CASH TRANSFERS AND HEALTH 105


separately in an effort to reach more men with sensitive messages about HIV and AIDS (Devereux et al. 2007, 9–10). Evaluation results from the scaling-up Mchinji Cash Transfer program illus- trated important improvements in healthcare access for both adults and chil- dren. At baseline in March 2007, the share of households reporting inadequate healthcare for adults was about equal between intervention and comparison households at roughly 80 percent. By June 2007, about three months after the start of the program, fewer than 20 percent of the intervention households claimed inadequate healthcare compared to more than 60 percent of the com- parison households (Miller et al. 2007). Members of intervention households— both adults and children—were also more likely than those in comparison households to obtain care when they were ill: 84 percent of beneficiary adults received care when sick compared to 10 percent of nonbeneficiary adults, and 80 percent of beneficiary children received care compared to 8 percent of nonbeneficiary children. Of all children, 80 percent of those in intervention households were reported to receive “just enough” or “more than enough” healthcare when ill, compared to only 20 percent of children in comparison households (Miller, Tsoka, and Reichert 2008, 23, 25). As of September 2007, of all children who did not receive care during their last illness due to lack of money, 75 percent were from comparison households and only 14 percent were from intervention households. Among the intervention children, there was an increase in the use of private hospitals and medicines such as anti- biotics and painkillers, as well as decreased use of herbs for treatment (Miller, Tsoka, and the Mchinji Evaluation Team 2007). In South Africa, a study of barriers to healthcare use and illness-related impoverishment involving 280 households across two communities (Goudge et al. 2007, 2009) found that cash transfers accelerated access to healthcare beyond the effect of the income transfer. The study found that grant recipi- ents seeking treatment at health facilities were far more likely to be granted the fee exemptions for which they are eligible (based on their poverty status) than were those eligible for the exemptions but not receiving grants: 100 percent of CSG recipients and 82 percent of pension and disability grant recipients received the exemptions. Of those neither receiving grants nor earning income, only 55 percent received the exemptions. Those receiving grants were assumed to be eligible and thus not required to show proof of income, while those not receiving grants had to document their eligibility (Goudge et al. 2007). Qualitative research also found that cash transfers pro- tected against illness-related risks by making healthcare and transportation to clinics and hospitals more affordable, by enabling automatic qualification for fee exemptions, and by strengthening social networks that could be called upon if needed (Goudge et al. 2009).


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