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In 1997, Mexico launched a new incentive-based poverty reduction program to enhance the human capital of those living in extreme poverty. This book presents a case study of Progresa-Oportunidades, focusing on the main factors that have contributed to the program's sustainability, policies that have allowed it to operate at the national level, and future challenges.
PROGRESA is one of the Mexican government's major programs aimed at developing the human capital of poor households. In early 1998, IFPRI was asked to assist Mexico's government to determine if PROGRESA was functioning as it was intended to. This research report synthesizes IFPRI's findings about PROGRESA's impact and operation. The majority of IFPRI's findings suggest that PROGRESA's combination of education, health, and nutrition interventions into one integrated package has had a significant positive impact on the welfare and human capital of poor rural families. The report will interest researchers, policymakers, and advisers seeking a better sense of the basic elements of a program that can be effective in alleviating poverty in the short and long run.
PROGRESA (Programa de Educacion, Salud y Alimentacion) is an innovative Mexican program that provides cash transfers to poor rural households, on condition that their children attend school and their family visits local health centers regularly. Confronted with rising poverty after the economic crisis of 1995, the Mexican government progressively changed its poverty reduction strategy, ending universal tortilla subsidies and instead funding new investment in human capital through PROGRESA. The program gives cash grants to poor rural households, provided their children attend school for 85 percent of school days and the household, visit public health clinics and participate in educational workshops on health and nutrition. Founded in 1997, PROGRESA grew to cover around 2.6 million families by the end of 1999, the equivalent of 40 percent of all rural families, and one in nine families nationally. Operating in 31 of the 32 states, in 50,000 localities and 2,000 municipalities, its 1999 budget of US$777 million equaled 0.2 percent of Mexico's gross domestic product. The high level of funding for PROGRESA, and reduced funding for other programs, was based on a deliberate policy decision - to favor programs that are better targeted to the poor, which involve co-responsibility by beneficiaries, and which promote long-term behavioral change.
Why has an economy that has done so many things right failed to grow fast? Under-Rewarded Efforts traces Mexico’s disappointing growth to flawed microeconomic policies that have suppressed productivity growth and nullified the expected benefits of the country’s reform efforts. Fast growth will not occur doing more of the same or focusing on issues that may be key bottlenecks to productivity growth elsewhere, but not in Mexico. It will only result from inclusive institutions that effectively protect workers against risks, redistribute towards those in need, and simultaneously align entrepreneurs’ and workers’ incentives to raise productivity.
Conditional cash transfer programs are based on a simple, yet powerful premise: creating adequate incentives today to stimulate the accumulation of human capital in poor families can provide future generations with the opportunity to generate their own higher incomes. Looking at the experience of Progresa-Oportunidades--the oldest such program whose results after 10 years provide valuable lessons--offers the opportunity to examine whether the youth of Progresa-Oportunidades, in a not too distant future, will be able to find productive jobs that allow them to escape the poverty that has trapped their parents. In this study, Santiago Levy looks at this question from an innovative perspective, analyzing how the intrinsic structure of incentives created by a set of social policies can aid or inhibit the achievement of the principal objective of Progresa-Oportunidades: to break the intergenerational transmission of poverty. This study can help spark a discussion in many countries on the links between social policy, productivity growth and, in turn, poverty reduction.
Over the past fifteen years, people in low- and middle-income countries have experienced a health revolution—one that has created new opportunities and brought new challenges. It is a revolution that keeps mothers and babies alive, helps children grow, and enables adults to thrive. Millions Saved: New Cases of Proven Success in Global Health chronicles the global health revolution from the ground up, showcasing twenty-two local, national, and regional health programs that have been part of this global change. The book profiles eighteen remarkable cases in which large-scale efforts to improve health in low- and middle-income countries succeeded, and four examples of promising interventions that fell short of their health targets when scaled-up in real world conditions. Each case demonstrates how much effort—and sometimes luck—is required to fight illness and sustain good health. The cases are grouped into four main categories, reflecting the diversity of strategies to improve population health in low-and middle-income countries: rolling out medicines and technologies; expanding access to health services; targeting cash transfers to improve health; and promoting population-wide behavior change to decrease risk. The programs covered also come from various regions around the world: seven from sub-Saharan Africa, six from Latin America and the Caribbean, five from East and Southeast Asia, and four from South Asia.