Leveraging social protection programs

mechanisms to enforce them, and are complemented with multisectoral interventions that include raising awareness among leaders at all levels, the practice will be difficult to root out.

LEVERAGING SOCIAL PROTECTION PROGRAMS

The existing Takaful and Karama program (TKP) presents a strong opportunity for expanding its reach. With its tight focus on supporting women’s access to health (especially FP services) and on promoting girls’ education, the TKP can be leveraged to optimize the impact on fertility reduction by creating platforms for “cash plus” interventions. That is, the TKP programs affect other aspects of people’s lives, including those that influence fertility.

The TKP database hosts over 8 million households (31 million individuals), encompassing all those who have applied to the program. Of those who applied, 3.4 million households (12 million individuals) were found eligible and enrolled in the program. Seventy-five percent of the cardholders are women, and 67 percent of the cash is dedicated to upper Egypt. In 2018, the government decided to have the TKP support up to two children only, which became effective in January 2019, echoing a clear message that the government is promoting smaller families to curb fertility and enhance social transformation. This is further emphasized through a program called “Two Is Enough” (box 7.2).

Policy interventions targeted at lower-quintile households to incentivize demand for schooling and attendance have proved effective in Egypt. They should be reinforced and diversified through the TKP, an effective mechanism for rewarding school attendance and health clinic visits. Other incentivizing

Box 7.2

“Two Is Enough”—Egypt’s campaign to address high fertility

The “Two Is Enough’’ program was launched in 2018 by the MOhP and the Ministry of Social Solidarity, in coordination with the united nations Population Fund (unFPA). It is meant to curb fertility rates by targeting Takaful beneficiaries, encouraging them to have only two children, raising their awareness of FP, and providing them with subsidized access to birth control. The initiative relies on awarenessraising sessions in addition to printed material, which is distributed among target groups to address social and health beliefs of FP.

The program includes a strong communication component, where messages are disseminated through Tv, radio, and social media campaigns to reach out to 1 million Takaful households in the poorest 10 governorates experiencing the highest poverty and fertility rates. The program’s outreach depends largely on community involvement. Over 2 million home visits were conducted by community workers, resulting in over 400,000 women visiting FP clinics, where they receive counseling and FP supplies free of charge. The role of community health workers has proved central to this agenda, along with the provision of quality services and access to subsidized birth control. nGOs also played a key role in establishing clinics on their premises and training staff to support beneficiaries. Over 40,000 women visited such clinics, 25,000 of whom have started using FP methods because of the intervention.

Source: UNFPA 2019.