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Browsing Doctoral Theses by Author "Rukiko, M. D."
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Item Impact of conditional cash transfer program on health outcomes in Tanzania(The University of Dodoma, 2023) Rukiko, M. D.The study investigated the impact of Conditional Cash Transfer (CCT) programs on health outcomes in Tanzania using data from Tanzania Social Action Fund (TASAF) program. The focus was to inform the third-order health outcomes of CCT program conditionalities, as previous studies commonly ended with first or second-order outcomes, leaving little evidence for third order health outcomes. Specifically, guided by the theory of change, the study examined the conditionalities used during the design and implementation of TASAF program in the study area, assessed the level of compliance to health conditionality among health seekers and analysed the influence of conditionality on the utilization of health services among health seekers. Moreover, the study analysed the effect of conditionality compliance on health outcomes. Secondary data was supplemented with field survey data and the Regression Discontinuity design (RDD) was used to determine the program’s impact. The study have observed that conditionalities are positively perceived and have the potential to enroll the poor and achieve the program objectives. Compliance to health conditionality is high (above 90%), and no differences in compliance were observed based on locality, sex or time, except for enrollment in the program. The program, through health conditionality, can increase clinic visits by 3.4 times while reducing household health expenditure by 70,000 Tanzanian Shillings. Furthermore, the program can reduce stunting and wasting by 0.43 Height for Age Z score (HAZ) and 0.19 Weight for Height Z score (WHZ) respectively. Moreover, the program can reduce household morbidity by 2.9 times. It has been concluded that the conditionalities used have the potential to achieve the intended program objectives, as well as increasing clinic attendance for households with under-five children, thus increasing health service utilization as a second-order health outcome. The CCT program significantly reduce household morbidity, children’s stunting and wasting given extension of time. The time dimension should be given more weight as most of the desired health outcomes are observed in the longer time.