pensions core course 2013: boosting income security for older persons - non-contributory pension...

Boosting

Income Security for

Older Persons:

Non-Contributory

Pension Benefits

A9467-EA-2 11/2011

Main Research Goals

• What is the best design for cash transfer programs?

– Method of payment (cash or debit card)

– Frequency of payment (monthly or bimonthly)

• What is the impact of the program on health, nutrition,

and well-being of recipients?

• What are the effects of additional health interventions?

– Detection of undiagnosed anemia or hypertension

A9467-EA-3 11/2011

Our Program Is the First To Experiment With

Cash Transfers for Older Adults

• $550 pesos per month ($78 USD PPP) to adults age 70+

in Yucatan

• Treatment and control groups were surveyed

before/after and at six and 18 months

• Proven questionnaire adapted from previous

surveys(MHAS) administered in CAPI

• Large investment in human capital

– Staff of 70

– Spanish and Maya speakers

A9467-EA-4 11/2011

Yucatan

• Experiment 1 (2008)

– Treatment: Valladolid

– Control: Motul

• Experiment 2 (2009)

– Randomized treatment

and control: Merida

• Experiment 3 (2010)

– Randomized treatment

and control: Merida

Program Was Phased into Three Yucatan

Towns with Populations of 20,000+

Mexico

Motul

Valladolid Merida

A9467-EA-5 11/2011

Evaluation Study Is Called Escuchar

or “Listen”

• Baseline survey for treatment and

control groups before the intervention

• Follow-up interviews approx every six

months

• Data collection includes in-person interviews,

biomarkers, and anthropometric measurements

• Community level surveys: prices, community

infrastructure, economic activity, and macro

shocks

A9467-EA-6 11/2011

All of the Questions Are Translated Into

Spanish and Maya

• English

– Do you have any difficulty with getting into or out of

bed or a hammock?

• Spanish

– ¿Usted tiene dificultad al acostarse o levantarse de

la cama o hamaca?

• Maya

– Teche’ istikiaj a chital wáa a líik’il ti’ a kaama wáa ti

a k’aan?

A9467-EA-7 11/2011

The Survey Measures a Variety of Health

Indicators Before and After Intervention (1 of 3)

Blood pressure

Pulmonary capacity

Balance

A9467-EA-8 11/2011

The Survey Measures a Variety of Health

Indicators Before and After Intervention (2 of 3)

Waist circumference

Weight

Height

A9467-EA-9 11/2011

The Survey Measures a Variety of Health

Indicators Before and After Intervention (3 of 3)

Anemia

Diabetes and other

conditions measured

with blood test

Grip strength Grip strength is correlated

with disability, mortality,

and health-related quality

of life

A9467-EA-10 11/2011

Results So Far Suggest that Cash Transfers

Improve Well Being

• Increases use of medical services and medicine

• Improves food availability and decreases hunger

• Reduces number of older people still working

• Decline in cash transfers from family members

A9467-EA-11 11/2011

Results So Far Suggest More Frequent Cash

Transfers Alleviate Poverty More Effectively

• Monthly benefit is more effective improving food

availability and decreasing hunger

• Bi-monthly benefit increases consumption of durable

goods (for example: cell phones and bicycles)

• Monthly benefit decreases cash transfers from family

members

• Bi-monthly benefit increases transfers from the older

person to family members

A9467-EA-12 11/2011

• Analyze cost effectiveness for the government

– Have health care costs in hospitals decreased

due to investment in preventive medicine?

– Merge administrative records of hospitals to

individual survey data

• Conduct other experiments

– Health intervention

Future Research Projects