trabajadores...

The document that presented, attempts to give the discussion with regard to the emergence and characteristics that acquire the conditional income transfer program. It seeks to describe the corporate conditions that generate them, trying to find at lukacsianas reflections on the crisis of philosophy bourgeoisie and its apologetic expression, cast light on this complex process of distributive conflict. Its aim is to demonstrate that the incorporation of technology in social programs can be analyzed with the same emphasis on productive restructuring. In this sense, can be considered as a complement to the offensive of bourgeois political economy on the political economy of workers...

Impact of Janani Suraksha Yojana on Institutional Delivery Rate and Maternal Morbidity and Mortality: An Observational Study in India.

The Government of India initiated a cash incentive scheme—Janani Suraksha Yojana (JSY)—to promote institutional deliveries with an aim to reduce maternal mortality ratio (MMR). An observational study was conducted in a tertiary-care hospital of Madhya Pradesh, India, before and after implementation of JSY, with a sample of women presenting for institutional delivery. The objectives of this study were to: (i) determine the total number of institutional deliveries before and after implementation of JSY, (ii) determine the MMR, and (iii) compare factors associated with maternal mortality and morbidity. The data were analyzed for two years before implementation of JSY (2003-2005) and compared with two years following implementation of JSY (2005-2007). Overall, institutional deliveries increased by 42.6% after implementation, including those among rural, illiterate and primary-literate persons of lower socioeconomic strata. The main causes of maternal mortality were eclampsia, pre-eclampsia and severe anaemia both before and after implementation of JSY. Anaemia was the most common morbidity factor observed in this study. Among those who had institutional deliveries, there were significant increases in cases of eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage (APH), postpartum haemorrhage (PPH), and malaria after implementation of JSY. The scheme appeared to increase institutional delivery by at-risk mothers, which has the potential to reduce maternal morbidity and mortality, improve child survival, and ensure equity in maternal healthcare in India. The lessons from this study and other available sources should be utilized to improve the performance and implementation of JSY scheme in India.

Fluxos decisórios na formulação das condicionalidades de saúde do programa bolsa família / Decision-making fluxes related to counterpart healthcare condition's concept in the programa bolsa família

Os programas de transferência condicionada de renda (TCR) entram na agenda pública por sua potencialidade em interferir no ciclo intergeracional de pobreza. Este artigo tem como objetivo analisar o processo de formulação das condicionalidades de saúde do Programa Bolsa Família e, secundariamente, avaliar sua interface com a trajetória das políticas de alimentação e nutrição no Brasil. Para isso, o estudo adotou como referencial analítico o modelo de análise de múltiplos fluxos, proposto por Kingdon, para quem a mudança na agenda pública acontece com a convergência entre o fluxo dos problemas, o fluxo das soluções e alternativas e o fluxo político. A trajetória desses fluxos foi recomposta por meio da análise de documentos governamentais e de relatos orais obtidos por meio de entrevistas. No momento da formulação das condicionalidades de saúde, no fluxo de problemas, havia a necessidade de mudar a estratégia de combate à desnutrição, devido às críticas ao Incentivo ao Combate às Carências Nutricionais (ICCN) e à extinção do Programa de Distribuição de Estoques de Alimentos (PRODEA). No que diz respeito ao fluxo das soluções, diversas propostas de TCR estavam em curso. No fluxo político, havia a decisão de criação de uma rede de proteção social. Nesse processo, a Coordenação Geral da Política de Alimentação e Nutrição assumiu o papel de empreendedora de políticas. A reflexão sobre esse processo ajuda a compreender o papel dos serviços de saúde em um programa de caráter intersetorial.

Pobreza e Política Social: a implementação de programas complementares do Programa Bolsa Família / Poverty and Social Policy: the implementation of complementary programs for the Bolsa Família Program

The Bolsa Família Program involves the transfer of income and the implementation of complementary programs to foster human capital development and empower the beneficiaries. To analyze the implementation of complementary programs in Manguinhos, Rio de Janeiro, a review of documents and secondary data was conducted, focus groups of beneficiaries studied and semi-structured interviews were staged with governmental, nongovernmental stakeholders and beneficiaries. The design, coverage and evaluation of the complementary programs have been weak, and beneficiaries were even unaware of vocational training courses. The program administrators acknowledged the failings and the fact that the courses offered by Próximo Passo are not adapted to local demand, even though they were conceived as a vocational training strategy aimed at creating construction jobs in the Growth Acceleration Program and the tourist industry in the city. Considering that the social inclusion perspective is linked to access to public policies, the supply and follow-up of these activities by government agencies and civil society organizations are essential for the effectiveness of the fight against poverty and hunger, aimed at contributing to the so-called "exit routes" from the Bolsa Família Program.

O Programa Bolsa Família articula a transferência de renda à implementação de programas complementares, a fim de promover o desenvolvimento de capital humano e a autonomização dos beneficiários. Para analisar a implementação dos programas complementares em Manguinhos, Rio de Janeiro, realizamos consultas documentais; grupos focais com beneficiários; entrevistas semiestruturadas com atores governamentais, não-governamentais e beneficiários, além da coleta de dados secundários. O desenho, a cobertura e a avaliação dos programas complementares mostraram-se frágeis. Os beneficiários desconheciam cursos de qualificação profissional. Os gestores reconheceram a debilidade das ações e destacaram que os cursos do Próximo Passo não se adéquam à demanda local, ainda que pensados como estratégia de capacitação voltada às obras do Programa de Aceleração do Crescimento e à vocação turística da cidade do Rio de Janeiro. Considerando que a perspectiva de inclusão social está atrelada ao acesso às políticas públicas, a oferta e o acompanhamento destas ações pelas esferas governamentais e organizações civis constituem um eixo crucial para o combate à pobreza e à fome, contribuindo para as chamadas "portas de saída" do Programa Bolsa Família.

Additional cash Incentive within a conditional cash transfer scheme: A 'controlled before and during' design evaluation study from India.

Background : Conditional Cash Transfer (CCT) schemes have shown largely favorable changes in the health seeking behavior. This evaluation study assesses the process and performance of an Additional Cash Incentive (ACI) scheme within an ongoing CCT scheme in India, and document lessons. Material and Methods: A controlled before and during design study was conducted in Madhya Pradesh state of India, from August 2007 to March 2008, with increased in institutional deliveries as a primary outcome. In depth interviews, focus group discussions and household surveys were done for data collection. Results: Lack of awareness about ACI scheme amongst general population and beneficiaries, cumbersome cash disbursement procedure, intricate eligibility criteria, extensive paper work, and insufficient focus on community involvement were the major implementation challenges. There were anecdotal reports of political interference and possible scope for corruption. At the end of implementation period, overall rate of institutional deliveries had increased in both target and control populations; however, the differences were not statistically significant. No cause and effect association could be proven by this study. Conclusions: Poor planning and coordination, and lack of public awareness about the scheme resulted in low utilization. Thus, proper IEC and training, detailed implementation plan, orientation training for implementer, sufficient budgetary allocation, and community participation should be an integral part for successful implementation of any such scheme. The lesson learned this evaluation study may be useful in any developing country setting and may be utilized for planning and implementation of any ACI scheme in future.