Hi Liliana,

From my experience of a realist evaluation of financial incentives to improve hospital processes, I imagine some of the theories are assumptions related to incentives changing behaviour and motivation:

-The money may motivate some people but for how long? for whom? in what circumstances?

- The assumption that behaviour will be changed long-term (incentives only normally work for short-period of times for complex problems)

- The assumption that complex problems can be changed just with single-level theories ("I'll give you money, and you will take your kids to school"). What about micro/meso/macro barriers?

-Unintended consequences: money will be spent somewhere else, displacement, meeting the target but missing the point (meets short term outcome (take kid too school) but does not meet long-term target (improved education)

Hope this is helpful!

Good luck with it...

Ana

Hi dear Ana,

Thanks for your valuable help!... and for good luck with it.

Liliana

Thanks Judith. Very useful summary of outcomes and context. I am currently working in a realist evaluation of conditional cash transfers in Nigeria (mother & child health) and some of your findings are transferable to our area of study....

Ana

Thank you very much for your comments, they are very helpful.

Our realist review about CCT in  is concluded and was published  (Italian version at the moment). The review aimed at analysing the impacts of welfare behaviour conditionality in OECD countries. Main review questions were: In which circumstance and for whom are behaviours conditionalities effective and appropriate? Which are mechanisms operating in CCT? How do the implementation mechanisms and integrated case-managemente strategies influence the success of CCT measures? It demonstrated that welfare behavioural conditionalities are effective as a means to balance disincentive to work introduced by antipoverty and minimum income measures, particularly in those contexts where a mix of fiscal measures, social benefits and a provision of good quality services and efficient administrations were in operation. 

A key factor that determines how conditionalities influence people behaviours is the degree of knowledge of the rules: about one out four of sanctioned recipients resulted not having a clear understanding of conditions either because they were not informed by service or they did not understand the complex rules.

Medium enforcement of job conditionalities with low sanctions rates together with a mix of fiscal credit and good quality services (Job centres, counseling, services for children care, out-of-school initiative for adolescents, housing benefit) are more probably associated with activation mechanism of most disadvantages recipients and positive outcomes (employment, income rates and children wellness).

Most sanctioned families resulted to be those less able to respect the rules and with more disadvantages. Unintended negative consequences  for adolescents emerged due to the lack of parent control. Other negative effects emerged due to the high costs for the local authorities and implementation inefficiencies  that should be considered in the design of the measure.

Liliana