Conditional cash transfer (CCT) programmes aim to redress poverty and gender biases in access to essential services. They offer loans or grants to eligible households, on condition that families send children to school regularly and participate in immunisation programmes and health examinations, especially for pregnant women. Critical in-depth studies assessing the long-term effectiveness of these programs are still pending, but some research has shown immediate demonstrable benefits. This research suggests that many of the benefits are the result of women's capacity to treat service provision as a commercial transaction in which they choose between private providers.
The Oportunidades program in Mexico, the Female Stipend Programme in Bangladesh and the Japan Fund for Poverty Reduction scholarship programme in Cambodia are examples of cash transfer programmes that have contributed to improving girls' educational opportunities by offering higher payments to families who enroll their daughters in school. A recent analysis of women who participated in Mexico's Oportunidades also found significant improvements in the health of newborns due to better quality prenatal care. The Oportunidades programme provided women with education as well as encouragement to be 'informed and active health consumers.' It informed women of their entitlements to quality services, clarified their expectations of providers, and gave them skills to negotiate superior care. As a result, women gained self-confidence. One doctor noted that "beneficiaries are the ones who request the most from us."
However, if quality services are not available, women may not be able to comply with the conditions of the programmes. The Bolsa Familia program in Brazil, for example, raised awareness about the importance of regular health examinations and child immunizations, but evaluations found no effect on immunisation rates. This was also the case with Paraguay's Tekoporã Programme. The exact reasons for this have not yet been established, but evidence suggests that services must be conveniently located and available in sufficient quantity for women to take advantage of them. In principle, CCTs should result in better accountability to women because they have the money to choose a service provider and ‘take their business elsewhere' if they are not satisfied. In practice, however, women living in remote areas, or areas where there is limited choice, are not always able to hold providers accountable through these means.
