Transcript Perspectives for social protection in West and Central Africa

Perspectives for social protection
in West and Central Africa
Anthony Hodges
Chief of Social Policy, UNICEF Regional Office, Dakar
Key concepts
• Social protection as measures to reduce vulnerability
and risk
• The heightened vulnerability of children:
– Physical and psycho-social immaturity, especially in the
earliest years of life
– Dependence of children on adults
• So child vulnerability is also linked to the vulnerability
of the family and the household
• The critical link between vulnerability and poverty
• But not all risk is economic in nature
2
Key concepts (2)
The multidimensional nature of risks to
child wellbeing
Political
Economic
Health
Social
Natural
3
Key concepts (3)
• The components of social protection (‘as normally
understood’):
– Social transfers: non-contributory; in cash or in kind;
– Social insurance: (usually/partly) contributory; riskpooling/smoothing
– Social welfare services: including preventative and
responsive child protective services
– Legislation (protecting workers, children, etc)
• A brief word on ‘transformative social protection’:
– Preventative, protective, promotive and transformative as
attributes (some programmes may have several at once)
4
Social protection in WCA
1. Traditional solidarity mechanisms
•
•
Kin-based mutual aid → private transfers &
remittances
Declining due to modernization and urbanization
2. Employment-based social security systems
•
•
Reach on average about 10% of population in formal
sector and exclude most of the poor
The big challenge: How to extend social protection to
the mass of the population?
3. Social welfare services: weak and fragmented
5
Efforts to broaden social
insurance, especially for health
Efforts have focused
mainly on health -- in
context of:
• high child/maternal
mortality
• low access to health
care (high proportion
of ‘out-of-pocket’
private payments -OOPs)
Composition of health expenditure in
WCA, 2006
Government,
36%
Private: prepaid, 4%
Private:
OOP, 60%
6
Social insurance & health equity
• Mutual health organizations:
Community-based risksmoothing – but very small
(max. 3-4% of population in
Mali and Senegal)
• National health insurance:
Only in Ghana on a significant
scale -- NHIS (45% of
population) -- limitations
• Alternatives:
Fee waivers or fee abolition for
essential MCH services (new
UNICEF policy in the making)
Skilled delivery at birth:
Ratio of top and bottom quintiles
( So ur ce: W HO)
Chad
15.4
Niger
11.8
Nigeria
6.5
Mauritania
6.3
Guinea
6.0
CAR
5.7
Senegal
4.4
0
5
10
15
20
7
Social transfers
1. In-kind transfers
 Humanitarian assistance (food distribution)
 School feeding programmes (role in increasing school
attendance)
2. Cash transfers
 Small government led programmes in Cape Verde (social
solidarity pensions), Ghana (LEAP), Nigeria (COPE) &
Sierra Leone (SSN)
8
6 key considerations for social
protection in WCA
1. Extensive nature of poverty – ‘we’re all poor’
2. ‘Top inequity’
3. Supply side vs. demand side challenges
4. Fiscal space
5. Governance and administrative capacity
6. The complementary role of transfers and social
welfare services
9
1. The extensive nature of
poverty in WCA
The poor are not a small marginalized or ‘left-behind’ minority,
but often 50-70% of the population.
Poverty rates in West and Central Africa
(%; based on national absolute poverty lines)
80
70
60
46
50
40
30
33
37
37
38
47
50
51
62
59
55
62
62
66
67
70
40
28
20
10
go
G
am
bi
a
G
N
ui
ne ig
er
aB
is
sa
u
S
ie
C
A
rr
R
a
Le
on
e
To
al
i
M
d
C
ha
B
C
a p e ni
n
e
V
C
ot erd
e
e
d'
Iv
o
C
a m ire
er
oo
n
B
ur
ki
M
au na
ri
ta
ni
a
C
on
go
S
en
eg
al
G
ha
na
G
ab
on
0
10
What are the implications?
• A universal approach?
– Not worth targeting 40 to 70% of the population
– But are universal programmes affordable?
• Targeting the ultra-poor/destitute?
– Approach adopted in Ghana and Sierra Leone (OVCs,
elderly and disabled in extreme poor HH)
– Mix of categorical targeting, means-testing and community
based targeting
– Will only reach small minority of extreme poor
– Too restrictive eligibility criteria?
– Robustness of targeting? Inclusion/exclusion errors?
11
2. ‘Top inequity’
• Fairly flat income distribution for bottom 3-4 quintiles,
with much higher incomes only in the top 1-2
quintiles.
• Reflected in ‘shape of the curves’ for social indicators
by wealth quintiles.
• Contrast with other regions of the world.
• Example: U5MR
12
Under 5 mortality: ratio of quintile
U5MR to bottom quintile U5MR
1.0
0.9
0.8
Sub-Saharan
Africa
Other
Regions
0.7
0.6
0.5
0.4
Lowest
Middle
Highest
13
Implications
• Need for universal approaches
• 2 main options:
– National health insurance – Ghana model – but can poor
afford premiums?
– Public provision of free essential health services
• Ghana is combining the 2 approaches:
– NHIS plus free health services for all children (<18) and
expectant mothers
• More limited fee abolition in some other countries.
14
3. Supply side deficits in
basic social services
• Rationale for CTs in Latin America: address demand-side
constraints on access to basic social services
• But in SSA there are still huge supply deficits: e.g. primary pupilteacher ratio is twice as high as in Latin America
Pupil teacher ratio in primary education, 2004
(UNESCO)
Sub-Saharan Africa
44.6
North America and Western Europe
13.8
Latin America and Caribbean
21.6
East Asia and the Pacific
24.1
Central/East Europe & Central Asia
18.1
Midle East & N Africa
20.2
0
10
20
30
40
50
60
15
Implications
• Conditionality in cash transfers makes no sense –
and risks excluding the most marginalized
• Governments face trade-offs between priorities
(within hard budget constraint):
– e.g. invest in availability & quality of primary education? Or
invest in social transfers to overcome demand side barriers?
– Need for evidence of cost-effectiveness of alternative policy
options
16
4. Fiscal space
Overall budget balance (% of
GDP) in WCA countries, 2008
• Arbitrary to specify a
benchmark percentage
of GDP for social
protection spending
• GDP and fiscal space
vary enormously
between countries,
even within WCA:
– Oil producers
– The rest
Source: IMF
17
Implications
• Universal benefits (e.g. child grants & social pensions) in
oil states?
A possible income redistribution mechanism, not just
for ‘poverty reduction’
A word of caution: future sustainability?
• Affordability in low income countries?
Even cash transfers targeted at all the poor would be
very difficult to afford (would cost equivalent of entire
health budget in Senegal and Mali)
Go for more limited schemes, targeted at ultra-poor?
(the model in most of SSA, e.g. Ghana, Kenya, Malawi)
18
5. Governance and
administrative capacity
• Out of 24 countries in WCA, 14 are ‘fragile states’
(World Bank)
• Low administrative capacity – especially in Ministries
of Social Affairs
• Fragmentation and weak coordination
• Low budgets and weak staffing (social workers, etc)
• Corruption: Transparency Perceptions Index: All but 4
WCA countries are in the bottom 80 out of 180
19
Implications
• Minimize the administrative burden of programmes by
avoiding complex targeting processes or monitoring
of conditionality
• Where affordable, universal approaches are less
burdensome administratively and less prone to
corruption
• Give high priority to capacity building of the
responsible government bodies
20
Some final observations
• No ‘one size fits all’
• Have a broad perspective: Start with good diagnostics
of poverty, vulnerability and risk, with a strong child
focus
• Help governments develop broad social protection
policy frameworks
• Look at a range of options for operational programmes
– simulate their impacts, estimate their costs and affordability,
consider exclusion and inclusion errors, consider institutional
issues
– Don’t reduce social protection to cash transfers!
• Emphasize systems building and capacity development
21