EVIDENCE 2011 Number 7 from to POLICY a note series on learning what works, from the Human Development Network Can Targeted Assistance Help the Very Poor? 65348 Policymakers often struggle to promote improvements in lems that keep people poor, the World Bank supported an the well-being of the poorest individuals and families. The evaluation of Chile’s targeted extreme poverty reduction challenges are many. People living in extreme poverty fre- program, Chile Solidario. The program, which twins regular quently have multiple needs that require a range of services. visits from social workers with a reorganization of programs They also may face special psychological and social challeng- to increase access, make them more relevant to the needs of es that can make it difficult for them to connect with and poor households, and better meet demand, has resulted in benefit from social assistance programs. Governments that increased take-up of subsidies for the indigent. It also has want to assist this most vulnerable group need to engage the raised enrollment in housing and employment programs, participants, deliver the mix of services that works best for among other services. Overall, people who participated in each family, and know what incentives help people success- Chile Solidario show gains in living standards, including fully utilize available programs. more stable housing and, for some groups of participants, At the World Bank, we are committed to helping coun- more stable work and increased income. Chile’s program of- tries eradicate extreme poverty and alleviate hunger, the fers some important examples of the uses of, among other first of the eight United Nations Millennium Development things, concerted and regular social worker visits. But more Goals. To help policymakers and development experts de- work still needs to be done analyzing what works best to sign programs that successfully address the range of prob- target all of the very poor. Case Study Chile Researchers set out to study the effectiveness of Chile Soli- on a “waiting list.� Social workers help families navigate the dario, a targeted social welfare program designed to reach, system to access benefits and social services and families pre- in its first phase, the country’s 225,000 families living in ex- pare and sign personal plans, called “contracts,� to identify treme poverty. Rolled out in 2002 and fully phased in by strategies and actions to improve their living conditions. 2005, the program combines cash transfers and other assis- In addition to the cash benefits mentioned above, enrolled tance programs with regular visits by social workers. Fami- families also receive regular and relatively small cash transfers lies get priority access to employment, education and other (decreasing over time) to compensate them for their efforts. social programs, including housing improvements, and spe- To analyze the impact of the program, researchers compared cial programs for children, among others. Families are also families just above the cut-off point for eligibility, with those just guaranteed the cash subsidies available to poor families for below. By employing this method, called regression discontinuity which they are eligible, such as child allowances. Previously design, researchers could attribute differences in use of assistance if funding was not adequate, eligible families might be put programs, in employment and in income, among other mea- surements, to participation in the program. The evaluation Did You Know… combined information from administrative records used by A 2009 national survey found that 3.7 percent of Chile’s population, the government to identify people eligible for social programs, or about 630,000 people, were living in extreme poverty (World Bank defines that as living on less than $1.25 a day) with survey data collected specifically for the evaluation. The Still, according to Chile’s own CASeN study in 2009, there were survey data was used for more detailed and in-depth measure- 634,000 Chilean—or 3.7 percent of the population—living in extreme ments of psychological outcomes and income. The evaluation poverty. extreme poverty was defined as living on less than about focused on those people who joined the program between the $2.00/day in urban areas, and less than $1.50/day in rural areas. launch and nationwide implementation in 2005. The Findings Among families participating in the program, …but there was not always an increase in there was increased take-up of government employment or income. subsidies for the very poor. Most male heads of households were already working when The program resulted in more people accessing govern- the program was started so there was limited room for im- ment subsidy programs to help stabilize and raise living provement. Nonetheless, among those aged 51-65, there conditions for the very poor, ranging from an increase of was a positive effect on employment, mainly linked to more two percent to 20 percent, depending on the specific sub- stable jobs. Participants in this age group had a two percent sidy and how long the family had been in the program. to three percent increase in the likelihood that they would Available subsidies included those for families with chil- have a job with a labor contract. dren under the age of 18, for the elderly, for disabled fam- Among women who headed households, there was no ily members, for people with mental disabilities and to discernable effect on employment, despite the fact that help families cover the costs of water consumption. The most of these women were biggest impact in terms of take-up of these subsidies was not working when the pro- among families who lived in municipalities with a good gram was started. Female- “We have set the goal of network of social services, who were working with a social headed households may be achieving a ‘Chile free from worker with a relatively low caseload and who had a male harder to reach because they misery,…’ head of household. have less work experience, –Ricardo Lagos, then and the experience they do The program also raised enrollment in employ- have is intermittent, coupled President of Chile, speaking ment training and other jobs programs… with more poorly developed at launch of Chile Solidario skills and greater child-care in 2002. The people registered for Chile Solidario often had few of responsibilities. the skills needed to get a job and a poor vision of their own abilities. Women, in particular, had little or no experience The biggest impact on employment and in the labor market, further hampering their chances of income was registered among spouses of finding work. The program helped direct and ensure plac- heads of households. es for participants in training and self-employment pro- grams. Similar to the increased take-up in available sub- For spouses who took advantage of the jobs services, which sidies, the program led to greater enrollment in programs included training, there was a corresponding increase in em- designed to help people find and hold jobs. ployment, or in increased income from employment. The increase in take-up of the jobs services was about four to six percent, compared with similar families not enrolled in Chile Solidario. (About 20 percent of spouses were employed before the program began.)This impact did translate into a small but This note is adapted from “The Impact of Providing Psycho-Social Support to Indigent Families and Increasing their Access to Social Services: Evaluating Chile Solidario,� by Pedro Carneiro, emanuela Galasso, and Rita Ginja. The evaluation and the Policy Note were supported by the Spanish Impact evaluation Fund (SIeF). Overall, on average families that benefited the most from the program—in terms of take-up of services—had been paired with social workers with low caseloads. An innovative aspect of the Chilean program is the con- certed use of social workers to help families navigate the system of social assistance programs and develop goals. In addition to helping families identify what their priori- ties are for improving their living conditions, they also provide active encouragement to the families, which can boost self-confidence and optimism. Although the effect of using social workers cannot be separated from the effect of the social assistance pro- grams, results suggest that the quality of the social worker can help explain some of the substantial variation in the overall program’s impact on households. Future work by the researchers will explore the more in-depth aspects of the interplay between the involvement of social workers and the take-up of services. The Chilean program also led to increased use important boost in higher total household income. The im- of housing programs and home ownership pact was greater in rural areas and, similar to the increased take-up of subsidies, was seen mainly among families served Families had better access to municipal programs de- by a social worker with a low caseload. signed to help them protect their homes from rain and cold. In the longer-term, there was an improvement in The program takes a comprehensive approach access to adequate sewage systems and to legalizing their to the problems faced by the very poor, making housing situations. For families in the program, there was sure enrolled families have access to a range of a 3.5 percent to 7 percent increase in the rate of home assistance programs, from social worker visits to ownership or rental of the house in which they live, in- subsidy programs. Families are also made active stead of squatting or staying for free somewhere, com- players in working to better their situations. pared with families not in the program. This is important because housing conditions, like employment, was a key Families work directly with their appointed social worker problem for participating families and something fami- to identify and prioritize principle problems and develop lies said they wanted improvement. a strategy for overcoming them. Social workers explain what programs are available, who qualifies and how ex- Percentage of People in Chile Living in Poverty actly these services can be accessed. Families commit to working to meet certain improvement goals—such as in 1998 21.6% family dynamics, education, health and housing—and 2000 20.2% sign personal plans with the social worker. The ‘contract’ 2003 18.7% commits the government to providing services and com- 2006 13.7% mits the families to use these opportunities to help over- 2009 15.1% Source: World Bank come the difficulties they have identified. In terms of the program leading to improve- But one thing that was clear, younger fami- ment in psychological and social well-being, lies that participated in the program were less the results are harder to pin down. likely to break apart. How people perceive the impact of the program is very de- The stability, as reflected in maintaining the same head pendent on how the survey questions are framed. It is clear of household, may be due to the effect of families’ work that people in the program are more optimistic about their to improve communications and relationships with the future, in line with the program’s goal of working with support of the appointed social worker. The social work- households to develop a future life plan. While there were er works with family members to improve communica- some mild positive effects on self-esteem, there also was a tion and settle conflicts, among other things. In some negative impact in perceived social support and psychoso- cases, special programs and training are also available to cial distress. The analysis uncovered some weaknesses in help families improve how they relate and interact with the tests used, making it clear that more work needs to be one another. done in how psychological and social effects are measured. Conclusion Making policy from evidence The households targeted had not previously taken advantage Nonetheless, as governments and aid organizations of available social programs, despite qualifying for them. The continue to exert efforts to focus on the very poor, Chile’s research suggests that social workers were key in helping these program is a useful example of the range of issues that need families bridge this gap, and that pairing active social worker to be addressed in trying to reach people who live in ex- involvement with an existing good supply of social programs treme poverty. From helping families access the services to to which families have “guaranteed access� can help increase which they are entitled, to focusing on the psychological the use of programs and subsidies by families in extreme and social issues that act as another barrier, the Chilean poverty. Even then, there appeared to be stubborn pockets program provides an example of the broad approach gov- of poverty where the assistance did not help: especially in ernments may need to consider in their efforts to reduce increased employment or income for female heads of house- extreme poverty. hold, an already very vulnerable population. The Human Development Network, part of the World Bank Group, supports and disseminates research evaluating the impact of development projects to help alleviate poverty. The goal is to collect and build empirical evidence that can help govern- ments and development organizations design and implement the most appropriate and effective policies for better educational, health and job opportunities for people in developing countries. For more information about who we are and what we do, go to: http://www.worldbank.org/hdchiefeconomist This Evidence to Policy note series is produced with the generous support of the Spanish Impact Evaluation Fund (SIEF) THE WORLD BANK, HUMAN DEVELOPMENT NETWORK 1818 H STREET, NW WASHINGTON, DC 20433 Produced by Office of the Chief Economist, Human Development Network, Communications/Aliza Marcus