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  • Unjust Conditions: Women's Work and the Hidden Cost of Cash Transfer Programs by Tara Patricia Cookson
  • Marieka Sax
Cookson, Tara Patricia, Unjust Conditions: Women's Work and the Hidden Cost of Cash Transfer Programs, Berkeley, CA: University of California Press, 2018, 204 pages.

Tara Patricia Cookson's institutional ethnography of a conditional cash transfer (CCT) program in Peru called Juntos (Together) is a nuanced analysis of a widely implemented and evaluated approach to poverty reduction. Like similar CCT programs operating in 67 countries in 2017, Juntos gives poor households small cash incentives to use targeted government services. Such programs generally select mothers as recipients, because they are seen as primary caregivers who are more likely than men to invest cash in the household.

The book draws on fieldwork from 2012 to 2013, first with urban bureaucrats in Lima and later in the highland areas of rural Cajamarca, located in northern Peru. This is one of the country's five poorest regions, with a large population of indigenous descendants who self-define as campesinos (peasant farmers) and with profound inequities in health care and education. Juntos emerged in the wake of trailblazing CCT programs developed in Mexico and Brazil in the 1990s. CCT programs are supported by international development agencies like the World Bank, where they are seen to improve health outcomes and socio-economic indicators at the household scale. Cookson draws attention to what is not considered in CCT program evaluations: the quality of services provided and the demands made of recipients.

While mainstream quantitative research finds conditional cash transfers both effective and efficient for increasing household consumption of health and education services, Cookson emphasises the blind spots in this literature. She asks many questions. Should efficacy be attributed to conditionality, or might other elements of program design (such as increased household income or complementary health and nutrition training) be more important? Can positive economic impacts in one country be expected to be produced in another? What do we know about sustained impacts and long-term outcomes? It is not enough to measure quantitative changes by themselves, she argues. It is important to also consider the program's negative impacts and unexpected consequences.

The book develops two arguments: first, that CCT programs frame poverty as a result of the irresponsible behaviour of individuals, which excludes political-economic drivers beyond the household; second, that the coercive power of incentives in conditional aid produces hidden costs borne by poor recipients who experience unjust outcomes. Unintended effects go unacknowledged in program evaluations, as few researchers look for them.

The conceptual tools of care and power ground the analysis. Women fill in the gaps left by inadequate public services with unpaid household and community care work. Development programs that depend on the unpaid work of women to be efficient reinforce rather than ameliorate the gendered face of poverty. The regulation (or disciplining) of behaviour by the state is achieved through monitoring rural mothers to ensure conditions are met, and dispensing sanctions when they are not. This creates power-laden relationships between poor mothers and the local managers who enforce the program conditions set by urban bureaucrats.

How Lima-based development experts understand Juntos is the focus of Chapter 2. These bureaucrats frame Juntos in terms of state obligation to provide basic services for the poorest populations, even as the quality and availability of those services are the responsibility of other government agencies. Access, rather than health and education outcomes, is the key metric of success for Juntos. Conditionality is used to manage public anxieties about dependency and deservingness and to make redistribution more acceptable to taxpayers and voters. By targeting the household and casting poverty as the result of individual deficiencies (for example, the failure of poor parents to feed, educate and invest in the health of their children), Juntos relieves the state of responsibility to address political-economic conditions that make and keep people poor.

Moving from Lima to the highlands, Chapter 3 turns to the realities of low-quality rural service provision and institutionalised discrimination. Schools contend with chronic staff shortages and inadequate infrastructure and instruction. Health clinics are often closed due to staff absenteeism and turnover compounded by...

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