Workability of Conditional Cash Transfer Programme in Nigeria
Yinusa, Olumuyiwa, G. PhD
Department of Accounting , Banking & Finance
Olabisi Onabanjo University
Ago –Iwoye Ogun State, Nigeria
Elumah Lucas O.
Department of Accounting, Banking and Finance
Olabisi Onabanjo University
Ago-Iwoye, Ogun State, Nigeria
ILO, Bamidele M. PhD
Department of Accounting , Banking & Finance
Olabisi Onabanjo University,
Ago –Iwoye Ogun State, Nigeria
This study evaluates the workability of conditional cash transfer (CCT) programme in Nigeria. It presents a framework on CCT based on what obtains in proximate economies where such programme has been adopted to reduce poverty, improve health conditions of the poor, reduce illiteracy, among others. Findings from literatures revealed that over the years the programme has assisted in reducing illiteracy by encouraging school attendance, reduce those living below poverty line, improve the social status of poor families in rural areas and provided regular medical check-ups for mothers and their children. The present study recommends that this programme should be undertaken on a wide scale in a country like Nigeria where there is high level of poverty, mortality rate, vulnerability and inequality as some states already have such programmes.
Keywords: Cash Transfer, Conditionality, Poverty
COPYRIGHT, American and Review of Political Economy , the authors
Conditional cash transfer (CCT) program is a new type of social assistance program that represents an innovative approach to the delivery of social services especially to the vulnerable and those in extreme poverty (Rawlings, 2004). Conditional cash transfers provides money to poor families conditional upon investments in human capital, usually sending children to school, bringing them to health centres on a regular basis and any other condition that may be prescribed by the institution offering it. The cash transfer is aimed at providing short-term financial assistance to families often in extreme poverty without the means to provide for adequate food consumption while the conditions are aimed at promoting longer term human capital investments, especially among the young (Rawlings, 2004).
The CCT originated from Latin America and the Caribbean. In 2002, Mexico’s CCT program reached more than four million families, representing 20 percent of the Mexican population, and commanded and annual budget was around Mex$18 billion (US$1.8 billion equivalent to approximately 0.32% of GDP). Rawlings, (2004) reported that in Jamaica, Programme of Advancement through Health and Education (PATH) is introduced as a national program to replace three major income transfer programs, while improving targeting and cost-effectiveness. Fiszbein and Schady, (2009) estimated that at least 29 developing countries have a CCT programme. In many countries, including Brazil, Ecuador, and Mexico, the CCT is the largest social assistance program, covering millions of households, and accounting for as much as 0.5% of GDP (Filmer and Schady, 2011)
There is currently much discussion about whether conditionality, or conditions for the cash transfer, is necessary or important to a cash transfer program. Research, such as the pilot conditional cash transfer program in Indonesia called Generasi , examined the importance of conditionality (Olken and Junko, 2011). Brauw and Hoddinott, (2010) report considered data from Mexico’s Oportunidades/Progresa program, which looked at families who accidentally did not receive forms that monitored school attendance and therefore received unconditional cash transfers. It then compared them with those households that did received the forms. The report discovered that conditionality had the strongest impact on children’s attendance to secondary school, as enrolment rates in secondary school were higher for those that received the forms.
According to Janvry and Sadoulet, (2004) efficiency gains from CCTs can be enhanced by adjusting transfers for increased participation, and by reducing leakages by focusing on cases where the conditionality will be most effective in altering behaviour. This implies that the tighter the program’s budget constrains in selecting among qualifying beneficiaries, the larger the potential efficiency gains from selection of beneficiaries and calibration of transfers.
Despite strong economic growth and having the highest GDP in Africa in 2012, 54% of Nigeria‘s population lives in poverty (Holmes, Samson, Magoronga, Akinrimisi and Morgan, 2012). According to World Bank Report (2014), Nigeria has one of the highest economic growth rate in the world, averaging 7.4%. While recent forecasts suggest that poverty may be reducing slightly, of most concern is the fact that the poverty rate has doubled in the past 20 years. Nigeria is also highly unequal: the GINI coefficient was 48.8 as of 2013 (UNDP, 2013).
Studies has shown that majority of the Nigerian population lives below the poverty line, despite the numerous wealth in the country (Holmes et al., 2012). Despite indications that poverty may be declining (AfDB et al., 2009; NPC, 2010), of significant concern is that, between 1980 and 2004, both rural and urban poverty was on the high, from 28.3% to 63.3% in rural areas and from 17.2% to 43.2% in urban areas (UNDP, 2009). Nigeria‘s national poverty line states that 54% of the 140 million population lives in poverty (approximately 75 million people) (NPC, 2010), of whom 22% were defined as ‘core poor‘, i.e. extremely poor in 2004 (UNDP, 2009). This is a huge challenge in terms of development and poverty reduction.
The key drivers of poverty, vulnerability and inequality in Nigeria includes inequality in income and asset distribution, unequal access to basic infrastructure and services and social-cultural (UNDP, 2009). Nigeria has one of the most unequal societies in the world (AEO, 2010). According to (UNDP, 2009) report, inequality increased between 1985 and 2004 (from 0.43 to 0.49), although others suggest it has been decreasing (from 0.491 in 1990 to 0.438) (Ortiz and Cummins, 2011): however, generally, it remains high. When adjusted to reflect inequality, Nigeria‘s Human Development Index value drops significantly, from 0.423 to 0.246 (UNDP, 2010).
In a multi-cultural state like Nigeria, the issue of conditionality should be examined carefully as conditionality in cash transfers is often an area of contentious debate. In our study of countries with CT programme, almost all the cash transfer programmes initiated by government are with conditions, which ranges from school attendance, living below poverty line, poor families in rural areas and regular medical check-ups. There are advantages and disadvantages to attaching conditions to transfers. Proponents of CCTs argued that conditions increase health and education outcomes for poor children; strengthen state–citizen accountability relations through the use of co-responsibilities and improve institutional coordination of the supply side of services (Holmes, et al., 2012). Critics also argued that it is the regularity and predictability of transfers and not the conditions attached to the cash transfer that are important to support human development outcomes; that conditions are paternalistic; and that they add a further complex administrative and financial layer for countries with often limited institutional capacity (Holmes, et al., 2012).
Hence, this study considers the role that cash transfers can play in Nigeria and the workability of a conditional cash transfer programme Nigeria. This paper is organized into three sections, including this introductory section. The second section is a review of literatures on Conditional Cash Transfer as obtained in different economies while the final section discusses the summary, conclusion, and policy recommendation.
This study adapts the social capital theory to explain why there is need for interaction between individuals in the community and participating in programmes established to reduce poverty and support the community. This theory emanated from social capital which is defined as “the institutions, the relationships, the attitudes and values that govern interactions among people and contribute to economic and social development” (World Bank, 1998: 2). Social capital has to do with the relationship that exists among people and institutions that makes up the community which is expected to lead to social and economic development.
The social capital theory asserts that when people act or function in a group as in a community or community programmes, it leads to the economic and social development of the group, individuals in the group and the immediate community where such group operates(World Bank, (1998); Anderson, Locker and Nugent, 2002). Most cash transfer programmes are embedded with conditions which must be done before the benefit accrued to the programme can be enjoyed. If household refuse to take part in some of these programmes, the expectation of the cash transfer programme may not be met.
A study carried out by Carola, Florencia and Paul (2008) analysed the characteristics of beneficiaries who drop out of the Mexican conditional cash transfer program Oportunidades, to determine if dropping out of the program is a result of self-targeting by the non-poor or the exclusion of the target poor population. Questionnaires were administered while percentages and test of difference were used to analyse data gathered. The analysis of the study indicated that wealthier beneficiaries have greater odds of dropping out, suggesting that conditionality acts as a screening device, implying that it is the poor that have tended to remain in the program while the wealthier have been more likely to leave. The results also indicated that administrative factors and the provider of health services to beneficiaries also have an important influence on whether beneficiaries remain in or leave the program.
Lia, Fernald, Paul and Lynnette (2008) evaluated the role of cash in conditional cash transfer programmes for child health, growth, and development in Mexico’s Oportunidades CCT program. Results from their study suggest that the cash transfer component of Oportunidades brings about better child’s health, growth, and development. The cash serves as additional income to the family and could allow parents to have greater purchasing power. Also they could use the cash to invest in household materials and equipment that could reduce a child’s exposure to infection, all of which could contribute to increased growth and health outcomes. The money could also be used to buy books, newspapers, or age-appropriate toys that could be used to provide cognitive stimulation to children. The cash could also improving the psychological wellbeing of family members and thereby improving the care, support, and nurture provided to the children in the household. The findings support the notion that Oportunidades is achieving its objectives in improving health via cash transfer.
In a similar study carried out by Fernald, Gertler and Neufeld (2009) investigated the effect of Oportunidades on children growth, cognition, language, and behaviour ten years after the programme was initiated. Multiple regression was used to analyse data gathered. The study discovered that early enrollment into the program reduced behavioural problems for all children in the early group relative to the late treatment group but there was no difference between height, BMI or assessment scores for language. Results also show that an additional 18 months of inclusion in the Oportunidades programme in very early childhood reduced the number of socio-emotional problems reported in children between the 8–10 years. No significant treatment effects was recorded between early and late treatment groups for height, BMI-forage, and cognitive or language development. However, results show a significant, independent, positive association between cumulative cash transfers and height, cognition, and vocabulary score, and a negative association with behavioural problems, agreeing with the results we reported for these children when they were aged 3–5 years. They suggest that increased financial resources might allow parents to provide an improved environment for their children or to purchase goods that could directly affect child growth and development.
Meghna and Mylene (2012) evaluated the impact of conditional cash transfer programmes in promoting healthy behaviours and improving health outcomes in Latin-American countries. Thirteen CCT programmes was identified and their performance evaluated. Their results suggest that CCTs have been effective in increasing the use of preventive services, improving immunisation coverage, certain health outcomes and in encouraging healthy behaviours. They suggested that CCTs can be a valuable tools to address some of the problems faced by populations in poorer countries to access health care service, however they recommended that, CCTs need to be combined with supply-side interventions to maximise effects.
Davide, Rosana, Carlos, Rômulo and Mauricio (2013) assessed the effect of the Bolsa Familia Programme (BFP) on deaths of children younger than 5 years. Panel data was used since the study covered different municipals in Brazil. The results of the study revealed that BFP had a significant role in reduction of under-5 mortality, overall and from poverty-related causes such as malnutrition and diarrhoea, in Brazilian municipalities from 2004–09. The effect of the BFP was stronger when, with high municipality population coverage, full coverage of the target population of poor families was maintained for 4 years or more. With regard to factors involved in the causal chain of mortality reduction, the BFP substantially reduced rates of under-5 admission to hospital and increased vaccination coverage and prenatal visits. The study suggests that a multi-sectoral approach, using a large-scale CCT programme, with the potential to act on important social health determinants, and effective primary health care, capable of attending basic health demands of the same population and of attending conditions imposed by the conditional cash transfer programme, can significantly lessen mortality rate among children from poverty-related causes in a large middle income country.
Hotenzia, Chandirb, Werea, Rubina, Obora, Levineb, Gibsonb, Odhiambo, Laserson, Feikin (2013) studied the feasibility of using short message services (SMS) reminders and mobile phone-based conditional cash transfers (CCTs) to reach parents in rural Western Kenya using survey research. The findings of the study shows that in rural Western Kenya mobile phone-based strategies are a potentially useful platform to deliver reminders and cash transfers. It also revealed that the strategy was well-accepted by parents especially mothers, who expressed positive impressions of their experience about the strategy. The study recommended that more training should be given to personnel in order to know the importance of entering correct data.
Carolyn (2007) in her study evaluated the demand and supply-side determinants of conditional cash transfer program effectiveness in Argentina. The study used multilevel methods to explore the role of program management and execution in explaining variation between schools in student outcomes. Baseline survey research was employed while descriptive statistics, chi square and regression were used for analysis. The findings of this study suggest that the Becas program improved students’ attendance and performance of students since good attendance and academic progress is a prerequisite for scholarship receipt. The study also confirms the findings of prior studies that conditional cash transfer programs helps to increase educational attainment among poor youth.
Sebastian and Patrick (2013) evaluated the heterogeneous impact of conditional cash transfers in Honduras, 70 respondent were considered in their study while the study employed descriptive statistics and regression for analysis. The study finds no consistent evidence that children who are ineligible for education transfers are affected by the municipal-level treatment, regardless of whether an eligible child lives in the same household. It also found little evidence of spill-overs to ineligible children and impacts on adult labour supply. The heterogeneous results point to the importance of adequate targeting in order to maximize the impact and cost-effectiveness of CCTs.
In a similar study carried out by Mario, Maria and Paul (2012). They tried to analyse dropouts in an urban conditional cash transfer program, using the Mexican Oportunidades program while test of difference, descriptive statistic and regression analysis was used to analyse data gathered from 19,649 respondents under the study. Results indicated that the very poorest recipients, particularly in large urban areas and less marginal communities, are more likely to drop out, increasing the errors of omission. The study revealed that administrative reassessment and recertification tend to drop out the marginally poor and those with migrants and more education. This suggests that the process of dropping recipients through administrative procedures is focusing the program more on the poorest households and therefore minimizing the errors of inclusion, but not at the expense of dramatically greater errors of omission. The study therefore recommended that with the high level of dropouts, information should be gathered on whether the costs of retargeting are justified by the benefits.
Brian (2012) examined whether political criteria explain the federal government’s distribution of Bolsa Famılia in Brazil. Findings from the study posits that Brazil appears to have succeeded in implementing an automatic government transfer where political criteria do not explain the distribution of this program to municipalities. It therefore suggest a strong evidence that Bolsa Famılia is distributed in a programmatic matter. The study recommends encouragement of technocratic government at the national level to assist in strengthening the government’s administrative capacity.
Martin and Francisco (2013) in their study elucidated the main determinants of the impact of Conditional Cash Transfer (CCT) and Payments for Environmental Services (PES) programs. The study identified two factors that are key to understanding the program efficiency; the counterfactual or pre-program compliance with program conditions and the degree of selection bias in program applications. The study concludes that if poverty alleviation or general compensation to land owners for environmental service provision is the primary aim of the program, then a CCT or PES may be a reasonable policy choice. However, the benefit should be weight with the cost. Also, if a program’s main purpose is to transfer resources to the poor, then increasing payments and targeting payments (potentially reducing the number of beneficiaries) to achieve higher additionally may not be acceptable. On the other hand, it may still be acceptable if the change in distribution is progressive.
Robertson, Mushatip, Skovdal, Eaton, Makon, Crea, Mavise, Dumba, Schumacher, Sherr, Nyamukapa and Gregson (2013) investigated the effectiveness, coverage, and efficiency of census- and community-based targeting methods for reaching vulnerable children in western Zimbabwe. Focus group discussions and in-depth interviews were used in gathering data while descriptive statistics, tables and percentages were used for analysis. Community members reported that their participation improved ownership and reduced conflict and jealousy. Findings from the study revealed that the benefits of community involvement in the targeting of cash transfer programs include enhanced community ownership, increased transparency, and reduced potential for conflict and jealousy. Making use of existing local resources also reduced the need to build parallel structures. Analysis showed that there was poor agreement between the community-based wealth ranking procedure and an asset-based wealth index in terms of describing the distribution of wealth in Manicaland and identifying the poorest households. The study found that the poor agreement was attributable to the communities’ failure to assign equal numbers of households to each of the wealth categories, as was intended.
Zavier and Santhya (2013) examined the association between the receipt of benefits from Janani Suraksha Yojana (JSY) conditional cash transfer scheme and postpartum contraceptive use in Rajasthan, India. Survey and in-depth interviews were used in gathering data from 4770 while regression was used for analysis. Findings show that adoption of postpartum contraception was limited among study participants and women who had experienced the benefits of JSY were more likely than those who had not to have received postpartum contraceptive counselling and to have adopted contraception within 3 months of delivery. The findings make a case for special efforts to use the increased opportunity women experience to interact with the health system as a result of CCTs for promoting maternal and new-born health practices, including post-partum contraception.
Fernanda (2013) evaluated the impact of conditional cash transfers on public education expenditures from a political perspective using data gathered from Brazil, Colombia, and Mexico. Results show that while CCT programs may cause a slight initial decrease in education expenditures per student, this trend is reversed for larger values of the transfer for Brazil and Mexico. The simulation results explain the increase in education expenditures observed in Mexico and Brazil following the implementation of CCT programs. In Colombia, the pivotal voter is not eligible for the CCT program, which led to the relative stability in education expenditures per student. This study shows that CCT programs may contribute to increasing enrolment and also to improving education quality through the political economy of education expenditures.
Keetie (2014) observed the benefits and harms of CCT programs. The provision of cash or other forms of transfers holds promising potential for children’s care. Supporting families’ abilities to make ends meet can prevent the loss of parental care, improve quality of care, and encourage preferential care options. However, it is important not to turn a blind eye to the potential perverse incentives. The availability of and access to high-quality services is imperative for the success of CCT programs, particularly given that the theory of change is built on the use of services like education and health care. In terms of child protection, services are crucial for two reasons.
Alexandra, Evan, Ellen, William, Sergio and Nancy (2014) evaluated the feasibility of Yo-Puedo intervention which addresses social network influences and socioeconomic opportunities in a neighbourhood with substantial gang exposure and early childbearing. 79 respondents were available for the study while chi-square and logistic regression were used for analysis. The study found no evidence that cash payments financed illicit or high-risk behaviour. At 6 months, compared with controls, intervention participants had a lower odds of hanging out on the street frequently and a lower odds of reporting that their close friends had been incarcerated The study reported less regular alcohol use and a lower odds of having sex.
Carolyn and Robert (2015) examined administrative burden and quantify its implications for grant access and impacts in the South African Child Support Grant (CSG) program, as the age of eligibility and application requirements changed over time. The study discovered that approximately 60% of the children under study experienced an interruption in cash transfer receipt, and that both timing and “dosage” loss are associated with adolescent engagement in risky behaviours, and for females, lower educational attainment. The study therefore suggested that governments implementing cash transfer and other social welfare programs should take early and aggressive steps to ensure that application requirements and processes are as simple and transparent as possible. It also suggests that this type of manipulation of program rules by those implementing social welfare programs could have negative consequences that are too serious to ignore.
Ximena, Norman and Tomoko (2015) analysed the conditions under which exogenous changes in household wealth and behavioural incentives lead to changes in the amount and type of child labour in poor households in Nicaragua. They developed a simple theoretical model where child labour and training are chosen to maximize inter-temporal household income, given constraints to social, household, and child endowments using tobit regression analysis. Findings from the study shows that the CCT program had a selective impact on the volume and quality of child labour, reducing it in the aggregate and steering it toward skill-forming activities. Specifically, the program appears to have reduced child labour for household chores and traditional farming while increasing it for non-traditional. They also found out that the source behind the increase in the better-quality type of child labour is not the basic component of the program but distinctively its business-grant intervention. The study suggest that it is through the introduction of specific complementary production factors that the Nicaragua CCT program could not only reduce child labour in the aggregate but also improve its quality, steering it toward skill-forming activities.
Sudhanshu, Amber, Carolyn, Carolyn, Audrey and Harsha (2015) studied the impact of the Kenya Cash Transfer for Orphans and Vulnerable Children on early pregnancy and marriage among females aged 12 to 24, four years after program initiation. Findings indicated that, among 1549 females included in the study, while the program reduced the likelihood of pregnancy by five percentage points, there was no significant impact on likelihood of early marriage. Program impacts on pregnancy appear to work through increasing the enrolment of young women in school, financial stability of the household and delayed age at first sex. Although the objective of the program is primarily to alleviate poverty, it appears to have an important impact on facilitating the successful transition of adolescent girls into adulthood
Samuel, Sudarno and Asep (2015) investigated the significance of timing in shaping household consumption responses to fiscal interventions using large-scale unconditional cash transfer program in Indonesia. This study shows that on average, beneficiary households that received the full two transfers as expected by early 2006 do not differ from comparable non-beneficiaries in terms of per capita expenditure growth, i.e. timely receipt of transfers yields no expenditure change relative to non-recipients. However, beneficiaries still awaiting their second transfer report significantly lower expenditure growth especially in areas with limited financial access. Results suggest that managing and meeting household expectations about transfer programs is critical to effective fiscal policy.
TABLE 1: Structure of Cash Transfer Programme in Dierent Countries
As stated by Attanasio, Battistin, Fitzsimons, Mesnard and Vera-Hernández (2005), Conditional cash transfer (CCT) programmes are becoming an extremely popular tool for improving the education and health outcomes of poor children in developing countries. CCTs may help resolve one very basic feature of poverty, the persistent lack of access to capital. CCT programmes may assist to break the cycle of inter-generational transmission of poverty, as well as spurring growth “from the bottom” (Dolberg, 2012). However. in the short run, CCTs that are durable and display a minimum level of generosity offer to cushion the worst of food-insecurities, insure families against risks and shocks, reduce the scope of child labour, empower women, provide capital for investments and savings, and equip families with a sense of hope for the future, enabling them to plan ahead and invest in their farms, businesses, jobs, health, and children (Dolberg, 2012). In the long run, positive investments in education and child health are expected to generate long-lasting human development and drive local economies forward. As opined by Reyes and Tabuga (2012), in the short run, CCT programmes will reduce income poverty and vulnerability while in the long run it human capital will be improved.
Extant literatures revealed that the political future of CCT programme in the countries where they are currently being implemented is not assured. For instance In Brazil and Mexico, the programs have a high degree of political backing, having survived different administration, translating into a very high probability of being sustained over the medium run (Sudhanshu and Benjamin, 2006). With the unstable political system currently practised in Nigeria, coupled with the fact that new administrations do not continue the programmes by past administration, the CCT programme may encounter a setback. However, with continuity in governance at both the state and federal level, there is possibility that the programme if implemented on a large scale will achieve its desired objective. Based on experiences from other countries, the CCT should be backed up by government policy so that funding need not rely on external sources as it needs to be sustained for a long time.
According to Janvry and Saudolet (2004) the efficiency gains from CCTs can be enhanced by calibrating transfers for increased participation, and by reducing leakages by focusing on cases where the conditionality will be most effective in altering behaviour. This implies that the tighter the programme’s budget constraint is in selecting among qualifying beneficiaries, the larger the potential efficiency gains from selection of beneficiaries and calibration of transfers. It is believed that with large proportion of individuals and families involved in the programme, there will be increase in efficiency in the gains accrued from the programme especially when leakages are curtailed. The Nigerian government should as a matter of urgency increase the scale of the programme as what is currently obtained in Nigeria are pilot scheme which may even cost much.
The CCT programmes has been successful to an extent in upper middle-income countries like
Brazil and Mexico, but this does not mean that it can work in all countries (Rayes et al., 2012). Several low-income countries which have adopted the model like Guatemala, Honduras and Nicaragua have faced immense challenges in implementing CCT programmes because they did not meet the necessary prerequisites (Cecchini, 2009). The first requirement is that there has to be a multidimensional approach to poverty reduction, hence demanding coordination among all agencies implementing poverty reduction efforts. Therefore, strong and coordinated institutions are critical. Second, it has to be a state policy wherein the programme can withstand changes in administrations and funding must not rely from external sources for the programme needs to be sustained for a long period of time. Third, there has to be strong statistical capacity and banking systems. Such important prerequisites are often lacking in low-income countries like Nigeria (Cecchini, 2009).
In economies where the CCT programme have been implemented, the programme has considerably increased household consumption, increased school attendance and improved child health and reduced mortality rate (Attanasio et al., 2005). It therefore implies that if such programme is executed in Nigeria, there is possibility that it will assist in increasing school attendance especially in the northern part were the level of school attendance is low and improve health service provided to expectant mother and their children. However, there is need for health service providers to improve their service delivery as providers of health service have an important influence on whether beneficiaries remain in the CCT programme (Carola, et al., 2008). The cash transferred to families could also improving the psychological wellbeing of family members and thereby improving the care, support, and nurture provided to the children in the household (Li et al., 2009).
An important requirement in achieving better results from the CCT is that the necessary services are in place and that they are of good quality before imposing conditions. For instance, providing some cash to families on the condition that their children attend school or go for health check-ups is inappropriate in localities where there are no school or accessible health centres to go to. Thus, CCT funds should not only be dedicated to encourage demand for social services but also by increasing the supply of such social services in order to meet the increasing demands of such services (Reyes et al., 2012).
Finally, there is need for monitoring and evaluation of the CCT programme in order to improve the mechanisms of identifying the beneficiaries to minimize leakages and exclusion, address loopholes in the system to avoid wastage of scarce resources, and address the supply side deficiencies. The CCT programme is an important but capital intensive program and going on hastily with further expansion from the state level to federal level, with all these concerns is the last thing a poverty-stricken, politicised, budget-constrained, and highly indebted country like the Nigeria should be doing. Given the benefits accrued to CCT, a word of caution is necessary as CCTs are, like all other approaches to development, and not a ‘magic bullet’; they are only able to improve the lives of the poor if implemented in a way tailored to local circumstances.
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