40 generation access to credit, business skills training, enhancing productivity, or improving market
access, which complicates research and confounds findings. However, of all HES interventions, family income promotion has the most distant causal links with child well-being. The impact pathways have not
been adequately explored beyond descriptive studies. The implications are that traditional approaches may only work for some families, while others require alternative approaches or longer time
horizons.
119, 120,121
Careful analysis and highly capable implementing partners are prerequisites for success, and further rigorous research is necessary to better understand what works and why.
The impact of HES interventions on child well-being depends greatly on the response of the family.
122
Household behavior in this regard is determined by its current vulnerability profile, intra-household decision making,
123,124
and prevailing sociocultural norms.
125
HES approaches are therefore highly contextual and must be grounded in a coherent hypothesis for how family responses to HES
interventions are likely to result in measurable improvements in child well-being. It is often easier to observe how families are spending or investing their money than how they are earning it. These
o se atio s e a le e tai i fe e es a out a fa il s ealth status a d othe fa to s affe ti g thei purchasing decisions. As shown in Table 3 below, this can indicate key intervention strategies that are
appropriate for a fam
il s u e t situatio , espo si e to thei i ediate eeds and desires, and
aligned with key outcomes associated with child well-being. In most contexts, money management interventions are the highest HES priority for OVC families.
6.2.1 Consumption support
Consumption support interventions are direct transfers of resources, usually in the form of cash, to families in order to support basic needs of household members, particularly children. These transfers
may come with conditions, with households engaging in specific behaviors to continue accessing the transfers.
126
Co su ptio suppo t is ost app op iate fo the ost ul e a le fa ilies fa ilies i destitutio
a d ai s to uild thei apa it to pa fo asi e essities. PEPFAR OVC programs should prioritize supporting governments to initiate, expand, or be innovative in their social protection
initiatives to better serve the needs of OVC families.
6.2.2 Money management
OVC partners and programs should integrate money management andor income promotion interventions to help OVC families transition to more stable and self-sustaining economic circumstances.
Money management interventions introduce mechanisms for saving financial and other assets, accessing prudent consumer credit, and fostering the knowledge and behaviors families need to better
match their expenses with their income. Formal financial services tend to be available only from a
119
de Mel, S. McKenzie D, Woodruff C. 2008. Returns to Capital in Microenterprises: Evidence from a Field Experiment. Quarterly Journal of Economics 1234, 1329-1372.
120
Duflo E, Kremer M, Robinson J. 2008. How High Are Rates of Return to Fertilizer? Evidence from Field Experiments in Kenya. American Economic Review 982, 482-488.
121
Fafchamps M, McKenzie D, Quinn S, Woodruff C. 2011. When Is Capital Enough to Get Female Enterprises Growing? Evidence from a Randomized Experiment in Ghana. Policy Research Working Paper No. 5706. The World Bank.
122
Barrientos A, DeJong J. Child Poverty and Cash Transfers. CHIP Report No. 4. Childhood Poverty Research and Policy Centre.
123
Anderson S, Baland J. 2002. The Economics of Roscas and Intrahousehold Resource Allocation. Quarterly Journal of Economics 1173, 963- 995.
124
Duflo E. 2011. Womens Empowerment and Economic Development. Working Paper No. 17702. National Bureau for Economic Research.
125
Conning J, Udry C. 2005. Rural Financial Markets in Developing Countries. Economic Growth Ctr Discussion Paper 914. Yale University.
126
Fiszbein A, Schady N. 2009. Conditional Cash Transfers: Reducing Present and Future Poverty. The World Bank.
41 limited number of financial institutions, usually located in urban areas and targeting less vulnerable
clients. Accordingly, more informal mechanisms independent of financial institutions are often more appropriate and accessible for more rural or vulnerable households. Such mechanisms
127
use self- selected groups of individuals or households to mutually pool an
d gua a tee ea h othe s sa i gs, a d they are derived from traditional arrangements easily understood by most households.
128
These interventions are helpful and appropriate for many families, particularly those with access to some
income sources but still u a le to i est ade uatel i thei hild e fa ilies st uggli g to ake e ds
eet . I a o te ts, these fa ilies likel make up the majority of potential participants in OVC programs and, accordingly, savings-led money management interventions should be a core focus of
PEPFAR programs and partners.
6.2.3 Income promotion
