¿La Comunitat Valenciana ha progresado en la implementación de fuentes energéticas renovables dentro de su

48. Experience with social transfers is quite limited. Madagascar has not developed large social transfer programmes on an entitlement basis, such as social pensions for the elderly (in contrast with many SADC countries) or child allowances, outside the framework of contributory social insurance schemes. Experience with other types of social transfers is limited mainly to humanitarian transfers in kind, nutritional supplements and school feeding. Pure humanitarian assistance will not be discussed here, and school feeding is covered below in sub-section 4.5. In addition to nutrition-related transfers in kind, this sub-section discusses briefly a range of small, scattered pilot transfer programmes, as well as social welfare services (generically known as ‘social action’ in francophone countries) to assist highly vulnerable groups, such as single mothers, orphans, persons with disabilities and out-of-school children.

i. Nutrition related transfers in kind. The National Nutrition Policy (see section 5.1) includes a

wide range of strategies, from measures to improve food security to the growth monitoring of children, communication of good nutritional practices to mothers, preventive supplementary feeding and therapeutic interventions to rehabilitate young children with severe acute malnutrition. The food security interventions include labour intensive public works, a type of social transfer discussed in section 4.3. Several agencies, including WFP, USAID (through the SALOHI programme – see below) and GRET, supported by AFD and the EU, provide supplementary foods to pregnant and lactating women and to very young children, as a preventive nutrition measure complementing nutritional screening and communication activities. WFP and the National Nutrition Office (ONN) also support the distribution of food rations composed of rice, pulses, oil and enriched flour to tuberculosis patients for 2 months after leaving hospital in order to increase their adherence to TB treatment and to raise recovery rates.

ii. Conditional cash transfers. UNICEF has piloted the first conditional cash transfers (CCT) in

Madagascar, but on a very small scale, using short-term project funds. Two pilots have been implemented. The first, which ran for one year from February 2009, provided transfers of A 40,000 per family per month to 499 families in two districts of Antananarivo, conditioned by school attendance by their children (UNICEF, n.d.). A second small project, also in Antananarivo, is providing transfers over a two-year period (from 2010) to 150 families living from recycling waste, with links to school enrolment (up from 22% in 2010 to 58% in 2011), civil registration of children and improved access to medical facilities (UNICEF/ATD Quart Monde, n.d.).

38 iii. Free access to water for the urban poor. Another innovative pilot experience, initiated by

UNICEF in 2010, is a scheme to provide free access to community water taps for very poor families in the peripheral neighbourhoods of Antananarivo. The beneficiaries are selected using targeting criteria developed by WFP and are then issued with cards.

iv. Services for vulnerable children and women. A large number of fragmented projects,

supported by religious confessions and donors and executed by NGOs, provide assistance for highly vulnerable children and women, sometimes in partnership with the Ministry of Population and Social Affairs, which has the official mandate to coordinate these types of assistance programmes. There are too many such projects to cite all of them here, but the following provide examples of the kind of social welfare services provided:

• WFP provides food and other assistance (for health care, reintegration into primary education and professional training) for out-of-school orphans and vulnerable children in urban areas, through NGOs working in about 150 centres accredited by the Ministry of Population and Social Affairs.

• Catholic Relief Services (CRS), supported by USAID through the SALOHI programme (see below, section 4.3), provides support for vulnerable single mothers through 15 of these centres in Antananarivo, Tamatave and Fianarantsoa, combining food assistance with counselling, medical assistance, the preparation of individual ‘life-plans’, training, the establishment of small savings and loans groups, the registration of land titles, links to other services (schools and health centres) and the development of revenue generating activities.

• UNFPA has assisted the Ministry of Population and Social Affairs to set up centres for counselling and legal advice for girls and women who are victims of violence and other rights abuses.

• UNICEF supports ‘child protection networks’ in about 700 communes, in partnership with the Ministry of Population and Social Affairs. These involve the commune and fokotany authorities, the police, local NGOs, schools, health centres and other local services, to protect children from the risks of violence and exploitation. However, this system has never been fully institutionalized and, according to UNICEF, the networks have been undermined by a general loss of motivation of officials at the local level since the onset of the political crisis in 2009. v. Services for the elderly and persons with disabilities are very limited, with the churches

playing some role, despite the increasing number of old people living isolated without family support, especially in the south, and the risks of social exclusion and disadvantage faced by those with disabilities. A law has been drafted to protect the rights of the elderly, including the issuance of a ‘green card’ that would give old people access to medical services, drugs, public transport and some other basic necessities at reduced prices, but the law has not yet been formally adopted. The government has set up some recreational centres for old people, and also provides limited financial support for the socioeconomic integration of persons with disabilities.

49. These programmes, despite their small scale, are all relevant to the vulnerability/risk

profile. The nutrition related transfers are justified by the high levels of malnutrition and the

contribution that supplementary foods can make as a preventive nutritional measure for young children and expectant and lactating mothers, especially during the lean season. The other types of assistance described above all respond to clear needs, if only on a very small scale compared to the size of the problems they are intended to address. Conditional cash transfers could be a valuable complementary

39 initiative to the demand-side measures already being implemented to improve access to primary education and to deter drop-out (see section 4.5), and can have wider impacts on food security, nutrition, use of health services, child labour and other facets of well-being. The added value and practical feasibility of human development focused cash transfers will be discussed further in section 6. Although it is geographically limited to the capital, the provision of ‘water cards’ providing free access to community water points for the very poor also clearly responds to a felt need, since water consumpition is strongly correlated with household income and 13.6% of residents of Antananarivo are unable to procure adequate water, according to the Antananarivo McCRAM II survey in November 2010 (UN, 2011).

50. Little is known about the objectivity of targeting criteria. Nutrition-related transfers-in-kind tend to be focused on geographical areas with high levels of food insecurity and high nutrition risk profiles. For example, WFP’s supplementary feeding for mothers and young children targets high-risk areas of the south. WFP’s distribution of food rations to TB patients is also concentrated in the south and south-east. In both cases, there is no socioeconomic targeting of individual beneficiaries, as nutritional criteria are paramount.8 _{Some programmes target vulnerable groups in the major urban areas, for reasons that seem}

to be based mainly on ease of programme delivery. Thus, WFP’s support for orphans and vulnerable children is delivered through social centres in the urban areas, mainly in Antananarivo, Tamatave, Toliara and Fianarantsoa, recognized by the Ministry of Social Affairs and Population. This is also the case for CRS’s programme to build the self-reliance of single mothers and the UNICEF water card project and CCTs, which are limited to the capital. The individual selection of beneficiaries for many of these programmes is based partly on pre-existing lists of highly vulnerable households maintained by the

fokotany authorities and churches, supplemented by the use of broad targeting criteria.9 _{Very little is}

known about the objectivity of these selection criteria and how they are applied in practice. UNICEF has entered into a partnership with FID to undertake a joint study on the targeting criteria and procedures for its water programme in Antananarivo, which could have useful lessons for other projects using individual selection criteria.

51. The main shortcomings of these projects are that they tend to be small and depend

largely on donor assistance, making them difficult to sustain and scale up. The nutrition-

related activities are the largest, but still cover only a small minority of those in need of assistance. WFP’s support for orphans and vulnerable children in social assistance centres reaches 22,000 children, but is limited to the main urban centres. WFP’s supplementary feeding activities benefit about 52,000 mothers and young children, mainly in the south, and its food rations to complement tuberculosis treatment go to about 8,000 patients, mainly in the south and urban areas. The UNICEF water card scheme currently benefits 9,000 residents of poor neighbourhoods of Antananarivo. Most of the other projects, such as the UNICEF conditional cash transfers and the CRS integrated support for single mothers, are extremely small, often with only a few hundred beneficiaries, in some cases because they require complex and intensive support to highly vulnerable individuals, which is both costly and inherently difficult to scale up. It is estimated that programmes for the disabled reach only 3% of those incapacitated for work (Ravelosoa, 2011). The lack of formal evaluations means that it is impossible to draw clear conclusions about the effectiveness or efficiency of these different initiatives.

8 However, WFP plans to introduce a household food ration for TB patients, based on assessment of households’ food security, from January 2012 to complement the present individual rations.

9 In CRS’s case, the criteria are households headed by women, with large household size, a large number of children, low income, poor quality housing and dependence on day labour. The UNICEF education-related CCT used different selection criteria in the two districts covered, including household income below A2,000 per day (in both districts), single parent households, households with orphans, households with more than 8 members and households not receiving other sources of assistance.

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