Sustainability of cash transfer programs: A realist case study

Cash transfers (CTs) are increasingly high on the agenda of governments and development partners in low-and middle-income countries (LMICs). While CTs have shown to be one of the most potent social policies to reduce poverty and improve human capital, concerns have been raised about their sustainability. This paper examines the mechanisms of, enablers of, and barriers to CT sustainability. Realist qualitative methods were employed to interview policymakers, development partners, and program managers (N = 32), as well as program beneficiaries (N = 93) in Ghana. The data were analyzed using a thematic framework approach. The findings show that enablers of CT sustainability include program institutionalization, availability of a functional exit strategy, and networking of social programs around beneficiary households. CTs' mechanisms of sustainability were shared vision and formalization of roles of service providers, program acceptability and buy-in, and productive inclusion. Key barriers to CT sustainability were political prioritization and ownership of the program, and weak intersectoral collaboration. From the analyses, we propose a conceptual framework which can be used to plan for CT sustainability.