Cash rewards keep children in school

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By Jane Dreaper BBC health correspondent in Mexico City

A programme which gives cash handouts to millions of Mexico's poorest people is being drawn on by other countries around the world.

Women are entrusted with the money for their families

The Oportunidades scheme distributes the funds only on the basis that families agree to keep children in school and attend regular medical check-ups.

Five million families throughout Mexico benefit from Oportunidades.

Because many of them have at least three children, the scheme looks after 25 million people overall.

On average, each family receives the equivalent of £30 a month.

It represents about a third of their income - and is vital in a country where employment can often be intermittent.

Cleaning workshops

Recently, the payments have risen by £6 a month, to try to help Mexico's poor adjust to rising food prices.

I went to a small, but very clean and well-ordered clinic in the hills above Mexico City.

The Rodeo medical clinic offers a range of services from family planning to basic nutritional supplements and ante and post-natal care.

The clinic also has a pharmacy, and there are even weekly workshops on the importance of keeping a household clean.

The poorest families who sign up to Oportunidades have to attend the clinic at least once every six months, to receive their cash payment.

It's efficient, filling a gap and allowing people to hold their heads up high Professor Lorraine Sherr, University College London

The incentive works - only 5% don't turn up.

Dr Ariadn Dominguez Kelly, 28, has been running the morning appointments there for three years.

He runs special health sessions for teenagers in the area, when he takes off his white coat and plays videos from YouTube to keep their interest.

He said: "Being involved with this work isn't like the normal doctor-patient relationship - it's more like a friendship."

'Filling a gap'

Oportunidades is well-established now, and it's a surprisingly cheap scheme.

Ninety-five per cent of its cost goes to the cash payments.

The money is always given to the women, on the basis that they're more likely to prioritise feeding and clothing their children.

Two new mothers, who nursed their babies as they spoke, told me how they valued it.

Before Oportunidades, they said, they didn't have any medical care at all.

One of the women said: "Everything's expensive now - tortilla, tomatoes, eggs, chicken, milk, rice, cooking oil - everything."

An expert from University College London, Professor Lorraine Sherr, was impressed with the clinic.

She said: "Cash transfer programmes like this hold out an example of how you can directly provide care to the poorest families - and enhance their basic living conditions.

"This is a really exciting programme.

"It's efficient, filling a gap and allowing people to hold their heads up high."

The strings attached to the cash payments have led to tangible achievements.

Children who were on the verge of dropping out from school are now at university.

Other versions of Oportunidades are springing up in countries such as Zimbabwe.

And the New York mayor, Michael Bloomberg, hopes to offer a similar programme to the American poor.