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Paying for Better Parenting
New York is searching for new ways to fight per-
sistent poverty, and 1)Mayor Michael Bloom-berg’s Commission for Economic Opportunity has recommended useful reforms. To encourage families to participate in these programs, the mayor hopes to recruit private donors to provide parents with a cash 2)incentive to make the right choices for their children, like taking them in for regular checkups, making sure they stay in school and sending them to visit health care providers.
The idea is based on a highly successful Mexican antipoverty program, set up in 1997 and known as Oportunidades, that is now being tried by at least 25 other countries, including some poverty-stricken countries like 3)Argentina, 4)Columbia, 5)Honduras, and 6)Nicaragua. The purpose of this program is to promote education, improve health care, health maintenance, and better nutrition among Mexico’s rural families living in extreme poverty. The program provides education 7)grants, nutritional supplements, education on hygiene and nutrition, and cash transfers for food to mothers in participating villages.
“One of the greatest tragedies of extreme poverty is its intergenerational transmission. Few children of extremely poor parents are able to escape poverty. And Oportunidades seeks to interrupt this cycle of poverty.” said Paul Gertler, 8)Haas School professor and faculty director of the Graduate Program in Health Services Management. He was one of six researchers from the US and Mexico asked by the Mexican government to evaluate the success of Oportunidades on different aspects.
Today the program covers one in four Mexican families, helping virtually all the country’s poor. Families are sent a bimonthly check if their children regularly attend school in grades three through nine; the amount varies from about $10 a month in third grade to $35 for girls in ninth grade. Girls in secondary school are paid 15% more than boys because girls have a higher dropout rate. Families with many children in school can get up to $153 a month, a ceiling imposed to remove the incentive to have more children.
Families are also given a grant to buy school supplies, and a monthly food subsidy if they get medical check-ups, 9)immunizations and health education lectures. The education grants are substantial, about two-thirds of what secondary students would receive for full-time work. The payments start after third grade and go through high school, rising each year as dropout rates get higher and a child’s 10)forgone earning potential is higher. Because checks go directly from the central government to mothers whose families meet the requirements, administrative costs and the chance of corruption are reduced.
Oportunidades is effective because it addresses a root cause of low school attendance and child labor: low family income. The main determinant of whether children work or attend school—both across countries and across families—is family income. Most families in poor countries would prefer to send children to school instead of work, but they cannot afford to forgo the income their children bring home. Oportunidades raises family income and reduces the cost of attending school.
From the beginning, Oportunidades built in 11)rigorous evaluation. Those studies have shown that it does focus its help on Mexico’s poorest people, and they are benefiting. Children are bigger and healthier. Oportunidades has also cut child labor and led to more schooling. In rural areas, the number of children starting high school increased by 85 %. On the other hand it has succeeded in reducing childhood illness by 12 % and has significantly increased the health of babies and pregnant mothers among program participants, according to a recent study by Gertler.
In the evaluation of Oportunidades’s health care effects, Gertler also found that participating villages showed a quicker increase in visits to the available health clinics than in non-participating villages. The study also found that Oportunidades resulted in more pregnant women visiting health clinics during their first, instead of their second or third 12)trimesters, thus increasing their own health and that of their babies.
As Oportunidades participants increasingly took advantage of the available health care—such as visits to monitor nutrition, prenatal care, and immunization—the number of severe illnesses declined, reducing the number of hospitalizations by 23%. Gertler also found that Oportunidades participants had 19% fewer days on which they had difficulty completing their daily activities, 17% fewer days of being incapacitated, and 22% fewer days spent in bed. The adults were also reported being able to walk 7% more without getting tired than their non-Oportunidades peers.
Even a rich city like New York can envy such success. Mayor Bloomberg is smart to explore a brilliantly simple idea that is fighting poverty now and poverty later around the world. Hope that donors will rally to the effort.
纽约正寻求消除持续性贫穷的新方法，纽约市长迈克尔·布隆博格成立的经济机遇委员会已经提出了行之有效的改革建议。为了鼓励贫困家庭参加这项计划，市长希望招募个体捐赠者，由他们为家长提供现金奖励，以激励家长们为孩子做出正确的决定，包括带孩子们去例行体检，确保孩子不辍学，以及让他们去卫生保健中心。
这项举措借鉴了墨西哥政府推行的一个消除贫困的计划，这个名叫Oportunidades的计划始于1997年，迄今已取得巨大成效，至少在其他25个国家中推广开来，包括一些饱受贫困之苦的国家，如阿根廷、哥伦比亚、洪都拉斯和尼加拉瓜。该计划的目的是面向墨西哥农村赤贫家庭发展教育，改善其医疗、保健和营养状况。该计划为参与的村庄提供教育资助、营养品，普及卫生和营养方面的知识，并通过银行转帐向当地母亲提供现金购买食品。
“赤贫的最大悲剧之一就是它的‘代代相传性’。如果父母极度贫穷，他们的孩子基本上不能摆脱赤贫的命运。Oportunidades计划试图打破这种恶性循环。”哈斯商学院教授兼卫生服务管理研究生课程主任保罗·杰特勒说道。墨西哥政府委托美国和墨西哥的六名研究员从不同角度评估Oportunidades计划的成效，他是其中一人。
如今，该计划扶助着四分之一的墨西哥家庭，全国几乎所有的穷人都从中受惠。这些家庭的孩子读三到九年级期间，如果能坚持上学，政府会每两个月给他们家里寄去一张支票，金额从三年级的每月10美元到九年级女生所得的每月35美元不等。读中学的女孩获得的资助比男孩要高15%，因为女孩的辍学率更高一些。多子女家庭每月获得的资助额不会超过153美元，设定这个上限，是为了防止有人把资助当作财路而拼命多生。
政府还设立了基金，资助贫困家庭购买学习用具，如果他们参加医疗体检、免疫接种和健康教育培训课程，还可以每月获得食物津贴。这些教育津贴并非杯水车薪的零钱，它相当于中学生全职工作所得收入的三分之二。这些津贴从孩子读完三年级后开始发放，一直持续到中学结束。资助的金额随年级的增加而递增，因为越到高年级，学生的辍学率就越高，而且学生由于留校读书而放弃打工的潜在金钱损失也越大。由于支票由中央政府直接发放到符合条件的家庭的母亲手里，因此行政开支和贪污几率都降低了。
Oportunidades计划之所以有效，是因为它从上学率低和童工现象的根源—家庭收入低—着手来解决问题。儿童是打工抑或上学，决定性因素在于家庭收入，这无论对哪个国家哪个家庭来说都是一样的。在贫困国家，大多数家庭其实更希望送自己的孩子去读书，让孩子打工来增加家庭收入，是迫于现实的妥协。Oportunidades计划不但增加了贫困家庭的收入，还降低了上学的费用。
从一开始，Oportunidades计划的推行就是经过严格把关的。有研究表明，该计划确实致力于帮助墨西哥最贫困的人，他们确实从中获益。贫困家庭的小孩更健康更茁壮地成长起来。Oportunidades还减少了童工人数，让更多的孩子得到上学的机会。杰特勒最近作的一项研究显示，在农村地区，进入高中的孩子人数增加了85%。此外，Opor-tunidades还使儿童患病率降低了12%，使参加计划的婴儿和怀孕母亲的健康状况都得到了显著的改善。
杰特勒评估Oportunidades在卫生保健方面的成效时，还发现在前往诊所的人数增长速度方面，参加了Oportunidades计划的村庄比未参加的村庄要快。他的调查还显示，正是得益于Oportunidades计划，更多的怀孕妇女并没有等到妊娠第二期或者第三期，而是在妊娠第一期就主动到诊所接受检查。这样一来，孕妇和宝宝的健康状况都得到了改善。
随着Oportunidades计划的参与者越来越多地接受医疗保健服务，例如营养状况监测、产前护理和免疫接种，患重疾的人数得以减少，住院接受治疗的人数因而下降了23%。杰特勒还发现，参加了Oportunidades计划的人，由于身体羸弱而导致日常活动受影响的天数减少了19%，无法进行日常活动的天数减少了17%，卧床天数减少了22%。参加了Oportunidades的成年人与未参加的成年人相比，能多走7%的路而不感到劳累。
如此卓越的成就甚至让如纽约之类的富裕城市也艳羡不已。市长布隆博格是聪明的，他采用了一个简单有效的方法，这个方法不仅在世界各地被用来消除现今存在的贫困，也将会被用来消除以后出现的贫困。希望有人能积极响应这项捐赠计划。
Paying for Better Parenting
New York is searching for new ways to fight per-
sistent poverty, and 1)Mayor Michael Bloom-berg’s Commission for Economic Opportunity has recommended useful reforms. To encourage families to participate in these programs, the mayor hopes to recruit private donors to provide parents with a cash 2)incentive to make the right choices for their children, like taking them in for regular checkups, making sure they stay in school and sending them to visit health care providers.
The idea is based on a highly successful Mexican antipoverty program, set up in 1997 and known as Oportunidades, that is now being tried by at least 25 other countries, including some poverty-stricken countries like 3)Argentina, 4)Columbia, 5)Honduras, and 6)Nicaragua. The purpose of this program is to promote education, improve health care, health maintenance, and better nutrition among Mexico’s rural families living in extreme poverty. The program provides education 7)grants, nutritional supplements, education on hygiene and nutrition, and cash transfers for food to mothers in participating villages.
“One of the greatest tragedies of extreme poverty is its intergenerational transmission. Few children of extremely poor parents are able to escape poverty. And Oportunidades seeks to interrupt this cycle of poverty.” said Paul Gertler, 8)Haas School professor and faculty director of the Graduate Program in Health Services Management. He was one of six researchers from the US and Mexico asked by the Mexican government to evaluate the success of Oportunidades on different aspects.
Today the program covers one in four Mexican families, helping virtually all the country’s poor. Families are sent a bimonthly check if their children regularly attend school in grades three through nine; the amount varies from about $10 a month in third grade to $35 for girls in ninth grade. Girls in secondary school are paid 15% more than boys because girls have a higher dropout rate. Families with many children in school can get up to $153 a month, a ceiling imposed to remove the incentive to have more children.
Families are also given a grant to buy school supplies, and a monthly food subsidy if they get medical check-ups, 9)immunizations and health education lectures. The education grants are substantial, about two-thirds of what secondary students would receive for full-time work. The payments start after third grade and go through high school, rising each year as dropout rates get higher and a child’s 10)forgone earning potential is higher. Because checks go directly from the central government to mothers whose families meet the requirements, administrative costs and the chance of corruption are reduced.
Oportunidades is effective because it addresses a root cause of low school attendance and child labor: low family income. The main determinant of whether children work or attend school—both across countries and across families—is family income. Most families in poor countries would prefer to send children to school instead of work, but they cannot afford to forgo the income their children bring home. Oportunidades raises family income and reduces the cost of attending school.
From the beginning, Oportunidades built in 11)rigorous evaluation. Those studies have shown that it does focus its help on Mexico’s poorest people, and they are benefiting. Children are bigger and healthier. Oportunidades has also cut child labor and led to more schooling. In rural areas, the number of children starting high school increased by 85 %. On the other hand it has succeeded in reducing childhood illness by 12 % and has significantly increased the health of babies and pregnant mothers among program participants, according to a recent study by Gertler.
In the evaluation of Oportunidades’s health care effects, Gertler also found that participating villages showed a quicker increase in visits to the available health clinics than in non-participating villages. The study also found that Oportunidades resulted in more pregnant women visiting health clinics during their first, instead of their second or third 12)trimesters, thus increasing their own health and that of their babies.
As Oportunidades participants increasingly took advantage of the available health care—such as visits to monitor nutrition, prenatal care, and immunization—the number of severe illnesses declined, reducing the number of hospitalizations by 23%. Gertler also found that Oportunidades participants had 19% fewer days on which they had difficulty completing their daily activities, 17% fewer days of being incapacitated, and 22% fewer days spent in bed. The adults were also reported being able to walk 7% more without getting tired than their non-Oportunidades peers.
Even a rich city like New York can envy such success. Mayor Bloomberg is smart to explore a brilliantly simple idea that is fighting poverty now and poverty later around the world. Hope that donors will rally to the effort.
纽约正寻求消除持续性贫穷的新方法，纽约市长迈克尔·布隆博格成立的经济机遇委员会已经提出了行之有效的改革建议。为了鼓励贫困家庭参加这项计划，市长希望招募个体捐赠者，由他们为家长提供现金奖励，以激励家长们为孩子做出正确的决定，包括带孩子们去例行体检，确保孩子不辍学，以及让他们去卫生保健中心。
这项举措借鉴了墨西哥政府推行的一个消除贫困的计划，这个名叫Oportunidades的计划始于1997年，迄今已取得巨大成效，至少在其他25个国家中推广开来，包括一些饱受贫困之苦的国家，如阿根廷、哥伦比亚、洪都拉斯和尼加拉瓜。该计划的目的是面向墨西哥农村赤贫家庭发展教育，改善其医疗、保健和营养状况。该计划为参与的村庄提供教育资助、营养品，普及卫生和营养方面的知识，并通过银行转帐向当地母亲提供现金购买食品。
“赤贫的最大悲剧之一就是它的‘代代相传性’。如果父母极度贫穷，他们的孩子基本上不能摆脱赤贫的命运。Oportunidades计划试图打破这种恶性循环。”哈斯商学院教授兼卫生服务管理研究生课程主任保罗·杰特勒说道。墨西哥政府委托美国和墨西哥的六名研究员从不同角度评估Oportunidades计划的成效，他是其中一人。
如今，该计划扶助着四分之一的墨西哥家庭，全国几乎所有的穷人都从中受惠。这些家庭的孩子读三到九年级期间，如果能坚持上学，政府会每两个月给他们家里寄去一张支票，金额从三年级的每月10美元到九年级女生所得的每月35美元不等。读中学的女孩获得的资助比男孩要高15%，因为女孩的辍学率更高一些。多子女家庭每月获得的资助额不会超过153美元，设定这个上限，是为了防止有人把资助当作财路而拼命多生。
政府还设立了基金，资助贫困家庭购买学习用具，如果他们参加医疗体检、免疫接种和健康教育培训课程，还可以每月获得食物津贴。这些教育津贴并非杯水车薪的零钱，它相当于中学生全职工作所得收入的三分之二。这些津贴从孩子读完三年级后开始发放，一直持续到中学结束。资助的金额随年级的增加而递增，因为越到高年级，学生的辍学率就越高，而且学生由于留校读书而放弃打工的潜在金钱损失也越大。由于支票由中央政府直接发放到符合条件的家庭的母亲手里，因此行政开支和贪污几率都降低了。
Oportunidades计划之所以有效，是因为它从上学率低和童工现象的根源—家庭收入低—着手来解决问题。儿童是打工抑或上学，决定性因素在于家庭收入，这无论对哪个国家哪个家庭来说都是一样的。在贫困国家，大多数家庭其实更希望送自己的孩子去读书，让孩子打工来增加家庭收入，是迫于现实的妥协。Oportunidades计划不但增加了贫困家庭的收入，还降低了上学的费用。
从一开始，Oportunidades计划的推行就是经过严格把关的。有研究表明，该计划确实致力于帮助墨西哥最贫困的人，他们确实从中获益。贫困家庭的小孩更健康更茁壮地成长起来。Oportunidades还减少了童工人数，让更多的孩子得到上学的机会。杰特勒最近作的一项研究显示，在农村地区，进入高中的孩子人数增加了85%。此外，Opor-tunidades还使儿童患病率降低了12%，使参加计划的婴儿和怀孕母亲的健康状况都得到了显著的改善。
杰特勒评估Oportunidades在卫生保健方面的成效时，还发现在前往诊所的人数增长速度方面，参加了Oportunidades计划的村庄比未参加的村庄要快。他的调查还显示，正是得益于Oportunidades计划，更多的怀孕妇女并没有等到妊娠第二期或者第三期，而是在妊娠第一期就主动到诊所接受检查。这样一来，孕妇和宝宝的健康状况都得到了改善。
随着Oportunidades计划的参与者越来越多地接受医疗保健服务，例如营养状况监测、产前护理和免疫接种，患重疾的人数得以减少，住院接受治疗的人数因而下降了23%。杰特勒还发现，参加了Oportunidades计划的人，由于身体羸弱而导致日常活动受影响的天数减少了19%，无法进行日常活动的天数减少了17%，卧床天数减少了22%。参加了Oportunidades的成年人与未参加的成年人相比，能多走7%的路而不感到劳累。
如此卓越的成就甚至让如纽约之类的富裕城市也艳羡不已。市长布隆博格是聪明的，他采用了一个简单有效的方法，这个方法不仅在世界各地被用来消除现今存在的贫困，也将会被用来消除以后出现的贫困。希望有人能积极响应这项捐赠计划。