DREAMING TO “LEAP” OUT OF EXTREME POVERTY 2: THE LEAP’S IMPACT

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Some Housekeeping Matters

Apparently, the LEAP is the “flagship programme” of the Ghana government as far as social protection is concerned. So, President John Mahama says in his 2014 State of the Nation speech, that “… through this [LEAP] programme, the Ministry has made cash grants to 74,000 of the poorest households in our country.” The plan, by Mr. President’s speech, is to increase the number of beneficiary households to 100, 000 this year and 150,000 by 2015. (Well, never mind that Mr. President’s Ministrix’ press release, which I mentioned in my previous blog, projected that the pockets of some 100, 000 households were to receive transfers by “December, 2013”; last year).  Also, to His Excellency, these numbers mean “that now, the poorest 74,000 families in Ghana will be able to afford food, clothing and the cost of basic transportation” and that “[n]ow, these families will have access to healthcare and education; now, these families can even invest in some small income-generating activity.”

Clearly, the Government is very positive about the impact of the LEAP. As a matter of fact, this extremely-high expectation of the LEAP is not new. The NPP government’s 2007 National Social Protection Strategy (NSPS) too states that the LEAP is aimed at reducing “extreme poverty, hunger and starvation among the most severely disabled and incapacitated persons living with disabilities”, stimulating “access to social services”, and positively impacting on the livelihood of women, children and HIV/AIDS patients. It is also believed that “when the financial capacity of the poor has been strengthened, the dividend would be recorded in the form of increased basic school enrolment among children in the extreme poor households, reduced infant mortality rate, and improved child nutrition and birth registration.” In fact, the 2007 NSPS describes the LEAP as “The New Dawn in Social Protection.” The general argument that the transfer program does alleviate life-threatening poverty is often reiterated by government officials too. For example, the Director of Finance at the Ministry of Employment and Social Welfare (the ministry that had oversight responsibility for the LEAP at the time) is reported to have suggested that “the local economy would be improved when the poor spent their stipends in their communities.”

Indeed, there have been questions about the LEAP since Mr. President’s speech on Tuesday. Interestingly, the queries focus on transparency and accountability rather than the impact of the program. However, as I indicated in the first part of the blog on this matter, I’ve found some time to look at the general impact of the LEAP. I’ll also attempt to answer the question whether the LEAP in particular and CCTs in general constitute a serious approach to fighting global poverty.

The LEAP’s Impact

Research on the LEAP program after nearly 4 years of implementation reveals some interesting results. A joint report by the University of Carolina, the University of Ghana and the FAO attributes 7% increase in secondary school enrolment and a reduced class repetition among both secondary and primary school children to the LEAP. Even though the report records zero impact of the LEAP on household consumption levels, the likelihood of savings and repayment of debt are recorded to have increased. NHIS enrolment was also found to have been pushed up by LEAP, though the result on morbidity is found to be “mixed”. Generally, social network is found to have been strengthened and household heads made happier by the LEAP.

Another study by Emmanuel Debra in 2013 reports that women in some coastal fishing communities as well as others in the farming communities in the northern part of the country have made good use of the LEAP cash transfer and have made returns in their petty trading. The report also indicates that access to healthcare has been stimulated by the LEAP, and that “pregnant women who were registered under LEAP gained access to antenatal care, and their children received continuous vaccinations through the mandatory immunization of children of beneficiary households.”

The Debrah report however indicates that those who report an improvement in livelihood as a result of LEAP are in the minority. Majority of those covered by the research report “disappointment”. According to one interviewee, Akosua Nyarkoaa of Winneba in the Central Region, the household’s “expenditure on food alone for one month far exceeded the income.” Akosua Nyarkoaa laments that “[t]he money got finished less than a week after receiving it because there was a tall list of items that had to be bought to keep the family alive.” Similar concerns about the near-uselessness of the stipends was reported by the universities of Carolina/Ghana report, which also captures the disconnect between the increase in NHIS enrolment and actual utilization of health services. In fact, just 9 days preceding the minister’s October 14, 2013 press release, there was a cry from the Ho Leprosarium over 9 months arrears of cash transfer to the inmates of the facility. This cycle of irregular payments was also cited as one of the down sides of the LEAP by the two reports I’ve referred to. This irregularity in the payment structure is itself a function of a far bigger problem – lack of funds. Further, the LEAP program pays no attention to the urban poor. This implies that the large army of extremely poor rural-urban migrants are left out. of this “flagship program.”

With background in mind, let’s turn to look at what we mean when we say poverty; global poverty.

Global Poverty

A person is absolutely poor if he lives on less than $2 per day. Such persons, currently numbering about 2.7 billion (of about 7 billion world human population), lack access to safe food and water, decent clothing, shelter and, of course, basic medical care. Yet, the UN Human Development Report (2013) found that as much as thirty percent of the people in 104 countries covered by an MPI (Multidimensional Poverty Index) in 2012, is multi-dimensionally poor. This simple means that they live below US$ 1.24 a day. These 104 countries are spread mainly among the developing countries or the global south.

Far back 2001, the World Bank found that 1.1 billion of the 6.1 billion human beings in the world lived below the international poverty line of that year – $1.075 per day. This is notwithstanding the fact that the world has never been as rich as it is today.  This simply means, as found by the Nobel Laureate Prof. Amartya Sen, that global poverty is increasing even as global wealth increases. This trend offers a great deal of support to the argument that the form of poverty in the world is not as a result of lack of resources or wealth. It may therefore be seen that the issues of global poverty is a very complex one with various causal explanations. In fact, too complex to be tackled seriously by cash transfer programs, whether conditional or unconditional.

In his essay on eradicating global poverty, Professor Thomas Pogge, the renowned German philosopher at Yale, identifies three main causes of global poverty. He terms these causes the “grounds of injustice”, as a way of making a claim of duty so as to bring poverty into the framework of rights. The causes he identified are: (1) the effects of shared social institutions, (2) the uncompensated exclusion from the use of natural resources and (3) the effects of a common and violent history. With respect to the ground of shared social institutions, Prof. Pogge argues that there is a shared institutional order made up of rules; and that this institutional order is designed and entrenched by the powerful countries of the global north. These countries, through “their vastly superior military and economic strength” which they acquired through violent history of colonization and slavery, control these rules. He argues further, that even though these institutions are capable of shaping the global network of resource distribution to improve the lot of the poor, they have refused to do so. Prof. Pogge, concludes that these powerful states are implicated and therefore “share responsibility for their foreseeable effects” – the misery of the almost 2 billion citizens of the world. The evidence for this allegation is derived from how these powerful countries “affect the circumstances of the global poor through investments, loans, trade, bribes, military aid, sex tourism, culture exports and much else.”

It appears that we’re living in a global economy where the conditions of trade are fashioned to perpetually make some nations suppliers of raw materials to other nations that have constituted themselves into a de facto monopoly of sophisticated industry. These hegemony of heavily industrialised countries ‘purchase’ raw materials from the poor nations at extremely low prices, turn them into extremely expensive goods and services, and export them back to the developing world. It appears we’re running a global financial market where poorer countries, victims of Pogge’s violent history of colonization and slavery, seeking financial assistance are burdened with onerous conditionalities. A trade system which preaches principles of free trade and globalization, when what actually seems to happen is wealthy multinationals, wealthier and more powerful than states, of the global north being given the platform to muscle-out and collapse small enterprises of the global south. The European Union, for example, grants daily subsidies to cows at a rate ($2.20) that is more than what the farmer in Guanxi province of China, Rajasthan state of India, the Congo or Sonora in Mexico, and in fact, what about half of the world’s human population lives on in a day. The produce of this subsidised activities are then exported to the developing countries in the name of free trade and globalization, where their main effect is, actually, to push the local cattle farmer out of business. All this weakens the already-fragile economies of these developing countries. So we have created for ourselves, as found by Oxfam, a world where almost half of the total wealth is owned by just 1% percent of the population, with the bottom half of the population, 3.5 billion people, owning the same as the richest 85 people.

Under these soul-crushing circumstances, it is very difficult to see how the powerful global institutions, the World Bank, the IMF, etc., which claim to be leading the fight against global poverty, could expect to sound convincing that the fight against global poverty is an honest one. As the evidence shows above, giving out meagre stipends to the “extremely poor” hardly deals with the real causes of global poverty; and that is the problem with the CCT model in general and the LEAP in particular.

Some Closing Points

Indeed, the LEAP may enable the poor pupil to commute to the school located several kilometres away from her village. The poor fisherman may have been assisted by the LEAP stipends to access the public health facility located several miles away from his small fishing community (and we are assuming here that the LEAP programs runs smoothly without the hitches of irregular payments, effective coverage, etc.). But you see, the reality in our country is that about 40 of every 1,000 live births die before celebrating their first birthday (forget about stillbirth and maternal mortality). Twice that number per 1000 don’t make it past their fifth birthday. Those who cross over this survival line spend their next 10 years battling malnutrition, malaria, measles and other preventable diseases. A little below a quarter of them never get to see the inside of a classroom. As much as a third of those who get to see the inside of some classroom (including ‘tree-under’ classrooms) don’ t have access to secondary education. They spend the rest of their lives battling the indices of extreme poverty – lack of access to food (including clean water), basic health care, education and employment. The remaining half who proceed to secondary school come out with absolutely no employable skills (some unable to read or write). Unemployment still reigns supreme. We’re still a net importer of consumables.  As if that is not enough, we are not even expected to live up to even 65 years.

“Now”, the President says “these families will have access to healthcare and education; now, these families can even invest in some small income-generating activity.” But, with this background, one cannot help but begin to wonder how these bi-monthly cash transfers, the “flagship program”, could do something about this situation. And, it’s still unclear how mere access to these facilities could help a person leap out of extreme poverty, when there is no assurance of quality and sufficiency. Apparently, most of these free schools and clinics hardly meet the standard expected of a school or a health facility.

In all, I think, CCT programs (including the LEAP) have the propensity of (and they actually are) taking governments’ already-exhausted attention off the real issues of poverty. I honestly believe that the LEAP is more of a humanitarian intervention than an attempt at eradicating poverty. At best, it keeps you alive just to go the whole hog of the “extreme poverty” you find yourself in. So, it’s like … you can’t really LEAP out.

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DREAMING TO “LEAP” OUT OF EXTREME POVERTY

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The stick-and-carrot approach is a well-known method for getting people to behave in a certain way. “Stick-and-carrot” because a donkey-cart driver would usually hang carrots in front of the donkey while beating the donkey with a stick from behind. The donkey would pursue the carrot in front while at the same time trying to avoiding every contact with the master’s stick from behind it. However you look at this treatment in terms of cruelty or fairness, the cart-driver gets the donkey to make only a forward movement and quickly. This works almost like Ivan Pavlov’s classical conditioning approach to learning. This is, perhaps, the closest way I could describe the principle behind the program that has become known as the Conditional Cash Transfer (CCT).

CCT are social intervention programs that impose on, and therefore seek to instil in, a selected group of people certain behavioural patterns by motivating them with periodic (usually a monthly) cash transfer. This rather loose description of CCT shows two things: One, that there is a reward for a certain pattern of behaviour; and, two, that there is no punishment (in the strict sense of the word) for failure by the recipient of the cash transfer to follow the preferred (or perhaps, prescribed) pattern of behaviour. This also means that the CCT approach does not exactly fit the stick-and-carrot approach that I described above. Quite contrary to its name, Conditional Cash Transfer, CCT programs may be conditional or unconditional. Conditional in the sense that it makes certain behaviours a condition for benefiting from the project – cash transfer. It, however, may also be unconditional in the sense that moneys are given to individuals falling into a carefully defined group even without any prescribed behaviour.

CCT formally began in Latin America, Brazil to be specific, where the Bolsa Familia (formerly known as Bolsa Escolia) program was instituted in 1990 to provide monthly cash transfer to extremely poor families if they enrolled their wards, aged 6 to 15 years, in school. They also received cash transfers if they vaccinated their children, 6 years or below. The initial success of the program in Brazil made it a preferred method for development agencies. The program was, thus, implemented in other Latin American countries. Chile instituted the Chile Solidario in 2002; Colombia, Guantemala, Nicaragua and Mexico also followed by instituting the Familias en Acción, the Mi Familia Progresa, the Social Protection Network and the   Opportunidades, respectively. The program soon spread across the developing world with, of course, at least 15 African countries dipping their feet in it. These African countries include Burundi, Burkina Faso, Côte d’Ivoire, Cameroon, Ethiopia, Ghana, Guinea, Gambia, Kenya, Madagascar, Mozambique, Malawi, Nigeria, Uganda and Zambia. Yes, they’re currently implementing a variety of the CCT.

The ultimate goal of the CCT is to help root out extreme poverty by enticing members of a group, through cash incentives, to adjust their behaviours toward the society’s average. Subsidies are provided in exchange for specific actions. The program also enjoys, in a very impressive way, the support of key global development agencies – the World Bank, the IMF, the UNDP, etc. and has since 1990 seen some several billions of US dollars of World Bank money going into it. To this extent, Nancy Birdsall, who is president of the Centre for Global Development, was reported by the New York Times of January 3, 2004 as remarking: “I think these programs are as close as you can come to a magic bullet in development. They are creating an incentive for families to invest in their own children’s futures. Every decade or so, we see something that can really make a difference, and this is one of those things.”

But, does this assessment reflect the achievements of the CCT program? Does the CCT program constitute a potent blow to the current level of extreme poverty on the globe? In this short note I’ll, in a way, provide some hints to the answers to these questions. Maybe I should begin by describing Ghana’s cash transfer program – the Livelihood Empowerment Against Poverty (LEAP) program. I’ll briefly describe the LEAP – its origin, aims and how it works. Later, sometime next month or so, when I find time, I’ll write another note, a continuation of this. That note will discuss the impact of the LEAP on the people the government says are its target – the extremely poor in rural communities. I’ll also attempt to situate our LEAP program, in particular, and Conditional Cash Transfer (CCT) programs, in general, within the rhetoric of the fight against global poverty. I’ll then carefully conclude that the LEAP, like most CCT programs, are hardly an attack on global poverty.

Social Protection in Ghana

Apparently, Ghana has not done badly. We’ve put in place a number of social protection programs since independence. The Minister for Gender, Children and Social Protection, Nana Oye Lithur, stated in a press release dated October 14, 2013, that there’re “approximately 25 social intervention programmes” currently being ran by the State. These programs are subject-specific. For example, the Social Security and National Insurance Scheme (SSNIT), which was instituted in 1965 was originally to provide social protection for the aged. Osagyefo Kwame Nkrumah’s policy of providing free education (up to the secondary school) in the northern part of the country was instituted in 1957 to bridge the educational gap between that part of the country and the south. More recent is the National Health Insurance Scheme (NHIS), which was established in 2003 by the Kufour Government. The Scheme exempts children, the aged, “indigents” and persons with disability from paying premium. The Free Compulsory Universal Basic Education (F-CUBE) program and the Kufour Ghana School Feeding Program (2005), respectively, to ensure access to basic education by making it free and to provide pupils with one hot meal a day in school. Admittedly, these social protection programs have, in one way or the other, improved access to healthcare, education, and general livelihood.

These intervention programs are however not without gaps. Even though these facilities, free education, free medical care, etc., are generally available to all persons belonging to their respective target groups, not all qualified persons actually benefit from them. For example, a 10 year old girl in the northern part of the country technically qualifies to have free education up to secondary school level and free lunch at the primary school level. She may however not benefit from any of these programs. This “non-benefit” (if I may call it so) is not because she is unwilling. It is simply because of lack of access. The nearest school may be located several kilometres away from her village, making it very burdensome if not entirely impossible (in terms of the cost of transportation) for her to attend the school. Same applies to the poor fisherman at the coastal region, whose village is several miles away from the district health centre (where free medical care is available to him). To enjoy this free healthcare, he must first get to the healthcare facility. However, since he lacks physical access (in terms of means of transportation) to the facility, he, though covered by the scheme, could not enjoy the services. And, I recall reports, during a working visit to some communities, from pensioners that they spend almost two-third of their monthly pension allowances on transportation just in order to access their pension monies. Actually, some of these pensioners, former railway workers, teachers, etc., had to travel from Buipe all the way to Accra to be able to access their pension allowances.

What I’m trying to say is that these people are so poor that they cannot not even afford to benefit from the existing socioeconomic programs. There’s therefore a qualified-but-automatically-excluded group of persons. This group of people constitute a gap between these numerous intervention programs and the social goals that the programs seek to achieve. This gap obviously undermines the effectiveness of the approximately 25 social intervention programs. And, this is where the cash transfer social protection program, the LEAP program, comes in.

The LEAP

The LEAP social grants programme was established in 2008, again, by President Kufour, I remember. It’s a component of the general National Social Protection Strategy (NSPS) of 2007; and, therefore, should be considered within that general framework. The NSPS is itself designed to complement the New Partnership for Africa’s Development (NEPAD) which aims at eradicating poverty, promoting sustainable growth and development, integrating Africa in the world economy, and accelerating the empowerment of women. NEPAD could also be situated with the broad aim of the Millennium Development Goals (MDGs), which has poverty eradication from the face of the earth as its primary goal. So, its poverty eradication all the way. Let’s, thus, keep in mind that the ultimate question is: are these CCT programs, in this case the LEAP, really dealing poverty a blow?

Now, let’s take a look at what the LEAP actually does. Through the LEAP, the government directly gives cash and free health insurance, among others, to “extremely poor” households to help alleviate short-term poverty and ensure long-term human capital development. The program took off effectively in 2009, under President Mills; and by March, 2012, the government had announced that 68,000 households in 100 of the then 170 districts in the country were benefiting from the program. The number is expected to shoot up to 100,000 households by December 2013, that is last year. Under the program, beneficiaries enjoy a bi-monthly cash transfer ranging between GHC 30 – GHC 50,  from an annual budget of approximately US$20 million. This budget is largely footed by the government, the taxpayer (and with some help from our donor partners).

For a household to qualify as a beneficiary under the program, at least one of its members must fall within at least one of these three demographies: single parent with orphan or vulnerable child (OVC); poor elderly above the age of 65; and persons with extreme disability. As at October, 2013, there were as many as 7,860 persons with disability enrolled on the program. (The 2010 census shows that there are 737,743 persons with some form of disability, constituting about 3% of the country’s total population.) The general target group of the LEAP, however, is the 18.2% “extremely poor” of the 28.5% poor population in the country.

Characteristically, the LEAP is partly conditional and partly unconditional. Cash transfer to the aged and PWDs has no conditions attached to it. On the other hand, cash transfer to households with OVCs is subject to three main conditions: Children of school-going age must be sent to and retained in school; they must not be allowed into child labour, child-trafficking or marriage. All members of the beneficiary family must be enrolled in the NHIS. Finally, births must be registered and children taken through post natal care and the Extended Immunization Program.

The selection criteria is an almost-clear one. The Food and Agriculture Organization of the United Nations (FAO) finds that the “selection of beneficiary communities follows a range of locally-identified poverty criteria including: the prevalence of adverse health conditions such as high incidence of guinea worm, buruli ulcer and HIV/AIDS; the level of NHIS registration; the availability of and access to quality basic social services; the prevalence of child labour or child trafficking; and the degree of geographical isolation.” Individual beneficiaries are identified through a process called “quasi-exhaustive survey approach”. This approach involves collecting data through home visits and interviews; entering collected data and information into a unified household registry; comparing household characteristics with pre-established eligibility criteria; and then finally establishing the beneficiaries list. This is how the LEAP works.

It looks like I have to pause here. When I find time (probably in a couple of weeks), I’ll review the impact of the LEAP on our rural communities’ “extremely poor.” The questions we’ll be answering together, when I return, include the following: Has the LEAP helped people to “leap” out of extreme poverty? Is it likely to ever do so? …