66563 ATING ATING N INTEGRATING A INTO POVERTY AND SOCIAL IMPACT ANALYSIS (PSIA) UNICEF—World Bank Guidance Note September 2011 A B B R E V I AT I O N S AIDS Acquired Immunodeï¬?ciency Syndrome CBR Community-based Rehabilitation CCT Conditional Cash Transfer CIS Commonwealth of Independent States DHS Demographic and Health Surveys ECD Early Childhood Development GDP Gross Domestic Product HIV Human Immunodeï¬?ciency Virus LFS Labor Force Survey LSMS Living Standards Measurement Survey MICS Multiple Indicator Cluster Survey OECD Organisation for Economic Co-operation and Development PSIA Poverty and Social Impact Analysis SCAT Social Capital Assessment Tool TB Tuberculosis UNICEF United Nations Children’s Fund NGO Nongovernmental Organization ARI Acute Respiratory Infection AIS AIDS Indicators Survey PIRLS Progress in International Reading Literacy Study SIMPOC Statistical Information and Monitoring Programme on Child Labour TIMSS Trends in International Mathematics and Sciences Study 2 THE WORLD BANK GROUP Contents Abbreviations Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1. Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2. Why Is It Important to Consider the Impact of Policies and Reforms on Children and Adolescents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3. When Is There a Need for Detailed Analysis of Impacts on Children? . . . . . . . . . . . . . . . . . 10 4. How Do Key Reforms Affect Children Positively and Negatively? . . . . . . . . . . . . . . . . . . . . 14 PSIA Transmission Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Effects on Household Incomes and Livelihoods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Impacts from Changes in Services Used by Children and Their Families. . . . . . . . . . . . . . . . . . . . . . 24 Social Capital and Cohesion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Interactions between Effects Arising through Different Routes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Diversity among Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Potential Child Well-Being Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Distinguishing Short- and Longer-Term Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 5. Methods for Assessing Impacts on Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Quantitative Analytical Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Qualitative Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 6. Including Children’s Perspectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 What Kind of Information?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 How to Include Children’s Views in PSIA Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 7. Mitigating Negative Effects and Enhancing Positive Effects of Reforms on Children . . . . . 56 Deciding on the Type of Policy Response Needed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Identifying Different Policy Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Modifying Proposed Reforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Mitigation Policies to Protect Children’s Well-Being. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Complementary Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Grievance Redress Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Annex 1. Checklist: Consolidated Set of Key Questions for Child-Focused PSIA . . . . . . . . . . . . . . . . . 68 Annex 2. Child Well-Being Indicators and Possible Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Annex 3. Examples of Sector Reform Impacts on Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Annex 4. Rapid Assessment of Potential Impacts on Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 1 Contents List of Tables Table 1. Age-Related Vulnerabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Table 2. Distinguishing Short-, Medium-, and Longer-Term Effects on Children of Declining Households Incomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Table 3. Some Qualitative Analytical Tools Used in Child-Focused PSIAs . . . . . . . . . . . . . . . . . . . . . . 47 Table 4. Tools for Political and Institutional Analysis in a Child-Focused PSIA . . . . . . . . . . . . . . . . . . . 47 Table 5. Qualitative Research Methods and Their Use with Children in a PSIA . . . . . . . . . . . . . . . . . . 53 Table 6. Reform Scenarios and Possible Courses of Action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Table 7. Key Child Well-Being Vulnerabilities and Possible Policy Approaches . . . . . . . . . . . . . . . . . . 65 List of Figures Figure 1. Summary Conceptual Framework: Tracing Impacts of Reforms on Children . . . . . . . . . . . . . 16 Decision Tree 1. The Screening Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Decision Tree 2. Consulting Directly with Children in ex Ante Analysis . . . . . . . . . . . . . . . . . . . . . . . . 55 List of Boxes Box 1. Key Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Box 2. Quick Assessment of Impacts of Reform on Children Using Transmission Channels . . . . . . . 11 Box 3. PSIA Transmission Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Box 4. Key Questions: If Incomes Fall, How Are Children Likely to Be Affected? . . . . . . . . . . . . . . . 17 Box 5. Key Questions: Impact of Changes in Services on Children . . . . . . . . . . . . . . . . . . . . . . . . . 24 Box 6. Key Questions: Impacts of Changes to Social Capital and Cohesion on Children . . . . . . . . . 27 Box 7. How Are Particular Reforms Likely to Affect Children? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Box 8. Gender and Social Diversity Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Box 9. Possible Indicators for Health and Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Box 10. Possible Indicators for Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Box 11. Possible Indicators for Work and Leisure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Box 12. Possible Indicators for Abuse and Emotional Well-Being . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Box 13. When Additional Data Collection May Be Needed to Bring a Child Focus to a PSIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Box 14. Age-Disaggregated Beneï¬?t Incidence Analysis in Belize . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Box 15. Ex Ante Microsimulation Analysis of the Potential Impacts of Redesign of Conditional Cash Transfer Programs in the Dominican Republic . . . . . . . . . . . . . . . . . . . 44 Box 16. Regressions to Estimate the Likely Impacts of Electricity Tariff Rises in Bosnia Herzegovina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Box 17. Simulation Techniques to Understand the Potential Impacts of Economic Crisis, Shocks, or Policy Changes: The UNICEF Project on the Impact of the Global Economic Crisis on Children in West and Central Africa . . . . . . . . . . . . . . . . . . . 46 Box 18. Key Questions for Political and Institutional Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Box 19. Mozambique Example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Box 20. Interviewing Other Key Informants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 2 THE WORLD BANK GROUP AND UNICEF ACKNOWLEDGMENTS This is a joint World Bank and United Nations Children’s Fund (UNICEF) paper, which has been partly supported by the Poverty and Social Impact Analysis Multi-Donor Trust Fund. This Guidance Note is based on a longer draft toolkit for analyzing the impacts of economic and social policy reforms on child rights (Marcus and Birdi 2010). That publication was produced with the assistance of the European Union. The contents of this publication are the sole responsibility of the World Bank and UNICEF and can in no way be taken to reflect the views of the European Union. The guidance note was produced by a team led by Margaret Wachenfeld from UNICEF and Sonya M. Sultan from the World Bank. The principal writer was Rachel Marcus (consultant), and other team members include Clemens Gros, Andy Norton, Dorothee Georg, and Jennifer Vibert. We are grateful to the following colleagues for their ex- pert insights and for providing material, resources and comments. We are particularly grateful for peer review comments received from Isabel Ortiz, Jingqing Chai, and Sarah Hague of UNICEF; and Asta Olson and Ludovic Subran of the World Bank. From UNICEF, Enrique Delamonica, Joanne Dunn, Susan Durston, Cheryl Gregory Faye, Peter Gross, Theresa Kilbane, Gerison Lansdown, Leonardo Menchini, and Francesca Moneti provid- ed helpful feedback on the ï¬?nal draft of the Guidance Note. Nilufar Ahmad, Maitreyi Das, Verena Fritz, and Ambar Narayan from the World Bank provided important feed- back and examples during the drafting of the note. Gaspar Fajth, Jennifer Yablonski, Namsuk Kim, Alberto Minujin also provided valuable comments on earlier drafts of the Guidance Note. This paper is a product of the staff of the International Bank of Reconstruction and De- velopment/The World Bank. The ï¬?ndings, interpretations, and conclusions expressed herein do not necessarily reflect the views of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 3 1. Introduction Poverty and Social Impact Analysis (PSIA) involves the analysis of the distributional impact of public policy reforms on the well-being of different stakeholder groups, with a particular focus on the poor and vulnerable (World Bank 2005). It is a tool for generating evidence about the likely impacts of policy reforms that can be used to inform dialogue, debate, and decisions on policy choices. PSIA can be used to predict the effects of any type of reform; it is most commonly used in economic, environmental, social policy, and governance reforms. This Guidance Note outlines some of the potential poverty and social impacts of common eco- nomic and social policy reforms on children and the pathways through which they arise. It also gives an overview of existing tools and methods that can be used for analyzing these impacts. This note outlines some approaches for mitigating negative and enhancing positive effects on children. It also discusses briefly how children’s perspectives can be included in a PSIA. This Guid- ance Note is complemented by the “Children and PSIA Resource Packâ€? (hereafter referred to as Resource Pack), which guides users to additional relevant resources on methodological issues, data sources, policy approaches, and ways of including children’s perspectives. The Guidance Note is intended to help analysts prevent a decline in children’s well-being as a result of policy reforms, and identify ways of enhancing positive impacts on children. However, designing policies or programs for the maximum possible positive effects on children requires more detailed and speciï¬?c planning than can be covered in this Guidance Note, but the Resource Pack covers this point in more detail. Box 1 contains some key questions covered in this note. This Guidance Note assumes that: • Identiï¬?cation of the key transmission channels in a given PSIA has already taken place • Distributional analysis and gender analysis will be undertaken alongside any child-focused analysis • Insights from these different forms of analysis will be used to complement one another. BOX 1. Key Questions Covered by This Guidance Note WHY is it important to consider the impact of policies/policy reform on children and adolescents? WHEN is there a need for detailed analysis of possible impacts on children? WHAT possible positive and negative impacts on children should be looked for and how should they be measured? HOW can the negative impacts of policies on children be reduced or mitigated and positive effects enhanced? HOW can the PSIA process ensure the inclusion of children’s perspectives? 4 THE WORLD BANK GROUP AND UNICEF The Guidance Note is intended to help analysts prevent a decline in children’s well-being as a result of policy reforms, and identify ways of enhancing positive impacts on children. 2. Why Is It Important to Consider the Impact of Policies and Reforms on Children and Adolescents? Although the impacts of reforms on children are rarely considered systematically in ex ante analysis, there are good reasons for doing so. First, children and adolescents1 are a numeri- cally signiï¬?cant population group (32.6 percent of world population [UNICEF 2011a] and one- third to half of the population of most countries) and are also disproportionately likely to live in poverty.2 For example, in Latin America and the Caribbean in 2002, 56 percent of under 14-year-olds, and 45 percent of 15–19-year-olds were considered poor, compared with 33 percent of adults aged 30 years or more (UNDESA 2007). In 2010, 7.6 million children under age 5 died before their ï¬?fth birthday,3 and 68 million primary school–age children were not attending school.4 Second, children and adolescents are uniquely vulnerable to even short periods of deprivation, which can have lifelong and intergenerational effects. Because of the rapidity of neurobiologi- cal, cognitive, and emotional development in early childhood, even short-term deprivations can have long-term and potentially irreversible harmful effects. Nutritional and emotional depri- vation in the ï¬?rst two years of life in particular can prevent essential brain development that can diminish children’s capacity to learn and their ability to effectively relate to others as they grow up (Victora et al. 2008). This, in turn, can lead to lower educational achievements and lower earnings in adult life (Alderman, Hoddinott, and Kinsey 2003). Nutritional deprivation in early childhood can also lead to health problems later in life (Harper, Marcus, and Moore 2003; Yaqub 2002) and to adolescents being less able to regulate their emotions and having poorer behavior than children who had not suffered nutritional deprivation (Walker et al. [2005] cited in Ferreira and Schady [2009]). Even later in childhood, lost opportunities for education and for healthy development can be hard to recoup. Children and young people growing up in difï¬?cult circumstances are at greater risk of being drawn into activities that undermine their long-term well-being, such as unsafe sex or substance abuse (World Bank 2007). Through a combination of these factors, they are more likely to become poor and deprived adults and risk passing their poverty and deprivation on to their own children. 1 “Children and adolescentsâ€? in this Guidance Note refers to people under age 18. For guidance on assessing the impacts on young people from age 13 to mid-20s, see World Bank (2006). 2 http://www.unicef.org/socialpolicy/ï¬?les/Global_Inequality_Beyond_the_Bottom_Billion.pdf. 3 http://www.childinfo.org/mortality.html. 4 http://www.childinfo.org/education.html. 6 THE WORLD BANK GROUP AND UNICEF W H Y I S I T I M P O RTA N T ? TABLE 1. Age-Related Vulnerabilities AGE PERIOD MAIN VULNERABILITIES In utero • Malnutrition and poor maternal health—affecting brain and physical development Infancy—age 0–2 • Malnutrition—affecting brain and physical development • Health—greatest vulnerability to disease; access to adequate health care most critical at this age • Inadequate stimulation, loving care, and attachment to main carer—essential for physical, emotional, social, and cognitive development; vulnerability to abuse Early childhood— • Malnutrition—affecting brain and physical development approximately • Health—signiï¬?cant vulnerability to disease; access to adequate health care age 3–5 • Inadequate stimulation, loving care, and attachment to main carer—essential for physical, emotional, social and cognitive development; vulnerability to violence and abuse • Inadequate access to early learning opportunities Middle childhood— • Malnutrition—affecting growth, health, and ability to learn approximately • Health—vulnerability to disease and access to adequate health care age 6–11 • Inadequate loving care—essential for emotional, social, and cognitive development; vulnerability to violence and abuse • Inadequate access to quality education • Growing vulnerability to child labor and to substance abuse Early adolescence • Inadequate access to quality education and information on risky behavior • Social—ability to socialize with peers; risk of developing social bonds with older youth who draw them into dangerous or criminal activity; absence of supportive adult guidance; vulnerability to violence and abuse • Health—risky sexual activity and substance abuse • Risk of child labor endangering health and education • Exposure to exploitation through Internet activities Late adolescence • Inadequate access to quality education (secondary, tertiary, and vocational) and youth • Transition to work—high youth unemployment rates and poor working conditions • Social—ability to socialize with peers and build social capital; risk of socializing with criminal/socially undesirable groups; vulnerability to violence and abuse • Health—risky sexual activity; substance abuse; access to maternal and reproductive health care services affecting both young women and next generation • Access to housing; ï¬?nancial ability to make transition to adulthood (for example, through marriage or forming independent household) • Opportunities for voice and to exercise citizenship rights and responsibilities; access to justice • Exposure to exploitation through Internet activities CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 7 W H Y I S I T I M P O RTA N T ? Short periods of deprivation can thus have long- Identifying likely effects on children provides an term effects on children. Children’s particular vul- opportunity to design policies that maximize the nerability to the effects of reforms arises from: potential for investing in their well-being, and thus in the social and economic development of • Their biological and emotional vulnerabil- both the children and their societies. The poten- ity, because key developmental processes of tial impacts of economic and social policy reforms maturation are under way. on children therefore need careful consideration. • Their social vulnerability and dependence on adults—within and outside their house- States’ parties to the United Nations Convention holds—for care and protection. The depen- on the Rights of the Child5 commit to upholding dence of young children in particular on their the “best interests of the childâ€? as a primary con- mothers, and the signiï¬?cance of mothers’ sideration when taking actions affecting children. access to resources and decision-making This requires an understanding of the potential power for children’s well-being, means impacts of different courses of action on children, that broader gender analysis is an essential which a child-focused PSIA can help achieve. In complement to the more child-speciï¬?c general, approaches that include a focus chil- analysis outlined in this Guidance Note. dren’s rights will emphasize preventing negative impacts on the most disadvantaged children while Reforms that affect the resources available for enhancing their opportunities. children’s development, such as, food, safe water and access to education, or adults’ capacity to care However, few PSIAs consider the potential im- for and protect them, for example, adult time, pacts of proposed reforms on children. Those mental health and a safe living environment, are that do focus primarily on children’s access to likely to have signiï¬?cant impacts. Table 1 on p.7 education and, to a lesser extent, on the poten- outlines some of the different vulnerabilities of tial impacts on child labor and children’s health. children at different ages. Protection of children from violence, exploitation, and abuse are rarely considered. This also means Aside from the social costs, the economic costs of that the spotlight tends to be on older children, allowing child and youth deprivation can be enor- and the potential impacts on others—infants and mous. For example, youth crime and violence incur preschool-age children, for example—are less rou- public and private costs of 3.2 percent of gross do- tinely examined. mestic product (GDP) in Jamaica. In Uganda, if girls who currently only ï¬?nish primary school also com- One reason for this limited attention to the im- pleted secondary school, they would contribute pacts on children is that at ï¬?rst sight, reforms an additional 34 percent of current GDP over their may seem child neutral and not warrant addi- working lives (Hempel and Cunningham 2010). tional investigation, or be concerned with assess- Today’s children, and the societies they will inherit, ing changes to family welfare. However, many of stand to pay the costs or reap the beneï¬?ts of pol- the effects on children arise through a chain of icy decisions taken today for the rest of their lives. processes set in motion by policy change. With an understanding of the kinds of social processes engendered by particular types of policy reforms, the potential impacts on children and their social costs and beneï¬?ts can be more easily identiï¬?ed. 5 All countries have ratiï¬?ed the convention except the United States and Somalia, which have signed it. 8 THE WORLD BANK GROUP AND UNICEF Children and adolescents are uniquely vulnerable to even short periods of deprivation. Which can have lifelong and intergenerational effects…lost opportunities for education and for healthy development can be hard to recoup. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 9 3. When Is There a Need for Detailed Analysis of Impacts on Children? All PSIAs should involve a brief analysis of whether children are a stakeholder group likely to be affected in a signiï¬?cant way by the proposed reform. Then, as a second step, a more detailed analysis should be carried out. Not all reforms will have signiï¬?cant impacts on children and adolescents. Those that are most likely to affect either large numbers of children, or smaller numbers moderately or severely, are those that: • Signiï¬?cantly impact household incomes and livelihoods • Affect access to and quality of key services used by children and their families • Affect key forms of social capital that protect children and help them develop. Initial screening to assess whether in-depth child-focused analysis is required involves: • Identifying key issues and questions (see boxes 2–6 for possible screening questions) • Identifying main stakeholders and possible winners and losers • Estimating the magnitude and likelihood of possible impacts in the short, medium, and long term • Assessing what data and information are available and identifying key gaps • Analyzing the feasibility of ï¬?lling these gaps in the time available. Annex 4 outlines a possible approach to rapid child-focused assessment for PSIA. Decision Tree 1 is a tool to work through the screening process and help identify whether fur- ther detailed analysis of impacts on children is needed. To effectively use the Decision Tree tool, the following section, “How Do Key Reforms Affect Children Positively and Negatively?â€? should be reviewed so that the user can assess the likelihood and signiï¬?cance of effects on different groups of children. Before using the Decision Tree it is also assumed that some initial analysis and assessment of probable distributional effects have already taken place to identify how much poor households are likely to be affected by proposed reforms. 10 THE WORLD BANK GROUP AND UNICEF WHEN IS THERE A NEED? BOX 2: Quick Assessment of Impacts of Reform on Children using Transmission Channels A simple matrix can be used as a rapid ï¬?rst step in identifying and presenting potential impacts on children in a consolidated manner. IMPACTS INTENSITY TRANSMISSION Short-term impacts Long-term impacts Magnitude Severity (depth) CHANNELS (no. children) Employment and XXX X X wages Prices XXX X XX XXX Transfers and Taxes XXX XX XX XXX Access to Goods/ XX XX XXX Services Assets XX X XXXX Authority XXX XXX The intention of the matrix is to provide early inputs for policy dialogue, ensuring that main short and long term impacts, as well as the intensity of the impacts of reforms, are under- stood and considered in time to shape policy reforms. Source: Isabel Ortiz, UNICEF Not all reforms will have signiï¬?cant impacts on children and adolescents. Only those that are likely to affect either large numbers of children, or smaller numbers moderately or severely, will require a more detailed, child focused PSIA. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 11 PROPOSED REFORMS 12 ROUTES POTENTIAL EFFECTS POTENTIAL EFFECTS POTENTIAL EFFECTS BY ON INCOMES/ ON ACCESS TO ON SOCIAL CAPITAL DECISION TREE 1. The WHICH LIVELIHOODS SERVICES AND COHESION CHILDREN Is proposed reform likely to • Budgets: Are budgets for • Are interhousehold trans- WHEN IS THERE A NEED? ARE AFFECTED have signiï¬?cant impacts on services/expenditures of fers likely to be affected? poor households’ incomes/ direct beneï¬?t to children Could this reduce/increase livelihoods? likely to increase/decrease? children’s access to key • Quality: Could the quality goods/services? Could coping strategies Screening Process involve: of services used by children • Are social contacts be- • Increased child/adolescent decline, for example, if tween families and among THE WORLD BANK GROUP AND UNICEF labor? service providers start children and young • Reduced consumption of moonlighting? people likely to decline nutritious food (especially • Financial accessibility: due to longer work hours among children and Could poor children’s or being unable to afford pregnant women)? access to services be to participate in commu- • Reduced school affected, such as by nity life? enrolment/attendance or increased /reduced formal • Could informal childcare increase in drop-outs? or informal charges? arrangements be affected, • Reduced use of for example, if more • Changing policy priorities: preventative or curative women enter the work- Could these affect the health services for children force? delivery of key services or adults? used by children and • Is there a risk of increased • Increased numbers families? intrahousehold tension of children left with and violence? Of increased inadequate supervision household break-up? while parents are working? • Could crime or violence • Increased migration of increase (affecting children, adolescents, or children’s mobility and adults? opportunities to play), or • Placement of children in risks of sexual exploitation nonfamilial care? or drug or people trafï¬?ck- ing increase? Y ES Are children likely to be affected through more than one route, Child impact or in three or more ways? analysis needed NO Y ES Child impact Are signiï¬?cant numbers of children likely to be affected? analysis needed NO Y ES Child impact Are particularly vulnerable groups of children likely to be adversely affected? analysis needed NO Y ES Child impact Are effects likely to be moderate or severe? analysis needed NO CHILD FOCUSED PSIA 2011 GUIDANCE NOTE Detailed child impact analysis may not be needed— a rapid assessment may still be useful 13 WHEN IS THERE A NEED? Note: See Resource Pack for further tools and guidance. 4. How Do Key Reforms Affect Children Positively and Negatively? This section outlines some of the main ways that children of different ages, genders, and in dif- ferent circumstances may be affected by common reforms (summarized in ï¬?gure 1). The focus is primarily on possible negative impacts so that these can be avoided, since even reforms that im- prove the position of the majority of social groups may undermine the well-being of a minority. Preventing these adverse impacts can also be an opportunity for designing policy to enhance child well-being. This section also identiï¬?es some possible positive effects, so that reforms can be designed to further enhance these positive effects. Box 3 at right describes the six transmission channels through which public policies generally affect people’s welfare, and which are examined in most PSIAs. The second part of this chapter explains in more detail reforms that are most likely to affect chil- dren, namely those that: • Signiï¬?cantly impact household incomes and livelihoods • Affect access to and quality of key services used by children and their families • Affect children’s, youth and families’ opportu- nities to form social capital, and enhance the social communities in which they are living. This section discusses each of these three main routes in turn. Key questions for analysis are sum- marized in boxes for each subsection. 14 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? BOX 3. PSIA Transmission Channels EMPLOYMENT. To the extent that a policy change affects labor market structure or labor demand, particularly in sectors that employ the poor (such as unskilled, rural off-farm, and agriculture), low-income households’ welfare will be affected. Transmission may be direct or indirect and may different affect formal and informal sectors, including self-employment. PRICES. (production, consumption and wages). Prices determine real household income, both the actual monetary price paid as well as opportunity costs (e.g. of queuing), and costs incurred through rent-seeking behavior. Price changes will affect both consumption and resource alloca- tion decisions. Producers will also be affected by policies that cause relative changes in output and input prices. Wage changes will affect net buyers and sellers of labor differently, and policies that change relative prices will induce shifts in both demand and supply. ACCESS. Access to good and services affects well-being, whether in the form of access to markets and services outlets, or through improvements to public or private sector quality and responsiveness. ASSETS. Changes in assets’ values affect income and non-income welfare dimensions. Asset en- dowments include physical (i.e. housing), natural (i.e. land, water), human (i.e. education, skills), ï¬?nancial (i.e. savings accounts), and social (i.e. membership in social networks that increase access to information or resources) capitals. TRANSFERS AND TAXES. Transfers, which can take the form of private flows (such as gifts and remittances), or public flows (such as subsidies and taxes) affect welfare. Public ï¬?nance has a direct impact on the welfare of speciï¬?c groups through transfers—including subsidies, targeted inform transfers and social protection initiatives—and tax policy that can be more or less pro- gressive in its distributional impact. AUTHORITY. This channel encompasses changes in power, structure and processes that govern public institutions’ formal and informal functions, operating at the macro-level (i.e. public service reform), meso level (e.g. decentralization of administrative authority), and micro levels (e.g. redirecting welfare payments from men to women). Source: WB “Good Practice Note: Using Poverty and Social Impact Analysis to Support Development Policy Operationsâ€?, August 2008 CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 15 HOW DO KEY REFORMS AFFECT CHILDREN? FIGURE 1. Summary Conceptual Framework: Tracing Impacts of Reforms on Children Source: Adapted from Marcus and Birdi (2010). HOUSEHOLD Increasingly ECONOMIES & Child-Speciï¬?c RESPONSE Analysis STRATEGIES • Management of Assets • Consumption POLICY REFORMS AND PROGRAMS • Household MEDIATING OUTCOMES Labour FACTORS FOR CHILDREN allocation • Household • Health Mediated Socioeconomic • Nutrition by ACCESS TO Status Affecting • Emotional AND QUALITY • Children’s age children Well-being OF SERVICES and gender through • Work & impact on • Financing • Wider social Leisure • Costs to users norms • Education • Incentives of • Geographical Location • Exploitation, Providers neglect & • Existing abuse policies, programmes & civil society SOCIAL CAPITAL provision for & COHESION speciï¬?c groups • Reciprocity • Connectedness • Violence Feeding back into 16 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? Effects on Household Incomes and Livelihoods Declining incomes and associated household coping strategies could affect children in a number of ways that are not necessarily obvious and should be explored as part of the child impact analysis. Conversely, increased incomes could lead to improved child well-being (see box 4). BOX 4. Key Questions: If Incomes Fall, How Are Children Likely to Be Affected? FOOD • How likely are households to shift to less nutritious food (for example, less frequent consumption of protein, vitamins, minerals, substitution with cheap fats or carbohydrates, or inappropriate baby foods such as unsuitable powdered milk) or consume less food overall? • Are changes in breast-feeding patterns likely, for example, if mothers need to work away from infants at a younger age? Or (positively) increased breast-feeding to substitute for purchased formula/baby food? • Are children who receive food at school likely to receive less at home? CLOTHES AND SHOES • How likely are households to cut back on children’s clothes, including school uniforms that might be required for attendance, and shoes? UTILITIES • Is there a risk of shifting to more dangerous/polluting fuels (for example, unventilated wood-burning or makeshift electricity connections) or unsafe water sources? ADULT GOODS • Are households likely to increase or decrease spending on tobacco and alcohol? SERVICE USE • What is the risk of delaying seeking medical care or purchasing cheaper, nonprescription medicines? • What is the risk of households cutting back on school supplies (for example, books and stationery) or having some children in the family drop out of school? If Household Incomes Rise, How Are Children Likely to Be Affected? • How far is spending likely to rise on goods and services that beneï¬?t children? CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 17 HOW DO KEY REFORMS AFFECT CHILDREN? KEY COPING STRATEGIES AND THEIR Using cheaper fuels and water sources. In times EFFECTS ON CHILDREN of economic stress, households often shift from relatively expensive electricity and gas to cheaper In periods of temporary hardship, families often wood fuel and kerosene, or replace bought fuels manage to protect children, or at least to protect with scavenged ones (wood or dung). This can in- expenditures viewed as a priority in particular cul- crease the workloads of children (often girls in tural contexts (for example, education). However, parts of sub-Saharan Africa) who are expected to the longer and deeper the period of poverty, the collect fuel. Increased exposure to air pollution more likely that incomes will be insufï¬?cient for from burning solid fuels with inadequate ventila- key expenditures for child well-being. For exam- tion may increase children’s risk of respiratory dis- ple, during economic crises in Mexico and Brazil, eases and preventable death. Girls, who often spend parents who lost their jobs were often able to more time cooking and doing other domestic keep children in school for a few months, but chores, are particularly affected.7 Reduced electric- then, if their incomes did not increase again, ity consumption can make it harder for children to would not enroll them for the following school study, reduce access to information (for example, year (Skouï¬?as and Parker 2002; Duryea, Lam, and from television), and can affect access to hot water Levison, 2007). for bathing (Birdi et al. 2007). For households that respond to high energy costs by limiting cooking Reducing consumption of nutritious food is one and eating more cold food, nutrition may be af- of the most common responses to economic stress fected. In countries with cold climates, poor (World Bank 2008a). Common changes in con- households may decide to heat only one room or sumption include reducing overall food intake,6 cannot afford heating at all, leading to increased reducing consumption of relatively expensive pro- incidence of respiratory diseases among children tein- and micronutrient rich food, and consum- and more missed days of school due to illness ing more of cheaper foods, typically those high in (Ablezova et al. 2004). Illegal electricity connec- carbohydrates and fats (Mendoza 2009). This has tions and homemade wood burning are other become disturbingly common in poor households ways of reducing costs, but pose a serious risk of affected by food price rises since 2007 (Ortiz and accidents (Dudwick et al. 2003). Cummins 2011). Though harmful for all children, the effects can be particularly severe for children For households that pay for water (as in most under age two, because this is when brain and urban and many rural areas), increased bills may physical development are most rapid (Victora et lead to reduced bathing and clothes washing, al. 2008). Malnutrition accounts for one-third of with implications for health and hygiene, and the deaths of children under age ï¬?ve (Black et may lead to households’ greater use of unprotect- al. [2008] in Ortiz and Cummins [2011]), indicat- ed water sources (Beddies et al. 2004; Gavrilovic et ing the extreme vulnerability of young children to al. 2009), which can also impact children’s health. food deprivation. The youngest children, who are most vulnerable to diarrheal diseases, are particularly at risk—almost 2 million children under age ï¬?ve die from diar- rheal disease every year.8 6 Such changes are often widespread in the face of economic shocks. For example, Lokshin and Yemtsov (2004) found that 64 percent of households had reduced food expenditures following the Russian ï¬?nancial crisis of 1998. 7 http://www.who.int/mediacentre/factsheets/fs292/en/index.html. 8 http://www.unicef.org/health/index_43834.html. 18 THE WORLD BANK GROUP AND UNICEF Today’s children, and the societies they will inherit, stand to pay the costs or reap the beneï¬?ts of policy decisions taken today for the rest of their lives. HOW DO KEY REFORMS AFFECT CHILDREN? Reduced expenditure on education. For house- Reduced consumption of adult goods may be of holds that cut back on children’s clothing and beneï¬?t to children. In lean periods, households shoes, school attendance may decline if children often spend less on tobacco and alcohol, as in are prohibited from (or too ashamed of) attend- Thailand during the 1997–99 crisis (Tangcharoen- ing school. Access to education may also be affect- sathien et al. 2000). However, this is context specif- ed by increasing difï¬?culties for families in afford- ic, and there is also evidence of increased alcohol ing user fees (where these exist), stationery and consumption in much of the Commonwealth of books, transport costs, or informal or additional Independent States (CIS) following the collapse of charges such as school fund contributions or ex- the Soviet Union. This has been a key factor in so- amination fees (World Bank and UNICEF 2009). cial breakdown, leading to increased child abuse In cases where teachers are dependent on addi- (UNICEF 2001). tional income from out-of-school tuition, children whose families cannot afford to pay may receive Reducing household size to reduce the costs of very little attention or persistently poor grades living. Children are often directly affected, when, (UNICEF 2006), limiting their prospects of achieving for example, they are sent to live in another functional skill levels in key areas and graduating household (related or not), sometimes as de facto with recognized qualiï¬?cations, and thus limiting domestic servants (Whitehead, Hashim, and Ivers- future employment prospects. en 2007). Families under extreme stress may aban- don children (particularly infants), sometimes in Reduced use of health care facilities. If copayments the care of welfare institutions such as orphan- for health care are expected (whether user fees, in- ages (UNICEF 2011b). Older children, particularly formal payments to providers, costs of medicines, girls, may be pressured or forced into marriage to or others), people may avoid health care alto- reduce the number of mouths to feed, or to bring gether, or manage illnesses using home remedies assets (bride price) into their natal family (Warner or self-medicating until an illness becomes very 2004; Hervish and Feldman-Jacobs 2011).9 severe or life threatening. At this point, health care can be very expensive, and therefore severe Distress sales of assets, such as land, livestock, illness of either children or adults can lead to fur- housing or equipment, often at a lower price ther impoverishment. Self-treatment may mean than would have been commanded in better using cheap medicines, which may be counterfeit times, may affect children through the impacts on or expired or not necessarily appropriate for the their household’s current and future livelihood illness concerned, and thus potentially dangerous. and income-generating capacity. For example Given young children’s greater vulnerability, all in Kyrgyzstan, where poverty rates rose sharply of these factors can affect their survival chances. after transition, poor farming households were Some studies have found small decreases in the faced with the option of selling seed potatoes use of antenatal care and in attended deliveries to fund immediate food and schooling expenses and increases in home births when household and then having nothing to plant the following incomes have declined, for example in Thailand year, or retaining their seeds but going hungry (Tangcharoensathien et al. 2000) and Indonesia (Counterpart Consortium and World Bank 1999). during the crisis of the late 1990s (Macfarlane Bur- Where assets had been earmarked for particular net Centre 2000), and in Peru in the late 1980s and purposes, such as funding education or a child’s early 1990s (Paxson and Schady 2005). future marriage, children’s (and their parents) 9 Child marriage is an outcome of broader social norms and societal pressures. While it may be exacerbated by economic pressures, removing these pressures is often insufï¬?cient to eradicate the practice, which requires social mobilization. 20 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? aspirations may have to be sacriï¬?ced and their opportunities diminished. Financial pressures may also lead to overuse and degradation of environmental assets, both those privately owned or used (such as land) and com- mon pool resources (such as forests or water). This can affect children through their impact on households’ present livelihoods and on children’s available time (for example, if they now have to travel further to collect fuel), which in turn can affect their access to education and their health and security (World Bank 2008b). Their future live- lihoods and those of succeeding generations may also be undermined. Borrowing—often from informal lenders charging high interest rates—is a common response to ris- ing costs. Children may be affected by repayment arrangements if they involve the loss of key as- sets such as their homes or land, or if they involve repayment through labor. In such cases, children may be obliged to work to help repay their fam- ily’s debt, in a form of bonded child labor. In some contexts, girls of marriageable age may be forced to marry the debtor to cancel their family’s debt. Children and adults working longer and harder. Reducing consumption of nutritious food is one of During difï¬?cult times, parents often try to work longer and harder to generate more income in second or third jobs. Previously “economically in- activeâ€? adults, such as mothers of young children the most common responses or pensioners, may start taking on paid work. They may also try to reduce costs by making formerly to economic stress. purchased items, such as bread, at home. These longer work hours can mean that there is less time available for the care of young children (Ruiz-Casares and Heymann 2009), or to provide emotional sup- port and guidance to older children and teenag- ers, which may affect the children’s physical and emotional well-being. Children, particularly older children, may also have to take on paid work, more household domestic work, care of younger siblings (this is often gendered, but should not be assumed to solely affect girls), or contribute to family-run CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 21 HOW DO KEY REFORMS AFFECT CHILDREN? businesses, all of which may affect their education. live in their destination (Whitehead, Hashim, and Some approaches to supporting family livelihoods, Iversen 2007). This may enable them to help sup- such as microï¬?nance, may exacerbate this demand port their families, for example, to help ï¬?nance a for children’s labor. sibling’s education or to learn new skills (Hashim 2006). In some parts of Africa in particular, send- Labor migration. Children are affected in differ- ing a child to live with a relative and perform ent ways by different types of labor migration, household duties in exchange for board and lodg- another common household response to declining ing, and in principle (though not always practice) incomes. If children are left behind when one (or schooling, is an established practice (Serra 1997). both) parents migrate, typically children’s work- Depending on the nature of their work and their loads increase. Remittance income can improve living conditions, both independent migrants and households’ socioeconomic status and thus chil- those sent by their families may be vulnerable dren’s living conditions and opportunities, but this to exploitation, abuse and trafï¬?cking, and their is not always a steady income stream, or may dry up health may be put at risk. altogether for long periods (UNICEF 2008b). There are potentially negative emotional impacts—chil- dren often feel neglected and forgotten by their absent parent(s) (De La Garza 2010). A study in POSSIBLE POSITIVE EFFECTS Moldova, a country with very high levels of adult emigration, found that children left behind by a When reforms lead to increased household in- migrant parent often fared worse educationally comes, consumption of key goods and services even if materially they were better off (Helpage may also be increased. There are strong asso- International and UNICEF 2008); this is borne out ciations between higher incomes and improved in studies from Jamaica, though other studies have child nutrition, health and education, particularly found positive economic effects to outweigh neg- when funds are controlled by women. However, ative psychological ones (De La Garza 2010). the effects of any increases need to be assessed in context—it may be that gains principally ac- When whole families migrate, the effects on chil- crue to certain household members, for example, dren depend on living conditions in their destina- adult men or boys. Alternatively, gender-based (or tion, and access to services. This may be governed other) inequalities may be redressed if increased by income, by general levels of service provision incomes enable households to spend on formerly in areas housing low-income migrants, or by gov- disadvantaged children. ernment policy concerning migrants’ access to services (in countries where internal migration Reforms focusing speciï¬?cally on assets, such as is controlled and residence permits are needed, land reform and titling programs, could have and in international migration). While for some positive and negative net effects for children. children migration presents an opportunity for Redistribution and securing of assets is likely to better education, for others it means that educa- beneï¬?t the current generation, but this may be at tional opportunities are curtailed, their workloads the expense of future generations if population intensiï¬?ed, and the quality of their environment growth is high and assets, such as land, are lim- deteriorates (Ablezova et al. 2004). ited. Gender equity principles need to be incorpo- rated into asset reforms to ensure that children’s Children, particularly teenagers, may also migrate present well-being as well as future livelihoods alone, using kin- and friendship-based networks are protected; otherwise, for example, children of in their home area to ï¬?nd work and a place to divorced women may be dispossessed. 22 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? Stronger livelihoods can enable households to in- and may assist with the school–work transition. vest in higher return activities, with less reliance An ability to save or to safeguard existing assets on children’s labor. Greater investment in liveli- also protects a household’s longer-term well-being, hoods could, however, create a greater demand meaning that it may be increasingly possible to for children’s labor—some studies ï¬?nd that child ï¬?nance longer-term projects, such as secondary or labor rates are higher among poor and middle- higher education. income farmers than among landless laborers, reflecting the necessity of contributing to family The magnitude of any positive impacts such as businesses (Bhalotra and Heady 2003). How far these must be weighed against the scale of nega- this is the case and whether it is likely to be bur- tive impacts outlined above—qualitative analysis densome to children or conflict with their educa- can help illuminate what these trade-offs mean in tion will need to be assessed in context. In some practice and how they should be assessed (see sec- cases, enhanced family businesses may provide tion “Methods for Assessing Impacts on Childrenâ€?). older children the opportunity to develop skills CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 23 HOW DO KEY REFORMS AFFECT CHILDREN? Impacts from Changes in Services Used by Children and Their Families BOX 5. Key Questions: Impacts of Changes in Services on Children Key services used by children and families include: health, education, social protection, child protection, utilities (water, electricity), and housing. OVERALL FUNDING LEVELS • What are the impacts of proposed changes on overall budgets for particular sectors, and for different areas of expenditure within sectors? • How do areas with direct beneï¬?ts to children fare? − For example, transfers targeted to families with children, child welfare and child protection services − Maternal and child health services, young people’s mental and reproductive health − Employment services for young people QUALITY OF SERVICES • Are front-line staff (teachers, health workers) likely to experience increasing/falling real incomes (affecting motivation)? • Could service quality suffer or improve? • Could moonlighting increase or decrease? • Are budgets for key equipment used by or beneï¬?ting children (such as teaching aids and medicines) or infrastructure (for example, repairs/building) likely to be affected? FINANCIAL ACCESSIBILITY • Will the reform change the ï¬?nancial accessibility of services to poor families? • Could informal payments be demanded, preventing poor children from accessing services? • Which social groups are most likely to reduce/increase service use, and which services are likely to experience the greatest uptake or decline? • Is disadvantaged children’s access likely to be reduced or increased? 24 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? PHYSICAL ACCESSIBILITY • Will the reform increase the accessibility of services to poor households, and if so, is children’s service use likely to increase? • If closure of some services is planned, which social groups are most likely to be affected? CHANGING POLICY PRIORITIES • Could changed policy priorities and incentives to service providers affect the availability/ quality of service provision? • Could key services for children be affected? • What is the threshold at which signiï¬?cant declines in children’s service use may occur? The vital role of social services such as education, Quality of services. Increases in budgets (de- health care, and water and sanitation in promot- pending how these are structured) should lead ing human development and securing children’s to increased service quality and accessibility and well-being is well recognized (Mehrotra and Jolly improved child well-being outcomes. However, 2000) and encapsulated in the Millennium De- when real budgets are declining or static, there velopment Goals. While the international policy can be a range of negative effects on children. For community has long focused on the importance example, where service providers are living below of primary education, the value of good quality or close to the poverty line, as in half the coun- early childhood development programs and of tries in a recent UNICEF study (Chai, Ortiz, and secondary education is increasingly recognized. Sire 2010) incentives to perform their jobs well are Other services, such as utilities, access to electric- limited, and the temptation to moonlight or de- ity (Birdi et al. 2007), and transport (Porter and mand informal payments is greater. This can mean Blaufuss 2002) can also make major contributions that poorer children are held back at school and to children’s well-being, although this is much less given lower grades if their families cannot pay for recognized. Similarly, the importance of child pro- tuition or bribes, and that the quality of educa- tection services in protecting the most disadvan- tion for all children suffers (UNICEF 2006). Declin- taged children and those subject to abuse, exploi- ing budgets for equipment and supplies may also tation and violence, is often under-recognized. affect service quality, particularly in the health Changes in overall ï¬?nancing and the distribution sector, where inadequate stocks of essential medi- of public and private funding between services cines and basic hygienic supplies are a frequent may affect children’s and their families’ access to consequence of ï¬?nancial pressures. The quality and uptake of services in a number of key ways, as of education can also be affected by declining detailed in the following sections (see also box 5). availability of teaching aids. Child protection and CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 25 HOW DO KEY REFORMS AFFECT CHILDREN? welfare services, often serving some of the most Changing policy priorities. Changed incentives disadvantaged children and generally already for service providers, typically as a result of sector underfunded, are often particularly vulnerable reforms, may result in some services being priori- to further cuts because they generally have few tized over others, which in turn can affect particu- powerful advocates. lar groups of children or sections of society. For example, there is some evidence that the current Financial accessibility. Policy changes leading to international emphasis on (and funding for) HIV/ increased costs for users (such as the introduc- AIDS (human immunodeï¬?ciency virus/acquired tion or expansion of user fees or increased health immunodeï¬?ciency syndrome), tuberculosis (TB), insurance premiums) above a certain threshold and malaria (themselves major killers of children) usually result in lower consumption and lead to has distracted attention away from other serious families reducing service use, which can limit use threats to child survival such as acute respiratory of both preventative and curative care for chil- infections and diarrhea.10 A shift to a stronger dren. Reducing or removing school fees at both pro-poor emphasis in most services is likely to ben- primary and secondary level is almost ubiqui- eï¬?t children, who are disproportionately concen- tously associated with increased enrolments and trated in poor households. reduced dropouts, though this may occur at the expense of the quality of education (Kattan and Institutional capacity. In addition to reducing ser- Burnett 2004). Data from Sierra Leone, Niger, and vice quality, reforms that downsize public services Burundi cited by Save the Children (2008a) show may also reduce capacity for policy and service de- signiï¬?cant increases in health care utilization by velopment; reforms may also affect capacity for children under age ï¬?ve and antenatal check-ups inter-institutional coordination and “joined-upâ€? by pregnant women after the removal of user service delivery. This, in turn, may undermine capac- fees for these groups. ity for multisectoral intervention (for example, in health, education, social protection, and water and Physical accessibility. Important changes include sanitation), which have crucial synergies for promot- improvements (or declines) in transport infrastruc- ing child well-being (Mehrotra 2004). For example, ture affecting access to services (such as health if a child is living in an overcrowded accommoda- care and education) and supply and prices of key tion located in a poor environment, this may contrib- medicines and other supplies; changes in access to ute to poor health, low educational attainment, utilities, such as connections to the electricity grid, and undermine life chances. Conversely, access to or improved water and sanitation supply, which sufï¬?cient family income, supportive care, decent can improve health and reduce adults’ and chil- housing, and good quality health care will have a dren’s workloads; and building programs increas- positive impact on a child’s life, both now and into ing access to, or repairs improving the condition the future. Given the interdependent nature of of, key facilities (such as schools and clinics). This the problems, child well-being needs to be inte- is particularly important in remote rural areas grated across a range of policy areas, but this often in least-developed countries and in some poor requires formal arrangements to coordinate the urban areas: for example, lack of facilities is the efforts of all actors horizontally (across different single most important reason for rural children government departments) and vertically (between not attending school in Yemen (UNICEF 2010) and different levels of government). emerged as a critical constraint in the Mozam- bique education sector PSIA (Valerio et al. 2005). 10 http://www.irinnews.org/Report.aspx?ReportId=86754, accessed 1/4/2010. 26 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? Social Capital and Cohesion Key Questions: Impacts of Changes to Social Capital and BOX 6. Cohesion on Children • Are interhousehold transfers likely to be affected? Could this reduce or increase children’s access to key goods or services? • Are social contacts between families or among children and young people likely to decline, for example, due to longer work hours or being unable to afford to participate in community life? • Could informal childcare arrangements be affected, for example, if more women enter the workforce or kin/neighbors can no longer afford to care for the children of working parents? • Is there a risk of increased intrahousehold tension and violence or increased household break-up? • Could crime, such as violence affecting children’s mobility and opportunities to play, sexual exploitation, drug pushing, or people trafï¬?cking increase? Social capital, understood in terms of the strength emotional development and well-being, and ado- of connections between individuals and house- lescents’ opportunities to form social relationships holds, and as part of the “glueâ€? holding societ- that assist them in ï¬?nding work and in making ies together, is increasingly recognized as vital for the transition to adulthood (see also box 6). children’s well-being (Harper, Jones, and McKay 2009). In good times, social capital can be a criti- Patterns of reciprocal (or nonreciprocal) childcare cal resource that helps people access and take ad- with kin and neighbors may also change, depend- vantage of new opportunities and thus improve ing on how widespread impacts on livelihoods livelihoods and life chances. Typically, however, in are, and (in most contexts) how women’s time times of economic stress, social capital becomes use has been affected (Ruiz-Casares and Heymann both more important for survival and well-being, 2009). Reciprocity could increase as households but also more subject to strain, as whole com- pull together in difï¬?cult times, or decline if they munities, particularly those dependent on similar feel unable to share resources beyond their imme- livelihood sources, are affected simultaneously. diate family. Informal gifts and transfers to poor households may decline, and patterns of social interaction One of the effects of rapid and widespread eco- may change if households can no longer afford nomic change can be declining social cohesion, as to offer customary hospitality or contribute to levels of trust within communities decline and in- festivals and celebrations (Kuehnast and Dud- dividual survival becomes more pressing (Knowles, wick 2002). This can affect the resources available Pernia, and Racellis 1999). Interactions between for children’s development, their social contacts, effects arising through household livelihood inse- CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 27 HOW DO KEY REFORMS AFFECT CHILDREN? curity and public ï¬?nancing may also be important. affect children’s ability to learn and reforms that For example, if declining budgets for policing or affect young people’s access to employment can the criminal justice system coincide with growing affect social cohesion and the next generation’s poverty and inequality, there may be a decline in likelihood of escaping poverty. the rule of law. This can lead to an environment where opportunities for criminally based liveli- hoods flourish, including sexual exploitation and/ or trafï¬?cking (of adults or children) and drug Diversity among Children pushing, often targeting adolescents. There may Some reforms—particularly those that directly or also be a rise in rates of violence against all social indirectly affect the quality or accessibility of food, groups, including children, because communities health care, or education—will affect almost all become less able to control violent behavior (Pin- children. Others—such as those that affect the heiro 2006), adults vent frustrations on children, livelihoods of particular groups—will only affect and the risk of punishment through the criminal speciï¬?c groups of children (box 7). Most reforms justice system declines. are likely to fall somewhere in between. Because PSIAs are intended to identify vulnerabilities to the effects of reforms, particularly the effects on Interactions between Effects Arising the most disadvantaged, it is important to under- through Different Routes stand the ways that different groups of marginal- ized children may be affected. Patterns of inequal- It is also important to take into account the pos- ity and discrimination in any given context and sibility of interactions between effects arising children’s age are crucial factors affecting the through different routes. For example, reforms likely impacts of reforms. The gender and social that affect food security and nutrition can also diversity checklist (box 8) and table 1 outlining BOX 7. How Are Particular Reforms Likely to Affect Children? Annex 3 provides some examples of the pathways by which reforms in selected sectors may affect children, focusing on: • Electricity tariff increases • Agricultural price liberalization • Consolidation and improved targeting of social assistance transfers. These are intended as illustrations to help identify relevant issues in PSIAs on similar reforms. Some, such as electricity tariff reform, may affect children through all the main routes discussed. Others are much more speciï¬?c, such as agricultural price liberalization, which primarily affects children through impacts on household incomes. The social assistance example also includes some disaggregated analysis of impacts on different groups of children that may be useful. See the Resource Pack for further examples and key questions to ask in particular sectors. 28 THE WORLD BANK GROUP AND UNICEF INTRODUCTION Social capital, understood in terms of the strength of connections between individuals and households, and as part of the “glueâ€? holding societies together, is increasingly recognized as vital for children’s well-being CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 29 HOW DO KEY REFORMS AFFECT CHILDREN? vulnerabilities of children at different ages should when assessing the potential impact of a reform. help identify whether and what type of disaggre- This section also identiï¬?es indicators that may be gated analysis may be needed. used to assess potential impacts on children (box- es 9–12). These indicators may be used in ex ante analysis and in baselines and follow-up studies if reform impacts are analyzed ex post. Annex 2 out- Potential Child Well-Being Outcomes lines data sources for each of these indicators. All reforms can affect children through several routes simultaneously. The previous section dis- cussed some of the routes through which these HEALTH AND NUTRITION impacts might arise. This section consolidates that discussion, focusing on the main effects on differ- Infant and child mortality rates. Economic shocks— ent aspects of child well-being that may arise from whether systemic or at individual household levels— common reforms and that analysts should consider can have a profound impact on children’s health. BOX 8. Gender and Social Diversity Checklist INCOME-POOR AND VULNERABLE HOUSEHOLDS • Are all households in certain quintiles, including those close to but above the poverty line, likely to be affected, or are effects most likely to be felt in speciï¬?c sectors/livelihoods? • Are children disproportionately concentrated in affected quintiles or groups? • Does number of children or household size affect vulnerability to income poverty, and if so, which kinds of households are most at risk? GENDER • Given existing patterns of gender discrimination, is this reform likely to have differential impacts on boys and girls? • Could it sharpen or help reduce existing gender inequalities between boys and girls? MARGINALIZED ETHNIC, RELIGIOUS, OR CASTE GROUPS • How will the livelihoods and access to services of these groups be affected? • Are special provisions needed to ensure that the children of these groups beneï¬?t from or are protected from the negative impacts of the reform? CHILDREN IN DISADVANTAGED GEOGRAPHICAL AREAS • Will the effects of this reform reach remote rural or disadvantaged urban areas? • Are there barriers that need to be addressed before children in these areas can beneï¬?t? 30 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? DISABILITY • Is this reform likely to have signiï¬?cant effects on disabled children? • Could it enhance their educational opportunities? • Could it increase or lessen the accessibility of support or community-based rehabilitation (CBR) services? • Could it sharpen discrimination against them? SIGNIFICANTLY DISADVANTAGED CHILDREN • Could this reform affect the livelihoods and access to services of children with signiï¬?cant disadvantages, especially children with limited family and community support structures, such as orphans or child-headed households and demobilized child soldiers? • Could it have speciï¬?c impacts on street children or child workers? For example, if the main sectors in which they work are likely to be affected, would opportunities for exploitative criminal activity increase? • Could the reform increase the marginalization of these groups, for example, if there is greater competition for limited resources? Baird et al. (2007, cited in Harper, Jones and McKay stress (Tangcharoensathien et al. 2000; Macfarlane [2009]) calculate that a one unit reduction in log Burnet Centre 2000; Paxson and Schady 2005). GDP is associated with an increase in mortality Conversely, reforms that reduce the vulnerability of between 18 and 44 infants per 1,000 children of poor households and improve disadvantaged born. Analyzing data from Mexico, Cutler et al. households’ access to health care may contribute (2002, cited in Ferreira and Schady [2008]) found to reduced infant and child morbidity and mortal- that economic shocks increased child mortality rates ity rates. by 6–10 percent in the 1980s and 1990s. Periods of reduced income can also affect children’s mor- Early sexual activity and drug use. Poorer children bidity and may be associated with an increase are more likely to engage in sexual activity at a in diarrheal diseases, respiratory infections, and younger age than their better-off counterparts, other diseases for which the costs of preventative and are more at risk of having unprotected sex measures (such as bed nets) are too expensive for or of having to resort to “transactionalâ€? sex as a poor families. The effects arising from household means of obtaining food, shelter, other goods, or income shocks may be compounded by changes advancing their education. Qualitative evidence to health service ï¬?nancing if these affect the ac- suggests that during periods of economic difï¬?cul- cessibility, affordability, and usage of health care ty, poor children and young people are at increas- by poor households, or the quality of service and ing risk of sexual exploitation (Hossain et al. 2010). availability of medicines. As noted above, use of There is also qualitative evidence of increased use antenatal care and attended or institutional de- of harmful substances, such as alcohol and drugs, liveries often decline during periods of economic among older and younger children living outside CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 31 HOW DO KEY REFORMS AFFECT CHILDREN? familial care (for example, street children) follow- following economic shocks. Harper, Jones and ing economic shocks in some contexts, such as in the McKay (2009) cite evidence from a World Bank CIS after transition (UNICEF 2001). Such increases study in Ethiopia where a 25 percent increase in are particularly likely if pressure on livelihoods cereal prices, a common occurrence due to droughts, leads to increased drug growing or trafï¬?cking, international price fluctuations, and so forth, thus increasing the availability of drugs. could increase the prevalence of child malnutri- tion by 3–4 percent. There is also some evidence Nutritional well-being. There is considerable evi- that rates of iron deï¬?ciency anemia and night dence that income shocks reduce children’s nutri- blindness increased in young children in Indonesia tional well-being. Ferreira and Schady (2008) report as a result of the economic crisis of 1997–99 (Hop- a small increase in wasting among children under kins 2006; Macfarlane Burnet Centre 2000). age ï¬?ve in Nicaragua and the Russian Federation BOX 9. Possible Indicators for Health and Nutrition • Infant and child mortality rates • Rates of antenatal health care utilization • Rates of institutional or attended deliveries • Prevalence of wasting or stunting, low birth weight, or obesity • Prevalence of micronutrient deï¬?ciencies, particularly iron deï¬?ciency anemia and Vitamin A • Breast-feeding rates and infant and young child feeding practices • Rates of sexual activity among young people under age 18 Increasing access to early childhood development (ECD) is often neglected in education subsidies or support despite the signiï¬?cant returns of ECD programs to children’s longer-term educational and social development. 32 THE WORLD BANK GROUP AND UNICEF The value of good quality early childhood development programs and of secondary education is increasingly recognized. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 33 HOW DO KEY REFORMS AFFECT CHILDREN? EDUCATION may also switch children from private to public schools, thus putting additional pressure on the Overall, there is a strong relationship between public system. If reforms lead to declining funds household economic well-being and children’s for schools, the quality of education is likely to de- enrolment, attendance, and retention in school. cline, with impacts on overall attainment. Schools Income shocks lasting beyond a few months may may also impose informal charges (for example, mean that children have to drop out, as Skouï¬?as for sports or repairs), undermining free education and Parker (2002) and Duryea, Lam, and Levison policies. As noted above, in such circumstances, (2007) show for Mexico and Brazil, respectively. teachers may moonlight or demand informal pay- Income shocks may also mean a delayed start to ments, with poorer students’ progress likely to education so that children are then “overageâ€? be impeded (Chai, Ortiz, and Sire 2010). In some for their subsequent school career or that they cases, parents may supplement teachers’ pay, im- are unable to enroll. Such decisions are often proving motivation in schools in better-off areas, gendered (with girls often disadvantaged), but but increasing socioeconomic disparities between patterns vary between contexts. If household in- the schools’ quality. During periods of economic comes are squeezed, children may attend without difï¬?culty, sexual exploitation of poorer students uniforms, shoes, or supplies and be stigmatized by (especially girls) by other students or teachers may other children or punished by teachers. Parents increase, as may physical violence (PLAN 2010). BOX 10. Possible Indicators for Education • Enrolment, drop-out, and absenteeism rates • Preschool attendance among relevant age group • Gender parity indices for primary and secondary school • School attendance among orphans (or other relevant vulnerable groups) • Incidence of expulsion for nonpayment • Incidence of children attending without uniforms or supplies • Teachers moonlighting or demanding additional payments • Incidence of informal charges • Student progression rates • Incidence of sexual exploitation or physical violence of school students 34 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? WORK AND LEISURE full-time and are unable to attend school. In ad- dition, increased workloads come at the expense The impacts of shocks on children’s work depend of children’ leisure time, as Skouï¬?as and Parker on changes in the supply and demand for labor in (2002) found in Mexico (box 11). both the adult and children’s labor markets. Re- forms that impact smallholder agriculture, home- In poorer countries and socioeconomic groups, based manufacturing, and the informal service the number of children, particularly teenagers, sector are most likely to affect the demand for attempting to earn money to help their house- children’s labor. Because these sectors often en- holds make ends meet is likely to rise as a result tail hazardous working conditions, any increase of economic shocks. In middle- and higher-income in child labor in these sectors would lead to in- countries, and those with better social protection creased numbers of children in the “worst forms systems, the reverse is true: economic shocks are of child labor.â€?11 Declining adult employment op- associated with lower rates of child labor and chil- portunities may lead to increased child labor in dren staying in school longer, reflecting the de- “invisibleâ€? occupations, including domestic work cline in income-earning opportunities and the op- and the sex trade. portunity costs of their time (Ferreira and Schady 2008). Youth employment opportunities are likely If adults are working longer hours, older children, to reflect broader effects on adult labor markets particularly girls, may take on some of the adult’s (expanding overall opportunities will increase domestic responsibilities. In some labor markets, youth employment opportunities and vice versa) children are able to combine school and work; in and in secondary school quality and completion others, and particularly among the poorest socio- rates (Godfrey 2003). economic groups, children and teenagers work BOX 11. Possible Indicators for Work and Leisure • Child labor rates for different age groups (both exclusive and combined with school) • Children engaged in worst forms of child labor • Youth employment opportunities • Adults engaging in play with preschool children • Time spent by children on play with siblings or friends • Time spent by children on domestic chores 11 http://www.ilo.org/public/english/standards/relm/ilc/ilc87/com-chic.htm, accessed 26/4/2011. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 35 HOW DO KEY REFORMS AFFECT CHILDREN? VIOLENCE, ABUSE, NEGLECT, AND al. (1993) found that adolescent girls’ emotional EMOTIONAL WELL-BEING well-being and boys’ behavior were negatively affected by parental economic stress. Children’s As Harper, Jones, and McKay (2009) document, ability to learn can also be affected. Greater eco- economic shocks commonly diminish families’ ca- nomic stress may lead to increased marital break- pacities to nurture and protect their children and down, and thus (typically) to more children liv- thus can lead to an increase in the numbers of chil- ing in single-parent households (UNICEF 2001) or dren growing up in contexts that jeopardize their leaving home to seek support from peers instead emotional well-being and physical safety (box 12). of adults. Economic stress—in particular low in- comes, cramped living conditions, and low lev- These situations can include economic and sexual els of education—are also often associated with exploitation, neglect, or risk of accidents due to harsher parenting and increased violence against insufï¬?cient care (for example, if young children children and women in the household (UNODC are looked after by slightly older siblings [UNDP and World Bank 2007; Pinheiro 2006). Economic 2009]) or being left alone (Ruiz-Casares and Hey- stress can also lead to an increase in abandon- mann 2009). If young children are deprived of ment of children, as occurred in the CIS following opportunities to play, for example, if they are its transition (UNICEF 2001); the sale and trafï¬?ck- constantly engaged in domestic duties, their emo- ing of children; and forced marriage. In some con- tional well-being and cognitive development are texts, increased youth unemployment has been likely to suffer (Sunderland 2006). linked to higher youth suicide rates (Chang et al. 2009; UNICEF 2001). Few studies have probed the connections be- tween income shocks and children’s emotional Older teenage boys and young men under age well-being in detail. Using U.S. data, Conger et 24 are typically at greatest risk of violent crime BOX 12. Possible Indicators for Abuse and Emotional Well-Being • Children under age 5 cared for by children under age 10 • Children experiencing serious accidents • Number of children living apart from biological parents (with foster carers, in residential care) • Child victims of sexual exploitation, trafï¬?cking, or abandonment • Child and/or youth victims of violence • Numbers of street children • Children’s perceptions of their well-being/happiness • Rates of child and/or youth drug and alcohol use • Youth suicide rate Note: Many of these issues are very difï¬?cult to measure; see the Resource Pack for further discussion. 36 THE WORLD BANK GROUP AND UNICEF HOW DO KEY REFORMS AFFECT CHILDREN? (Moser and von Bronkhurst 1999). Children and young people may be drawn into violent criminal activity to earn money and as a source of social identity; the rise of gang membership in parts of Latin America is a good example (Maclure and So- telo 2004; UNODC and World Bank 2007). More broadly, children’s opportunities to play outside may decline if their neighborhoods become more violent, affecting their health, emotional well-be- ing, and opportunities to form relationships with peers (Pinheiro 2006). Though the numbers affect- ed from reform-related changes may be relatively Economic shocks low, any such changes would occur in a context of endemic violence against children, exacerbating a commonly diminish families’ serious existing problem. Experiencing violence in childhood has been associated with dropping out capacities to nurture of school, mental and physical health problems, and protect their children. and a continuing intergenerational cycle of vio- lence—all of which have long-term economic and social costs (Pereznieto et al. 2010). PSIAs should consider whether reforms could lead to an in- crease or reduction in children’s exposure to any of these abusive situations. Distinguishing Short- and Longer- Term Outcomes The effects of particular reforms unfold over time, with some outcomes likely to occur soon after implementation, and/or as a direct result of a re- form; others occurring as a longer-term outcome of a combination of coping strategies and their wider social effects; or the cumulative effects of several reforms occurring over a relatively short timeframe. Table 2 summarizes some of the differ- ent manifestations of impacts on child well-being in the short, medium, and longer-term. Given that the short-run effects of reforms can have signiï¬?- cant lifelong or intergenerational effects on those children, protecting children from even short- term negative effects should be a priority, even where analysis suggests that the overall or long- term effects of a reform will be positive. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 37 HOW DO KEY REFORMS AFFECT CHILDREN? Short-, Medium-, and Longer-Term Effects on Children of TABLE 2. Distinguishing Declining Households Incomes Area Short-term effects Medium-term effects Longer-term effects Education • Falling attendance • Declining enrolment • Lower lifetime earnings for individuals • Increase in dropouts with compromised education • Declining quality • Subsequent generations do not attend school • Loss of literacy after early drop-out • Fertility rates do not fall Nutrition • Micronutrient deï¬?ciencies • Stunting • Malnutrition-related illness and ef- • Wasting fects on ability to learn and on next generation (low birth weight babies, unsafe deliveries) Health • Increased morbidity • Lower educational attainment • Lower productivity and earnings from through lost schooling long-term poor health • Increased mortality Child labor • Increased casual or part- • Increased full-time work if labor • Risk of long-term poverty from lost time work market opportunities exist education, opportunities to acquire • Increased substitution for • Risks to health and education more lucrative skills, and poor health adults in domestic activity • In late adolescence, work may • Depending on type of work (such as help transition to longer-term the worst forms of child labor), long- employment term emotional impacts, and social isolation Emotional • Children often protected • In medium term, children affected • Mental health problems well-being from adult stress initially by adult stress, family conflict, and • Greater use of drugs and alcohol increased likelihood of separation • Greater risk of suicide Care and • Less supervision of chil- • Increased family conflict and • Organized crime involving children, protection dren if adults are working violence for example, sexual exploitation or more to combat squeezed • Increased incidence of children trafï¬?cking incomes living apart from families, for • Greater risk of accidents example, among street children or in residential care Security • If crime level rises as a • Increased gang membership • Lost economic and social result of rising inequality • Increased child mortality development and poverty, greater risk of violence against children • Fewer opportunities for children to play outside 38 THE WORLD BANK GROUP AND UNICEF The effects of particular reforms unfold over time, with some outcomes likely to occur soon after implementation, and/or as a direct result of a reform; others occuring as a longer-term outcome of a combination of coping strategies and their wider social effects; or the cumulative effects of several reforms occuring over a relatively short timeframe. 5. Methods for Assessing Impacts on Children In a PSIA, assessing the impacts of reforms on children is likely to involve mixed methods. In principle, there is substantial quantitative data on some aspects of child well-being available through Multiple Indicator Cluster Surveys (MICS),12 Demographic and Health Surveys (DHS),13 Living Standards Measurement Surveys (LSMS),14 and similar household income and expendi- ture surveys such as Labor Force Surveys (LFS)15 and the like. In practice, however, in any given context, data may be out-of-date, of poor quality, or unavailable for critical issues. On some issues, relevant qualitative data may also be available. Annex 2 outlines some datasets that are frequently available for quantitative analysis of particular child well-being issues and potential sources of qualitative data. See the Resource Pack for additional possible data sources. If data are abundant and the timeframe for a PSIA is short, it may be possible to analyze the potential impacts of reforms on children without collecting additional data. In this case, it would be advantageous to conduct some ground-truthing of conclusions through consultation with stakeholders likely to be affected. If data on key issues are lacking or unusable, new data collection is likely to be needed. New data collection—either qualitative or quantitative—can be most useful if it helps understand the pro- cesses by which impacts may be transmitted to children, child well-being outcomes, and the ways that children living outside households (who are often signiï¬?cantly disadvantaged as well as not covered by household surveys) may be affected by a proposed reform. Box 13 out- lines some issues rarely covered by household surveys and for which additional data may be needed. 12 http://www.unicef.org/statistics/index_24302.html. 13 http://www.measuredhs.com/. 14 http://econ.worldbank.org/WBSITE/EXTERNAL/EXTDEC/EXTRESEARCH/EXTLSMS/0,,menuPK:3359053~pagePK:641684 27~piPK:64168435~theSitePK:3358997,00.html. 15 http://www.ilo.org/dyn/lfsurvey/lfsurvey.list?p_lang=en. 40 THE WORLD BANK GROUP AND UNICEF M E T H O D S F O R A S S E S S I N G I M PA C T S BOX 13. When Additional Data Collection May Be Needed to Bring a Child Focus to a PSIA 1. To assess the effects of reforms on groups of children not covered by household surveys, such as street children, children in refugee camps or residential care, children who have left their natal households due to economic stress and are now independent migrants, or children who have married into another household, among others. 2. If existing data do not have the potential to illuminate: • Household responses to potential changes, particularly changes in child-speciï¬?c expenditures and service usage (such as on education, food, clothing, health care, and childcare) • Likely changes in children’s time-use patterns and those of their carers • Likely changes in childcare arrangements • Key service providers’ likely responses to reforms, particularly on expenditure areas they would prioritize or be most likely to reduce if budgets changed signiï¬?cantly • How likely discrimination against particular groups of children would be heightened or reduced • Possible impacts on social capital, in particular interhousehold transfers, social contacts, and other forms of social support (for example, information and reciprocal labor). 3. To enable analysis of changes over time (for example, if new data collection could enable the construction of panel datasets) and/or provide for counterfactuals against which the potential effects of reform on children can be assessed. This is particularly important if effects on children are likely to be long term. 4. If additional data collection would enable construction of a more comprehensive baseline that could be used for assessing reform impacts on children. OPTIONS Additional data collection can consist of: • A few carefully selected interviews with key informants • Focus groups or semistructured or participatory exercises interviews with probable stakeholders (potentially including children and/or their families) • Collection of additional quantiï¬?able survey data. Identifying the most appropriate option in a particular PSIA will depend on time, resources, what data are already available, and what data are needed for effective analysis. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 41 M E T H O D S F O R A S S E S S I N G I M PA C T S Quantitative Analytical Approaches between these types of goods do not change, the impact of policy changes on expenditures of child- Many of the standard quantitative techniques speciï¬?c goods and services can be estimated: for used in PSIAs can be extended to include a focus on example, is the impact likely to be felt more in children. Some additional data—to analyze intra- households where child-speciï¬?c expenditures are household labor, consumption and income alloca- high?16 Another form of this analysis is child- tions, and for behavioral analysis—may be needed. focused beneï¬?t incidence analysis (box 14), which tracks how much children in particular income quintiles currently beneï¬?t from public expenditure, and could be used to identify how they might be CHILD-FOCUSED EXPOSURE ANALYSIS affected by changes in public expenditure. This type of analysis looks at the likely immediate A limitation of immediate impact analyses of this impacts on children and their families. It typically type is that they assume that households continue focuses on comparisons of households with and to behave as they currently do in the face of policy without children, households with different numbers changes. This is unrealistic, because income and of children, and households with children in different price changes will almost certainly lead to a real- income quintiles as well as other locally relevant location of household expenditures. For example, factors. In addition, geographical comparisons a rise in electricity prices may lead to households’ may be especially useful if there are regional dis- changing patterns of fuel use. Nevertheless, im- parities in children’s vulnerability. pact analyses are a useful starting point for fur- ther analysis and may be the only option available If impacts on expenditure are likely, disaggregated if data and time are scarce.17 analysis of child-speciï¬?c and adult-speciï¬?c expendi- tures may be revealing. Assuming that allocations BOX 14. Age-Disaggregated Beneï¬?t Incidence Analysis in Belize A World Bank analysis of different options for strengthening Belize’s social protection system disaggregated a beneï¬?t incidence analysis of current public expenditure on social protection by different age groups: 0–5, 6–17, 18–59, and 60+. This established that, by far, the smallest propor- tion of social protection spending accrues to 0–5-year-olds, despite the size of this group and the investment potential of this group to break intergenerational poverty cycles. The study recom- mended reallocation of social protection expenditures to increase the focus on poor and disadvan- taged households and to free up funds for investment in early childhood development. Source: World Bank 2010. 16 For further examples of disaggregating household data into child- and adult-speciï¬?c goods (with a gender focus), see Subramanian and Deaton (1991). 17 See the Resource Pack for resources on child-focused beneï¬?t incidence analysis and child-focused budget analysis. 42 THE WORLD BANK GROUP AND UNICEF BEHAVIORAL AND SINGLE-MARKET hold or labor force surveys), but some extra data ANALYSIS collection may be needed, as an example from Bosnia Herzegovina (box 16) indicates. Estimating how households will change their be- havior (for example, consumption or labor sup- Single-market methods or partial equilibrium ply) in response to changes in incomes and prices models incorporate the effects of behavioral can help predict potential consequences for chil- changes beyond households to account for feed- dren. This requires estimating behavioral equa- back effects on a sector as a whole. These ap- tions from which price and income elasticities can proaches model a complete sector (for example, be deduced. Simulations can then work out how the electricity sector) to understand behavior that households might adjust their behavior and deci- will result once markets have reached equilibrium, sions in response to those changes, as discussed that is, when supply and demand are equalized in in box 15, which provides an example from the the sector. The resulting prices would then be used Dominican Republic. to estimate the longer-run effects on intrahouse- hold expenditures and, by extension, on children. Depending on the precise nature of the change being analyzed, the data required for such estima- tions may be available in published data (house- CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 43 M E T H O D S F O R A S S E S S I N G I M PA C T S Ante Microsimulation Analysis of the Potential Impacts of Redesign of BOX 15. Ex Conditional Cash Transfer Programs in the Dominican Republic This study involved analysis of the potential impact of conditional cash transfer (CCT) reform on educational uptake, child labor, and children’s and pregnant women’s health. The model used for analyzing the impact on education combines mathematical methods with analysis on the demand for schooling models, generating predictions of individual behavioral changes associated with the CCT and its effects on household poverty and inequality. The model was constructed through two main equations: an occupational choice equation and a standard Mincer-type earning equation to predict children’s potential earnings. The analysis of the impacts on health involved a series of regressions, including a PROBIT regression. The analysis found potential substantial positive impacts for the poor on education and health from the CCT overhaul: education enrolment increases of 6 percentage points among poor children in rural areas and 1.5 percentage points among all children; a decrease in working children by 9.2 percentage points with an associated switch to attending school; a doubling of the number of children under age ï¬?ve using health care facilities; and a 9 percentage point increase in health care use for all children. Source: Reboul and Subran 2010. 44 THE WORLD BANK GROUP AND UNICEF M E T H O D S F O R A S S E S S I N G I M PA C T S BOX 16.Regressions to Estimate the Likely Impacts of Electricity Tariff Rises in Bosnia Herzegovina In Bosnia Herzegovina, Birdi et al. (2007) conducted a small sample survey within the sampling frame of an existing dataset (MICS) to provide additional information on child-speciï¬?c expendi- tures. They also collected some willingness to pay data. This enabled the estimation of regressions that linked child-speciï¬?c demand for certain goods and services with household characteristics. Lack of time prevented simulations based on the data, but these would have been desirable if time permitted. Source: Birdi et al. 2007. MULTIMARKET ANALYSES cused. It thus involves the same methods as other qualitative analyses—and can be conducted on a These include: small or larger scale, depending on the budget and timeframe available. In most PSIAs, qualita- • Multimarket systems of demand and supply tive research will be an important complement to equations quantitative analysis, particularly when speciï¬?c • Reduced form estimation child-focused data are lacking, or to illuminate • Full computable general equilibrium models. the processes by which impacts on children are likely to arise. Essentially, qualitative research These models are appropriate for circumstances within a child-focused PSIA is intended to produce where policy changes are likely to be wide reach- child-focused social impact analysis. ing, because the indirect effects of shocks and pol- icies directly affecting one part of the economy Some relevant tools and approaches that can be on other parts of the economy are automatically used to illuminate potential impacts on children accounted for using general equilibrium analysis are outlined in table 3. These approaches use (Bibi et al. 2010). Box 17 describes West Africa’s standard qualitative data collection tools such as use of this type of model. semi-structured interviews, focus group discussions, direct and participant observation, and the family of mostly visual methods associated with partici- patory research (such as mapping, diagramming, Qualitative Analysis ranking and matrix scoring). The PSIA User Guide and Tools for Institutional, Political and Social Child-focused qualitative analysis does not involve Analysis Sourcebook (World Bank 2005) provides speciï¬?c techniques; it is the questions asked, data detailed information on these tools and methods. collected, and the analytical framework used to interpret them that make an analysis child fo- CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 45 M E T H O D S F O R A S S E S S I N G I M PA C T S BOX 17. Simulation Techniques to Understand the Potential Impacts of Economic Crisis, Shocks, or Policy Changes: The UNICEF Project on the Impact of the Global Economic Crisis on Children in West and Central Africa Economic simulation techniques elaborate survey microdata by using economic and behavioral models to assess the potential impact of economic and policy changes on different outcome vari- ables including some key child well-being indicators, such as, child poverty, nutrition, child work, school attendance. They are important tools to support ex ante understanding of the potential im- pacts of policies and economic changes as well as the potential consequences of economic shocks and crises when actual data are not readily available. Macro-micro models are analytical tools that allow users to simulate the possible impacts of macro shocks and policies on economic variables such as wage rates, employment, food and nonfood prices, and the transmission of these impacts on different outcomes at the microlevel, for example, on different child well-being indicators. When analyzing the full implications of economic crises and policy shifts, tools of this kind are best because they reflect the structural aspects of the econ- omy and capture the numerous and complex direct and indirect interactions across different actors in the economy, including those related to factor markets, goods markets, households, govern- ment, private ï¬?rms, and foreign partners. A research project using a macro-micro simulation model simulated the potential effects of the 2008–9 global economic crisis on children in Burkina Faso, Cameroon and Ghana, thus informing proposals of concrete policy responses to policy makers. A model to simulate the transmission of the effects of the global economic crisis on employment, wages, prices, and remittances (the intermediate variables) was elaborated; its results were included in a micromodel to estimate the potential impact of the changes in intermediate variables in key aspects of child well-being. The study also simulated the potential effects of possible policy responses to confront the impacts of the crisis on children. The macro-micro model developed for the research on the impact of the global crisis in West and Central Africa has been already adapted for simulation exercises in other developing countries and can be expanded to account for different types of economic shocks and more sophisticated policy responses, including public budget policies. Sources: The key results of the study are summarized in Tiberti and Menchini (2010), and the methodology for macro- micro simulation model is available in Bibi et al. (2010). 46 THE WORLD BANK GROUP AND UNICEF M E T H O D S F O R A S S E S S I N G I M PA C T S TABLE 3. Some Qualitative Analytical Tools Used in Child-Focused PSIAs APPROACH USE IN CHILD-FOCUSED PSIA Participatory poverty Identifying: assessment • How poverty and deprivation are experienced by children • Causes of child deprivation • Vulnerabilities that may be exacerbated by proposed reform • Possible policy solutions Beneï¬?ciary assessment Identifying households’ and children’s perspectives on the likely effects of reforms Gender analysis Assessing how gender and intrahousehold relationships contribute to differences in: • Women’s and men’s livelihoods • Access to services • Decision-making power • Girls’ and boys’ well-being • How these may be affected by proposed reform Vulnerability analysis Identifying different vulnerabilities (for example, livelihood, broader economic, social, cultural, and environmental) that affect children and their families and may be exacerbated or lessened by proposed reform Social capital assessment Understanding current patterns of social capital and how they may be affected by reform; tool (SCAT)18 SCAT may need to be adapted to increase focus on issues affecting children TABLE 4. Tools for Political and Institutional Analysis in a Child-Focused PSIA APPROACH USE IN CHILD-FOCUSED PSIA Stakeholder analysis • Identifying key groups of children and households most likely to be affected by reform and key public, civil society, and private sector institutions with stake in reform • Identifying key stakeholders with a mandate for or interest in child well-being Institutional analysis Understanding: • Ofï¬?cial responsibilities of relevant implementing agencies • How interests and incentives within different stakeholder organizations may affect reform implementation • How different institutional structures may be affected by reforms • How all these factors could affect impacts of reforms on children Political economy analysis (tools such as power analy- Identifying key macro- and micropolitical forces in favor of or sis, drivers of change analysis, and political mapping) opposing reforms and possible mitigation strategies Note: See the PSIA User Guide and Tools for Institutional, Political and Social Analysis Sourcebook (World Bank 2005) for detailed descriptions of these approaches. 18 This generates both quantitative and contextual data. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 47 M E T H O D S F O R A S S E S S I N G I M PA C T S POLITICAL AND INSTITUTIONAL ANALYSIS pact children and young people. It can also help in framing recommendations and in clarifying strat- Bringing a child focus to political and institutional egies for engaging with decision makers. Table analysis can help identify the political forces and 4 outlines how key tools can be used in a child- institutional operation modes that are most likely focused PSIA, and the box 18 provides some key to affect reform implementation in ways that im- questions. BOX 18. Key Questions for Political and Institutional Analysis WHAT ARE THE POLITICAL AGENDAS OF KEY STAKEHOLDERS? Are there well-placed people who are: • Concerned about child well-being? • Interested in protecting the interests of poor people? • Likely to be supportive of child-focused social protection or of modifying reforms to protect children? WHAT ARE THE PERCEPTIONS OF PROPOSED REFORMS AMONG IMPLEMENTING AGENCIES? • What do representatives of implementing agencies perceive as the likely consequences of reform? • How do they stand to lose or gain? • What strategies might they use to compensate for possible losses? • How might these impact children and young people? EXISTING PROGRAMS • Are there existing programs that might mitigate reform impact on children? • Is there scope for them to be expanded? • Who are the main supporters and opponents of these programs? These and similar questions may be used with various analytical tools for assessing political and institutional dimensions of reform. Note: See the Resource Pack for further detail on qualitative and quantitative data sources and analytical techniques. 48 THE WORLD BANK GROUP AND UNICEF Since children and adolescents are usually less well placed to advocate for their own interests, there is an additional onus on analysts to ensure that the potential impacts on children and youth are adequately considered. 6. Including Children’s Perspectives As discussed in the previous sections, child-neutral, macrolevel reforms can often signiï¬?cantly affect children. Furthermore, while sufï¬?cient data on some aspects of child well-being, such as health and education, may be available to enable an informed analysis of the likely impacts on children, often there is insufï¬?cient information on other issues, or for other groups. Research either directly with children or with their representatives can improve analysis quality by ï¬?lling these information gaps, because: • It will help identify issues that may have been missed by others. For example, in a flood planning exercise in Vietnam, it was only when children were consulted that the issue of evacuation routes from schools during a flood was considered (Save the Children UK 2008b). • It can enable research on impacts affecting signiï¬?cantly disadvantaged groups, for example, street children, child laborers and orphans, for who there is often very little information, or for children living outside families who are not represented in household surveys. • It can provide insights into the differential impacts of policies on different members of the household, for example, increased ï¬?nancial pressures leading to removal of girls rather than boys from education, inequitable distribution of food within the family, or pressures for early marriage for girls. • It provides insights into the social processes by which impacts on children arise, particularly coping strategies used by poor households and the ways that they affect children. For ex- 50 THE WORLD BANK GROUP AND UNICEF INCLUDING CHILDREN’S PERSPECTIVE ample, a UNICEF-supported ex ante analysis What Kind of Information? of the impacts on children of an electricity tariff reform in Bosnia Herzegovina high- Direct collection of data from children, adolescents, lighted that increased child labor, increased or their carers is particularly useful in a PSIA when: use of dirty fuels, and reduced electric- ity consumption were the main ways that • No information on current or common cop- households expected to cope with price ing strategies and their impacts on children rises. Adolescents’ opportunities for eve- is available ning study, to engage in extracurricular ac- • Information on children’s time use is impor- tivities, and for information and recreation tant (for example, where impacts on child (for example, watching television) were labor are likely) most likely to be affected (Birdi et al. 2007). • Impacts are likely on areas poorly covered • It can enable ground-truthing and triangu- in quantitative studies (for example, sensi- lation of conclusions. tive or hard to measure issues). • It can help identify effective mitigation strat- egies, for example, by identifying promising small-scale approaches that might be scaled up to prevent negative impacts. How to Include Children’s Views in PSIA Processes Since children and adolescents are usually less well placed to advocate for their own interests, there is an additional onus on analysts to ensure that the DIRECT CONSULTATION WITH CHILDREN potential impacts on children and youth are ad- equately considered. At least some ground-truth- There is now substantial, accumulated evidence ing of conclusions with two key sets of stakehold- from conducting policy-related research on devel- ers (adolescents and families, and organizations opment issues with children and youth (see the Re- working with children) is likely to be necessary for source Pack for examples). This evidence indicates most PSIAs. that including adolescents and older children as BOX 19. Mozambique Example: Insights from Consulting Children The Mozambique PSIA of primary and secondary school fee reform conducted interviews with school-going and non-school-going children and their parents. This revealed concerns regarding the sexual harassment of girls both in and en route to school, which is a deterrent to girls’ school attendance, and highlighted the need for more concerted action on this issue, in addition to mea- sures to ease the direct costs of schooling. Source: Valerio et al. 2005. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 51 INCLUDING CHILDREN’S PERSPECTIVE potential stakeholders can bring important new Methods. Research with children will normally use information to PSIA, particularly with older chil- qualitative methods. Commonly used approaches dren, a greater proportion of whose lives are out- include: focus groups and semistructured inter- side the direct control of parents or carers. views, mapping and diagramming, creating time lines, discussing how parents and children might Direct research with children and adolescents can behave in different scenarios, photo diaries, draw- be especially helpful because it can bring up sensi- ings, and role-plays. Table 5 outlines the strengths tive issues important to children that are not cap- and weaknesses of these methods. tured by survey data or topics on which adults are strategically silent, such as the extent of hazard- Ethics. Conducting research with children requires ous child labor in communities that rely on chil- additional capacity to ensure that children are not dren’s economic contributions or violence against exploited or harmed by the research process. The children. Such research should be structured to Resource Pack outlines key requirements for the raise issues of concern to children, and should not ethical involvement of children, based on accept- exclusively follow researchers’ agendas (see box ed child rights’ principles. Speciï¬?cally, any involve- 19 for an example). ment of children should be relevant to their lives and concerns, designed to ï¬?t in with their daily Age. Accumulated evidence suggests that chil- routines (for example, not conflicting with school, dren approximately age 12 and over are usually domestic chores, or work), and engage children in able to participate in policy-related research. In an interesting way. The purpose of research addition, younger children who have had to take should be clearly explained to children and their greater responsibility for their own economic and carers. Children’s inputs should be treated with re- social well-being, such as child laborers, child car- spect—care should be taken to avoid manipulat- ers of sick relatives, or who have lived to a greater ing children into providing the answers research- degree outside adult control, are also likely to be ers wish to hear, and due weight to given to able to effectively participate. In PSIAs that need children’s contributions, even if the emerging in- additional information from hard-to-reach or sig- formation conflicts with that provided by other niï¬?cantly disadvantaged groups, peer research stakeholders. Children’s involvement must be vol- may be useful, and with support, adolescents can untary—they should never be coerced or required participate in such research (see the Resource Pack to participate. The research process should be for further information). structured to avoid discrimination; ensure the safety of children during the research; respect Accessing children. UNICEF country ofï¬?ces, child- their conï¬?dentiality, except if there are concerns or youth-led organizations, and/or NGOs or gov- about their well-being; and to minimize the risk ernment services working directly with children of any negative consequences of participating in may be able to facilitate access to children. These the research. Researchers should also feed back to organizations should be considered key infor- child participants on how the information they mants because of their front-line knowledge of provided and issues they raised have been used in disadvantaged children’s lives, and become po- the research. tential partners in conducting research because many are highly experienced in facilitating con- sultations with children. 52 THE WORLD BANK GROUP AND UNICEF INCLUDING CHILDREN’S PERSPECTIVE TABLE 5. Qualitative Research Methods and Their Use with Children in a PSIA METHOD POSSIBLE USES IN A PSIA CAVEATS/COMMENTS Mapping and • Identifying how use of space, services, or key social diagramming contacts could change Time lines • Identifying likely changes in children’s time use Children’s photos • Identifying changes that researchers have not • Cost, environmental impact with disposable anticipated, for example, revealing issues around cameras safety and security, patterns of movement, un- covering aspects of children’s lives that might be otherwise hidden from view Drawings • Identifying possible before and after scenarios • Need interpretation with child; less use- visually ful if children unused to drawing Role-plays • Can enable signiï¬?cant insights into potential • Need skilled facilitation changes • Risk of children simply reproducing skits or songs they’ve seen before • Can exclude shy children Scenarios • Provide a basis for discussion that avoids asking • May need to be carefully chosen to personal questions on sensitive topics, for example, reflect priority scenarios impacts on household incomes in a group setting Semistructured • Most useful for children uncomfortable with group- • Time consuming on large scale interviews based participatory or performance-based methods Internet-based • May be useful with youth • High levels of self-selection discussions • Likely to primarily reflect concerns of highest socioeconomic groups • Greater risk of falsiï¬?cation of data compared to face-to-face methods CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 53 INCLUDING CHILDREN’S PERSPECTIVE TALKING TO OTHER KEY INFORMANTS, State structures, such as children’s ombudspeople SUCH AS PARENTS OR OTHER CARERS, OR or representatives of departments of child wel- CIVIL SOCIETY ORGANIZATIONS WORKING fare and NGOs working with children and child WITH CHILDREN. or youth organizations, can be other useful key informants and/or partners in research. The Re- Young children in particular cannot advocate for source Pack contains more detailed suggestions their own interests. Typically in a PSIA, informa- on organizations that may be relevant. tion relating to the likely impacts of reforms on young children’s nutrition, health, or access to However, it is important to note that adult key in- education may be better sought from parents or formants, and indeed older children speaking on other carers. Parents can also describe their likely behalf of younger children, may not always share decision-making processes in response to declin- children’s interests. They may go to some lengths ing or rising household incomes. If social services to cover up exploitative arrangements from which used by children and their families are likely to they beneï¬?t or of which they are ashamed. Sepa- be affected by reforms, front-line service provid- rate discussions with each main stakeholder group ers such as teachers, health care professionals or (children/adolescents, parents/carers, and key in- social workers working directly with children and formants) can increase the likelihood of uncover- residential child care institutions and service man- ing hidden issues.19 agers (for example, department heads within lo- cal authorities, health care management bodies, Decision tree 2 is a tool to help determine the best and so forth) can be other vital sources of insight ways for children’s perspectives to be included in into potential impacts (box 20). a PSIA. BOX 20. Interviewing Other Key Informants In UNICEF and Save the Children research on the potential impact of electricity tariff reforms in Bosnia Herzegovina, researchers interviewed directors of children’s residential institutions and sports clubs and social workers. The research revealed that many youth and sports clubs would probably have to close because they would be unable to meet electricity bills. The impacts on chil- dren in residential institutions were likely to be particularly severe: directors indicated that they might have to reduce use of electricity in the evenings, affecting children’s opportunities to study and curtailing leisure activities; lower stafï¬?ng levels, thus potentially increasing risks to children’s well-being; switch to cheaper, less nutritious food; and limit hot water for bathing and laundry. Source: Birdi et al. 2007. 19 See the Resource Pack for further reading on ethical standards and methodologies for researching with children. 54 THE WORLD BANK GROUP AND UNICEF INCLUDING CHILDREN’S PERSPECTIVE DECISION TREE 2. Consulting Directly with Children in Ex Ante Analysis Does initial analysis NO Relevant child well-being variables should suggest signiï¬?cant impacts be considered in quantitative analysis, but on children likely? direct research with children and families probably unnecessary YES Which areas of child • Consultations with Do budgets and timeframe well-being are most likely parents (especially allow adherence to ethical to be affected? mothers) may be needed standards for child • Nutrition to establish potential participation? impacts and effective • Child health • Avoid conflicts with protective strategies • Care of young children children’s other activities • If older children and/or (such as school and work) elders provide signiï¬?cant • Schooling • Ensure children’s safety care of young children, • Adolescent health they may also be • Appropriate and relevant important informants to children • Child/adolescent labor • Facilitated by skilled • Young people’s access practitioners to work • Consultations with children/adolescents may • Voluntary participation • Emotional well-being be helpful in identifying • Transparency about likely response strategies purpose and process and possible impact and • Respectful of children’s mitigation strategies contributions YES NO Design ï¬?eld research to Design ï¬?eld research to include direct consultations include parents, key profes- with children and adoles- sionals, and relevant CSOs cents through: and /youth organizations • Focus groups through: • Participatory exercises • Focus groups • Semi-structured interviews CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 55 7. Mitigating Negative Effects and Enhancing Positive Effects of Reforms on Children Once analysis indicates that a proposed policy reform is likely to affect children and young people, the next step is to identify how negative effects be can prevented and positive effects enhanced. This section discusses two possible approaches to improving the outcomes of a re- form for children: modifying the proposed reform to prevent negative effects on children and measures to mitigate the effects of reforms on children and their households. Deciding on the Type of Policy Response Needed In deciding whether a reform should go ahead as planned, should be modiï¬?ed, or whether speciï¬?c policies to mitigate the effects on children should be implemented, key factors to consider are: • The numbers of children likely to be affected • The severity of likely impacts • The proï¬?le of the children likely to be affected, with particular attention to the most dis- advantaged • The number of different ways children are likely to be affected • The costs of mitigation policies and the possibilities for scaling up existing provision • The speed at which negative effects might occur compared with the timeframe needed to implement mitigatory programs • The long-term costs of not preventing harm to children’s welfare • The overall gains expected from the reform. To recap from the earlier discussion, the following points should also be kept in mind when deciding whether impacts on children are too severe to be acceptable: 1. Children’s development processes mean that they are highly vulnerable to the effects of even short-term deprivation, which can result in even longer-term effects than for adults. This means that a more cautious approach is needed in deciding whether the negative consequences of a proposed reform are too severe for children compared to a stakeholder group of similar size. Speciï¬?cally, it is essential to implement modiï¬?cations or mitigation measures quickly—even when a reform policy is well designed, if it takes too long to implement, without adequate interim measures in place, the development and emotional well-being of a whole cohort of children may be irreversibly damaged. 56 THE WORLD BANK GROUP AND UNICEF EFFECTS OF REFORMS ON CHILDREN 2. Even if democratic space exists for adults to ï¬?ed, or whether mitigation strategies should be challenge policy decisions, children, by con- put in place. Such an analysis should consider the trast, have very little voice in policy process- short- and longer-term impacts of: es and few opportunities to seek redress if reforms have negative consequences. Chil- • Improved/worsening nutrition among chil- dren often cannot advocate for themselves, dren and pregnant women thus there is an even greater onus on ana- • Improving/declining educational enrolment, lysts to ensure that potential costs to chil- attendance, and attainment dren have been adequately examined to • Improving/declining infant, child, and ado- prevent harmful impacts. lescent health • Increased/declining child labor • Other relevant factors. Identifying Different Policy Options Sometimes the most effective response will be child speciï¬?c; sometimes it will be broader, or fo- A cost-beneï¬?t analysis of different policy options cused on supporting disadvantaged groups more should provide the basis for assessing whether a generally. Table 6 summarizes different scenarios reform should be implemented as planned, modi- and recommended courses of action. TABLE 6. Reform Scenarios and Possible Courses of Action SCENARIO ACTION Many children are negatively affected and costs of Modify proposed reform mitigation high Many children are negatively affected, costs of mitigation Put in place mitigation policies and programs low or reasonable, and implementation capacity exists Moderate numbers of children are negatively affected and Assess whether modifying reform or implementing costs of mitigation are high mitigating measures is more cost-effective Moderate numbers of children are negatively affected, costs Put in place mitigating measures of mitigation are low or reasonable, and implementation capacity exists Relatively small numbers of children are negatively affected Put in place mitigating measures Negative impacts on children negligible No additional provisions needed CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 57 EFFECTS OF REFORMS ON CHILDREN Modifying Proposed Reforms If signiï¬?cant numbers of children are likely to be negatively affected by reforms, it may be more cost-effective to modify the reform than to intro- duce a mitigation package. Such modiï¬?cations would aim to prevent serious decline in poor households’ livelihoods or access to services, or rises in the prices of key goods vital for children’s development. Some examples of possible modiï¬?- cations include:20 Even if democratic space • If a sales tax or value-added tax is being in- troduced, key goods used disproportionately exists for adults to by poor families (for example, certain food- stuffs) or children (children’s clothes, shoes, challenge policy decisions, books, and school supplies) could be exempt • Slowing down the timeframe for phasing children, by contrast, in tariff changes, privatizations, liberaliza- tions of certain sectors, or other provisions have very little voice in likely to undermine the livelihoods of certain groups, to give those most severely affect policy processes and few time to adapt to new conditions • Ring-fencing funding for key services sup- opportunities to seek porting children’s development and dis- redress if reforms have advantaged families’ welfare during ï¬?scal consolidations negative consequences. • Avoiding commercialization of public ser- vices, such as education, health care, or water and sanitation in a manner that does not address the appropriate, accessible, and affordable provision of quality services to poor families, particularly disadvantaged children • Emphasizing pro-employment monetary and ï¬?scal policies to protect household livelihoods • Prioritizing pro-poor taxation to protect and promote livelihoods • Allowing a greater proportion of project funding than initially envisaged for comple- mentary measures that enhance beneï¬?ts to disadvantaged groups. 20 Section 4 of the Resource Pack provides further details on possible policy modiï¬?cations. 58 THE WORLD BANK GROUP AND UNICEF EFFECTS OF REFORMS ON CHILDREN Mitigation Policies to Protect Efï¬?ciency arguments are often made in favor of Children’s Well-Being minimizing inclusion errors when targeting. A child rights’ approach places more emphasis on Many policies (of varying effectiveness) that have being as inclusive as possible, thereby giving ex- the potential to mitigate negative effects on child clusion errors more weight than inclusion errors welfare are already in place as part of more gen- when weighing up policy choices. In such a case, eral child well-being and social protection pro- policy choices should emphasize the most positive grams. In some cases these may be scaled up, or impact on children or the least negative. additional programs or services integrated, to better meet the needs likely to arise as a result Cash transfers. Both conditional and uncondition- of reforms. If no existing infrastructure is in place, al transfers have been shown to have a positive or capacity to extend existing services is minimal, effect on child well-being. For example, Mexico’s it may be necessary to develop temporary free- Oportunidades and its precursor, PROGRESA, have standing programs to protect child well-being, reduced the risk of both primary and secondary although integration with existing structures is school–age children dropping out of school if their usually preferable. families suffer sudden income shocks (de Janvry et al. 2006). Oportunidades and Nicaragua’s Red When targeted compensation measures are pro- de Proteccion Social have also contributed to im- posed to mitigate the impact of reforms, target- proved child nutrition, although several other Lat- ing can involve both inclusion and exclusion errors. in American conditional cash transfer programs CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 59 EFFECTS OF REFORMS ON CHILDREN have not (Hoddinott and Basett 2009). Recent re- Employment generation, for example, cash for search from Malawi has found that cash transfers work and food for work programs. The great- have a positive effect on increasing school enrol- est contribution to child well-being is likely to ment and attendance rates among poor children be in circumstances in which a reform leads to and girls, but that making them conditional on increased employment among the poorest socio- school attendance had no additional effect (IRIN economic groups, where children are usually dis- 2010). There is also evidence that general cash proportionately concentrated (Mazza et al. 2009). transfers, such as social pensions, can increase Traditional employment generation programs school enrolment rates and improve child nutri- have principally involved building public works tion (Barrientos and de Jong 2004). Expanding and have often excluded or discriminated against cash transfers can therefore be an effective way women who have been (or have been considered) to protect child well-being in the face of reform- less productive than men at heavy manual work induced shocks. In general, the added value of and thus have been paid less. These programs can, conditional transfers appears to be in contexts however, be designed to be more women friendly where service provision is adequate and demand and thus to make a greater contribution to child for services among disadvantaged groups weak; well-being. For example, on-site child care can be if demand is high but money is a barrier, uncon- provided (van der Gaag 2009) and, if provided ditional transfers are as effective. If service provi- by trained staff, can also contribute to improv- sion is inadequate, this needs to be addressed in ing educational outcomes among disadvantaged parallel; this is particularly important if proposed children. Extending the range of work ï¬?nanced reforms could weaken the service on which trans- through employment-generation programs to in- fers are conditioned. clude social care, for example, for older or chroni- cally sick people, may also increase their appeal to women (van der Gaag 2009). One risk with em- ployment-generation programs (whether target- ed at men, women, or both) is that older children may have to take on additional domestic duties to substitute for working parents; this can affect children’s access to education and the quality of care offered to younger siblings. Economic shocks often lead to rising unemploy- ment. Poor young people are already dispropor- tionately likely to be unemployed. While improv- ing overall employment opportunities is the single most important approach to reducing youth un- employment (Godfrey 2003), active labor market programs, such as support for on-the-job training and job and wage subsidies, have all proved effec- tive in helping young people ï¬?nd work and stay employed (Mazza et al. 2009). Young people can also be encouraged to continue their education by extending subsidies and transfer programs, many of which only support children up to age 16. Such programs also have spin-offs to promote 60 THE WORLD BANK GROUP AND UNICEF EFFECTS OF REFORMS ON CHILDREN young people’s social integration and reduce the risk of youth crime. Nutritional support. If reforms are likely to affect children’s nutritional well-be ing, the following ap- proaches may be effective. First, cash transfers can help secure overall access to food by protecting or boosting incomes. In particular, cash transfers may help increase low-income children’s consumption of protein, fruits and vegetables, which are often sacriï¬?ced in times of economic difï¬?culty. Micronu- trient supplementation for young children, preg- nant women, and other groups at risk—such as adolescents—can also help prevent problems such as iron deï¬?ciency anemia, night blindness, and If signiï¬?cant numbers goitre. The provision of supplements (through the health or education systems) and/or the for- tiï¬?cation of key foods, such as iodization of salt and fortiï¬?cation of flour with minerals and vita- of children are likely to mins, could help reduce micronutrient deï¬?cien- cies. Other approaches include subsidized rations be negatively affected for staple foods and food stamps or vouchers for low-income groups. School meals and take-home by reforms, it may be rations programs can also improve the nutritional status of school children and younger siblings, as more cost-effective to well as contribute to improved school attendance modify the reform than rates, lower drop-out rates, and higher attain- ments (Bundy et al. 2009). to introduce a mitigation Subsidies for service use. Earmarked transfers package. have been used effectively to secure poor house- holds’ and children’s access to a range of social and other services. These differ from conditional transfers in that they are earmarked for particular services, but rarely (except in the case of school-re- lated transfers) conditioned on particular behav- ior. If there are particular concerns about aspects of child well-being (for example, high rates of child labor or low secondary school attendance), earmarked transfers are a way of increasing the likelihood that resources reach particular groups of children. They may also be a more effective way to reach disadvantaged children if there is doubt about the social welfare system’s capacity to pro- vide a signiï¬?cantly increased volume of transfers. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 61 EFFECTS OF REFORMS ON CHILDREN Education subsidies include school scholarships Maintaining or extending service quality. Most or fee waivers, low-cost loans,21 grants for school child-speciï¬?c mitigatory measures are intended to uniforms or books, school feeding programs, and protect consumption of goods or services via meal subsidies. These measures have been used to transfers or subsidies. However, there is evidence mitigate shocks related to unemployment and the that protecting the quality and availability of social rising cost of living, such as those arising from the services can be as important in protecting child Asian ï¬?nancial crisis in Indonesia, Thailand, and well-being, particularly in middle-income coun- the Republic of Korea (Ablett and Slengesol 2001). tries. For example in Peru in the late 1980s and Measures to protect or extend access to health early 1990s, public health spending was not pro- care for disadvantaged children include subsidies tected and child health indicators declined signiï¬?- or waivers on user fees or health insurance con- cantly, with a sharp rise in infant mortality (Paxson tributions. Some packages also cover the cost of and Schady 2005). In Indonesia, by contrast, public speciï¬?ed essential medicines. Typically, existing health expenditure was protected during the ï¬?nan- programs may be scaled up or their coverage ex- cial crisis of the late 1990s and there was no sig- tended to groups facing sudden income shocks, niï¬?cant decline in child health. However, mothers’ as in Indonesia and Thailand during the 1997–99 nutritional well-being declined (Macfarlane Burnet crisis (Tangcharoensathien et al. 2000; Sumarto 2000), affecting newborns, and this may have et al. 2000). Access to utilities, such as water and been a contributing factor to the observed rise in electricity, may be achieved through lifeline tariffs infant mortality.23 (low price or free access up to a certain threshold deemed sufï¬?cient to guarantee basic needs) and/ Preventing a decline in child health—and particu- or subsidized tariffs for low-income consumers. larly in the health of the youngest, most vulner- able children—during periods of economic shocks Increasing access to early childhood development may require investment in maternal health, (ECD) is often neglected in education subsidies or support for safe birth, postnatal newborn care support despite the signiï¬?cant returns of ECD pro- (UNICEF 2008a) and care for children with diar- grams to children’s longer-term educational and rheal and respiratory infections, which currently social development.22 An important caveat is that account for a signiï¬?cant proportion of the disease return rates are unlikely to be so high for ECD pro- burden for young children. The incidence of these grams that simply function as daycare compared illnesses could be exacerbated by some common to those with a signiï¬?cant educational compo- strategies for coping with reduced income, such nent (Penn 2004). Nonetheless, because good as increased use of wood fuel, poorer hygiene quality ECD can help protect children education- practices, and more overcrowded living condi- ally, socially and nutritionally, and ensure their tions. Targeted programs to prevent unsafe sexual safety while adults work, supporting or extending practices, early parenthood, and substance abuse ECD provision should be considered if a PSIA sug- among young people can also help prevent these gests that very young children may be particularly problems that arise during periods of economic vulnerable to the effects of reforms. stress (World Bank 2007). 21 Thailand’s crisis education loan program, introduced in 2007, was so popular that demand far outstripped the funds avail- able (Mazza et al. 2009). 22 For example, Fajth (2009) cites evidence of a ratio of 6:1 for returns to investments in an ECD program in Indonesia, while the high social as well as individual returns to preschool education in the United States are well known. 24 http://www.childhelplineinternational.org/. 62 THE WORLD BANK GROUP AND UNICEF EFFECTS OF REFORMS ON CHILDREN Scaling up child protection services and programs. and increasing institutional capacity to identify Extending child protection services and programs abusive and exploitative situations and respond rarely forms part of mitigation packages: this is a quickly. Exploited and abused children may need signiï¬?cant gap. As discussed above, periods of eco- temporary residential care (such as shelters for nomic insecurity can lead to increased numbers of street children) to help them recover from their children at risk of abuse, exploitation, or neglect experiences, return to education when possible, (Harper, Jones, and McKay 2009). Furthermore, and, if desirable, facilitate reuniting them with child protection programs and services are gener- their families or placement in foster care. Since ally severely underfunded and often ill-equipped residential (that is, nonfamilial) care is normally institutionally to support the growing numbers of a poor environment for meeting children’s emo- children in need, especially if a signiï¬?cant propor- tional needs and is often associated with lower tion of low-income households are affected. educational attainments and sexual and physical child abuse, it should only be a last resort in the If proposed reforms increase children’s vulnerabil- longer term (UN 2010). Peer support and men- ity to neglect, abuse and exploitation, there is a toring programs for children at risk, particularly strong case for enhancing child protection systems street children and poor urban boys, have been as part of a mitigation package. Some relevant successful in reducing recruitment by criminal provisions include establishing temporary shel- gangs (UNODC and World Bank 2007). ters, counseling, help lines and the legal system, 23 Thanks to Jingqing Chai of UNICEF for this observation. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 63 EFFECTS OF REFORMS ON CHILDREN Complementary Policies the child sensitivity of the juvenile justice system. At the macrolevel, economic policies that pro- Many mitigatory policies for children are more mote employment, access to assets, and maintain effective when complemented by pro-child social ï¬?scal space for ï¬?nancing social services are cru- policies. For example, cash transfers conditioned on cial complements to more child-speciï¬?c policies use of social services depend on there being effec- (Ortiz and Cummins 2011). tive social services. Investment in water and sani- tation can reduce the burden on young children Table 7 on the right summarizes the discussion of waterborne diseases such as diarrhea, and can above and links policy options to the speciï¬?c vul- reduce demands on women’s and girls’ time, particu- nerabilities of children of different ages. larly time spent caring for sick children and collect- ing water. In education, maintaining or boosting service quality can help prevent dropping out, Grievance Redress Mechanisms particularly at the secondary level where pressures on children to drop out of school during periods of In cases where the government and civil society or- economic difï¬?culties to save costs or contribute to ganizations feel it may be worth tracking whether their households can be particularly acute, espe- or not there are unintended negative consequenc- cially if schooling is perceived to be poor quality. es of policy reform on children, they may con- sider adapting existing country grievance redress Similarly, provisions for abused and exploited mechanisms to receive and deal with complaints, children may be more effective if supported by or they may consider setting up a new telephone strengthened preventative elements such as social number and database to receive complaints and work (combining emotional support, advice, and thus complement any monitoring of the reform ï¬?nancial support), parenting education, labor in- process already in place. The adaptation or set up spection, a more effective police and court system of new mechanism can be accomplished with the for bringing child abusers to justice, and increasing help of CSOs that focus on children or with the help of government departments and ministries re- sponsible for children’s welfare. Grievance redress If proposed reforms mechanisms that try to reach children, and there- fore often deal with sensitive issues such as child increase children’s abuse or exploitation, will need more thought and care than grievance redress measures targeted at vulnerability to neglect, adults. Many Organisation for Economic Co-opera- tion and Development (OECD) and middle-income abuse and exploitation, countries have established hotlines and other sys- there is a strong case for tems for both children and adults concerned about children’s welfare to register complaints and seek enhancing child protection advice on a range of issues affecting children. Child Helpline International,24 an NGO that supports chil- systems as part of a dren’s helplines worldwide, may be able to provide advice. mitigation package. 64 THE WORLD BANK GROUP AND UNICEF EFFECTS OF REFORMS ON CHILDREN TABLE 7. Key Child Well-Being Vulnerabilities and Possible Policy Approaches KEY GROUPS OF CHILDREN ISSUE-SPECIFIC POLICY RESPONSES BROADER APPROACHES VULNERABILITIES MOST AFFECTED Nutrition • Infants and young children, • Cash social protection Livelihoods especially under age 2 • Policies to increase food security (including • Speciï¬?c measures to help • Pregnant girls and women agricultural investment) households adapt to new • Micronutrient supplementation and fortiï¬?cation livelihood sources, for example, change cropping • Increased availability and affordability of mixes improved water, sanitation, and health care • Phasing in reforms to allow Health • Children under age 5 are • Health system reform, leading to free treatment vulnerable households time most at risk of dying, but for children and young people (fee waivers, to adapt children of all ages are eliminating user fees, subsidized insurance) affected • Support to set up microen- • Targeted action on speciï¬?c diseases that terprises, assistance with job • Preteens and teenagers most disproportionately affect children (for example, searching at risk due to unsafe behavior malaria, diarrhea, pneumonia), directly or indi- (risky sexual practices, rectly through their impact on family members • Broader economic develop- substance abuse) ment measures—pro-poor • Health education/promotion programs; youth- growth /job creation friendly health services • Protection of labor rights • Cash social protection • Regional development in • Improvements to water and sanitation disadvantaged regions Emotional well-being • All age groups—long-term • Parent and carer education effects of emotionally inad- Protecting consumption • Cash social protection to ease ï¬?nancial and time equate care on neurological pressures on households • Protecting consumption of development most critical for goods essential for children, • Extending (and ï¬?nancially supporting) foster children under age 3 for example, through limiting care rather than residential care sales tax on children’s books, • Extending formal or informal (and extracurricular) clothes, and the like educational and leisure opportunities to • Reconsidering tariff or disadvantaged children nontariff barriers to import of key goods for children’s development Services • Maintaining ï¬?scal space for public services • Pro-poor taxation Table 7 continues on next page CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 65 EFFECTS OF REFORMS ON CHILDREN Table 7 continued KEY GROUPS OF CHILDREN ISSUE-SPECIFIC POLICY RESPONSES BROADER APPROACHES VULNERABILITIES MOST AFFECTED Education • Infants and young children— • Maintaining/increasing expenditure levels; inadequate stimulation; lack increased investment in early childhood develop- of affordable preschool provi- ment, primary and secondary education, and sion for young children maintaining/increasing salaries of social service • Children of all age groups providers vulnerable to poor quality • Targeted transfers to educationally vulnerable education and pressure to groupsa drop out for ï¬?nancial reasons; • Elimination of school fees often starkest for teenagers, • School grants for whom labor market opportunities are greatest Protection from • Neglect—physical well-being • Cash transfers and employment creation to neglect, abuse and of younger children most improve household economic well-being exploitation at risk • Early childhood development programs and en- • Older children may miss out hanced childcare provision for working parents on guidance for negotiating • Educational/prevention programs with children transition to adulthood and young people, and parenting programs with • Abuse—all age groups at adults risk; younger children and • Support to child protection systems, including babies, and in some contexts, police and law enforcement agencies, labor late teenage boys at most risk inspectors, and social workers of violence • Counseling, helplines, shelters, and targeted • Exploitation (including labor, services, for example, peripatetic educational trafï¬?cking, and sexual exploi- programs for street-working children unable or tation)—middle childhood unwilling to participate in formal education and teenagers Posteducational • Youth • On-the-job training and job and wage subsidy opportunities programs most effective in promoting youth employment; most effective in context of overall job-creating growth • Active citizenship programs, such as youth com- munity development programs and programs promoting young people’s engagement in local governance a This approach has been used frequently to redress gender inequalities, or to support education among orphans and refugees. While this is often effective for the target group, it runs the risk of alienating those not receiving subsidies who may be almost as disadvantaged. 66 THE WORLD BANK GROUP AND UNICEF Education subsidies include school scholarships or fee waivers, low-cost loans, grants for school uniforms or books, school feeding programs and meal subsidies. These measures have been used to mitigate shocks related to unemployment and the rising cost of living. Annex 1. Checklist: Consolidated Set of Key Questions for Child-Focused PSIA TRANSMISSION CHANNELS TO HELP IDENTIFY TYPES OF REFORMS THAT MAY HAVE SIGNIFICANT EFFECTS ON CHILDREN25 Employment • Are there sectors where adult employment is likely to become less secure/lower paid, affecting household incomes? • Is there a risk of increased child labor in these or other sectors (including domestic labor)? • Is increased adult or child labor migration likely, and if so are children likely to be separated from their families for extended periods? • Are impacts on youth employment opportunities likely? Prices • Are prices of key goods produced/consumed by poor households likely to increase? • Is children’s consumption of food and other essentials and use of key services likely to alter as a result? Assets • Are poor households likely to have to sell assets and compromise children’s current or future well-being? • Do asset distribution programs (for example, land reforms) make adequate provision for the next generation? Taxes and transfers • Are public transfers to families or children likely to be affected (including pensions)? • How may remittances and other private transfers be affected by proposed reforms? • Are reforms likely to change the current tax burden for low-income families? Authority • Are changes to likely to affect access to entitlements and household incomes? • Are changes to public service governance likely to affect the quality of health, education, or child protection services? 25 Access to goods and services is not included here because there is a separate detailed set of questions on how changes in access to services affect children. 68 THE WORLD BANK GROUP AND UNICEF ANNEX 1 TRANSMISSION CHANNELS TO HELP IDENTIFY TYPES OF REFORMS THAT MAY HAVE SIGNIFICANT EFFECTS ON CHILDREN25 Routes by which impacts on children may arise Declining incomes Food: • How likely are households to shift to less nutritious food (for example, less frequent con- sumption of protein, vitamins and minerals, substitution with cheap fats or carbohydrates, inappropriate baby foods such as unsuitable powdered milk) or consume less food overall? • Are changes in breast-feeding patterns likely, for example, if mothers need to work away from infants? Or increased breast-feeding to substitute for purchased formula or baby food? • Are children who receive food at school likely to receive less at home? Clothes and shoes: How likely are households to cut back on children’s clothes (including school uniforms) and shoes? Utilities: Is there a risk of shifting to more dangerous and/or polluting fuels (for example, unven- tilated wood burning, makeshift electricity connections) or unsafe water sources? Adult goods: Are households likely to increase or decrease spending on tobacco and alcohol? Service use: What is the risk of delaying seeking medical care, purchasing cheaper, nonprescrip- tion medicines, cutting back on school supplies (for example, books, stationery), or having some children in the family drop out of school? Rising incomes If household incomes rise, how far is spending likely to rise on goods and services that beneï¬?t children? Impacts on services used by • Overall funding levels. What are the impacts of proposed changes on overall budgets for children and their families, for particular sectors, and for different areas of expenditure within sectors? How do areas with example, health, education, direct beneï¬?ts to children, such as transfers targeted to families with children; child welfare; social protection, utilities (water, protection services; maternal and child health services; young people’s mental and reproductive electricity, gas), and housing health; and employment services for young people fare? • Quality of services. Are front-line staff (for example, teachers, health workers) likely to experi- ence falling real incomes (affecting motivation)? Is there a risk that service quality will suffer or moonlighting will increase? Are budgets for key equipment used by/beneï¬?ting children (for example, teaching aids and medicines) or infrastructure (for example, repairs/building) likely to be affected? • Financial accessibility. Will the reform change the ï¬?nancial accessibility of services to poor families? Could informal payments be demanded, preventing poor children from accessing ser- vice? Which social groups are most likely to reduce /increase service use, and which services are likely to experience the greatest uptake or decline? Is access likely to be reduced or increased for disadvantaged children? • Physical accessibility. Will the reform increase the accessibility of services for poor house- holds, and if so, is children’s service use likely to increase? If closure of some services is planned, which social groups are most likely to be affected? • Changing policy priorities. Could changed policy priorities and incentives to service providers affect the availability/quality of service provision? Could key services for children be affected? CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 69 ANNEX 1 TRANSMISSION CHANNELS TO HELP IDENTIFY TYPES OF REFORMS THAT MAY HAVE SIGNIFICANT EFFECTS ON CHILDREN25 Impacts on social capital • Are interhousehold transfers likely to be affected? Could this reduce/increase children’s access to key goods or services? • Are social contacts between families or among children and young people likely to decline, for example, due to longer work hours or being unable to afford to participate in community life? • Could informal childcare arrangements be affected, for example, if more women enter the workforce or kin/neighbors can no longer afford to care for children of working parents? • Is there a risk of increased intrahousehold tension and violence or of increased household break-up? • Could crime such as violence (affecting children’s mobility and play opportunities), sexual exploitation, drug pushing, or people trafï¬?cking increase? Identifying which children may be most affected Income-poor and vulnerable • Are all households in certain quintiles (including those close to the poverty line) likely to be households affected, or are effects most likely to be felt in speciï¬?c sectors or livelihoods? • Are children disproportionately concentrated in affected groups (likely if the bottom quintiles are most affected)? • Does the number of children or household size affect vulnerability, and if so, which kinds of households are most at risk? Gender • Given existing patterns of gender discrimination, is this reform likely to have differential impacts on boys and girls? • Could it sharpen or help reduce existing gender inequalities between boys and girls? Marginalized ethnic, religious, or • How will the livelihoods and access to services of these groups be affected? caste groups • Are special provisions needed to enable children of these groups to beneï¬?t from the reform or prevent negative impacts? Children in disadvantaged • Will the effects of this reform reach remote rural or disadvantaged urban areas? geographical areas • Are there barriers that need to be addressed before children in these areas can beneï¬?t? Disability • Is this reform likely to have signiï¬?cant effects on disabled children? • Could it enhance their educational opportunities? • Could it increase or lessen the accessibility of support or CBR services? • Could it increase discrimination against disabled children? Signiï¬?cantly disadvantaged • Could this reform affect the livelihoods and access to services of disadvantaged children, for children example, orphans, child-headed households, or demobilized child soldiers? • Could it have speciï¬?c impacts on street children or child workers, for example, if the main sectors in which they work are likely to be affected or if opportunities for exploitative criminal activity could increase? • Could it increase the marginalization of these groups, for example, if there is greater competi- tion for limited resources? 70 THE WORLD BANK GROUP AND UNICEF ANNEX 1 TRANSMISSION CHANNELS TO HELP IDENTIFY TYPES OF REFORMS THAT MAY HAVE SIGNIFICANT EFFECTS ON CHILDREN25 Identifying possible effects on children’s well-being Health-related outcomes • How are infant mortality rates and under-5 mortality rates likely to be affected? • Is there likely to be a rise/decrease in children’s vulnerability to particular communicable or noncommunicable diseases, for example, respiratory, waterborne, pollution related, HIV/AIDS and other sexually transmitted diseases, and others? • How may adult and young people’s use of harmful substances, for example, drugs, alcohol, tobacco, be affected? Nutrition-related outcomes • How are changes in access to food, water quality, health care, and the existence of micro- nutrient supplementation or fortiï¬?cation programs likely to affect children’s nutritional status? • How may rates of wasting, stunting, and obesity be affected? Are there likely impacts on micronutrient deï¬?ciencies? Education-related outcomes • How are enrolment and attendance rates at different levels of education (preschool, primary, secondary, and higher) likely to be affected, for example, due to changes in cost, availability, and conflicting priorities for children’s time use? • What are the likely impacts on children’s uptake of extracurricular activities (such as paid tuition,music or sport?), • What are the likely impacts on learning outcomes, for example, if teachers moonlighting ignore children who can’t pay additional fees? • Could children’s risk of violence (physical and/or sexual) at or en route to school be height- ened? Opportunities for play and leisure How are the following key influences on children’s opportunities for play and leisure likely to be affected? • Children’s time use and opportunities to socialize with other children • Adult and/or older child availability to play with very young children • Changing public investment in and costs to users of leisure/play/sports facilities • Changes in children’s environment and security (for example, environments becoming safer or less safe for play) Emotional well-being How are the following key influences on children’s emotional well-being likely to be affected? • Adult stress • Amount of time carers are able to spend with children • Opportunities in school and wider community Protection from exploitation, • How likely are they to increase: abuse, and neglect – Children entering harmful work either on their own initiative or because they are forced to do so by carers – Homelessness or children moving onto streets and separated from families – Abandonment, trafï¬?cking, sale of children, and forced marriage – Violence against children; children and young people in trouble with law – Neglect—due to lack of time to care for children or inadequate supervision • How signiï¬?cant are the risks of the above? CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 71 ANNEX 1 TRANSMISSION CHANNELS TO HELP IDENTIFY TYPES OF REFORMS THAT MAY HAVE SIGNIFICANT EFFECTS ON CHILDREN25 Political and institutional issues Existing programs • Are there existing programs that might mediate the impacts of reforms on children? • Is there scope for them to be expanded? • Who are the mains supporters and opponents of these programs? Political agendas of key Are there well-placed people who are: stakeholders • Concerned about child well-being, or protecting the interests of poor people? • Likely to be supportive of child-focused social protection or of modifying reforms to protect children? Perceptions of proposed reforms • What do representatives of implementing agencies perceive as the likely consequences of on implementing agencies reform? • How do they stand to gain or lose? • What strategies might they use to compensate for possible losses? • How might these strategies impact children and adolescents? 72 THE WORLD BANK GROUP AND UNICEF INTRODUCTION Preventing a decline in child health— and particularly in the health of the youngest,most vulnerable children— during periods of economic shocks may require investment in maternal health, support for safe birth and postnatal newborn care. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 73 Annex 2. Child Well-Being Indicators and Possible Data Sources AREA OF CHILD SOURCES OF HOUSEHOLD OTHER DATA WELL-BEING INDICATORS DATA SOURCES Health • Infant mortality rate MICS, DHS • Under-5 mortality rate MICS, DHS • Incidence of speciï¬?c diseases such as diarrhea and DHS prevalence and treatment of ARI MICS, DHS • Use of improved water and sanitation facilities MICS, DHS • Antenatal care and rates of institutional deliveries MICS, DHS, AIS • Young people’s sexual behavior, for example, condom Specialized use and multiple partners studies • Young people’s use of drugs or alcohol Nutrition • Prevalence of underweight, stunting, wasting, low birth MICS, LSMS27 Food security weight, and obesity DHS and nutritional • Prevalence of anemia26 surveillance MICS, DHS surveys • Breast-feeding rates and infant and young child feeding DHS, MICS practices • Micronutrient intake among children and mothers Education • Preschool attendance among relevant age group (usu- MICS ally ages 3/4–5/6) MICS • Net primary and secondary school attendance ratios MICS, LSMS • Drop-out rates at different levels MICS, LSMS • Gender parity indices for primary and secondary school • School attendance among orphans PIRLS, TIMSS28 • Learning outcomes 26 In selected DHS surveys, see http://www.measuredhs.com/topics/anemia/start.cfm. 27 LSMS is used here as shorthand for all household budget or income and expenditure surveys. 28 See http://timssandpirls.bc.edu/TIMSS2007/countries.html; http://timssandpirls.bc.edu/timss_advanced/countries.html and http://timssandpirls.bc.edu/timss2011/countries.html. 74 THE WORLD BANK GROUP AND UNICEF ANNEX 2 AREA OF CHILD SOURCES OF HOUSEHOLD OTHER DATA WELL-BEING INDICATORS DATA SOURCES Work, play, and • Adults engaging in play with preschool children MICS leisure • Time spent by children on play with siblings or friends Some LSMS and MICS modules • Child labor rates (both exclusive and combined with MICS, LFS, LSMS school) MICS and SIMPOC29 • Children engaged in worst forms of child labor LFS and administrative data • Youth employment opportunities Security and • Children under age 5 cared for by children under age 10 MICS • Thematic protection from • Children experiencing serious accidents Administrative data studies and exploitation, abuse, states’ parties • Number of children living apart from biological parents MICS and administrative data and neglect or alternative (with foster carers or in residential care) MICS reports to • Child victims of sexual exploitation, trafï¬?cking, and Administrative data Committee abandonment on Rights of Administrative data and MICS • Child/youth victims of violence Child • Numbers of street children • Voices of children surveys Children’s • Children’s perceptions of their well-being/happiness • Child mental emotional • Rates of child/youth drug and alcohol use health surveys well-being • Qualitative • Youth suicide rate studies Note: AIS = AIDS Indicators Survey; ARI = Acute Respiratory Infection; PIRLS = Progress in International Reading Literacy Study; SIMPOC = Statistical Information and Monitoring Programme on Child Labour; TIMSS = Trends in International Mathematics and Sciences Study. 29 See http://www.ilo.org/ipec/ChildlabourstatisticsSIMPOC/Model%20questionnaires/lang--en/index.htm CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 75 EXAMPLE 1. Liberalization of Markets for Annex 3. Examples Staple Foods of Sector Reform Impacts on Children REFORM: MAIN ROUTES BY Liberalization of WHICH CHILDREN MAY markets for staple BE AFFECTED: foods with four pos- Increased disposable sible scenarios over incomes for net producer the medium term: households This annex provides some contrasting ex- 1. Farmgate prices Reduced disposable amples of the ways that reforms in differ- rise, consumer incomes for net consumer ent sectors may impact children. These are prices rise households intended as illustrations to help identify 2. Farmgate prices Possible increased relevant issues in PSIAs on similar reforms. rise, consumer exposure to agricultural prices fall chemicals Some, such as the electricity tariff reform, may affect children through all the main 3. Farmgate prices fall, consumer prices rise routes discussed. Others are much more speciï¬?c, such as agricultural price liberaliza- 4. Farmgate prices fall, Disposable incomes consumer prices fall fall for net producer tion, and primarily affect children through households their effects on household incomes. The social assistance example indicates some Disposable incomes rise for net consumer disaggregated analysis of impacts on differ- households ent groups of children that may be useful. 76 THE WORLD BANK GROUP AND UNICEF ANNEX 3 POSSIBLE POSITIVE EFFECTS ON CHILDREN ARISING THROUGH INCREASED INCOMES: • Increased consumption of nutritious food • Increased school enrolment and attendance, reduced drop-out • Increased use of health care • Improved health status • Increased household investment in housing, water, and sanitation INDICATORS: • Reduced child labor if the need for children’s contributions is reduced • Food consumption • Stunting, wasting, and obesity rates • School enrolment, attendance, and POSSIBLE NEGATIVE EFFECTS ON CHILDREN: drop-out rate at different levels • Possible increase in child labor if demand for agricultural labor rises, or to • Child morbidity and mortality rates compensate for declining disposable incomes in net loser households • Prevalence of medical problems • Health risks from increased exposure to agrochemicals if smallholder pro- related to agrochemical exposure duction intensiï¬?ed or child labor in agriculture increases • Child labor rates (paid and unpaid) • In net loser households, reduced: in agricultural, domestic, and other sectors – Consumption of nutritious food • Use of improved water and sanitation – School enrolment/attendance • Quality of housing – Use of health care CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 77 ANNEX 3 EXAMPLE 2. Consolidation and Improved Targeting of Social Assistance System POSSIBLE ROUTES BY WHICH CHILDREN MAY BE AFFECTED: Incomes /livelihoods • Increased transfers to low-income households with children • Increased numbers of formerly excluded households REFORM: receiving transfers • Consolidate beneï¬?ts to • Reduced income amount for high- and middle- low-income households income households (possible hardship just above • Consolidate child beneï¬?ts eligibility threshold) • Improve targeting of beneï¬?ts and reducing leakage to nonpeer Services households • Indirect effects arising from increased demand for ser- • Improve governance and vices, particularly if transfers are conditional on service reduce corruption in social use; risk of declining quality due to increased demand protection system Effects on social capital likely to be limited in the short term, but could arise from reduced household stress 78 THE WORLD BANK GROUP AND UNICEF ANNEX 3 POSSIBLE EFFECTS ON CHILDREN: DISAGGREGATED ANALYSIS OF • Increased consumption of nutritious food EFFECTS ON FOLLOWING GROUPS MAY BE HELPFUL: • Increased school enrolment and attendance, reduced drop-out • Children in different geographical locations (remote rural, urban slum, etc) • Increased average years of schooling completed • Girls and boys • Increased use of health care • Working children • Improved health statues • Orphans • Reduced child labor • Children in different types of households (female-headed, • Improved environmental well-being (quality multi-generational) of housing and access to improved water and sanitation) • In longer term, possible reduction in violence against children and other forms of child abuse in more economically secure households CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 79 ANNEX 3 EXAMPLE 3. Electricity Tariff Reform POSSIBLE ROUTES BY WHICH CHILDREN MIGHT BE AFFECTED: Incomes /livelihoods • Reduction in household electricity use • Increase in use of other fuels • Reduction of expenditures in other areas • Increase income earning to meet expenses • Increases in domestic workloads (if electric-powered REFORM: labor-saving and technology are reduced) Increase electricity tariffs for domestic and commercial users to improve sustainability in Services the electricity sector • Squeeze on budgets for other areas of provision (equipment, stafï¬?ng, repairs) • Reduced use of electricity and thus cuts in quality and availability of services Social capital • Less evening socializing and leisure activity among children and youth • More opportunities for criminal activities to flourish in dimly lit environments 80 THE WORLD BANK GROUP AND UNICEF ANNEX 3 POSSIBLE EFFECTS ON CHILDREN: POSSIBLE CHILD OUTCOME INDICATORS: • Reduced study time due to less electric light in Short term the evenings • Average hours of electric use per day by • Increase respiratory disease through the use households with children of dirtier fuels • Changes in child-focused expenditures • Reduced consumption of cooked, nutritious (children’s clothes, educational supplies, food food, etc) • Reduced use of health care, education, leisure, • Hours worked by children in paid or or other services due to increased cost domestic work • Increased child labor to generate income or to • Frequency of consumption of key foods (for do more laborious domestic chores example, meat/protein, fruit, vegetables) • Reduced quality of teaching if schools can’t • Incidence of respiratory diseases use electricity-dependent teaching aids • Child victims of violence • Reduced quality health care if key electrical • Child victims of accidents equipment rationed • Increased risk of accidents due to illegal con- Long term nections • Incidence of malnutrition • Increased violence, robbery, and rape if street • Educational attainment lighting reduced • Child health CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 81 Annex 4. Rapid Assessment of Potential Impacts on Children A rapid assessment of potential impacts of reforms on children may be needed if: • It is unclear whether a full assessment is needed • The potential impacts on children have been ignored in a PSIA already under way or recently completed • A reform is being rushed into effect, for example, because of domestic political agendas or because of donor conditionality or pressure • If the budget for a PSIA is very limited. The limited time frame and budget for a rapid assessment mean that prioritization will be needed in the following areas: • Focus of analysis, particularly the choice of impact pathways • Scale and coverage of any primary research. Prioritizing focus of analysis A rapid child impact analysis will need to focus on a few priority areas that are likely to be most signiï¬?cant for children. Depending on the nature of the reform in question, the following con- siderations may help focus analytical effort. • Routes by which impacts reach children. In a rapid assessment, it may be feasible to ex- amine only one, or at most two, of the principle routes by which children are affected, which are: impacts on household economy and household response strategies; impacts on services; and impacts on social capital and cohesion. • Within each route, focus on the few issues most likely to be signiï¬?cant. For example, in terms of household responses, efforts to generate income or to cut expenditures are likely to be the most signiï¬?cant in the short term, and thus should be the key focus. • Understanding effects of changes on children. Policy changes often reach children through their: consumption, time use, and quality of services. It may therefore be useful to focus on these mechanisms. • Areas of child well-being most likely to be affected and for which data are available: nutrition, health, education and child protection, for example, child labor, security, care, and violence. 82 THE WORLD BANK GROUP AND UNICEF ANNEX 4 • Strategic disaggregation of data. If time is cents and/or their parents/carers in socioeconomic limited, analysis should focus on effects on groups or locations likely to be affected by the children in aggregate and by socioeconom- reform, as well as key informant interviews with: ic quintile, unless there are good reasons to expect signiï¬?cantly gender-differentiated • Central government representatives of the effects or for particular groups of children sector(s) where change is planned and so- to be particularly affected. cial sector ministries • Local government representatives in poorer regions and/or areas where changes may be concentrated Data sources and analysis • Representatives of service providers, for ex- ample, health, education, social protection, In a rapid child impact analysis, secondary data and child welfare services are likely to be the key source of information. • Representatives of civil society organiza- tions working in relevant geographical areas or with relevant population groups. ANALYSIS OF EXISTING DATASETS Such interviews can also help identify political and If there is time for analysis of existing data (mini- institutional issues of relevance to reform imple- mum around three months, depending on the mentation. quality and cleanliness of the data and the com- plexity of the analytical techniques planned), the The priority data gaps in a rapid child-focused priority for analysis is likely to be estimating ex- impact assessment will, of course, be speciï¬?c to isting patterns of expenditure on goods and ser- the policy changes under investigation. Collection vices, segmented by important variables such as of new data should concentrate on areas where number of children in the household. This would existing data are limited or poor quality. These be used to work out the immediate impacts on are likely to include: households of proposed policy changes, assuming that they continue to behave as before. • Identifying likely household responses to reforms If the data are already available, it may also be • Identifying key impacts on accessibility and possible to estimate how households would real- quality of services locate expenditures in response to policy changes. • Identifying impacts on children’s consump- This would require estimation of behavioral param- tion and time use eters, such as elasticities. However, often obtaining • Identifying possible outcomes for children the necessary data would require an additional and young people survey, and this analysis would therefore not be • Possible policy responses to concerns identiï¬?ed. possible in a rapid analysis. Primary data collection. Even if time and budgets Identifying gaps in knowledge. A rapid child-focused are very limited, consideration should be given to analysis can also help identify knowledge gaps in conducting some rapid qualitative research that can relation to the impact of a particular reform. This ï¬?ll information gaps and triangulate conclusions. can be important for flagging areas where further Typically this will involve a small number of focus research is needed before deciding on the course groups or semistructured interviews with adoles- of a reform or developing mitigation strategies. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 83 References Ablett, J., and I.-A. Slengesol. 2001. Education in Crisis: The De La Garza, R. 2010. Migration, Development and Children Impact and Lessons of the East Asian Financial Shock, Left Behind: A Multi-Dimensional Perspective. New York: 1997–99. World Education Forum, Dakar, April 26–28. UNICEF Policy and Practice. Ablezova, M., G. Botoeva, T. Jukusheva, R. Marcus, and E. Dudwick, N., E. Gomart, A. Marc, with K. Kuehnast. 2003. Satybaldieva. 2004. A Generation at Risk? Childhood When Things Fall Apart: Qualitative Studies of Poverty in Poverty in Kyrgyzstan. CHIP Report 15, London: CHIP. the Former Soviet Union. Washington, DC: World Bank. Alderman, H., J. Hoddinott, and B. Kinsey. 2003. “Long-Term Duryea, S., D. Lam, and D. Levison. 2007. “Effects of Eco- Consequences of Early Childhood Malnutrition.â€? FCND nomic Shocks on Children’s Employment and Schooling in Discussion Paper 168, IFPRI, Washington, DC. Brazil.â€? Journal of Development Economics 84: 188–214. Barrientos, A., and J. De Jong. 2004. Cash Transfers and Child Fajth, G. 2009. “Child Sensitive Social Protection.â€? Presen- Poverty. CHIP Report 4, London: CHIP. tation, Strategies for the Extension of Social Protection, Bhalotra, S. and C. Heady (2003), ‘“Child Farm Labor: The Turin, October 5, UNICEF. Wealth Paradox,â€? World Bank Economic Review, Oxford Ferreira, F., and N. Schady. 2008. “Aggregate Economic University Press, vol. 17(2), pages 197-227, December. Shocks, Child Schooling and Child Health.â€? World Bank Beddies, S., H. De Soto, A. Bakllamja, and X. Chauvot de Research Observer August: 1–35. Beauchene. 2004. Decentralisation and Water Sector Priva- Gavrilovic, M., C. Harper, N. Jones, R. Marcus, P. Pereznieto, tisation in Albania, Part I. Washington, DC: World Bank. with K. Binazarova and I. Mukhametov. 2009. “Impact of Bibi, S., J. Cockburn, I. Fofana, and L. Tiberti. 2010. “Impacts the Economic Crisis and Food and Fuel Price Volatility on of the Global Crisis and Policy Responses on Child Well- Children and Women in Kazakhstan. Report for UNICEF Being: A Macro-Micro Simulation Framework.â€? Innocenti Kazakhstan Ofï¬?ce, London: ODI. Working Paper No. 2010-06, UNICEF Regional Ofï¬?ce for Godfrey, M. 2003. Youth Employment Policy in Developing West and Central Africa and UNICEF Innocenti Research and Transition Countries—Prevention as Well as Cure. Centre, Florence, http://www.unicef-irc.org/publica- Social Protection Discussion Papers, Washington, DC: tions/602. World Bank. Birdi, A., R. Marcus, F. Memić, A.-R. Maglajlić-HoliÄ?ek, and A. Harper, C., N. Jones, and A. McKay. 2009. Including Children Vuković. 2007. Child Rights Impact Assessment of Potential in Policy Responses to Economic Crises: Lessons from the Electricity Price Rises in Bosnia and Herzegovina. Sarajevo: Past and Policies for a Sustainable Future. London: ODI. UNICEF. Harper, C., R. Marcus, and K. Moore. 2003. “Enduring Poverty Bundy, D., C. Burbano, M. Grosh, A. Gelli, M. Jukes, and L. and the Conditions of Childhood: Lifecourse and Inter- Drake. 2009. Rethinking School Feeding: Social Safety Nets, generational Poverty Transmissions.â€? World Development Child Development, and the Education Sector. Washington, 31(3): 535–54. DC: World Bank. Hashim, I. 2006. “The Positives and Negatives of Children’s Chai, J., I. Ortiz, and X. Sire. 2010. “Protecting Salaries of Independent Migration: Assessing the Evidence and the Frontline Teachers and Health Workers.â€? Social and Eco- Debates.â€? Working Paper T16, Sussex Centre for Migration nomic Policy Working Briefs, UNICEF, New York. Research, Brighton. Chang, S.-S., D. Gunnell, J. C. Sterne, T.-H. Lu, and A. T. H. HelpAge International, and UNICEF (United Nations Chil- Cheng. 2009. “Was the Economic Crisis 1997–1998 Respon- dren’s Fund). 2008. Grandparents and Grandchildren: sible for Rising Suicide Rates in East/Southeast Asia? A Impact of Migration in Moldova: Project Findings and Time-Trend Analysis for Japan, Hong Kong, South Korea, Recommendations. Chisinau: HAI. Taiwan, Singapore and Thailand.â€? Social Science and Medi- cine 68(7): 1322–31. Hempel, K., and W. Cunningham. 2010. Children and Youth Development Notes, Volume 4, Number 1. August, Wash- Conger, R., Conger, K.J., Elder, G.H., Jr., Lorenz, F.O., Simons, ington, DC: World Bank. R.L. and Whitbeck, L. (1993) ‘Family Economic Stress and Adjustment of Early Adolescent Girls.’ Developmental Hervish, Alexandra, and Charlotte Feldman-Jacobs . 2011. Psychology 29(2): 206-219. “Who Speaks for Me? Ending Child Marriage.â€? Policy Brief, Population Reference Bureau, http://www.prb.org. Counterpart Consortium, and World Bank. 1999. Kyrgyz Republic: Consultations with the Poor. Bishkek: CC/World Hoddinott, J., and L. Basett. 2009. “Conditional Cash Transfer Bank. Programmes and Nutrition in Latin America: Assessment of Impacts and Strategies for Improvement, Iniciativa FAO De Janvry, A., F. Finan, E. Sadoulet, and R. Vakis. 2006. “Can Working Paper 9, Chile: FAO. Conditional Cash Transfer Programs Serve as Safety Nets in Keeping Children at School and from Working When Hopkins, S. (2006) ‘Economic Stability and Health Status: Evi- Exposed to Shocks?â€? Journal of Development Economics dence from East Asia before and after the 1990s Economic 79: 349 – 73. Crisis.’ Health Policy 75(2006): 347-357. 84 THE WORLD BANK GROUP AND UNICEF REFERENCES Hossain, N., Fillaili, R., Lubaale, G., Mulumbi.M., Rashid, M. Ortiz, I., and M. Cummins. 2011. “Global Inequality: Beyond and Tadros, M. (2010) ‘The Social Impacts of Crisis. Findings the Bottom Billion.â€? UNICEF Economic and Social Policy from Community Level Research in Five Developing Coun- Working Paper, New York. tries.’ Brighton: IDS. Paxson, Christina, and Norbert Schady. 2005. “Child Health Howell, J. 1996. Coping with the Transition: Household Cop- and Economic Crisis in Peru.â€? World Bank Economic Review ing Strategies in Kyrgyzstan. Working Paper 16, London: 19 (2): 203–23. Save the Children. Penn, H. 2004. Childcare and Early Childhood Development ILO (International Labour Organization). 2001. In-Depth Programmes and Policies: Their Relationship to Eradicating Analysis of the Situation of Working Street Children in the Child Poverty. CHIP Report 8, Childhood Poverty Research Leningrad Region 2001. St. Petersburg: ILO. and Policy Centre, London. IRIN. 2010. Analysis: Unconditional Money. http://www. Pereznieto, P., C. Harper, B. Clench, and J. Coarasa. 2010. The irinnews.org/Report.aspx?ReportId=90045, accessed on Economic Impact of School Violence: A Report for PLAN 31/08/2010. International. Woking: PLAN International. Kattan, R. B., and N. Burnett. 2004. User Fees in Primary Edu- Pinheiro, P. S. 2006. World Report on Violence against cation. Education Sector, Human Development Network, Children. United Nations Secretary-General’s report, Washington, DC: World Bank. http://www.unviolencestudy.org/. Knowles, J. C., E. Pernia, and M. Racellis. 1999. “Social Con- Plan International. 2009. Because I Am a Girl: The State of sequences of the Financial Crisis in Asia.â€? Economic Staff the World’s Girls 2009; Girls in the Global Economy. Paper 60, ADB, Manila. Woking: Plan International. Kuehnast, K., and N. Dudwick. 2002. “Better a Hundred ———. 2010. Prevention Pays: The Economic Beneï¬?ts of End- Friends Than a Hundred Rubles? Social Networks in the ing Violence in Schools. Woking: Plan International. Kyrgyz Republic.â€? World Bank Economists’ Forum 2: 51–88. Porter, G. and Blaufuss, K. 2002, Children, transport and traf- Lokshin, M., and R. Yemtsov. 2004. “Household Strategies of ï¬?c in southern Ghana, revised version of a paper presented Coping with Shocks in Post-Crisis Russia.â€? Review of Devel- at the international conference on Children, transport and opment Economics 8(1): 15–32. trafï¬?c, Copenhagen, May 2002 Macfarlane Burnet Centre for Medical Research. 2000. Reboul, V., and L. Subran. 2010. “Ex-Ante Micro-Simulation Impact of the Asian Financial Crisis on Health: Indonesia, of the Impacts of Conditioning Solidaridad on Educa- Thailand, The Philippines, Vietnam, Lao PDR. Report com- tion and Health in the Dominican Republic.â€? World Bank missioned by AusAID. mimeo, Washington, DC. Maclure, R., and M. Sotelo. 2004. “Youth Gangs in Nicara- Ruiz-Casares, M., and J. Heymann. 2009. “Children Home gua: Gang Membership as Structured Individualization.â€? Alone Unsupervised: Modeling Parental Decisions and As- Journal of Youth Studies 7 (4): 417–32. sociated Factors in Botswana, Mexico, and Vietnam.â€? Child Abuse and Neglect 33(5): 312–23. Marcus, R. and A. Birdi, 2010, Child Rights Toolkit: A Guide to Integrating A Child Lens into Poverty and Social Impact Save the Children UK. 2007. Stitching Footballs: Voices of Analysis Through a Child Rights Impact Assessment — Children in Sialkot, Pakistan. London: Save the Children Module 4, Report commissioned by EU and UNICEF UK. Mazza, J., Flores, R. Rosas Shady, D., et al. (2009) ‘The ———. 2008a. Freeing Up Health Care: A Guide for Remov- Financial Crisis and Latin American and Caribbean Labor ing User Fees. London: Save the Children UK. Markets: Risks and Policy Responses.’ In Mazza, J. et al. ———. 2008b. In the Face of Disaster: Children and Climate (2009) The Financial Crisis and Latin American and Carib- Change. London: Save the Children UK. bean: Potential Impacts and Policy Options in the Social Sector. http://cies.org.pe/ï¬?les/COPLA/UNT-BID-ï¬?nancial- Serra, R. 1997. “Fostering in Sub-Saharan Africa: An Eco- crisis-document.pdf. nomic Perspective.â€? Development Studies Working Paper No. 110, Centro Studi Luca d’Agliano and Queen Elizabeth Mehrotra, S. 2004. Improving Child Well-Being in Develop- House, October. ing Countries: What Do We Know? What Can Be Done? Childhood Poverty Research and Policy Centre Report 9, Skouï¬?as, E., and S. W. Parker. 2002. “Labor Market Shocks London: CHIP. and Their Impacts on Work and Schooling: Evidence from Urban Mexico.â€? IFPRI FCND Discussion Paper No.129, Wash- Mehrotra, S., and R. Jolly. 2000. Development with a Human ington, DC. Face: Experiences in Social Achievement and Economic Growth. Oxford: OUP. Subramanian, S., and A. Deaton. 1991. “Gender Effects in Indian Consumption Patterns.â€? Sarvekshana April–June. Mendoza, R. 2009. “Aggregate Shocks, Poor Households and Children: Transmission Channels and Policy Responses.â€? So- Sumarto, S. Wetterberg, A. and Pritchett, L. (2000) The Social cial and Economic Policy Working Paper, UNICEF, New York. Impact of the Crisis in Indonesia: Results from a Nation- wide Kecamatan Survey. Jakarta: Asem Trust and Ford Moser, C., and B. von Bronkhorst. 1999. “Youth Violence in Foundation. the Latin America and the Caribbean: Costs, Causes and Interventions.â€? LCR Sustainable Development Working Paper No. 3, Latin America and Caribbean Region, Wash- ington, DC. CHILD FOCUSED PSIA 2011 GUIDANCE NOTE 85 REFERENCES Sumarto, S., and A. Suryahadi. 2003. “Safety Nets or Safety Van der Gaag, N. 2009. “Pushed into Poverty: How Might the Ropes? Dynamic Beneï¬?t Incidence of Two Crisis Programs Current Economic Crisis Affect Girls and Young Women?â€? in Indonesia.â€? World Development 31(7): 1257–77. In Because I Am a Girl: The State of the World’s Girls 2009, Sunderland, M. 2006. The Science of Parenting. London: Plan International, 27–33. Dorling Kindersley. Victora, C. G., L. Adair, C. Fall, P.C. Hallal, R. Martorell, L. Tangcharoensathien, V., P. Harnvoravongchai, S. Pitayarang- Richter, and H. S. Sachdev. 2008. “Maternal and Child sarit, and V. Kasemsup. 2000. “Health Impacts of Rapid Undernutrition: Consequences for Adult Health and Economic Changes in Thailand.â€? Social Science & Medicine Human Capital.â€? Lancet 371 (9609): 340–57. 51 (6): 789–807. Warner, E. 2004. “Behind the Wedding Veil: Child Marriage Tiberti, L., and L. Menchini. 2010. “Global Economic Crisis as a Form of Trafï¬?cking in Girls.â€? Journal of Gender, Social and Children: Effects and Policy Options in West and Policy & The Law 12(2): 233–71. Central Africa.â€? Research Brief, UNICEF Regional Ofï¬?ce Whitehead, A., I. M. Hashim, and V. Iversen. 2007. “Child for West and Central Africa, Dakar, and UNICEF Innocenti Migration, Child Agency, and Inter-generational Relations Research Centre, Florence, http://www.unicef-irc.org/ in Africa and South Asia.â€? Working Paper T24, Develop- research/pdf/wcaro_irc_research_brief.pdf. ment Research Centre on Migration, Globalisation & UN (United Nations). 2010. Guidelines for the Alternative Poverty, Sussex University, Brighton. Care of Children. UN Resolution, A/RES/64/142, February World Bank. 2005. PSIA User Guide and Tools for Institutional, 24, 2010, http://www.crin.org/bcn/initiatives.asp. Political and Social Analysis Sourcebook. Social Develop- UNDESA (United Nations Department of Economic and Social ment unit, World Bank and DFID, Washington, DC. Affairs). 2007. World Youth Report 2007: Young People’s ———. 2006. Youth-Responsive Social Analysis: A Guidance Transitions to Adulthood; Progress and Challenges. New Note; Incorporating Social Dimensions into Bank-Supported York: United Nations. Projects. Washington, DC: World Bank. UNDP (United Nations Development Programme). 2009. ———. 2007. Development and the Next Generation, World Second Periodic Progress Report on the Millennium Devel- Development Report 2007. Washington, DC: World Bank. opment Goals in the Kyrgyz Republic. Bishkek: UNDP. ———. 2008a. Environmental Health and Child Survival: UNICEF (United Nations Children’s Fund). 2001. A Decade of Epidemiology, Economics, Experiences. Washington, DC: Transition. Regional Monitoring Report 8, Florence: UNICEF World Bank. Innocenti Research Centre. ———. 2008b. “Rising Food and Fuel Prices: Addressing ———. 2006. Innocenti Social Monitor 2006: Understanding the Risks to Future Generations.â€? Washington, DC: World Child Poverty in South-Eastern Europe and the Common- Bank. wealth of Independent States. Florence: UNICEF Innocenti ———. 2010. Belize: Issues and Options to Strengthen the Research Centre. Social Protection System. Washington, DC: World Bank. ———. 2008a. Countdown to 2015: Maternal, Newborn, and World Bank, and UNICEF (United Nations Children’s Fund). Child Survival. New York. 2009. Six Steps to Abolishing Primary School Fees: An ———. 2008b. Emerging Challenges for Children in Eastern Operational Guide. Washington, DC, and New York: World Europe and Central Asia: Focus on Disparities. UNICEF Bank and UNICEF. Regional Ofï¬?ce for Central and Eastern Europe and the Yaqub, S. 2002. “’Poor Children Grow into Poor Adults’: Commonwealth of Independent States. Harmful Mechanisms or Overdeterministic Theory?â€? ———. 2010. Stolen Childhood: A Study of Child Poverty and Journal of International Development 14: 1081–93. Disparities in Yemen. Sana’a: UNICEF. ———. 2011a. Adolescence: An Age of Opportunity; State of the World’s Children 2011. New York: UNICEF. ———. 2011b. At Home or In a Home? Formal Care and Adoption of Children in Eastern Europe and Central Asia. Geneva: UNICEF Regional Ofï¬?ce for Central and Eastern Europe and the Commonwealth of Independent States. ———. 2011c. Programme Guidance: Social Protection for Children. Final draft for consultation, May, New York. UNODC (United Nations Ofï¬?ce on Drugs and Crime), and World Bank. 2007. Crime, Violence, and Development: Trends, Costs, and Policy Options in the Caribbean. Report No. 37820, World Bank, Washington, DC. Valerio, E., E. Bardasi, A. Chambal, and F. M. Lobo. 2005. Mozambique Poverty and Social Impact Analysis: Primary School Enrolment and Retention—the Impact of School Fees. Report No. 29423-MZ, World Bank, Washington, DC. 86 THE WORLD BANK GROUP AND UNICEF Children and adolescents are uniquely vulnerable to even short periods of deprivation, which can have lifelong and intergenerational effects. THE WORLD BANK GROUP 1818 H Street, N.W. Washington, D.C. 20433 U.S.A. Tel: (202) 477-1234 Fax: (202) 477-6391 Telex: MCI 641 45 WORLDBANK INTEGRATING A CHILD FOCUS INTO POVERTY AND SOCIAL IMPACT ANALYSIS (PSIA) UNICEF