UNIVERSITY OF NAIROBI FACULTY OF ARTS COLLEGE OF HUMANITIES AND SOCIAL SCIENCES DEPARTMENT OF SOCIOLOGY AND SOCIAL WORK Cash transfer and its impact on the Welfare of the elderly in Kenya: A case of the Government of Kenya’s Older Persons Cash Transfer Programme in Makueni County BY; NAME: EMILY JEPKOECH KIMOSOP REG NO. C50/73144/2009 M.A (SOCIOLOGY) A RESEARCH PROJECT SUBMITTED FOR EXAMINATION IN PARTIAL FULFILMENT OF THE DEGREE OF MASTERS OF ARTS (SOCIOLOGY) November, 2013 . i DECLARATION I declare that this is my original work and has not been submitted to any Institution or University for academic crediting. Emily JepkoechKimosop Reg. No…………………………………… Signature………………………………... Date…………………………………………….. This Project Paper has been submitted for examination with approval as University of Nairobi Supervisor; Dr. Robinson M. Ocharo Signature………………………………………… Date……………………………………………… i ACKNOWLEDGEMENTS My due appreciation goes to my Project Supervisor Dr. Ocharo for his immense support and able guidance till the completion of my Project paper. Secondly, to Mr. MwakioRigha, the Director for Gender and Social Development for allowing me to undertake my research on the Older Persons Cash Transfer Programme which is implemented under his Department. To Emmanuel Simiyu the Coordinator for Gender and Social Development, MakueniCounty andBenedettaMwema, the District Gender and Social Development Makueni for their immense support especially in providing information about the programme at the County level. To my competent team of enumerators: RodahNtuka, Daniel Nzau and Daniel Mulitu for doing a wonderful job of data collection. Finally to my loving Spouse, Edwin Kiplagat, for supporting my Masters education financially. To my late Father Jonathan KimosopChebii whose proverbial words of encouragement gave me the inspiration to work hard. Finally, to my dear mum Anne Kimosop for her financial support and encouragements throughout my years of study. Thank you all. © 2013 ii DEDICATION To all those who labor in meeting the welfare needs of the elderly iii ACRONYMS AU -African Union CBOS -Community Based Organizations GOK - Government t of Kenya HAI -HelpAge International HIV/AIDs -Human Immunodeficiency Virus/Acquired immune Deficiency Virus CT -Cash Transfer CT-OVC -Cash Transfer for Orphaned and Vulnerable Children KIBHS - Kenya Integrated Budget household survey MOGCSD -Ministry of Gender, Children and Social Development NGOS -Non-governmental Organizations NHIF -National Hospital Insurance Fund NSSF -National Social Security fund OPCT - Older Person’s Cash Transfer Programme ROK - Republic of Kenya SAPs -Structural Adjustment Programmes SP - Social Protection UN -United Nations iv ABSTRACT This paper assessed the impact of cash transfer on the welfare of the elderly above 65 yearsand their household by establishing: how cash transfer is delivered to beneficiaries; some of the challenges faced by the older person in accessing the stipend or as are result of being a recipient of cash transfer programmeand finally on the impact of the cash transfer programmeon the socioeconomic welfare of the older person and that of their households. The research adopted a survey design. Sampling was done using proportionate sampling. Both primary and secondary data collection methods were used. Primary data source employed the use of interview schedule, key informant’s interview and observation. Secondary data was obtained through requesting for already stored data from the Department of Gender and Social Development of beneficiaries that were enrolled to the cash transfer programmein 2009. Data was analyzed descriptively using Statistical Package for Social Scientists. Presentation was done using graphs pie charts and diagrams. The findings revealed that the fund is disbursed from the Ministry of Gender Children and Social Development (MOGCSD) through PCK which is the sole disbursement agent of the cash transfer then to the PCK branches to undertake payment of beneficiaries. Some older persons were found to face challenges of distance which had implications in the cost of accessing the fund. Likewise the fund was found to be sometimes irregular. It was further seen to impact on food security, household assets (livestock), shelter, health, clothing, access to goods and services on credit and ability to join social groups. Based on the significant impact of the programme on the welfare of the older person and that of their households, the research recommends an enhancement on coverage to reach to all vulnerable older persons of Kenya. To mitigate the challenges emanating from being a beneficiary of the cash transfer programme, this paper recommends to the relevant government agency to devise strategies of ensuring that the fund reach to beneficiaries timely and predictable basis, and subsequently to explore more means of disbursing the stipendto reduce the cost of collecting cash transfer fund by beneficiaries. v TABLE OF CONTENTS DECLARATION ................................................................................................................................... i ACKNOWLEDGEMENTS .................................................................................................................. ii DEDICATION ..................................................................................................................................... iii ACRONYMS ....................................................................................................................................... iv ABSTRACT .......................................................................................................................................... v TABLE OF CONTENTS ..................................................................................................................... vi CHAPTER ONE: INTRODUCTION ................................................................................................ 10 1.0 Background ............................................................................................................................... 10 1.1 Problem statement ..................................................................................................................... 14 1.2 Research questions .................................................................................................................... 15 1.3 Broad objectives of the study .................................................................................................... 15 1.3.1 Specific objectives of the study .......................................................................................... 15 1.4 Scope and Limitations of the study ........................................................................................... 16 1.5 Operational definition of terms ................................................................................................. 17 CHAPTER TWO: LITERATURE REVIEW ..................................................................................... 18 2.0 Introduction ............................................................................................................................... 18 2.1 Challenges faced by the elderly ................................................................................................ 18 2.2 Welfare needs for the elderly Older persons ............................................................................. 20 2.3 Social protection ........................................................................................................................ 20 2.3.1 Social protection policy measures ...................................................................................... 22 2.4 International and Regional Policy and legal Frameworks of social protection for the elderly . 22 2.4.1 Universal declaration of human rights- 1948 ..................................................................... 22 2.4.2. Madrid International Plan of Action on Ageing (MIPAA)-2002 ...................................... 23 2.4.3 Livingstone call for action-2006......................................................................................... 23 2.5 Existing Social Protection legal and policy frameworks and programme Interventions for the elderly in Kenya .............................................................................................................................. 24 2.5.1 The constitution of Kenya, 2010 ........................................................................................ 24 2.5.2 National Policy on Older Persons and Ageing ................................................................... 24 2.5.3 Kenya’s National Social Protection Policy ........................................................................ 25 2.5.4 Kenya Vision 2030 ............................................................................................................. 25 2.5.5 Pension schemes ................................................................................................................. 26 2.5.6 National social Security fund ............................................................................................. 26 2.5.7 The National Hospital Insurance fund ................................................................................ 26 2.5.8 Non-governmental organizations ....................................................................................... 27 2.5.9 The family........................................................................................................................... 27 2.6. Institutionalization of the old ................................................................................................... 27 2.7 Understanding cash transfers. ................................................................................................... 28 2.7.1 Empirical literature on cash transfers programmes for the elderly .................................... 29 2.8 Theoretical Framework ............................................................................................................. 32 2.9.1 Maslow’s theory of needs ................................................................................................... 32 2.9.2 Motivation Theory. ............................................................................................................. 34 2.10 Conceptual framework ............................................................................................................ 35 CHAPTER THREE: RESEARCH METHODOLOGY ..................................................................... 36 3.1 Site selection and description .................................................................................................... 36 3.1.2 Description of the OPCT programme ................................................................................. 37 3.2 Target population ...................................................................................................................... 38 3.3 Unit of analysis.......................................................................................................................... 38 3.4 Sampling design and sample population. .................................................................................. 38 3.5 Type of data ............................................................................................................................... 39 3.6 Data collection methods. ........................................................................................................... 40 3.7 Pilot Study ................................................................................................................................. 41 3.7 Data analysis ............................................................................................................................. 41 3.8 Ethical Consideration ................................................................................................................ 42 CHAPTER FOUR: DATA ANALYSIS AND INTEPRETATION OF FINDINGS ......................... 43 4.1. Demographic characteristics of respondents ............................................................................ 44 4.1.1 Distribution of respondents by location.............................................................................. 44 4.1.2 Gender distribution of the respondents. .............................................................................. 45 4.1.3 Age Distribution of respondents. ........................................................................................ 46 4.1.4 Marital status of respondents. ............................................................................................. 48 4.1.5 Education level of respondents ........................................................................................... 49 4.1.6 Main occupation of respondent .......................................................................................... 50 4.1.7 Economic Status of households .......................................................................................... 51 4.2 How cash transfer flow from the ministry to the beneficiaries in Makueni County ................. 51 4.3 Challenges faced by older persons in accessing and as beneficiaries of cash transfer ............. 54 4.3.1 Regularity of the cash Transfer Stipend ............................................................................. 55 4.3.2 Hostility from the community or household members for being a beneficiary.................. 55 4.3.3 Distance from pay point ..................................................................................................... 56 4.4 Impact of cash transfer programme on the welfare of the elderly and their households. ......... 57 4.4.1 Other sources of income of the household other than from cash transfer. ......................... 58 4.4.2 Uses and prioritization of the use of cash transfer by beneficiary household. ................... 59 4.4.3 Findings on impact of Cash transfers on the welfare of the elderly and their households. 61 5.0 CHAPTER FIVE: CONCLUSIONS AND RECOMMENDATIONS ......................................... 79 5.1 Conclusions ............................................................................................................................... 79 5.2 Recommendations of the study ................................................................................................. 80 5.3 Recommendations for further research ..................................................................................... 81 List of Table Charts and Graphs Table 1: Makueni County, Constituency Level poverty prevalence…………………………….. 36 Table 2: Geographical distribution of beneficiaries in OPCT programme in Makueni County -2009………………………………………………………………………………………… 37 Table 3: Proportionate distribution of sample population per location and sex………………. 39 Table 4: Geographical Distribution of Respondents per Location……………………………. 44 Chart 1: Gender Distribution of respondents…………………………………………………. 45 Table 5: Age Distribution of respondents…………………………………………………….. 46 Graph 1: Marital status of respondents………………………………………………………… 48 Table 6: Education level of respondents-2012………………………………………………… 50 Graph2: Economic status of the household……………………………………………………. 51 Table 7: Regularity of receiving cash transfer by older persons……………………………… 55 Table 8: Incidence of hostility from the community and or relatives to the beneficiary older person2012……………………………………………………………………………………………. 56 Table 9. Table showing amount of transport to the paypoint-2012…………………………… 57 Graph 3: Mean income from other Sources -2012……………………………………………... 58 Table 10: Uses of cash transfer by beneficiaries………………………………………………. 59 Table 11: Prioritization of the use of cash transfer by beneficiary households………………. 59 Graph 4. Number of meals per day by beneficiary households………………………………. 62 Table 12: Nutrition of respondent’s households-2012……………………………………….. 64 Graph 5: Number of Livestock owned………………………………………………………. 65 Graph 6: Major construction material -2009…………………………………………………. 67 Graph 7: Major construction material -2012…………………………………………………. 67 Table 13: Health conditions as rated by of respondents-2012……………………………….. 69 Chart 2: Access of goods and services on credit by beneficiary households………………...... 73 Graph 8: Approximation in percentage of source of money used to settle debt from goods and services bought on credit-2012……………………………………………………… 73 Chart 3: Beneficiaries who joined social groups since enrolment into the cash transfer programme-2012……………………………………………………………………… 74 Graph 9: Coping mechanisms of households (%) when cash transfer programme is Withdrawn-2012…………………………………………………………………………….. 75 Annexes Annex I: Photo gallery of respondents……………………………………………………. 82 Annex: II: Interview.schedule............................................................................................... 84 Annex III: Key Informants’ interview guide for the District Gender and Social Development Officer…………………………………………………………………………………….. 91 Annex IV: Targeting and Registration tool for the OPCT programme……………………… 92 Reference………………………………………………………………………………… 102 CHAPTER ONE: INTRODUCTION 1.0 Background The population of older person’s throughout the world is increasing at a rapid rate. It was about 200 million in 1950, rose to 606 million in 2000 and is expected to reach the two billion mark by 2050. The most rapid increase is taking place in the developing world, with Africa alone projected to have between 205 and 212 million older persons by the year 2050. (MOGCSD, 2009) Kenya has a total population of 38,610,097 and that of the elderly above 65 years is 1,332,000 (KNBS, 2010). According to Kenya Integrated Household Budget Survey (KIHBS) of 2005/2007, approximately46 percent of Kenya’s population is said to be poor (KNBS, 2007). The poverty rate of older persons of 60 years and above is 56.4 % (MOGCSD, 2011) The level of vulnerability of older persons to poverty is high considering the fact their aging bodies become frail making them less able to work and meet their own needs. According to Harris and Maloney (1999) older adults are more different than alike, physically and psychologically, they age at different rates and what is true of one 70 year old may not be true of the other. Some may be old in 55 and others young at 80 years. A persons health outlook on life and agility often affects how old or young one feels. Most government policies give certain ages to mark the beginning of old age. Kenya’s National Policy on Older Persons and Ageing puts it at 60 years (MOGCSD, 2009). This age is equally set by UN and AU as the starting age for the elderly. This is also the age at which formal employment in Kenya is officially terminated. ‘In colonial America, old people were expected to remain working until they were physically unable to do so’ (Foner, 1986). The challenge of old age drives the older person into poverty. Poverty in old age is the inability of old persons to access basic needs that sustains household livelihoods. According to RBA (2008), a person is considered poor if his or her consumption or 10 income level falls below some minimum level necessary to meet basic needs. Poverty affects the welfare of the older person in that they are deprived of their livelihoods. They may not meet the threshold of nutrition, shelter, clothing, health. Lack/limited income deny the elderly other services as leisure. However, some writers argue that every stage is developmental and even old age comes with its opportunities. Papalia et al (2002:29) divided human lifespan and human history into three ages. The third and final stage which they say starts at sixty, present the stage as a period with less external pressure and more internal development, a time for giving back to society the lessons, resources and experiences accumulated and articulated over a lifetime. It is developmental in the sense that such experience could be counted as a resource to be utilized in the society. Foner (1986:106) opines that as people grow older, they accumulate knowledge experience and social relationships and such intimate knowledge of people and customs equipped them to settle local disputes and often replaced other activities that had to be given up. However the role of the elderly in decision making which has been common in traditional societies has almost been overtaken by the effects of modernity and urbanization In Kenya, the implementation of social protection initiatives has been informed by both international and local experiences. Kenya is a signatory to the Copenhagen Declaration of 1995 which urged heads of states to ensure that national budgets and policies are oriented as necessary to meeting the basic needs, reducing inequalities and targeting poverty as a strategic objective. Kenya ratified the Universal Declaration on Human Rights which states that Social Protection is a fundamental human right for all citizens -Articles 22- 26 specifically focus on social protection. The Commission for African Union identified social transfers as a key tool in tackling extreme poverty in sub-Sahara Africa. Kenya is a signatory to the Livingston Declarations of 2006 which committed Governments under the auspices of African Union (AU) to improve on the implementation of Social Protection Programme. In the Livingstone Call for Action, the African Governments then agreed to integrate social transfers within the National Development Plans and Budgets within the next 2 – 3 11 years after the 2006 meeting. In addition, Kenya’s Vision 2030 recognizes older persons as one of the vulnerable groups to be targeted in the Social Pillar through various programmes to ensure equity in power and resource distribution with the view of improving their lives. Article 57 of the Constitution of Kenya 2010 provides a legal frameworkin regard to the elderly. There is also a National Policy on older Person’s and Ageing in place that gives a broad overview of the situations of the elderly and the strategies of addressing these issues. Kenya started a cash transfer programme for the elderly known as the Older Persons Cash Transfer Programme (OPCT) in the year 2007 for older persons with 65 years and above. The programme was piloted under the Rapid Result Initiative Programmes of the MOGCD in 2007 in Nyando, Busia and Thika and the beneficiaries at this phase were 300. It was up scaled to 33,000 beneficiaries in financial year 2009/2010. In financial year 2011/2012 the number was further scaled up to 36,036 with a monthly stipend of KES 2,000. The overall objective of the programme is to strengthen the capacities of older persons and improve their livelihood while alleviating integrated poverty through sustainable social protection mechanisms. Its specific objectives are; to provide regular and predictable cash transfer to vulnerable older persons in identified households and to build capacities of beneficiaries in order to improve their livelihoods. The concept of cash transfer as a social protection mechanism is not new in Kenya. Besides OPCT, the Ministry of Gender, Children and Social Development also implements other CT programmes which include: a Conditional Cash Transfer for Orphaned and vulnerable Children programme (CT- OVC). The CT-OVC targets household with orphaned and vulnerable children It is aimed at enhancing school retention and reducing school drop outs among school going children of the beneficiary households. Another CT programmeimplemented by the MOGCSD targets Persons with Severe disabilities from poor and vulnerable households. The Ministry of Special Programmes coordinates aHungerSafety Net Programme (HSNP) which was piloted in 2007 in four ASAL Districts of: Wajir, Mandera, Turkana and Marsabit. 12 Latin America Countries like Brazil, Bolivia among others have targeted cash transfers for its vulnerable groups. Brazil for instance has a well-targeted Cash transfer programme for poor elderly. Brazil’s Continuous Cash Benefits Programme is an unconditional cash transfer to the elderly or to extremely poor individuals with disabilities whose per capita income is less that a quarter of the minimum wage (approximately one US dollar). The value of the transfer is equivalent to a monthly minimum wage which is approximately 4 US dollars (Soares et al, 2006). Kenya’s OPCT monthly stipend was until June, 2011 fixed at 1,500 per month. This figure was approximately equal to the Urban Food Poverty level (Kshs 1,474Ksh) and the Rural Basic Needs Poverty levels of Kshs 1,562 (MOGCSD, 2011).Countries of Africa like South Africa, Malawi and Zambia among others do give social transfers to their vulnerable groups. Lesotho for instance has a universal cash transfer for older persons of 70 years and above. The reasons for espousing cash transfers as interventions of poverty reduction as opposed to other forms like food subsidies and other forms of in kind support are that; cash transfers are easy to administer, they can reach the poor effectively, they promote development outcomes as beneficiaries can engage in micro financial activities, transferring money is cheaper than transferring in kind materials (Republic of Kenya, 2009). The effectiveness of the cash transfer as an intervention model for the poor depends on the effectiveness of the cash delivery mechanism. Cash Transfer are mainly predictable and being so older persons are able to plan on how they will spend. Kenya’s OPCT and CT-OVC are paid once in every two months, meaning in every payment, persons in programme are assured of receiving KShs 4,000. An evaluative research done on older persons and their right to work showed that older persons are ‘enabled to plan ahead, buy food and pay bills, pay for treatments and even invest in small scale income generation activities (Gorman et al 2010:12) when they are recipients of cash transfers. However, the adoption of cash transfer and other social protection assistance programmes are mostly criticized by politicians and economists on the basis of placing a strain on the economy. In many cases the challenge has been whether such programmes are financeable and or sustainable. It is often viewed as a strain on the part of the tax payer. 13 (Papalia 2002:28) argued about welfare programmes for retirees that Planners and Politicians in almost all industrialized nations fear that the cost of supporting a growing contingent of retirees will place an insupportable burden on a shrinking group of working adults 1.1 Problem statement There has been a progressive increase in cash transfer fund for older persons in Kenya and a subsequent increase in the number of older persons in OPCT programme since its inception in 2007. The assumption this paper made was that GOK could have found cash transfers a good instrument in improving the welfare of Kenya’s older persons. The paper therefore sought to establish the impact of OPCT programme on the welfare of the elderly above 65 years and their household in Kenya specifically in Makueni County. GOK through the Ministry of Gender, Children and Social Development started a cash transfer programme for the elderly piloted under Rapid Results Initiative (RRI) activities of the MOGCSD of 2007. At the pilot phase, the number of beneficiaries was 300 in three districts: Nyando, Busia and Thika, each of the three Districts was awarded a quota of 100 older persons. In 2009, the programme was scaled up to 33,000 in 44 Districts and in financial year 2011/2012 slightly rose to 36,036 older persons (MOGCSD, 2011). According to the programme, the progressive increase in budgeting has enhanced the number of older persons benefiting from OPCTprogramme. Cash transfers are advanced to the elderly because they are part of the poor and vulnerable constituents of the population. This is exacerbated by the fact that as people age their physiological processes decline leading to general deterioration on health. Diseases such as hypertension, arthritis and heart diseases are associated with older cohorts (Morgan and Kunkel, 2001). Most health insurance schemes terminate services upon retirement; old persons are burdened with complications of health and most of their assets may be used in meeting health needs (Gondi, 2009). Health problems coupled with frailty render the elderly unable to carry out the activities of daily living. Older persons with cumulative assets may not be able to manage them (Gondi, 2009). The assets may be squandered by those obliged to manage. The situation is even worse for older women 14 who face many socio-cultural barriers and discriminatory treatment during their lifetime (Sobleszczyk, Nodel and Chayovan, 2002). These are the issues that affect the overall welfare of the older person. Persons entering old age in poverty are likely to remain poor as chances of improvement in poverty level diminish with age. It is also difficult for older persons to recover from shocks of loss of property; a case example is the 2008 post-election violence in which older persons have had testimonies of their inability to re-accumulate the same amount of wealth that they had before the violence erupted. Most loaning institutions deny older persons the chance to access business loans (Cawthorne, 2008) Studies have shown a link between cash transfer in meeting the welfare needs of the elderly. The study would therefore seek to find out if cash transfers in Makueni County are of any impact to the welfare of older persons in OPCT programme including that of their households. 1.2Research questions The research focused on the following questions; 1. How does cash transfer reach older persons in programme? 2. What challenges do older persons face in accessing cash transfer fund? 3. What are the socio-economic impacts of cash transfer on the welfare of older persons and that of their households? 1.3Broad objectives of the study The study aimed at establishing the impact of cash transfer on the welfare of the elderly enrolled in OPCT programmeand their households in Makueni County. 1.3.1 Specific objectives of the study The study sought to; 1. Find out how cash transfer reach older persons in programme in Makueni County 2. Identify the challenges older persons faced in accessing the fund. 15 3. Establish the socio-economic impacts of Cash transfers on the welfare of the elderly and that of their households. 1.4Scope and Limitationsof the study The study sought to find out how cash transfer stipend is transferred to the household from the highest level structure that is the ministry of Gender Children and Social Development up to the ultimate beneficiaries who are older person in OPCT programme. It also examined the players involved in the delivery process. The research therefore limited itself to delivery process of OPCT cash transfer from the MOGCSD to the point where beneficiaries receive their transfer. The challenges the older person encounters while accessing the fund were also be assessed with limited focus to: frequency of receiving payment, issues of distance and aggressions associated with the fund by the household members and community. The study examined uses of the fund by the older person’s household. Specific focus was on socio-economic uses of the fund such as: food, health, improvement of dwellings/shelter, education of grandchildren in the household and leisure activities. Other sources of income, besides cash transfer were assessed in order to ascertain the impact cash transfers has had in the household. It therefore examined other pertinent sources such as: income from: agriculture, own business, remittances from relatives, farm produce and donations of cash or in kind materials from well-wishers. The study was based in Makueni County. Particularly; Waia, Kivani, Athi and Kitise Locations. The choice of Makueni is because The Kenya Household Data survey of 2005/2006 ranked it as among the poor in Eastern Province. The choice of the four locations was because they were the only locations which rolled out the programme in 2009 in the county. Research findings are limited to Makueni County. Older persons above 65 years and above were the focus of study and excluded by the formal pension scheme as a result of lack of a prior formal employment. This is because the programme enrolls persons who are at least 65 years and do not receive pension. 16 1.5Operational definition of terms Older Person- The older person’s Policy defines it as any person above 60 years. For purposes of this study, an older person refers to a person above 65 years and a beneficiary of OPCT programme. Welfare- A state of being able to meet basic household needs e.g. food, shelter, clothing, medical care, education and leisure. Impact- Is a lasting and or significant effect of an intervention on intended targets. Target in this case is an older person receiving cash transfer from the government. Older person in OPCT programme: Older persons enrolled in the Older Persons Cash Transfer Programme funded by GOK. Cash Transfers: These are regular non-contributory payments of money provided by government or non-governmental organizations to individuals or households, with the objective of decreasing chronic or shock-induced poverty, addressing social risk and reducing economic vulnerability. Older Person’s Cash Transfer Programme: A programme providing predictable cash of KES 2,000 shillings per month paid every two months at the rate of 4,000 Kenya shillings Social Protection: Kenya’s Social Protection Policy defines it as Policies and actions, including legislative measures, which enhance the capacity and opportunities for the poor and vulnerable to improve and sustain their lives, livelihoods and welfare; enable income-earners and their dependents to maintain a reasonable level of income through decent work; and ensure access to affordable healthcare, essential services and social transfers. Household: Encompass persons living and eating from the same pot. 17 CHAPTER TWO: LITERATURE REVIEW 2.0 Introduction This chapter begins with a review of literature on welfare related challenges facing the elderly and also their welfare needs. It goes ahead to review the policies that have been put in place with view to improving the welfare of the elderly. It includes literature on the background of social protection and the policies informing cash transfers as an instrument used by countries in tackling poverty among vulnerable groups. It presents empirical literature on cash transfers for the elderly from selected countries of Africa and Latin American. Existing policies and interventions for the elderly in the Kenyan context are also included in this chapter. 2.1 Challenges faced by the elderly Due to their physical deterioration, the aged with assets start relying on others for support and care. Increase in cost of living is posing a challenge to caregivers of the elderly especially in catering for their day to day needs. Intergenerational support mechanisms e.g. extended family supportis slowly collapsing. Progressive movement of rural persons to urban areas has left old persons at the mercies of those who lack the economic capacity to support them. Majority of elderly in Kenya live in rural areas largely because most people retiring from urban jobs end up in their rural homes. Most of the activities are hands on and the elderly may no longer have adequate physic to handle them. Rural infrastructure in most rural parts cannot allow for broader markets of Agricultural and Livestock products hence a challenge to the older person’s household socio-economic wellbeing (Gorman, Mark et al, 2010). The elderly also face social evils. Media reports have recently shown that older persons are being accused of witchcraft. According to Nation Newspaper of 6th October 2011, an elderly couple was lynched to death on suspicion that they had bewitched their 18 year old grandson. Others have fallen victims of rape. 18 HIV/AIDS is a critical factor in increasing vulnerability to poverty among the elderly. They suffer loss of adult children and take responsibility of caring of orphaned grandchildren and their children living with HIV/AIDS, at a time in their lives in which they could be taken care of. According to The Kenya National AIDS Strategic Plan of 2009- 2013, Children Orphaned with HIV/AIDS are estimated at 2.4 million (KNASP, 2009/13; 6). The vulnerability is even high when the elderly themselves are infected. It is estimated that 7 percent of the elderly above 50 years in Sub-Saharan Africa are infected with HIV/AIDS (HAI, 2008). Most of the existing social protection programmes in Kenya are contributory and work to cater for persons who are or were previously in formal employment. These include the pension scheme, the national social security fund, and the National Hospital Insurance fund. NHIF has grown to incorporate membership of above 60 years. However, people who have all along led a poor live are unable to raise the monthly membership contributions and thus these schemes disadvantage them. Majority of older persons in Kenya had no access to gainful employment. (Gondi, 2009) When the elderly are institutionalized, institutions take on the responsibility of taking care of them. They get detached from their normal lives and that of their extended families. This process could be denigrating and may cause psychological effects such as feelings of abandonment. However, because of work and emphasis on the nuclear family coupled with urbanization most old people especially in industrialized countries have found their way to spending the remaining part of their lives in institutions for the aged (Papalia et al 2001) The kind of work that is common among rural elderly include: agricultural work, weaving and sewing, domestic work, selling goods in streets, traditional birth attendance and traditional healing. These kinds of jobs are quite informal and ‘informal sector work tends to be characterized by long, irregular hours for very low wages’ (Gorman et al 2010). 19 2.2 Welfare needs for the elderly Older persons, living on their own, require certain amount of financial needs. They need to fend for themselves for; food, groceries, medicines, etc. Pensioners would have the benefit of a steady source of monthly income. However, those older persons who do not have any pension facilities or any other sources of income would live entirely on the basis of their savings or through special senior citizen government finance schemes. Older person’s health is the most important requirement when it comes to needs of the elderly. With advancing age, the body tends to slow down and becomes less efficient. Elderly people are prone to age-related health issues. These health issues need to be checked and prevented from causing them any serious harm. Regular medical checkups are necessary. They help in anticipating potential future health-related issues. At the same time, they help in identifying serious health problems at an early stage during which treatment is possible. As people age, their digestive system gradually starts to weaken. Aged and elderly people especially, face this problem then they start finding certain foods indigestible or difficult to digest. There is a change in diet as the elderly opt for more digestible foods. The elderly require certain amount of assistance in their daily routine as they become immobile due to sickness and or general frailty i.e. assistance in crucial basic activities like walking, eating, bathing, dressing, etc. The elderly also need love and care like any other human being this could be from relatives, family members, friends and other members of the community. Their dwelling places ought to be tidy because good hygiene reduce susceptibility to infections 2.3 Social protection National and international policy instruments recognize Social protection as key in cushioning vulnerable groups from sinking deeper into poverty or helping those in chronic poverty out of it. Kenya’s National Social Protection of 2012 cites various national, regional and international policy instruments as the foundations upon which 20 Kenya’s social protection policies are based on. These instruments include: UDHR of 1948 which recognizes SP as a fundamental right for all citizens, the UN/ILO Social Protection Floor Initiative (SPF) which guarantees minimum package that adopts lifestyle approach to social protection (GOK, 2011), The World Summit on Social Development (WSSD) of 2002 which recognizes the importance of social aspects of development. Social protection instruments are administered in the form of: cash transfers, feeding programmes, food subsidies, social or health insurance, microfinance, subsidized agricultural inputs, public works programs, waivers and exceptions and skills development. Some of these instruments do not suit the needs of the elderly due to their reduced ability on hand on activities. According to Vincent and Cull (2009), vulnerable groups require social protection to protect their livelihoods and each of these groups require different forms of social protection ranging from Social transfers e.g. grants to the elderly and cash transfers; social services including home based care, education, health insurance; Social transformations- i.e. broader policy and legislative changes to ensure rights of vulnerable groups The drivers and maintainers of poverty among the elderly include: poor health, frailness, loss of employment, labor constrains, limited information and awareness, lack of support among others reduces the older person’s ability to undertake income generating activities, a justification for most social assistance to households headed by the elderly and caring for OVCs. Time given to caring for grant children makes the elderly less able to engage in income generating activities. In a paper presented in a regional workshop by HelpAge international, previous failure to invest in primary education and nutrition are identified to diminish opportunities for later life. (HAI, 2010) The purpose of social protection for older persons is to mitigate and enhance their ability to cope with and recover from the hazards which they face, to enhance their ability to emerge from poverty, deprivation and insecurity and finally to enable older people to live a dignified life with an adequate standard of living so that poverty is not passed from one generation to another. (HAI, 2010) 21 2.3.1 Social protection policy measures Kenya’s National Social Protection Policy 2012 identifies three forms of social protection policy components 1. Social assistance- This include: safety nets and consumption transfers to sustain livelihoods and build human capital, social transfer in the form of direct cash transfers to poor and vulnerable groups and in kind benefits. Others are asset protection and rehabilitation to re-establish livelihoods and asset development and income opportunities to establish sustainable livelihoods. 2. Social security- These are social protection measures effected by employers and governments to its workers and citizens respectively. The policy identifies: retirements schemes, sickness benefits, maternity protection, and unemployment protection among others as the components of this policy measure. NSSF services fall under this. 3. Health insurance- this policy measure enlists the services of NHIF and proposes to be increased to cover in-patient services and also to a wider coverage. 2.4 International and RegionalPolicy and legal Frameworks of social protection for the elderly This looks into the various existing Regional and International policy and legal frameworks related to the welfare of the older person. 2.4.1 Universal declaration of human rights- 1948 This declaration was made as a common standard of achievement for all peoples and all nations. It declared that every individual and every organ of society, keeping the Declaration, shall strive by teaching and education to promote respect for the identified rights and freedoms and by progressive measures, national and international, to secure their universal and effective recognition and observance. Article 22 and 25 of these universal declarations provide the rationale for social protection to vulnerable groups to which older persons are included Article 22.Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in 22 accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality. Article 25.(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. 2.4.2. Madrid International Plan of Action on Ageing (MIPAA)-2002 UN held a second world assembly after the first of such assembly in Vienna, Austria in 1982. The second world assembly on ageing was held in Madrid in April 2002. The discussion was aimed at looking into the issues of the elderly and how old persons would be accorded and assured of a descent livelihood. The Madrid plan of action offered a new agenda and perspective for handling the issues of ageing in the 21st Century. The plan provides three broad priority directions which include older persons and Development, advancing health and wellbeing into old age and enabling supportive environments. 159 countries adopted the plan as a policy document that offers many suggestions including: Income security, Social protection and poverty prevention. The Madrid plan of action was reinforced by the Livingstone declaration of 2006 where 13 AU countries declared to include social assistance programmes for its vulnerable groups in their plan of action and national budgets. 2.4.3 Livingstone call for action-2006 The conference was held between 21stand 23th March in Livingstone Zambia. It was attended by thirteen African countries which included: Kenya, Uganda, Ethiopia, Madagascar, Malawi, Lesotho, Namibia, Rwanda, South Africa, Tanzania, Zambia and Zimbabwe. The conference discussed measures for protecting the poorest in Africa. Social protection was identified as a right and an empowerment agenda. In many of the 23 options, considerable evidence was noted to exist between cash transfer and poverty reduction and promotion of growth The provision of cash transfer was noted to increase human capital by helping people to grow health, educate children and support HIV/AIDS affected families. It was also seen to stimulate markets and therefore benefiting the whole community On the 3rd day of the conference delegates called for adoption of cash transfers and social pensions to vulnerable children, older persons and persons with disabilities, as a more utilized policy option in African countries. 2.5 Existing Social Protection legal and policy frameworks and programme Interventions for the elderly in Kenya Most of the existing social protection interventions in Kenya are contributory. These include: the NSSF, NHIF, pension schemes which serve to benefit the principle contributors and by extension their nuclear families. The family and community are still imperative sources of support for the elderly. Other interventions are those offered by non-governmental and faith based organizations who basically offer advocacy and institutionalization services for the aged. 2.5.1 The constitution of Kenya, 2010 The constitution devotes a whole article to the rights of the elderly. Article 57 particularly delineates that; the state shall take measures to ensure the rights of the older person: a) To fully participate in the affairs of the society b) To pursue their personal development c) To live in dignity and respect and be free from abuse d) To receive reasonable care and assistance from their family and state 2.5.2 National Policy on Older Persons and Ageing This policy was published in the year 2009. It has been prepared on a background of various challenges affecting the elderly in Kenya. Issue of the elderly have been outlined 24 in the policy to include: Law and human rights, poverty and sustainable livelihoods, poor health and lack of access, harmful cultural practices to the elderly, gender issues, in which older women are cited as more vulnerable, food security and nutrition, housing and physical amenities, access to information and training, employment and income security, social welfare, preparation for retirement, conflicts and disaster situations, institutional arrangements in support of the older persons affairs and negative impact of population migration. The policy also provides a broad framework for implementation through strategies that would enable the older person to make meaningful contribution to development process. The Policy recognizes the potential of older persons in terms of skills knowledge and experience and thus the need to mainstream them in development. 2.5.3 Kenya’s National Social Protection Policy Kenya’s National Social Protection Policy was debated and passed in parliament in May, 2012. The policy proposes use of several strategies and instruments for delivering social protection broadly within: Social assistance, social security and social health insurance sectors. Specific instruments range from Cash Transfers, Food Distribution, School Based Feeding Programme, Social Health Insurance, Price Subsidies, Public Works and Microfinance amongst others. The elderly are among the vulnerable constituent of the populace pointed in the policy as targets of the social assistance component of the National Social Protection Policy. 2.5.4 Kenya Vision 2030 Kenya’s development blue print, vision 2030, aims to provide a high quality of life for all citizens by the year 2030. The vision is built on three pillars: Economic, social and political. The Vision 2030’s Social Pillar aims to achieve a just and cohesive society, enjoying equitable social development in a clean and secure environment. It is based on transformation in eight social sector areas, namely: education and training; health; water and sanitation; environment, housing, and urbanization; gender, youth, sports, and culture; and promoting equity and poverty reduction. It makes special provision for those with disabilities, the elderly and those who live in marginalized areas. The consolidated 25 social protection fund is one of the flagship projects of the Vision 2030 out which cash transfer programme for the elderly falls under. 2.5.5 Pension schemes This is coordinated by the pension Department in the Ministry of finance; the department coordinates the processing and payment of pensions, death gratuities and other benefits to retired, deceased or terminated civil servants, teachers and the military officers in the Public Service as well as their dependents. Pensions are imperative in a period in which the beneficiary is at a vulnerable state e.g. at old age when terminally ill and even to the principle contributor’s household in an even of death. 2.5.6 National social Security fund This fund was established in 1965 by an Act of Parliament (CAP 258 of the Laws of Kenya) in order to administer a provident fund scheme for all workers in Kenya. This fund initially operated under the ministry of Labor but as operations became complex due to increased membership, an amendment was done to the NSSF Act in 1987 to transform it into an autonomous state corporation. NSSF members are entitled to the following benefit Age retirement benefits – Paid at the age of retirement which 60 years and above Withdrawal benefits- Early retirement benefit paid to a member who voluntarily retires early. This benefit is due when the person shall have attained the age of 50. Emigration grant- paid to members leaving the country permanently Funeral expenses benefits- paid to the deceased family Validity grant- Paid to a member who suffers permanent disability. Survivor’s benefits- paid to the dependents of the deceased member NSSF works to favor persons who have been in formal or informal employment leaving out the large populace of unemployed including farmers, casual laborers among others. 2.5.7 The National Hospital Insurance fund NHIF is a state Parastatal that was established in 1966 as a Department under the then Ministry of Health which has since been reviewed to meet the changing health needs of 26 the Kenyan population, employment and restructuring in the Health Sector. Its core function is to collect and manage members’ contributions and pay hospital benefits out of the contributions and their declared dependence which are utmost four children and a spouse. The Parastatal registers members from both formal and informal sector including retirees. Registration of membership is compulsory for all employees in the formal sector whilst membership is voluntary for those in the informal sector. Members are entitled to an inpatient cover of up to 396,000 shillings for the contributor spouse and children (NHIF, 2009) Recent development in the fund is the increase in the number of years of membership to above 60. This has been a plus in the part of the elderly population in Kenya which is often mired with health complications. Though this measure has been put in place, it is difficult for a poor elderly with irregular income and or living in absolute poverty to effect the monthly contributions that would qualify them for the hospital cover 2.5.8 Non-governmental organizations They provide services including advocacy of older persons’ needs, provision of in kind materials, homes, education among others. These organizations are run by Religious organization, NGOs and CBOs. Examples of such organizations are: HelpAge International, Help age Kenya, Cheshire Home for the elderly among others 2.5.9The family This institution is pivotal in taking care of the elderly though urbanization and modernity have contributed in reducing the effectiveness of this role of the family as young members leave for cities and towns to seek jobs and perceived better living. 2.6. Institutionalization of the old Kenya’s national Policy on older persons and Ageing encourages support of the elderly within the family. As a policy strategy, institutionalization is discouraged and retention of cultural respect for the older person is seen as the best alternative. Emphases are laid on: 27 community-based support systems such as kinship, extended family and neighborhood in taking care of the elderly. (MOGCSD, 2009) In recognition of the importance of family care for the elderly, thefirst world countries e.g. China, Japan and Singapore have passed laws obliging people to care for their elderly relatives. Japan and Singapore provide tax relief to those who give older relatives financial help. In Japan lotteries for tenancy in public housing gives households with a member of age 60 and above a ten times greater chances of winning. Institutionalization is still a last resort only for those who are destitute or without families’ (Papalia et al, 2001: 27). Institutionalization is considered as disjoining the elderly from normal living. They are disengaged from family members; work, among other life routines and associations. While homes are criticized, it also gives refuge to destitute elderly 2.7Understanding cash transfers. Samson, Nierkerk and Mac Quene, (2006) defined cash transfer as social protection interventions falling under social transfers. It involves the transfer of real cash to an intended beneficiary. They classified cash transfers into three categories: Cash transfers are social protection interventions falling under social transfers. It involves the transfer of real cash to an intended beneficiary (Samson, Nierkerk and Mac Quene, 2006). They classified cash transfers into three categories: Unconditional cash transfers- These are regular non-contributory payments of money provided without active conditionality by a government or non-governmental organization to individuals or households with the objective of decreasing chronic or shock induced poverty, providing social protection, addressing social risks or reducing economic vulnerability. Examples are: Social pensions, child grants, family assistance, widow allowances, grants for the elderly and persons with disabilities among others. Empirical literature shows that cash transfer for the elderly are commonly unconditional. Conditional cash transfers- They are regular payments of money by a government or non-governmental organization to individuals or households in exchange for active 28 compliance with human capital conditionalities with the intention of reducing chronic or shock induced poverty providing social protection, addressing social risk or addressing economic vulnerability. The human capital conditionalities include such requirements as; school attendance and academic performance by children, clinic visits, and adult education programs among others. Kenya’s CT-OVC is a conditional form of cash transfer aimed at increasing school attendance and retention among orphaned and vulnerable children. Public works- They are programmes that offer regular payments of money or in kind benefits by government or non-governmental organizations to individuals in exchange of work. An example is the Kenya’s KazikwaVijana(cash for work) initiative 2.7.1 Empirical literature on cash transfers programmes for the elderly There is increased attention on the adoption of cash transfers as social protection interventions by countries. Dithier, Pestieau and Ali, (2010) observes that there is increased advocacy for Cash transfers since policies that go through labor and output markets and educational training programmes are ineffective and that the only available instrument to alleviate old age poverty is the transfer of real income. The need for social grants in Kenya as a social protection instrument is motivated by extreme and persistent poverty which prevents a large population of poor people from accessing, or benefitting from mainstream development interventions (MOGCSD, 2011) In low and middle income countries, Examples of a few countries having universal minimum level social pension arrangements include Mauritius, Namibia, Botswana, Bolivia and Lesotho. In developed countries, New Zealand provides universal pension to its aged populations with the objective to lift old persons above poverty line. The government of the Kingdom of Lesotho introduced a non-contributory old age pension schemes for 70 years of age and above in the year 2004. The aim is to reduce poverty among the elderly. The recipients of the non-contributory pension ought not to be recipients of contributory old age pensions. Financing of the scheme is by general taxation (Bellow et al, 2007) 29 South Africa's state pension mirrors the history of the country. The first pensions were paid to whites in 1928 and extended to blacks in 1940, but huge disparities in the amounts paid to different race groups remained until a year before the first democratic elections in 1994. This is according to NCPPS Newsletter of March 2003. South Africa’s Old-age pension is a means-tested up to 1,010 rand a month is paid for a single pensioner; married couples may receive double the amount. The pension is reduced to 25 percent of the maximum amount if the pensioner resides in a care facility under contract to the State for more than 3 months. Constant-attendance allowance of 240 rand a month is additionally paid to the older person’s household (IRIN, 2011) A number of developing countries have a universal means tested schemes which applies to the household. Examples are the South Africa’s and the Brazil. South Africa’s social pension is equivalent to one third of per capita income. The targeted elderly are those who are 65year and above for men and 60 years and above for women. In Brazil, social protection programmes are funded through general taxation and the elderly targets for their BPC programme are women of above 55 years and men above 60 years of age. (Soares et al, 2008) Brazils BPC is enshrined in the Constitution and thus regarded as a constitutional right. Any individual meeting the criteria can receive the benefit and might demand it judicially. In Brazil it is estimated that Cash transfer programmes alone are accountable for 23 percent of drop in income inequality between 2001-2004 in the country (Soares et al, 2008). Brazil’s BPC is criticized for presumably encouraging evasion of social security contributions. The rationale for this criticism is that if individuals will receive from regular pension, there would be no reason to contribute to the public social security systems. The point of argument is that social assistance programmes cause dependence among the poor populace who are often the beneficiaries of such programmes (Soares et al, 2008) Bolivia’s Cash transfer programme was established in year 2008 under its RentaDignidad policy which requires that all persons above 60 years receive a monthly payment of 28.3 30 USD which is equivalent to 329USD per year if the beneficiary does not receive pension and a 75 percent of cash transfers to elderly in receipt of pension. The 75 percent is equivalent to 247 USD. The source of finance for the RentaDignidad program is from direct tax from the country’s hydrocarbons. Armed forces aid in distribution of the fund to ensure that the fund reaches hardly unreachable frontiers. This is according to a presentation done by Bolivia’s country representative in a regional workshop held in Lilian Towers, Nairobi, the beneficiaries of the this programme up to the year 2010 was approximately 750 thousand older persons. The presentations also unearthed that over 20 percent beneficiary households registered increase in their household income as a result of the benefit which allowed them to increase their consumption as well. Studies done on the impacts of cash transfer across South Africa showed that in addition to promoting food security, social transfers have additional beneficial effects that are wide ranging, and extend beyond the direct recipient of the transfer to the wider family. For the recipient, there is evidence to suggest that cash transfers promote self-esteem, social status and empowerment. They also improve food security and nutritional status not just for the transfer recipient but also that of the household, (Vincent and Cull, 2009). An impact evaluation report of CT-OVC Kenya done by Tomkins et al (2008) showed a reduction in the rate of absenteeism among children in programme from 31.3 percent to 11.9 percent. Cash transfers increase the purchasing powers of families as long as they receive the benefit (Soares et al, 2008) A policy analysis research project done by Barrientos and Nino-Zarazua (2009) indicated that the focus of social transfer programmes on extreme poverty suggested that they could have important effects in reducing persistent poverty. They also argued that social transfers are emerging as a core component within social protection policies aimed at tackling poverty and vulnerability. According to (HAI, 2010), pensions support the economy. ‘A social pension to an older person can inject cash into the local economies, by giving people spending power and access to markets.’ 31 2.8 Theoretical Framework The rationale of cash transfer is based on the challenges afflicting the elderly. These challenges are related to their needs. These needs are holistic and encompass: physiological, social psychological and economic needs. Cash transfers are offered to enable older persons meet their basic need of Food, shelter, clothing, medical care among others. Research has shown that Cash transfers enable poor people to meet basic needs and increase their chances of accessing services which they otherwise could not. Basic needs are also interrelated to psychological needs in that when basic needs are made people are motivated to pursue more things including engaging in income generating activities, leisure, visiting social places like ceremonies and religious places which in turn enhance a person’s self-esteem. The impact of the fund has been conceived on the basis of the following theories of social welfare. Maslow’s hierarchy of needs theory Hansell’s motivation theory 2.9.1 Maslow’s theory of needs This was developed by Abraham Maslow in 1968. The theory proposes a hierarchy of human needs that is applicable to the human services model.The Hierarchy consists of 5 levels. 1. Physiological needs. These are the literal requirements for human survival. These include: Food, shelter, oxygen. 2. Safety needs. This safety could be economic or physical. Economic needs manifest itself in form of: job security, insurance policies. Safety needs include: personal needs, financial needs, health and wellbeing, safety net against accidents among others. 3. Love and belonging. This is a social need related to intimacy and acceptance from others. 4. Esteem needs: Esteem presents the normal human desire to be accepted and be valued by others. It implies recognition by others that a person is competent or respected. 32 5.Self-actualization These needs relate to the fulfillment of a person’s innate potential as a human being. At self-actualized people possess attributes that are consistent with highly competent and successful individuals. Maslow's hierarchy of needs is often portrayed in the shape of a pyramid, with the largest and most fundamental levels of needs at the bottom (physiological needs), and the need for self-actualization at the top. Cash transfer enable older persons’ households meet their fundamental needs (physiological needs) of food, shelter and clothing. Physiological needs brings fulfillment in the person hence making it possible for persons to achieve the other needs in the pyramid which include: esteem, need to love and be loved, safety needs and finally self-actualization The challenges of old age can be understood in the context of disengagement theory. The theory, which was developed by Cumming and Henry in late 1950’s, postulates that aging is an inevitable mutual withdrawal or disengagement resulting in decreased interaction between the aging person and others in the social system he/she belongs (Fay, [ND]). Under this theory, as people age, they tend to grow more fragile and their social circles shrink as they start to pull away and be less actively involved. Being less active and with decreased ability of the aging person to engage in social relationships or engage in physical activities makes the older person susceptible to vulnerability and old age poverty. Provision of cash transfers reactivates older persons by making them able to engage in income generating activities, establish or enhance social relationships perhaps through merry go rounds and the like. It makes it possible for them to contribute to meeting household needs of food, shelter, clothing among others. This concurs with Robert Harvighust Activity Theory of 1960's which according to Fay [ND] supports the maintenance of regular activities, roles and social pursuits, he continues to say that persons who achieve optimal age are those who stay active as roles change, the individual finds substitute activities for these roles. 33 Interventions which are therefore conceptualized in the context of activity theory make it possible for older persons to come back towards active life. Other than making them possible to meet their own needs, their self-esteem can be enhanced and further a progressive growth towards self-actualization as proposed by Abraham Maslow in his theory of needs. 2.9.2 Motivation Theory. This Theory wasdeveloped by Hansell. It posits that people must achieve seven basic attachments in order to meet their needs and that if a person does not succeed in achieving each of these attachments it results into a state of crisis or stress. The seven basic attachments and their corresponding signs of failure are; 1. Food, water and oxygen along with informational supplies. Signs of failure: boredom, apathy, and physical disorder. 2. Intimacy, sex, closeness and opportunity to exchange deep feelings Signs of failure; loneliness, isolation, and lack of sexual satisfaction. 3. Belonging to a social peer group Signs of failure; not feeling part of any group 4. A clear definite self-identity Signs of failure; feeling doubtful and indecisive 5. Social role that carries with it a sense of being a competent member of society Signs of failure; depression and a sense of failure. 6. The need to be linked to a cash economy through a job, a spouse with income, Social security benefits. Signs of failure; lack of purchasing power leading to inability to purchase essentials. 7. A comprehensive system of meaning with clear priorities in life. Signs of failure; sense of drifting through life detachment and alienation. The challenges of old age relate to the signs of failure as indicated in Hansell’s theory. The theory therefore gives a perspective of welfare intervention in which GOK devised cash transfer to ensure that the challenges are reduced so that that older persons meet their minimum basic needsand subsequently psychosocial calmness through receiving a predictable t cash stipend of KES 4,000. 34 2.10 Conceptual framework Adequate welfare state of an elderly means that he/she is able to cater for his/her basic needs of food, shelter, clothing, medical care and leisure among others. In a case where the elderly is unable to cater for his/her welfare needs, support could be accorded through various social protection interventions including cash transfers. The aim of the interventions is to ensure that vulnerable older persons have their basic needs met. Lack of such interventions could compromise the welfare state of the elderly making them vulnerable to absolute poverty. The resulting impact of lack of intervention to cushion them from poverty is characterized by economic disempowerment, lack of food, poor housing, depression, lack of care and social isolation. This concept is represented in the following diagram. Diagram illustration of conceptual framework -Lack of food/hunger -Lack of shelter/ dilapidating shelter -Poor health -Low purchasing power Underlying causes Social Protection interventions -Social assistance (including cash transfers) -Social security (health insurance/NHIF/NSSF) -Family care and support -Donations from NGOs/FBOs. - Income from own investments/farm -Lack/loss of assets - No/limited income -Challenges of ageing (frailty) - Social exclusion -Improved Nutrition -Improved shelter - Health improvement -Economic empowerment -Increased social networks/leisure -Hunger, poor shelter, poor health conditions, lack of basic education of school going members of the household, low purchasing power, Isolation) 35 CHAPTER THREE: RESEARCH METHODOLOGY This chapter focuses on how the research was undertaken. It presents a description of the research site, target population, sampling techniques and sample size, target population, data collection instruments, pilot study to test validity and reliability of research instruments, data analysis techniques and logistical and ethical considerations. 3.1 Site selection and description Makueni County is located in the southern part of Eastern Province and borders four counties with Kitui to the east, TaitaTaveta to the south, Kajiado to the west and Machakos to the north. According to the Population Census of 2009, the County has a total population of 884,527. It has five parliamentary constituencies of; Kaiti, Mbooni, Kibwezi, Kilome and Makueni. It lies within the Arid and Semi-Arid zones of the Country. Drought is a main source of poverty and the most vulnerable are: women, children and the aged. Many families lose their livestock during prolonged drought and water can only be got from far. The poverty prevalence is estimated at 64.3 percent. (Republic of Kenya, 2009) During the start of the programme in Makueni County, the constituencies with the most poverty prevalence were selected to implement the programme. Therefore three constituencies of Makueni, Kaiti and Mbooni with a poverty prevalence of 67 percent, 66 percent and 61 percent respectively were chosen as illustrated in the table below (MOGCSD, 2009) Table 1: Makueni County, Constituency Level poverty prevalence. Name of Constituency Poverty incidence below poverty line. Poverty gap Estimated population year 2007. 1 Mbooni 61 22 207,094 Estimated number of poor individuals 113,902 2 Kaiti 66 24 142,432 78,337 3 Makueni 67 25 265,841 145,831 4 Kibwezi 54 18 246,841 135,690 5 Kilome 61 22 102,371 56,371 (Source Makueni District OPCT scale up report, 2009) 36 The County was awarded 750 chances of registering Older Persons to be Included in the OPCT programme. Four Locations were selected and chances of registration of older persons above 65 years awarded as presented in the table below. Table 2: Geographical distribution of beneficiaries in OPCT programme in Makueni County-2009. Constituency Division Location Male Female Number of older person in programme Makueni Kitise Kitise 58 158 216 Kaiti Kaiti Kivani 52 148 200 Mbooni Kalawa Athi 52 132 184 Mbooni Kisau Waia 45 105 150 Total beneficiaries 750 (Source: MOGCSD Makueni District OPCT scale up report, 2009) All the above four locations were sampled for the study. 3.1.2Description of the OPCT programme This gives a broader overview of the elderly programme. It has been derived from existing literature and information by key informant vis-à-vis the programme. The overall objective of the program is to strengthen the capacities of older persons and improve their livelihood while alleviating integrated poverty through sustainable social protection mechanisms. This is to be achieved by providing regular and predictable cash transfer to vulnerable older persons in identified households and building the capacities of beneficiaries in order to improve their livelihoods The government started the programme as recognition of the plight of the poor and vulnerable elderly population. This is based on the evidence that as people age production ability diminishes, most of them take care of orphans and a lack regular income especially those who are poor and had no access to formal employment. 37 The programme design is said to take place at the Ministry headquarters under the coordination of the OPCT unit. The implementation guideline is communicated to the provincial and district level through trainings. The district level under the coordination of District Gender and Social Development officer (DGSDOs) targets beneficiaries with the support of District Gender and Social Development committees (DGSDCs) comprising from line ministries and NGO representatives at the District level. At the location level Location Committees are formed through a community participatory process during mobilized community meetings (Barazas). The entry point of the programme is the household. Selection of beneficiaries is guided by a laid down criteria which include: household with: an older person of 65 years and above, which is extremely poor, one that is not enrolled in other cash transfer programme, a non-recipient of pension, has resided in a particular location for more than a year and finally must be a Kenyan citizen. The targeting process is done by enumerators Communities through gatherings at the location level validate enlisted persons based on the criteria for selection. Ranking is done to ensure that the most vulnerable are enrolled to the programme first. 3.2 Target population The study targeted older Persons who are beneficiaries of The Older persons Cash Transfer Programme and are aged 65 years and above. This is because the minimum age for enrolment into the programme is 65 years. 3.3 Unit of analysis According to Babbie (2009), unit of analysis is the ‘what or whom being studied’ the unit of analysis for this study was the impact of cash transfers on older persons above 65 years of age. The unit of observation was the older person enrolled in cash transfer programme and receiving cash transfer. 3.4 Sampling design and sample population. Kothari (2004:154) defines sampling as the selection of aggregate or totality on the basis of which a judgment or inference about the aggregate or totality is made; that is a process of obtaining information about an entire population by examining only a part of it. The 38 sample frame was a finite population of 750 which was the total number of beneficiaries implementing the programme in Makueni County in 2009. Approximately 20 percent of the 750 beneficiaries in the County were sampled for the research. Based on this a sample of 154 beneficiaries was selected. The rationale for sampling 20 percent was for the research to be undertaken within a manageable limit in terms of money and time. Proportionate sampling technique was used to obtain the sample per location and also by sex. The sample of 154 was proportionately distributed in the four implementing locations as follows. Table3: Proportionate distribution of sample population per location and sex. Location Total beneficiaries Sample per Sex Total sample per location Male Female Per location Kitise 216 12 32 44 Kivani 200 11 30 41 Athi 184 11 27 38 Waia 150 9 22 31 Total 750 43 111 154 Beneficiaries to be interviewed were randomly selected from the beneficiary data of older persons in Makueni District Genderand Social Development office. The reason for using proportionate sampling in coming up with a sample of equal proportion according to gender and geographic location and of further getting a random sample for data collection was to enhance representativeness of the sample population. 3.5 Type of data Both primary and secondary data was used. Interview schedule and key informants’ interview guide were used to obtain primary data. 39 At proposal stages of this project paper the researcher had envisaged to use baseline report as a comparative point of ascertaining impact. However, there was no baseline report available in the MOGCSD. What was available for Makueni County was a raw data of 868 older persons who were said to have been enlisted as having qualified for the OPCT programme in 2009 although all of them were not immediately enrolled considering the fact that the County had a quota of allocation of 750 beneficiaries. The researcher therefore requested to analyze the data of 868 older persons to inform baseline information. The baseline information is presented in chapter four together with the results of the analysis of the interview schedule and key informant’s interview guide used by the researcher to collect data. 3.6 Data collection methods. The data was collected using both qualitative and quantitative data collection methods. Basically interviews were used to obtain information from the respondents. Interview schedules were developed to capture both qualitative and quantitative data by incorporating both open and closed ended questions. Key informants were interviewed with view to gaining in depth understanding of the programme. The following data collection instruments were used. a) Interview Schedules In this case data is collected by filling up the schedules on the basis of replies given by respondents (Kothari, 2004:17) Schedules with open and closed ended questions were used. The interview schedules were administered by trained enumerators. Interview schedules were developed for use with the assumption that most of the older persons may be illiterate and thus the need for an enumerator to record their responses. According to Kothari (2004), the use of schedules reduces non-responses; It is also relevant in instances where the respondents happen to be illiterate. b) Key informants’ interviews Key informants, as a result of their personal skills, or position within a society, are able to provide more information and a deeper insight into what is going on around them 40 (Marshall, 1996). Officers involved in the direct implementation of the programme at the Department of Gender and Social development within The MOGCSD and the field level are deemed to have a great insight regarding the programme. To obtain information on how cash transfers reach beneficiaries, Gender and Social development officers working for the programme were deemed necessary to act as key informants for the research. The District Gender and Social Development officer was basically the key informant that gave insight on how the programme works at the County and District level. c) Observation This mode of data collection was used for particular variables specifically shelter and sanitation. 3.7 Pilot Study According to Mugenda and Mugenda (1999), the researcher should pretest the research instruments to be used in the study. The tool was pretested using three beneficiaries in Nairobi’s Langata District to establish whether the instruments met the necessary standards of an effective data collection tool such as to the length, clarity, coherence or consistency in the flow of questions. Based on this some of the questions were removed added or improved 3.7 Data analysis Since closed ended and open ended questions were incorporated in the interview schedule, both qualitative and quantitative data analysis methods were adopted. In quantitative data analysis, closed ended questions were organized, coded, data entered into computer. Data analysis was done using SPSS and tabulations done using excel spreadsheet and MS word. Data has been summarized descriptively by use of frequencies, percentages, charts (Bar graphs and pie charts) and tables. The Qualitative data from open ended questions were sorted into common themes and then coded. Information from key informant interview was organized appropriately for purposes of reporting and presentation. 41 3.8 Ethical Consideration Consent was sought from respondents before asking them questions about the research and or making photos. The purpose of the research was clarified as purely for academic 42 CHAPTER FOUR: DATA ANALYSIS AND INTEPRETATION OF FINDINGS This chapter gives analysis of data collected from impact assessment. In addition it provides analysis of data from the targeting and registration form used in 2009 with parameters related to the objective of the research. The data was obtained from the Ministry of Gender, Children and Social Development unanalyzed and already entered in SPSS. This data was used in 2009 for purposes of qualifying beneficiaries into the programme. There was no data available to inform baseline status prompting the researcher upon realization of lack of such crucial data to ask for the retrieval of the raw data particularly for Makueni County. The data for Makueni had 868 older persons enlisted as having made the eligibility criteria in 2009. Some items in the targeting and registration tool (tool annexed) has been analyzed to inform beneficiary baseline status. The presentation has logically followed the objectives of the research as outlined in chapter one. However, the demographic characteristic of respondents as asked in the interview schedule has been presented prior. The presentation is structured in accordance with research objectives as follows: Presentation of demographic characteristics of respondents and programme awareness levels. An exploration of how cash transfer is delivered from the highest level to beneficiaries of Makueni County Presentation on the challenges faced by the elderly in OPCT programme in Makueni District. The last part provides an analysis and presentation findings in relation to the socioeconomic impact of the OPCT programme on the welfare of the elderly. basicallyon: food security, health, clothing, micro investments, education of household members, access to goods and services on credit, social inclusion, and on the ability of the household to sustain their livelihood upon the termination of the government’s cash transfer programme. 43 4.1. Demographic characteristics of respondents These include: location of respondents, gender, age, education level of respondents, occupation, and household economic status of beneficiaries and or their households. Some of the demographics are presented in comparative manner that is as of 2009 and 2012 depending on whether such data was available. 4.1.1 Distribution of respondents by location Respondents were distributed in four programme locations of Athi, Kitise, Kivani and Waia. It is imperative to note that the locations mentioned here are pogramme locations and may not reflect administrative locations as of the year 2012 because it was established during data collection that new locations had been established. The distribution per location was as follows; Table 4: Geographical Distribution of Respondents per Location location Athi Kitise Kivani Waia TOTAL In 2009 Number of Percent (%) respondents 243 269 204 152 868 Location 28 31 23.5 17.5 100 Athi Kitise Kivani Waia In 2012 Number of beneficiary households 38 44 41 31 154 Percent (%) 24.7 28.6 26.6 20.1 100 The respondents’ distributions by location were: 28 percent for Athi, 31 percent for Kitise, 23.5 percent for Kivani and 17.5 percent for Waia locations. The sample population had 24.7 percent respondents from Athi, 8.6 percent from Kitise, 26.6 percent from Kivani and 20.1 percent from Waia Locations. Scale up report of Makueni, 2009 showed that more beneficiaries were selected for Kivani and Kitise because they are located in Kaiti and Makueni which has higher poverty indices at 66 percent and 67 percent respectively. By virtue of basing the criteria on poverty indices, two constituencies: Kilome and Kibwezi were left out. Among the many locations, four were selected to implement the programme. 44 In relation to location distribution of beneficiaries and considering the fact that many locations were left out, targeting some locations and excluding others deny eligible older persons in such areas their right of support by the state. 4.1.2 Gender distribution of the respondents. The Respondents at impact assessment comprised of a sample of 154 beneficiaries of the OPCT programme (43male, 111female). The sample was proportionally derived from summary distribution of 750 beneficiaries of the OPCT programme. The gender distribution is as presented in the chart below. The data of 868 older had 548 female and 320 males. The following is a pie chart distribution of respondents by gender. Chart 1: Gender Distribution of respondents Respondent distribution by gender-2009 Respondent distribution by gender-2012 36.9% Male 63.1% Female 72.1% Female 27.9% Male The percentages of male and female respondents in 2009 were 63.1 percent and 36.9 percent respectively. The percentages of women (72.1%) and men (27.9%) at impact assessment are consistent with the percentage of either gender in 2009. However, there is a slight difference in terms of the ratio in that the baseline had the highest women ratio. The difference can be attributed to the fact that the sample was derived from a sampling frame of 750 beneficiaries who were the beneficiaries of the programme as of June 2012. It could also be attributed to replacement of exited cases which considers vulnerability of the older person at the waiting list and not the gender aspects. 45 From this it can be noted that women were the majority. The reason for this could be because women are said to have a higher life expectancy. Robinson (2007) in his paper ‘the trends and healthcare use among older women of USA’ said that men have lower expectancy rates. Another general reason he gives for women’s longevity is the fact that women marry men older than them. Because of this, Robinson argued that women aged 65 years are more likely to be widowed (43 %) than older men (13%). Existing reports show that the world population is higher for women compared to older men. AU Policy Framework and plan of Action on Ageing indicate that the majority of older persons in almost every country are women (55% globally) with difference in gender ratios increasing with age (HAI, [ND]). According to Heslop (1999), women’s greater longevity means that the world of older people is predominantly one of poor women often widowed who all too often face physical suffering, economic disadvantage and social exclusion 4.1.3 Age Distribution of respondents. Ages of respondents are grouped from 65 years being the age of entry for older persons into the Cash Transfer Programme for the elderly. The ages have been grouped with intervals of ten (10) to conform to the national Census age grouping. Respondents’ ages of older persons during enrolment and at impact assessment are as presented below: Table 5: Age Distribution of respondents. Age Distribution 2009 Age group Number of Percent respondents (%) Age Distribution 2012 Age group Number of Percent 65-74 316 65-74 63 75-84 396 75-84 69 85-94 121 85-94 20 95 and above 35 respondents (%) 36.5 45.6 13.9 95 44.8 13 and 2 above 4 868 40.9 100 1.3 154 46 100 Going by the data in chart table 5above, the highest number of respondents lay between 75-84 years at 45.6 percent followed by a 36.4 percent for those in ages 65-74years. Those above 85 years were comparatively less. On the other hand, impact assessment reveals a higher percentage (44.8%) of older persons within age group 75-84 as beneficiaries of the programme followed by ages 65-74 (40.9%), then ages 85-94 years at (13.3. %) and finally those with 95 years and above at 1.3 percent. The low number of beneficiaries, despite their frailty and associated vulnerability, among 95 years and over olds can be attributed to the fact that less people live to see their hundred year birth day. This trend is evident in the distribution of older persons in the 2009 population census which revealed a reduction in number of older persons with advancement in age. Those within the age bracket of 65-74 totalled 593,778 as opposed to those above 80 years who were entirely 183,701 (KNBS, 2010). It can be argued that more older persons in programme between ages 75 and 84 years is because they could be more vulnerable than persons between 65-74 whose national statistics reveals has the highest among other age categories of elderly over 65 years of age. The National Policy on Older Persons and Ageing gives the minimum age for older persons needing welfare support at 60 years. Elevating the age for the elderly targeted in Cash Transfer Programme for the elderly means that a good number of vulnerable older persons within ages sixty and sixty four are left out. On the contrary, providers of social welfare programmes argue of lack of adequate resources for universal welfare programmes. The lack of adequate financing of social assistance programmes is the reason behind designing targeted programmes for vulnerable groups like the elderly. KNCHR (2009), supports this argument by reporting that high levels of poverty in developing countries including Kenya diminish available resources for the provision of basic financial assistance to older persons. Despite the limitation, it can be argued rightly that the implementation of cash transfer and the subsequent up scaling of the programme is an indication of the government’s will to support older persons’ policies. 47 4.1.4 Marital status of respondents. This presents the marital status of older persons targeted in 2009 and at impact assessment. The findings are as comparatively tabulated. Graph 1: Marital status of respondents Marital status of respondents 2009 90 80 70 60 50 40 30 20 10 0 Marital status of respondents 2012 60 80.1% 52.6% 50 42.2% 40 30 20 13.8% 0.6% 1.5% 10 4% 1.3% 1.3% 2.6% 0 Evidence from analysis of targeting tool indicates that majority (80.1%) of the respondents were married. This was followed by widowed cases at 13.8 percent, then single cases at 4.0 percent, separated at 1.5 percent and finally divorced at 0.6 percent. At impact assessment; widowed cases had gone up (from 13.8% during baseline to 52.6% during impact assessment). Married cases went relatively down (from 80.1% to 42.2 %). Marital status in old age is skewed toward widowhood/widower. This is because older persons loose their spouses as age advances and health complications crop up and therefore the difference to the results may not be linked to the effects of cash transfer. The higher married cases in 2009 imply that there are more than two older persons in the household. Since the programme does not enroll more than two persons in a household, the household with only one older person stands a better chance than one with more than two because many older persons can be an added vulnerability to an already needy household. 48 Significant change is observed for married and widowed cases at impact assessment though this may not be associated with the cash transfer. Life phase humans and other living beings as age advances through death. The reduction in married cases and increment in widowed cases can be attributed to natural attrition. According to the programme majority of the exits done are mainly through death of a beneficiary. The implication of a spousal loss is a tragic event in a person's life. As spouse live together for ages, they become part of each other. There is an emotional attachment to their relationship hence when a spouse dies it becomes a loss to the living partner. It is hereby thought that the psychological impact of widowhood/widower hood manifesting in form of stress can be devastative to an elderly. This is corroborated by Nalungwe, (2009) who brought out that the loss of a spouse is a challenging and life changing event, this is even worse in elderly people, whether the spouse dies expectedly or unexpectedly, loneliness among the elderly widows whose social network has already been reduced, affects the elderly widows quality of life and they become more vulnerable to loneliness. Emotional and social loneliness are the most talked about types of loneliness widows’ experience, whereby emotional loneliness is the absence of a close emotional relationship, which is obvious for the widows. Social loneliness is brought on by a lack of social network, or unsupportive social network. This is because as human we are interactive and we need someone to talk, to be with or share things with. A widow needs a social network that is supportive to help her close the gap left by the husband widows with an active social life rarely suffer social loneliness. During the impact assessment, majority of the older persons managed to join merry go rounds by virtue of receiving cash transfer. 4.1.5 Education level of respondents This is basically in relation to the sample population at impact assessment as findings of 2009 do not provide. 49 Table 6: Education level of respondents-2012 Education level Frequency Percent (%) Illiterate 141 91.6 Semi illiterate 5 3.2 Primary Level 8 5.2 Total 154 100 Illiterate cases were the highest (91.6 %) followed by primary level (5.2 %) and then semi illiterate at 3.2 percent. No one had gone beyond primary school. A study done in Nyanza by Ondigi and Ondigi (2012) on the influence of poverty and wellbeing of the elderly attributed limited sources of income including from pension schemes to minimum education level (primary and below). The high illiteracy level among the beneficiary elderly (91.6%) can be part of the reasons why all the households (100%) resorted to peasant agriculture. Acquisition of a moderate or higher education could increase a person’s probability of acquiring more income through employment. 4.1.6 Main occupation of respondent All the 154 (100%) beneficiaries interviewed said that they relied on peasant agriculture for their livelihood. However this question was not asked for the 868 older persons targeted for the OPCT programme in 2009. This is consistent with GOK (2009) which indicates that ‘The main sub-sector for Makueni District is agriculture and livestock production which constitute the major economic activity in the District and is estimated to contribute about 78 percent of household income and offering employment to over 107,211 residence’ Agriculture is an occupation that requires physical engagement. Old persons in their advanced ages may not be able to till land. Taking into account that Makueni is a semiarid area, farming can be a great challenge to the elderly. 50 4.1.7 Economic Status of households The findings on the main occupation of respondentsshow that all of them are peasant agriculture. Questions were further put up to ascertain the occupation of other household members for purposes of gauging the overall household economic status. Responses have been summarized in the graph below. Graph2: Economic status of the household 74.7% household members (%) 80 70 60 50 40 30 20 16.9% 8.4% 10 0 Earner Helper Dependant A majority (74.7%) of the household members are dependants. Majority of the dependants are school going children (70%). Earners (16.9%) were mainly house helps and casual workers. Helpers (8.4%) were mainly peasant farmers augmenting the household needs. The households’ earners and helpers are less (25.3%) compared to those who are dependants. It can therefore be assumed that the cash transfer expenditure goes beyond the older person since quite a large number of the household members are dependants. The implication is that, the livelihood of the older person may not be catered for fully as the programme envisages. 4.2 How cash transfer flow from the ministry to the beneficiaries in Makueni County The objective focused on examining how cash transfer stipend is delivered from the Ministry of Gender, Children and Social; Development to the ultimate beneficiary living villages of Makueni County. 51 The research found out that the fund is delivered through the PCK headquarters to the PCK branches which does the actual payment of beneficiaries with mobilizations done with the coordination of the District Gender and Social Development and actual mobilization by provincial administration (through the chiefs) and the lowest structure of the programme which is the location committees. 4.2.1How cash transfers reach older persons in Older Persons Cash Transfer Programme in Makueni County The diagram below illustrates the flow of funds from the Ministry of Gender Children and Social Development headquarters to the beneficiaries of OPCT programme in Makueni District specifically in three constituencies of Kaiti, Mbooni and Makueni. This data was basically derived from the District gender and Social Development officer, Makueni District who was the key informant. 52 Flow of cash transfer from the MOGCSD headquarters to the beneficiariesinMakueni County during payment. MOGCSD Headquarters Wires Funds/sends payrolls of older PCK Headquarters Persons to be paid. Information on payment dates Disburse funds to branches/sends payrolls (By the OPCT program officers) District Gender and Social Development office PCK Branches (Tawa, Kathonzweni and Makueni post offices) Information on payment dates Location Committees/local administration Beneficiaries turn up for payment Mobilize beneficiaries (informing of payment dates) Beneficiaries Diagram devised by researcher 2013 The cash transfer is wired from the MOGCSD headquarters to the PCK headquarters. At the same time the OPCT unit sends the payrolls to the post office headquarters for onward submission to the paying branches. Money is send from the headquarters to the 53 PCK branches. In Makueni County the branches that serve Makueni, Kaiti and Mbooni Constituencies which comprised the area of studyare:Makueni, Tawa and Mbooni post offices. The PCK headquarters upon payrolls and associated cash from theMOGCSDinforms the OPCT Programmeunit about the payment dates. The officer in Makueni then gets information from OPCT programme officers at the headquarters regarding payment dates so that they mobilize beneficiaries to turn up for payments as per the communicated dates. Payment timeline is a span of two weeks. It was reported that once information regarding payment dates is received from the Ministry headquarters dates are re-allocated according to sub-locations to avoid a big number of beneficiaries turning up for payment at once and avoiding long queues for older persons who are already too frail to stand. To ensure that the right beneficiaries receive their entitlement, beneficiaries are required to provide their national IDs which should conform to the details in the payroll. Older persons or their caregivers turn up for payment in line with the informed dates 4.3 Challenges faced by older persons in accessing and as beneficiaries of cash transfer The research looked at challenges directly affecting the beneficiary. The focus areas were: regularity of the cash transfer stipend hostility from the family or household emanating from being a recipient of cash transfer, distance from pay point and the cost of reaching the pay point. The research found out that the cash transfer stipend is not always regularized as indicated by majority who reported that their stipend is less often regular. An overwhelming majority did said that their community and their families were happy with them receiving the stipend. However, Limited hostility was noted in regard to withdrawal of support, maltreatment by significant others and being spoken of negatively by community members. As to the cost of transport, a few had challenges spending much of their stipend on transport. 54 4.3.1 Regularity of the cash Transfer Stipend Respondents were further asked to indicate whether they receive the cash regularly after every two months as per the programme guideline. The responses are assummarized in the table below. Table 7: Regularity of receiving cash transferby older persons Frequency of receiving cash transfer Less often Frequency 104 Percent (%) 67.5 Quite often Always Non responses Total 43 4 3 154 28 2.6 1.9 100 A majority (67.5%) said they received KES 4,000 less often. Some of the beneficiaries did not know why they did not receive their stipend as per the cycle while others said that they were informed that the release of money had been delayed. Though that was the case, respondents informed that their stipends were always backdated to the last payment cycle in case of a delay. The key informant at the secretariat confirmed this clarifying that sometimes funds are not released on time from the treasury hence affecting the regularity of payment cycles and that in the event that the delays occurred, the stipend is backdated so that beneficiaries are paid amount equivalent to the skipped months. The lack of consistency of the cash transfer impacts on the predictability of the fund an objective which the programme aims to achieve. The households are also likely to be constrained as far as planning for spending is concerned. 4.3.2 Hostility from the community or household members for being a beneficiary The questions posed to ascertain hostility narrowed on: withdrawal of support by significant others, maltreatment and overdependence on the older person because benefiting from cash transfer. 55 Table 8: Incidenceof hostilityfrom the community and or relatives to the beneficiary older person-2012 Presence of hostility Yes No Non responses Total Frequency 11 129 14 154 Percent (%) 7.1 83.8 9.1 100 While a minority (7.1%) of the respondents said that they did receive hostility, a majority (83.8 %) did not receive any. However, about 9.1 percent of respondents did not provide any answer to this question The following were reported among the 7.1 percent cases that exhibited hostility. About3.9 percent respondents indicated withdrawal of support by significant others when they started receiving the stipend. Another 1.9 percent indicated having been maltreated by either the community or significant others. Finally 1.9 percent of respondents reported of the community having spoken negatively about them when they started receiving the cash transfer stipend The limited number of hostile cases can be deduced to mean that the programme is largely accepted by the community. Acceptance by community members could be an indication of enhanced awareness of the programme, good security of the area and or acceptance of the elderly and the elderly programme by the Makueni community. 4.3.3 Distance from pay point The research sought to know whether beneficiaries experienced any challenge as far as the distance to pay point is concerned. Questions regarding the means of transport to the pay point and how much is spent to and from the paypoint were asked. Being aged, walking by foot or using a boda boda (motor bykes/bicycles ) is considered a challenge. On the other hand long distance means spending much money to the extend that the stipend might not benefit the household. The following were looked into as challenges related to distance 56 i). Means of transport to the pay point. Beneficiaries reported using public behicles (93%). A minority (3.2%) uses boda boda and another (2.6 %) go by foot. However 1.2 percent of the respondents beneficiaries did not provide any response. ii). Amount spend on transport to the pay point Table 9. Table showing amount of transport to the paypoint-2012 Amout (KES) 400 and below 401-800 801-1200 Total Frequency 121 32 1 154 Percent (%) 78.6 20.8 0.6 100 Though majority (78.6%) indicated using public vehicles and spending less than KES 400, almost a quota of the respondents (21.8 %) indicated spending more that KES 401. It is evident from the table that there are those whose who incur up to between KES 800 to 1,200 for transport alone. When much of the stipend is spend on transport the ultimate effect of the cash transfer to the household is drastically reduced. 4.4Impact of cash transfer programme on the welfare of the elderly and their households. This was the key objective of the research and aimed at establishing the impact of cash transfer on beneficiaries of cash transfer programme for the elderly. Focus was on the welfare of the older persons specifically in regard to: food security, health, clothing, shelter, education support of school going household members, access to goods and services on credit, social inclusion and household micro-investments. With view to establishing impact, the research compared findings from analysis of targeting and registration forms in cases where the welfare indicators were available. In instances where welfare indicators were not available in the 2009 data, the research controlled for variables. The control was mainly in regard to other sources of income other than cash transfer programme. 57 The research found cash transfer as the main source of income. Income from other sources amounted to a relatively small amount (KES, 1,089)compared to cash transfer stipend which is KES 2,000 per month. Significant impact is seen in household food security, clothing, social inclusion, enhanced access to goods and services on credit, shelter and education of school going household members. Priority in spending cash transfer largely went to food, shelter and education of household members Presented below are the findings in regard to households’ other sources of income, use and prioritization of cash transfer and finally on the impact of cash transfer on older persons wellbeing. 4.4.1 Other sources of income of the household other than from cash transfer. The research also assessed other sources of income of the older persons’ households so as to attribute any significant impact to the cash transfer. This is as presented in the comparative bar graph below. Graph 3: Mean income from other Sources -2012 450.00 415.20 400.00 325.30 Mean income in KES 350.00 300.00 250.00 185.80 200.00 162.70 150.00 100.00 50.00 0.00 Agriculture Employment Donations Remittance It can be observed from the graphical presentation that the mean income from other individual sources is less than KES 500 with the total mean monthly income from other 58 sources coming to approximately KES 1,089. This therefore implies that majority of the household income is from cash transfer since the monthly stipend is KES 2,000. This amount surpasses the cumulative amount from other sources. 4.4.2 Uses and prioritization of the use of cash transfer by beneficiary household. Uses of cash transfer were seen in terms of basic household necessities to include: food, shelter, clothing, medical care, micro investments, water and sanitation. Table 10: Uses of cash transfer by beneficiaries Type of use Food Education Health Shelter Clothing Small Water and Investments Sanitation N=101 N=82 N=96 N=128 N=88 N=114 N=152 Number of households 152 101 82 96 128 88 Leisure 114 18 Having known how the households spend their money, the research further sought to establish what the household considers a priority when it comes to spending of cash transfer. Table 11: Prioritization of the use of cash transfer by beneficiary households Ranking according to priority of spending 1 2 3 4 5 6 7 8 Total respondents Clothing Shelter N=110 N=92 1 45 40 15 4 3 1 1 110 18 14 18 30 5 4 2 1 92 Small investments N=79 0 17 11 18 18 11 4 0 79 Food Education N=104 N=152 121 22 5 4 0 0 0 0 152 29 15 12 15 11 9 3 10 104 Leisure Health N=19 N=77 0 0 0 2 2 3 6 6 19 Remittance N=19 15 35 10 5 3 4 3 2 77 The findings reveal that the older persons cash transfer is basically spend on basic needs. According to DFID (2005), initial evaluation of Kenya’s OVC-CT programme suggested 59 0 4 3 0 0 4 2 6 19 that the money had been spent on: food, clothing, shoes, medical expenses and minor household purchases. In so far as ranking of use of the stipend is concerned, a majority (121) indicated food as their number one need to consider in spending their cash transfer. This is followed by education (29 respondents), then shelter (18 respondents) followed by health (15 respondents). One case indicated clothing as their number one priority. In rank number two and three clothing came the highest with (45) and (40) respondents respectively. Leisure was pointed least with a total of 19 respondents ranking it but placing it at the rear or near rear. These findings relate to the framework of Maslow’s hierarchy of needs theory in the sense that majority of the respondents rated food as their first thing to spend on when cash transfer is received. Other areas that were identified as a priority are education of household members, shelter, clothing and health. All of these needs fall under physiological and safety needs according to Maslow. Leisure which probably falls under esteem needs was least ranked with majority not rating it at all. From the findings above it is apparent that food, education and shelter respectively were placed high by majority household. Poor households tend to meet survival needs like food and this could be the reason why majority (121) ranked food a priority to spend on. As far as education is concerned, one might wonder why education is not a need for survival yet a comparable good number identified it as a priority. It is hereby arguable that education being one of the imperative gates to better livelihood and could therefore be part of the reasons for directing household resources including cash transfer towards its spending. One old woman said that he would not like to see her grandchildren stay home as others went to school and hence she ensures that their fees are paid before thinking of other needs. Humans need warmth and a cover to survive and hence the rationale of spending first on shelter. According to Soares et al, (2008) Cash transfer programme are seen to provide steady and reliable source of income that can have significant effects upon the capacity of households to invest in human and physical capital, and overcome the threat of a long term, persistent poverty. Receipt of cash transfers provide small amounts of capital for 60 investment in productive activities, giving the recipients opportunity to not only protect but also improve their economic wellbeing .(Vincent and Freeland [ND). Being open ended, questions on the use and ranking of the cash transfer programmes brought out data regarding the impact of cash transfer on the wellbeing of the older person. In their explanation of the use of the fund and their priorities for spending, a wealth of qualitative welfare indicators in relation to: clothing, education of household members, and health of the older person among others came out strongly from the responses on the use and prioritization of the cash transfer stipend. 4.4.3Findings on impact of Cash transfers on the welfare of the elderly and their households. Impact was assessed by assessing such welfare indicators like: food security and nutrition, health of the older person, credit worthiness/ability to access goods on credit by virtue of being a recipient of cash transfer, social inclusion and economic sustainability of the households upon ending of the programme. 4.4.3.1 Food security and nutrition. In this case the research focused on the number of times the household is able to have meals. The targeting tool was useful in establishing the food security of the household because a question on the same was asked during 2009 targeting. The responses at the start and three years of the programme are as summarized in the graphs below 61 Graph 4: Number of meals per day by beneficiary households Number of meals per day 2009 Number of meals in a day 2012 48.7% 50 40 32% 30 20 85.3% 90 Number of household (%) Number of houholds(%) 60 19.3% 10 0 once in a day 80 70 60 50 40 30 20 14.7% 10 0 Two Times Three Times Two times Three times Evidence from baseline shows that majority of the households (48.7%) had two meals in a day 32 percent had approximately three meals in a day and another 18.3 percent had one meal in a day. Analysis of impact assessment shows a positive change in the number of days the households access their daily meal. A smaller (14.7%) percentage indicated their ability to access more than two meals while majority 85.3 percent indicated their ability to access three meals in a day. This change can be associated with the cash transfer considering the act that majority of the beneficiaries had their stipend spend on food. Hart, (2009) defines food security as availability at all times of adequate world supplies of basic food stuffs to sustain steady expansion of food consumption and to offset fluctuations in production. Relating to Hart’s definition, the research saw a significant change as far as the frequency of food consumption is concerned. Past researches indicate significant impact of cash transfers to households’ food security and nutrition. According to a research done by Barrientos and Lloyd-Sherlock (2002), in South Africa, having a recipient of social pension in a household has been correlated to a three to four centimeter increase in height among children 62 Sources of household food Most of the households (76%) said that they mainly sourced their food from the market followed by own farm (13.6%), relief food (7.8%). A minority (2.6%) of the household indicated getting from other sources which they did not specify. Access to cash transfers give them the advantage of getting food from the market; a source which was mainly mentioned by many households. The fact that majority obtain their food from the market means that lack of income denies them the very opportunity of obtaining food. Lack of regular income or cash threatens the food security of poor household. It can therefore be argued out that regularity in the disbursement of cash transfer fund can have positive influence on household food security. To establish the nutrition status of the household, questions on nutrition were posed and the responses are as presented below. 63 Table 12: Nutrition of respondent’s households-2012 Type of food Daily at least once a week at least once a month 1.3% 4 when it is available Total (%) Total Number 2.6% 2 100 154 Cereals and Cereal Products Milk and Milk Products Sugar and Honey 94.8% 146 1.3% 2 64.9% 100 27.3% 42 2.6% 4 5.2% 8 100 154 82.5% 127 11.7% 18 1.9% 3 3.9% 6 100 154 Oils and Fats Meat & Poultry Pulses ,legumes ,nuts Roots & Tubers Vegetables Fruits Fish and sea Food Miscellaneo us (e.g. sweets) 72.7% 112 24.7% 38 2.6% 4 0 100 154 3.2% 5 3.2% 5 80% 123 13.6% 21 100 154 54.6% 84 24% 37 9.7% 15 11.7% 18 100 154 16.2% 25 31.2% 48 24% 37 28.6% 44 100 154 51.9% 19.5% 2.6% 80 30 4 36.4% 39% 8.5% 56 60 13 6 9 33 7.8% 35.7% 67.5% 12 100 55 100 104 100 154 154 154 8.5% 13 11% 17 3.9% 5.8% 21.4 % 35.7 % 55 44.8% 69 100 154 - Majority (94.8%) households have cereal and cereal products daily followed by sugar and honey (82.5%), oils (72.7%) and then milk and milk products (64.9%). From the table above the intake of most vitamins and proteins is indicated by a few respondents as a daily meal. Meat is mainly taken at least in a week (80%). Fish and sea food is a rare food for the respondents It is however difficult to show how the households fared during baseline because there was no question asked to ascertain the nutrition of the household. From the findings, it can be observed that the households still do not have a balanced food intake as shown by the majority (80%) respondents for instance who indicated using meet at least once a month. 64 Good nutritional practices are very important during old age for health development and defense from diseases (Ondigi and Ondigi, 2012). It can be an adversity for an elderly to have imbalanced diet and more so when they miss a meal considering the fact that they are in their physically degenerative stages of life where food is depended majorly upon to build and protect the body. 4.4.3.2Household Assets The research assessed household assets in reference to livestock ownership specifically increment in the number of; sheep, goats and cows. The focus on livestock was informed by availability of baseline information on livestock as an household asset. Graph 5: Number of Livestock owned Number of livestock owned 2012 3 2.5 Average number of livestock Average nmber of livestock Number of livestock owned 2009 2.39 2 1.5 1 0.6 0.33 0.5 0 Goats Sheep Cows 3.5 3.12 3 2.5 2 1.5 0.71 1 0.35 0.5 0 Goats Sheep Cows The findings saw a relative change in livestock numbers. Respondents too associated the increment in livestock number to spending of cash transfer. Older persons were eager to show the livestock bought using the cash cash transfer. Most of the household said they have so far bought three (3) to seven (7) goats with their transfers since their enrolment to the cash transer programme. A sizeable nnumber too reported having bought local chicken. Yet a few others said their goats had multiplied but they had resold them to enable them pay school fees for their children. On purchase of livestock, one woman said; 65 ‘’One woman from Kinze sub-Location said that she used her cash transfer stipend to purchase three goats. One of it was sold to pay school fees for my granddaughter and another one died. The one left now has given birth to five young ones. I am planning to buy a cow when I get my next stipend.’’ Another 74 year old man said; ‘’I have two goats and one cow bought using government money for the elderly. These goats and cow and more that I ask God to enable me to buy will feed this family in future. Here in this region, we put seeds down (plant) and sometimes we don’t get any harvest from it. Having livestock especially goats which are resistant to drought are useful during dry seasons.’’ According to Arnold and Margaret (2010) cash transfers have reduced household vulnerability through asset accumulation and more stable income flows that allow them to better plan their expenses, pay their debts and get credit more easily, resulting in increasing consumption of goods and service. This confirms the above findings. From the statements above, it can be noted that such accumulated household assets can relief the family from strains should pressing need occur for instance respondents were able to indicate selling goats bought using their transfers to offset school fees arrears. At the same time household assets are added. 4.4.3.3 Shelter The graph below (6 and 7) presents a contrast of respondents shelter characteristics in year 2009 when most of the recipients of the cash transfer were enrolled into the programme and in 2012 when the research was carried out. 66 Graph 6: Major construction material -2009 80 70 60 50 40 30 20 10 0 Roof Material 73.4 26 0.5 0.1 Number of houselds(%) 70.7 80 70 60 50 40 30 22.8 20 4.2 1.8 0.5 10 0 Number of houselds(%) Floor Material Mud/Cow dung Grass/sticks/makuti Stone/brick/block… wood Iron sheets Number of houselds(%) Wall material 80.1 % 90 80 70 60 50 17.6 40 30 % 20 1% 10 0.7% 0.5%0.1% 0 Graph 7: Major construction material -2012 16.5 80 70 60 50 40 30 20 10 0 120 72.7 27.3 Number of houselds(%) 83.5 Number of houselds(%) Number of houselds(%) 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Roof material Floor material Wall material 100 96.1 80 60 40 20 3.9 0 Iron Sheets Grass Graph 6 shows the status of dwelling characteristics of targeted older persons in the year 2009. On construction material of the floor, it shows a high percentage of households which had the wall done using stone, block, brick or cement. During data collection, it was observed that the most available material for wall construction was particularly homemade bricks and locally available stones. An example is as illustrated in the photo below. 67 Photo showing the wall material of a grandmother’s house in Makueni(taken in 2009) Retrieved from the Department of Gender and Social Development-Makueni Most of the houses were made up of mud/cow dung as floor material. The commonest roofing material was iron sheets with a majority at 80.1 percent using it for roofing. It is worth noting that building materials especially for homemade for bricks are readily available. This could explain why the general condition of houses in either of the research periods were generally good Although majority of the households had relatively good shelter before benefitting from the programme, findings of 2012 reveals an improvement in shelter especially on the roofing and the wall. Most of the respondents showed their houses having been built a fresh using the stipend and a majority renovated/improved through plastering the house with a cement coating either on the floor and roof. Others still revealed having bought iron sheets to replace their previously grass thatched houses. Asizeable number of respondents (96) indicated having spend their cash transfer on shelter and another 18 ranked it as as number one priority item to consider when it came to spending their stipend on. Older persons were quite excited to show the houses that they have put up using their stipend. 68 Some of the photos that show the conditions of houses before and after the interventions are as shown Figure 1: House before receiving cash transfer Figure 2: House built using cash transfer (iron roofed) 4.4.3.4Health conditions of respondents. There was no baseline data to show the condition of elderly before enrolling for the programme. However, qualitative statements by some respondents depicts and improvement in overall health of the older person. A general rating of respondents’ health showed that majority of the elderly were in good condition. Respondents were asked to rate their health condition and responses are as presented in the table below Table 13: Health conditions of respondents-2012 Health condition Very good Good Poor Very poor Total Frequency 24 91 30 9 154 Percent (%) 15.6 59.1 19.5 5.8 100 69 Whereas the highest ratio of beneficiaries said their health was in good health, it could not be directly linked to the effects of cash transfer. This is because, the research made an assumption at the design stages of the existence of baseline survey findings from the MOGSD hence obtain the health status of the older person as at the time of enrolment in 2009. However, there was no such information available. On the other handagoodnumber of respondents (82)indicated using cash transfer in meeting medical expenses of self and household members. According to DFID (2005) social transfers enhances those living in extreme poverty to access health services and pay for medicines and associated costs. In Namibia for instance, pensioners spent 13.8 percent on the cash they receive on healthcare for themselves and also to cover the other members of the household (Devereux, 2001) While commenting of his inability to cope should the cash transfer programme end, one 77 years old man from Waia Location said; “I was bedridden before the government enrolled me to this programme. I had a disease that blocked my urinal system. When I got my first money, I went to hospital and I was given medicine and a tube that has helped open the urinary system. I can now walk and even go in person to collect the money from Tawa post office. When I get my stipend, I go to see the doctor for checkups. I live with two orphaned children one of whom has two children born out of wedlock, my wife looks after my granddaughter’s children while she is away in Nairobi doing housekeeping work to support our food needs. Basically this cash transfer is for my health and stopping it will mean the end of my life”. It can be seen from the statement that the cash transfer as done substantially well in so far meeting the health needs of older persons is concerned. 70 4.4.3.5Education support of household members A majority (101) used their cash transfer in meeting the education needs of their household members.A 68 years old woman beneficiary of Waia Location while explaining her use of the stipend on education said; ‘’I help my grandchildren in both primary and secondary. Two of my granddaughters are in Mweasecondary day school while three are in primary. I help a lot with the payment of fees for those in high school. The children belong to my son but he is a drunkard and does not have adequate money. I love my grandchildren because they help me a lot. The head teacher does not send my grandchildren home because he is aware that I pay when I get my stipend. At some point the stipend was delayed and we were given a cumulative amount of KES 8,000. The amount helped me a lot in settling the fees arrears.’’ This and many other responses from older persons revealed that in so far as cash transfer use on education is concerned, the stipend is mainly spend on paying fees partly or wholly, purchase of school uniforms, pocket money and in buying school stationeries like pens and books. From the above statement it can be argued that cash transfers boost the credit worthiness of recipient older person, who act the roles of household heads/or caregivers, to the extend that a school going child is retained in school even at a time when funds are not available. This therefore could enhance retention among school going children and hence uninterrupted learning. According to Barrientos and Lloyd (2002), there is evidence in Brazil to show that old age pensions have helped to increase school attendance. A research done in Namibia by Devereux (2001), shows that old age pension is spent on children’s education. 4.4.3.6Clothing and beddings Clothing is a source of warmth at the same time a boost of self esteem. A lot of older persons (128) used their stipend on their clothing and that of their hosehold members that 71 depend on them. It was placed higher with eighteen older persons putting at number one and 45 percent at number two. There was no data available to ascertain the situation of the elderly as of 2009 but the respondents brought out vividly while expounding on their use of the cash transfer. A seventy seven (77) year old woman from kathonzweni joyously said; ‘’Look at me. I am now smartly dressed. I have bought new dresses using my stipend. When we go inside there I will show you my new dresses. Initially I could not afford good cloths because I used to spend most of my income on food. Now I can go to church and even speak before the gathering because I feel I am smartly dressed and people respect me and my opinion.’’ It can be unearthed from the statement above that acquiring clothing not only gives warmth but also enhance the esteem of the person who has acquired. The acquisition of basic needs therefore adds to other imperative human needs of psychosocial nature for instance 4.4.3.7Access to goods and services on credit The research sought to know whether respondents were able to access goods and services on credit and if so to approximate the percentage amount obtained from specified sources including cash transfer. The research probed on such items as; obtaining household items like: sugar, soap, water, maize flour and such services as: medical attention, education of a school going child among others as some of the goods and services that a household can access through credit. The following were the replies. 72 Chart 2: Access of goods and services on credit by beneficiary households 37.7% Not 60.4% Yes 1.9% Non-response Majority of the respondents (60.4%) said that they could access services on credit, 37.7 percent said they could not because they either did not like borrowing or did not have the money to settle the debt. Respondents who indicated accessing credit were further queried to establish the sources of money they rely on for settling the debt. As to the sources of settling the debt, the following were pointed out. Graph 8: Approximation in percentage of source of money used to settle debt from Number of household (%) goods and services bought on credit-2012 90 80 70 60 50 40 30 20 10 0 85.7% 66.9% 60.9% 14.3% 13% 0-20 From own business/farm produce 15.4% 15.5% 21-40 15.5% 4.9% 41-60 From remmitance 1 cash transfer 5.8% 61-80 81-100 It is evident from the graph that cash transfer was awarded 81-100 percent by a majority ( 60.9%) as the main source of settling debt. A few household relied the least on income from remittences, farm and or own business to settle debts as shown by majority of the 73 respondents who rated them at the lowest percentage of between 0-20 percent. This is corroborated by DFID (2002), who pointed out that the provision of a guaranteed and predictable minimum income provides them with a level security and increase their ability to plan for the future including accessing and settling credits. 4.4.3.8Joining social groups The research sought to establish whether older persons are members of any social group as a result of being beneficiaries of cash transfer. The findings were as follows; Chart 3: Beneficiaries who joined social groups since enrolment into the cash transfer programme-2012 32.5% did not join any group 61.7% joined a group 0.6% Those who did not respond When older persons were asked whether they had joined a social group ever since becoming beneficiaries of cash transfer, a majority (61.7%) said they did, 32.5 percent said they did not while 0.6 percent did not respond to the question. Most of the social groups formed were merry go rounds and welfare groups. During pay days, members of merry go rounds contribute to each other with the aim of engaging in such activities as purchasing goats, improving shelter and water storage. One 75 older person from Magongo village of Kivani Sub-Location said that she was in a Self Help Group (called MumoWangui)consisting of 56 members, 18 of which are beneficiaries of the Older Persons Cash Transfer Programmes. The group was said to be engaged in table banking, basketry using sisal ropes, improving shelter and buying each other goats and beddings. In their current activity, they were buying each other plastic tanks and they had reached the 34th person. The 75 year old lady said that her joining the group was motivated by the fact that he was receiving regular money from the government. Welfare groups like any other organized group enhances individual 74 bargaining power in that they can be able to access other group benefits like community grants. Other benefits would entail help by group members in case a member has a social or monitory problem. Coleman (1994) opines that social capital is productive; making it possible the achievement of certain ends that in its absence would not be possible. The fact that older persons are engaged in group activities (merry go round and welfare groups) gives them the advantage to access other benefits which they would otherwise have not. Notable is ability of the older person to add assets to the household in the form of goats, cows and the like. The acquisition of assets, though small, is a social capital to the older person in the sense that they can be respected by community members as persons who own property. 4.4.3.9 Coping mechanism upon withdrawal of the programme This question was meant to ascertain the sustainability of the programme.Respondents were asked to explain how they would cope if the government of Kenya decides to end the support of the elderly through cash transfer. Graph 9: Coping mechanisms of households (%) when cash transfer programme is Number of households (%) withdrawn-2012 56.6% 60 50 40 30 20% 20 10% 7% 6.4% Relief Relatives 10 0 Agriculture Micro investments Difficult to cope About 10 percent said that they would sustain their livelihood with the small investments (purchased goats, cow and chicken) bought using the cash transfer 20 percent said that 75 they would continue with their peasant farming, 7 percent indicated reverting to reliance on relief assistance. Another 6.4 percent said that they will rely on relatives for support. Larger percentage (56.6%) said that they would not be able to cope when the cash transfer is withdrawn. It is interesting to note that less old persons (6.4%) indicated seeking support of family members/relatives when the stipend is withdrawn. The effects of modernization and urbanization have resulted to over emphasis on the nuclear family leaving out on the traditional safety nets by the extended family. The ever pressing needs force able household members to seek for employment from the urban areas leaving behind the elderly. KNCHR (2009) attributes this to the breakdown of the traditional family support structures so that the primary focus of the family is on the nuclear and not the extended family. Such finding confirms the need of the family to take care of the older person as expressed in the National Policy on Older Persons and Ageing and the AU Policy Framework and Plan of Action on Ageing. Those who said they would seek help from relief food indicated that their families were too poor to support them. This is what a 77 year old older woman said “I was surviving on well-wishers before the government included me in this programme. In the event that it decides to take it back, I will just rely on relief food to survive. My children are unable to sustain my needs because they currently have difficulty meeting their own needs” About 10 percent of the respondents who used part of their money to add themselves small household assets argued that they will use their small investments to meet their basic needs when the fund is taken from them. While expounding on this, one 75 years old woman said the following statement “Together with some other few older persons who receive the cash transfer, we have formed a merry go round and bought each other goats. Now I have five goats. This will sustain me if this fund is going to be taken away from us.” 76 Agriculture is another option in which respondents said they will revert to if they cease to benefit from the stipend. Many who mentioned agriculture said that the means is not so sustainable because sometimes they plant and fail to harvest because of drought and since they didn’t have any option, they will simply opt for. A 69 year old man had this to say. “I pray that they don’t take away the fund from us. If they do then I will just continue with my peasant farming” A majority (56.6%) said that it was difficult for them to cope without the fund. Those who said they would not be able to cope cited health, frailty and lack of money as their main reasons behind their inability to sustain their household should the cash transfer This could point to the fact that Eastern Region is a semi-arid zone and peasant agriculture may not be quite reliable to augment the household with farm food. Since majority of the households rely on market foods, a sizeable amount of the transfer could be spend on basic household need as opposed to income generating activities hence the inability of the household to sustain their households without the stipend. Another reason relate to the fact that older persons are in their less productive stages in life and thus the fear that their ageing bodies may not enable them to engage in other income generating activities. The rationale for most social protection programmes for the elderly is related to the challenges that come with aging. Most social assistance programmes like cash transfer does not give conditional assistance to adults. In Kenya for instance the OVC-CT programme is advanced on condition that the household sends all children to school. Kenya’s OPCT programme is non-conditional. Brazil’s older persons cash transfer programme is also unconditional. Soares et al (2006) says this about Brazil’s cash transfer of the elderly ‘the benefit is independent of previous to previous contribution to social security system and is not subject to any conditionality’. The government of South Africa equally implements a non-contributory pension scheme to older men above 65 years and older women above 60 years of age (KNCRH 2009:20) National, Regional and international instruments emphasis the need to protect the interest and wellbeing of older persons through development of policies and 77 programmes that address their needs. These include the AU Policy Framework of and Plan of Action on Ageing of 2003 which informed the formulation of the Kenya National Policy on Older Persons and Ageing and subsequently Social Protection programmes for the elderly. The Constitution of Kenya recognizes older persons of Kenyaasa vulnerable constituent who deserve to be taken care of by the state. 78 5.0 CHAPTER FIVE: CONCLUSIONS AND RECOMMENDATIONS This chapter basically presents the summary or conclusions of the study. It makes recommendations based on the findings of the study as presented in chapter four of this paper. It further makes recommendation for future research related to the topic of study and emanating from existing gaps and on potential areas of research. 5.1 Conclusions The research observed that the older persons cash transfer programme is a targeted programme which reached up to approximately 2.5 percent of all older person above 65 years as of November 2012. However, this percentage is seen to be small considering the fact that 56.4 percent of older persons above 60 years are poor according to the Kenya integrated Budget Survey of 2005/2006 (KNBS, 2007). Though the coverage in terms of numbers is small there is a considerable evidence of positive impact in the livelihoods of beneficiaries. The research used secondary data in establishing the baseline status of beneficiaries of the OPCT programme, and primary sources of data including interview schedule, key informant interviewand observation to establish; 1. How cash transfer reaches beneficiaries from the highest level to the beneficiaries in Makueni County 2. The challenges faced by the older person in accessing and as beneficiaries of cash transfer and; 3. The impact of cash transfer to the welfare of the older person and their household How Cash Transfer Flow from the highest level to beneficiaries The study found out that the Ministry of Gender Children and Social Development headquarters whose current physical office is the NSSF building, processes cash transfer for the elderly by requesting for funds from the exchequer account then wires to PCK which is the disbursement agent of the fund. PCK re-channels the money to their 79 branches which are identified by the older person through the District Gender and Social Development officer as their nearest pay points. The DGSDO through the assistance of location committees and local administration inform beneficiaries of the dates of payment upon which they turn up in tune with the informed dates. It also revealed that some older persons travel a long distance in order to reach the pay points hence forced to spend more money for transport. Challenges of Cash Transfer programme to beneficiaries The research made an assumption that because the programme was unable to reach to so many elderly, those excluded would feel bad for those who receive or household members may demonstrate withdrawal of support. Interestingly, only 7.1 percent (11) indicated having received hostility with a majority reporting to have experienced withdrawal of support. A few others indicated having been maltreated by the community and being spoken of negatively by the community members by virtue of benefiting from the cash transfer programme. This paper therefore concludes that the programme is widely accepted by the community as demonstrated by the majority who did no face any hostility. Impact of Cash Transfer programme on the welfare of older persons Recipient households were found to spend their cash transfer on basic needs including: food, shelter, clothing, education of household members, remittance, water and sanitation and leisure. Priority was seen to be given to food, education of school going children and shelter. Cash transfer was found to have impact on the welfare of the older person and that of their households. Evidence of impact was seen in such areas as: health of the older person, food security of the household, access of goods and services and a demonstrated enhancement in credit worthiness of the older person, ability of older person to join social groups, education of household members, shelter and clothing. 5.2 Recommendations of the study In light of the above and other findings of the study, the study recommends the following 80 1. That based on the impact that cash transfer brings about in enhancing the wellbeing of the older person, the research strongly recommend to the government of Kenya to increases funding of the programme in order to facilitate further expansion to reach to all the older persons in the Country who meet the criteria for support. 2. This paper confirmed that all the older persons interviewed were beneficiaries of the older persons cash transfer entitled to KES 4,000 after every two months. However, it came out clearly during the research that the stipend is not always regularized (every two months) as the guideline stipulates, though it is backdated to the previous payment in the event that the cash is delayed. A recommendation is made to the Ministry of Gender, Children and Social Development to ensure that the stipend is usually regular so that beneficiaries are able to predict and hence plan to expend. 3. It was also noted that beneficiaries spend up to approximately 800 on transport to collect their stipend. A recommendation is therefore made to the Ministry of gender, Children and Social development to consider exploring other disbursement agents like use of cell phones, Bank agents or to PCK to consider giving mobile services to older persons in programme being a special case. 5.3 Recommendations for further research 1. This study focused on Makueni County alone. An expansive study that includes more counties and likewise older persons would bring out more on the impact of cash transfer on the welfare of the older person than one county hence a recommendation for an expansive study 2. The research focused on Cash transfer and its impact on the welfare of older persons in Makueni County. Since Makueni is a rural setting, this paper recommends another study in the urban areas to bring out comparative findings. 3. The research revealed that older persons experience challenges in assessing their stipend and that the disbursement agent of the fund is solely the PCK. It therefore recommends a research aimed at assessing the effectiveness of the PCKin disbursing cash transfer stipends to the elderly with view to recommending improvements and or making recommendation on exploring more reliable agents. 81 Annex 1: Photo Gallery Above: A woman beneficiary waits to be paid in Makueni post office Below:Beneficiaries line up in makueni post office to receive their stipend 82 Left: A woman beneficiary of Magongo village shows some of the goats bought using the stipend 83 Annex 11: Interview schedule Introduction. My name is Emily JepkoechKimosop. I am a student at the University of Nairobi pursuing a Master’s Degree in Arts (Sociology). I am undertaking a research on Older Persons Cash Transfer programme. My research aims at establishing the impacts of the OPCT programme on the welfare of older persons in programme. The purpose of my research is purely academic. The reason why I have chosen you as my interviewee is because you are a beneficiary of the programme. I wish to assure you that whatever information you will give me regarding yourself and the Older Persons cash Transfer programme will be treated with due confidentiality. Thank you PART A: GENERAL INFORMATION 1. Location………………………….. 2. Age of the older person ………………………… (indicate the number of years) 3. Sex…………. (a) Male 4. Marital status…… (a) Married (b) Female (b)Separated (c) Divorced (d)Widowed 5. Education level (a) Illiterate (b) Semi illiterate (without formal education but able to read and or write) (c) Primary level (d) Secondary level (e) College and above 6. Main occupation………………………………………….. 7. (i)Family composition S/N o. Relationship with you Gender M F Occupation (specify the level Economic status of education if they are of Earne Helper Dependen school going age. Indicate whether any has dropped r ts out of school. 84 (ii) Give reasons for dropping out of school if any……………………………………………….................................................................. AWARENESS OF THE OLDER PERSONS CASH TRANSFER 8. Are you aware of the GOK’s cash transfer Programme for the elderly? (a) Yes (b) No 9 (i). Are you a recipient of the Cash Transfer fund? (a)Yes (b) No (ii). If yes, how much do you receive after every two months........................................... 10. (i)Do you receive the cash transfer regularly after every two months (a) Not at all (b) less often (c) Quite often (d) Always (ii)What is the reason for your choice in 10(i) above……………………………………………………………………………………… 11. (i) Have you received any aggression from the community and or members of your household because of being a beneficiary GOKs cash transfer for the elderly? (a) Yes (b) No (ii)If yes, tick (✓) the following possible responses appropriately Type of aggression Withdrawal of support Stealing of the cash Maltreatment(e.g beating or any kind of physical of verbal abuse) Overdependence Others. Specify……. Response 12. What is the means of transport to the pay point? (a) By foot (b) Bodaboda (c) public vehicle (d) Others, specify………………………………………………………… 85 13. How much do you spent for your transport the pay point (a) Less than 400 (b) 401-800 (c) 801-1200 (d) More than 1201 INFORMATION ON INCOME 14. On monthly basis, how much money do you get from the following? Business Agriculture Employment Contributions (harambee, gifts) Remittances (relatives and sponsors) Others, specify Total amount 15. Prioritize the following according to how you spent your cash transfer (from the area that cash transfer is mainly spent on) a) Clothing…………………………………………………………………… b) Shelter……………………………………………………………………… c) Investments e.g. purchase of goats, cows, chicken…………………………… d) Food………………………………………………………………………… e) Spending on children’s education……………………………………………. f) Leisure activities……………………………………………………………… g) Health………………………………………………………………………… h) Remittances…………………………………………………………………… 16. On a daily basis, how many times do you have your meal? 17. What is the main source of food in your household? (a) Own food (b) Purchase from the market (c) Relief food (d) Others (specify)……………………………………………. 18. Indicate the type of food you and your household consume in the order provided below 86 Pool Types in the pool(use the nutritional checklist) Frequency of consumption in a month (Tick as appropriate) Daily Cereals and cereal products(e.g. maize, spaghetti, rice, bread, sorghum, millet) Milk and milk products (e.g. goat/cow-fermented milk, milk powder.) Sugar and honey Oils/ fats(e.g. cooking fat or oil, coconut, milk, butter, ghee, margarine) Meat, poultry (e.g. goat, beef, chicken or their products) Pulses, legumes, nuts (e.g. green grams, lentils, cowpeas, peanut) Roots and tubers(e.g. sweet potatoes, cassava, arrowroot, Irish potatoes) 87 At least once a week At least once a month Only when available Vegetables(e.g. greens, or leafy vegetables, tomatoes, carrots, onions) Fruits(water melons, mangoes, grapes, bananas, lemon) Eggs Fish and sea foods (e.g. fried/boiled/roasted fish, lobsters) Miscellaneous (chocolates, spices, sweets, beverages) 19. What is the major Construction Material of your houses (observe) (i) Wall………………………….. (ii) Floor………………………… (iii) Roof…………………………. 20. How many Livestock to you have? (i) Goats……….. (ii) Cows……….. (iii) Sheep……….. 21. How do you rate your current health condition? 88 (a) Very good (b) Good (c) Poor (d) Very poor 22. (i) When you are sick, where do you often seek for treatment? (a) Government Dispensary (b) Private hospital (c) Local medicine men/women (d) Waiting to heal (e) Others, Specify……………………………………. (ii)What is the reason for your choice in 22(i) above………………………………………………….. 23. What do you spent your cash transfer on. (List the uses) …………………………………………………… ……………………………………………………….. 24. Are you able to access credit facilities in your local area (e.g. from local kiosks, groceries?) (a) Yes (b) No (if No skip to 26 ) 25. About what percentage (%) of income from the following do you use in settling your credit (a) Remittance (i.e. from relatives and sponsors)….…………………………. (%) (b) From Own business/Sell of farm produce………………………………… (%) (c) From Cash Transfer……………………………………..…………………. (%) (d) Any other, Specify…………………………………………………………. (%) 26. (i) Have you participated in any training programme for fund management? (a) Yes (b) No 27(ii) If yes, how has the training been useful to you…………………………………………………… 28. (i) Since your enrollment in cash transfer, have you joined any social group (e.g. women group, welfare group, social clubs, village committee, etc.?) 89 (a) Yes (b) No (ii)What motivated you into joining the group……………………………………………………………………………………… 29. If Cash transfer is withdrawn today, what options are you going to adopt to cope ……………………………………………………………………………………………… 90 Annex III. Key informant’s interview guide for District Gender and Social Development Officer-Makueni Introduction My name is Emily JepkoechKimosop. I am a student at the University of Nairobi pursuing a Master’s Degree in Arts (Sociology). I am undertaking a research on Older Persons Cash Transfer programme. My research aims at establishing the impact of the OPCT programme on the welfare of older persons in programme. The purpose of my research is purely academic. The reason why I have chosen you as my interviewee is because you are directly involved in the implementation of the OPCT programme which is my topic of study. It is also my assumption that you have wealth of information regarding the programme. I wish to assure you that whatever information you will give me regarding the Older Persons’ cash Transfer programme will be treated with due confidentiality. Thank you. 1. How is the processing of cash transfer money done 2. How do you relate with the ministry headquarters as far as payment of the elderly enrolled in the OPCT programme is concerned 3. How is the cash transfer disbursed from the higher level to the beneficiaries 4. Who mobilizes the beneficiaries to turn up for payment 5. How are payments of OPCT programme beneficiaries done? 6. How do you ensure that the rightful Older Persons receive their payments? 91 Annex IV: Targeting and Registration tool for the OPCT programme Form 3.1: Registration / Recipient Targeting REPUBLIC OF KENYA MINISTRY OF GENDER, CHILDREN AND SOCIAL DEVELOPMENT HOUSEHOLD TARGETING FORM A. GEOGRAPHICAL LOCATION 1. PROVINCE 2. DISTRICT 3. DIVISION 4. LOCATION 92 5. SUB-LOCATION 6. VILLAGE B. GENERAL INFORMATION 7. Full name of Household Head FIRST NAME MIDDLE NAME 8. ID. NO. 9. YEAR OF BIRTH 10. Marital Status 93 SURNAME 11. Sex 12. No. of dependants in the household a) No. of older persons (65 years and above) b) No. of chronically ill persons in the household C) No. of OVCs in the household d) No. of Persons with Disability in the household 14. Highest level of education of Household Head 1. None 2.Primary 3.Secondary 94 4.Tertiary 5.University 15. Highest level of education of household level 1. None 2.Primary 3.Secondary 4.Tertiary 5.University 16. No. of school-going children (0-17 years) a) Nursery F M b) Primary F M c) Secondary F d) Others M F C) BENEFITS FROM OTHER PROGRAMMES 18. Is the household receiving benefits from any other programme? Yes No 19. If yes, specify the programme. 20. What type of benefit do you receive? 95 M a) Cash b) In-kind c) Others (specify) 21. How much is the benefit in Kenya shillings (Kshs) per month? 22. How frequent? 23. Have you been in any formal employment? 24. Are you receiving any pension? 96 D. DWELLING CHARACTERISTICS AND WEALTH 26. What is the major construction material of the WALLS? MUD/COW DUNG ……………………………………………………. 1 GRASS/STICKS/MAKUTI …………………………………………... 2 STONE/BRICK/BLOCK/CEMENT …………………………………. 3 WOOD …………………………………………………………………… 4 IRON SHEETS ………………………………………………………… 5 TIN ………………………………………………………………………… 6 OTHERS (SPECIFY) ………………………………………………….. 7 27. What is the major construction material of the FLOOR? MUD/COW DUNG ……………………………………………………. 1 WOOD ……………………………………………………………………2 CEMENT …………………………………………………………………3 TILES.…………………………………………………………………… 6 OTHERS (SPECIFY) …………………………………………………. 5 28. What is the major construction material of the ROOF? MUD/COW DUNG ……………………………………………………. 1 GRASS/STICKS/MAKUTI …………………………………………... 2 WOOD …………………………………………………………………… BRICK/BLOCK/CEMENT ……….…………………………………. 3 4 IRON SHEETS ………………………………………………………… 5 TIN ………………………………………………………………………… OTHERS(SPECIFY) …………………………………………………. 7 97 6 29. What type of TOILET does the household have? FLUSH TOILET ………………………………………………………. 1 PIT LATRINE .………………………………………………………… 2 NONE/PAN/BUCKET ….…………………………………………... 3 OTHERS(SPECIFY) …………………………………………………. 4 30. What is the main source of drinking water used by this household? PIPED WATER INSIDE BUILDING .……………………………. 1 PIPED WATER OUTSIDE BUILDING .………………………... 2 WATER TRUCK/VENDOR ………………………………………… 3 PUBLIC TAP …………….. ……….…………………………………. 4 SPRING OR WELL …………………………………………………… 5 RIVER/LAKE/POND OR SIMILAR .……………………………… 6 OTHERS (SPECIFY) …………………………………………………. 7 31. What is the household’s main source of LIGHTING fuel? ELECTRICITY ….……………………………………………………. 1 PARAFFIN/KEROSENE .…………………………………………... 2 GAS ……………………………………………………………………… 3 FIREWOOD ……………….……….…………………………………. 4 CANDLES ……………………………………………………………… 5 OTHERS(SPECIFY) …………………………………………………. 6 32. What is the household’s main source of COOKING fuel? ELECTRICITY ….……………………………………………………. 1 PARAFFIN/KEROSENE .…………………………………………... 2 GAS ……………………………………………………………………… 3 FIREWOOD ……………….……….…………………………………. 4 CHARCOAL …………………………………………………………… 5 98 RESIDUE/ANIMAL WASTE/GRASS …………………………… 6 OTHERS(SPECIFY) …………………………………………………. 7 33. How many farming acres of land does this household own here or elsewhere? None 1-3 4-5 above 5 acres IF APPLICABLE 34. Do you own real estate property here or elsewhere? Yes No 35. Do you own the house that you are living in? Yes No If No, how much rent do you pay? 0 – 500 501 – 1000 1001 – 1500 1500 and above 36. How many cattle does this household own? Traditional Zebu Hybrid 99 IF APPLICABLE How many goats does this household own? IF APPLICABLE 37. How many sheep does this household own? IF APPLICABLE 38. How many pigs does this household own? 39. How many camels does this household own? 40. How many meals do you have per day? None One Two Three 41. Other poverty characteristics the household may have and are identified by the LOC. 100 ……………………………………………………………………………………………………… …………………………………………………………………………………… SURVEY CONTROL FULL NAME OF LOC. 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