“If all the child has to eat is colored water, instead of real juice, and a novelty food, such as a cheese stick, we know he is underfed,” says Faye Mullings, the school principal. “We can’t let a child eat like that.” So the undernourished child will join the 60 children (out of a total of 800 preschoolers) who get free and nutritional school lunches.

This is one way to determine if a person’s income and living conditions qualify them to receive public welfare benefits. But the Jamaican government has decided there is a better way. As part of a wide-ranging social safety net reform program, the country has consolidated and computerized the way beneficiaries enter the system, and the result is greater equity and quicker support for poor people.

The initiative is known as PATH, for Programme of Advancement Through Health and Education. In the program, social workers help parents fill out a four-page application that serves as a “proxy means test.” Information includes income, type of home construction, family members living at home, and details such as whether their homes have a telephone, toilet and electricity. The information provided is then randomly verified by social workers.

Families who are found to be below the poverty level receive monthly income support amounting to 300 Jamaica dollars (US$5) for each eligible family member. The amount will gradually be increased over the next few years. In addition, as part of the broader social safety net reform, linkages have been made so that secondary school children under the age of 17 automatically qualify for free high school tuition, which in Jamaica is charged in public, as well as in private, schools. The government is currently exploring ways to also reform the subsidized school feeding program in order to be able to provide free school lunches to children from PATH families, if possible. The identities of the children receiving PATH benefits are confidential.

“Many of these children would not be in school if it were not for the free lunches,” says Mullings. “For many children, this is the only meal they will have for the rest of the day.” As the number of children on the PATH system increases, and the reform is fully implemented, the old, improvised system of spot checks by teachers looking into lunch bags will fall into disuse. But in the meantime, the two systems will continue side by side. “We will not leave any child undernourished,” says Mullings.

The IDB supported the creation of the PATH program as well as the introduction of other related reforms beginning in 2001 with the approval of a $60 million sector loan, accompanied by a $1.1 million grant for technical assistance, to help finance the Social Safety Net Reform Programme. The World Bank provided investment financing specifically for the PATH program.

One card, three programs. The new social program comes at a time when Jamaica has seen considerable progress in reducing poverty. The poverty rate of 30 percent of the population at the start of the 1990s had dropped to an all-time low of 16 percent at the end of the decade, owing to factors such as increases in wages, reduced inflation, a thriving informal economy, and remittances from family members living abroad.

But poverty remains serious, particularly in urban areas and among children. In addition, studies have shown that female-headed households are more likely to be poor, a major factor in a country where 43 percent of households are headed by women.

A government doctor attends to a beneficiary of the PATH program.

The new PATH program helps Jamaica’s poor by combining three existing public assistance programs focused on the most vulnerable: children and the elderly. Beneficiaries of all three programs receive the same monthly stipend of 300 Jamaica dollars for each qualified family member. A PATH card also entitles beneficiaries to receive selected education and health benefits in addition to income support.

The PATH system consolidates a patchwork of overlapping administrative systems into one central computerized system with standardized poverty indicators. According to PATH administrators, the new system enables them to provide better service to more people while cutting administrative costs by between 10 and 30 percent. In one example of a cost-cutting move, checks once delivered by hand are now picked up by beneficiaries at local post offices.

The new system also enables the beneficiaries to enroll in the program and receive benefits more rapidly. The use of one proxy means test for multiple programs relieves potential beneficiaries of the need to apply to each program separately. The social workers now spend less time processing paperwork in offices and more time counseling clients and making field visits.

A new welfare culture. Beyond making welfare more modern and efficient, the PATH system is also changing the attitudes of the beneficiaries, says Marlene Miller, a compliance manager based in Kingston with the Ministry of Labour and Social Security. It used to be that beneficiaries were “not accustomed to giving something for something,” she said. Now, benefits come with obligations.

For example, in families receiving PATH benefits, the children must attend school at least 85 percent of the time each month. If not, the family loses benefits. Another requirement is that babies under one year of age must be taken to a government health center for a checkup every two months. Children between the ages of one and six must go for twice-yearly health visits. Medical checkups are also required for pregnant and lactating women and for the elderly.

But old attitudes die hard. “We are finding that some parents are not taking the program seriously,” says Miller. “Their children were not attending school.” Suspending payments has proven to be a powerful incentive for families to change their attitudes, she says.

Doctors and other PATH staff typically try to support clients to ensure that they are eligible for benefits. For example, entire families occasionally come to the health clinic for a checkup, not just for the individual members who are required to do so. This is fine with M. Minto-Blake, a physician assigned to the St. Jago Park Health Center in Spanish Town. “They all show up because they are afraid of losing their benefits,” she says.

Then there is the case of Forrester Powell, 63, of Spanish Town, who suffers from a bone ailment and has no pension. He receives 1,200 Jamaica dollars every two months for himself and for a 10-year-old grandson—because he is effectively the boy’s guardian. In addition, he is allowed to use his PATH card for medical treatment of his leg and health checkups for the boy.

Patricia Moodie, a 41-year-old cigarette vendor, applied for PATH benefits in October of 2002, but one year later she had still not received a notice of whether or not she was qualified to receive an income support payment. However, a piece of paper saying she applied for the PATH program was enough for her to get treatment at the St. Jago Park Clinic for her 4-year-old son when he suffered from a fever. “Nobody who needs help is turned away,” says Dr. Kyi Hlaing, a medical officer at the clinic.

But still, rules are rules. Carlet Walker, 46, a mother of two, receives 1,200 Jamaica dollars every two months for herself and a 7-year-old child who lives with her. But she does not receive benefits for her own 11-year-old daughter, because that girl lives with Walker’s sister. Although Walker questions the decision—“She’s still my daughter, and I visit her every day”—she concedes that the PATH system, her only source of financial support, is a major improvement over the previous system. In the old system, she said, “I got nothing.”