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More details on the functioning of Bolsa Familia

The Impact of Conditional Cash Transfers on Health Status: The Brazilian Bolsa Familia Programme

“Conditional cash transfers are becoming the standard approach to reducing poverty levels; the Brazilian Bosa Familia Grogram, in particular, is the largest programo fo this kind, and the evaluation of its impact allows for drawing some interesting conclusions, which may apply to other countires.  IN this paper, the lack of positve resutls in terms of both health status and modification of unhealthy habits is underlined.  Among idfferent causes, which are discussed, ehre thexistence of barriers on the supply side appears tas the most important limiation for obtaining better results.  The positive impact of this program on both educatino and poverty reduction however, allows for predicting improvements in health status in the long run.” –Castineria, Nunes and Rungo

This article is extraordinarily informative, outlining the functioning of the system (requirements and benefits), exploring the contrasting results in poverty and eduction vs. health, and finally discussing possible explanations.

Full text here: 


My notes here: Notes on Castineria


Bolsa Família

What it is: The Bolsa Família program is a system of conditional cash transfers, giving money to families if certain conditions are met such as sending kids to school or taking them to a health care facility.  Emergency assistance is also provided temporarily; the conditions seek to ensure “longer-term investments in human capital.”

Bolsa Família consolidates four social programs, reducing administrative costs and bureaucratic complexity, standardizing results and methodology,  and eliminating redundancies.  These four programs were: Bolsa Escola (Ministry of Education), Bolsa Alimentação (Ministry of Health), Cartão Alimentação ( Fome Zero), and Auxílio Gas (Ministry of Mines/Energy), promoting schooling, health care, food consumption and reduced dependence on government subsidies, respectively.

Objectives: The Bolsa Família program seeks to reduce current poverty and inequality in Brazil and to reduce future poverty and inequality through the building up of human capital.  Thus there exists a quantitative aspect – bringing more people into the safety net – and a qualitative aspect – improving the well-being of the beneficiaries.  Bolsa Família also aligns with some of the Millennium Development Goals (see pg. 68 for specifics).

Bolsa Famliia targets the family unit as the receiver of the conditional cash transfer as opposed to the individual unit.  Payments are made to the mother of the household since studies show she more than others will prioritize investments in her kids (i.e. education, health)

How it targets the poor: “By design, Bolsa Família identi- fied two target groups – the “extreme poor” (families with a per capita income of less than US$17 per month) and the “moderately poor” (families with a per capita monthly income between US$17 and $34). De- pending on the household’s composition and income, the program provides cash transfers ranging from US$5 to $33 (the average is US$24). These amounts were set, in part, to minimize the number of people who might lose benefits from previous programs. On a per capita basis, the average transfer per beneficiary represents about 6 percent of the minimum wage and 19 percent of the poverty line used by the World Bank.” (68).

Donor support: This program has support from the World Bank, the UNDP and the Inter-American Development Bank (see page 69 for SWap –sector wide approach – details: ex. intertwinement of effective implementation – widening the social net – and technical activities of monitoring and evaluation; incentives to exceed milestones, ex. loan’s financing percentage increases).  It uses a results-based approach in which technical milestones are linked to disbursements.

Challenges: a monitoring and evaluation that doesn’t just provide data but actually useful feedback on the quality of the service (coverage is one thing, quality of delivery another); reducing fraud (they are actually publishing names of beneficiaries by municipality on the Internet and setting up a hotline in which people can report suspected fraud).

Results achieved and expected:“Since its launch in December 2003, the Bolsa Família Program has grown exponentially, expanding by January 2005 to cover 26.6 million people. By the end of 2006, the program expects to cover about 44 mil- lion people. Translated as intermediate results in the results-based framework, this means:

  • At least two-thirds of extremely poor families will be receiving Bolsa Família income transfers.
  • At least 40 percent of total transfers will be going to families in the bottom quintile of income distribution.
  • At least 80 percent of primary school–age children in extremely poor beneficiary families will be at- tending school.
  • At least 95 percent of beneficiary children will have and be using health cards.” (71)

Lessons learned:

  • It is beneficial for borrowers to own, lead and sustain their commitment to the process
  • Conditional cash transfers are operationally feasible and political acceptable (as they are not seen as just hand-outs due to the fact that they are not unrestricted cash-subsidies)
  • Human capital conditionalities can help the poor “grow out of poverty

– for more see pages 71 and 72

Applicability: Bolsa Família is the largest conditional cash-transfer program in the developing world.  Thus, its challenges and solutions with respect to beneficiary selection, monitoring and evaluation, and quality control, as well as the World Bank’s lending mechanism designed to support the Bolsa Família program should be applicable to other countries.  Of course, this is not a one size fits all model, but clearly need to be adapted, taking into account new and different circumstances (“the (potential) success of the project is in many respects a function of the donor’s capacity to adapt to the specific needs of that program.” (73))

Source: http://www.mfdr.org/sourcebook/6-1brazil-bolsafamilia.pdf