Photo: St Kitts & Nevis Government

The Government of St. Kitts and Nevis through the Ministry of Community Development, Gender Affairs & Social Services (MoCDGASS) hired Ayala Consulting Corporation on the 10th of September 2014 for the operationalisation of the National Household Registry (NHR). The NHR was conceived as a dynamic Social Protection tool with the objectives to contain up-to-date socio-economic HH information; serve as a common targeting mechanism to identify the poor and vulnerable; guide social assistance and budget allocation; increase Social Protection program coverage and reduce inclusion and exclusion errors; as well as improve efficiency and effectiveness by reducing overlaps in administrative systems.

However, in order to not only meet but surpass the abovementioned objectives, the HHs registered in the NHR need to receive assistance from this Social Protection tool to access existing social services. On that basis, the MoCDGASS hired Ayala Consulting for an eight-month consultancy, starting on December 22, 2016 until August 22 of the same year, to provide technical assistance in designing a Linkages and Referrals (L&R) Model and assisting in its implementation in two Parishes to be selected in conjunction with the client.

The L&R component aims to serve as a system by which household members registered in the NHR can be referred and linked to different available services and programs upon their needs. Thus, it serves as a key component to further assist households, increasing the potential and impact of the NHR.

The scope of the consultancy covers the production of operational documentation describing the L&R processes and protocols, addition of functionalities in the NHR MIS (Management Information System) to support the operationalization of L&R, as well as technical support in the field for implementation of L&R in two Parishes. In addition to the aforementioned eight months of technical assistance, maintenance of the NHR MIS will be provided from the official date of delivery of the system until November 22, 2017.

When cash is not enough

Although Cash Transfer programs have been recognized as an essential tool in Social Protection policies, giving cash to ultra-poor and labor constrained households is sometimes not enough.

These days, no one in the Social Protection arena discusses the benefits of Cash Transfers to improve health and nutrition, increase school enrollment, reduce hunger and starvation, and defeat beneficiaries’ social stigma.

However, beneficiaries need to access other existing social and economic services in addition to cash, to surpass the above mentioned objectives. In this regard, the establishment of Linkages and Referrals (L&R) systems is seen as a practical tool to address the multiple varied vulnerabilities and the exclusions that the ultra-poor face.

Connecting existing services with people in need

In spite of Cash Transfer programs helping communities, several challenges are still affecting ultra-poor and labor constrained households: gender-based violence, barriers to access trade or local businesses, or no access to efficient agriculture techniques. These are urgent issues to be addressed to improve the quality of life of people living in poverty.

To address these challenges, connecting households with pre-existing services (provided by NGOs, public facilities, or private companies) can really make a difference between receiving cash transfers and maximizing the impact of these.

An L&R System is one of the best ways to achieve this, by connecting beneficiaries with service providers to access complementary services.

The L&R system targets those households that lack able-bodied adults to generate enough resources to support their members and evaluates their specific and most urgent needs. Then, these households are referred to an existing local service provider to meet demand.

L&R systems use a systematic protocol in which three important stakeholders are in continuous contact: beneficiaries, service providers, and extension workers acting as local experts connecting the first two.

L stands for Link, R stands for Referral

The key to success of this system is to connect cash transfer recipients with pre-existing services to reinforce the capacities, human development, and social opportunities of beneficiary households with the help of specialized service providers at community level.

To achieve this, local community members, known as Extension Workers, interview households and study the challenges they are facing in six different sectors: education, health, trade, social services, agriculture and livestock, and finally, construction.

The Extension Worker links the household member with a selected Service Provider, previously interviewed, that best fits the household needs, type of service required, proximity, etc.

Finally, the household accesses the referred service and informs the Extension Worker periodically about the referral development.

Different contexts, different methodologies

International experience has been gathered worldwide regarding this topic in recent years. In some cases, L&R have been connected with Cash Transfer programs while in other cases, these have emerged as systems intended to reinforce solutions to specific problems, such as implementing health plans aimed to provide assistance to communities and people living with HIV and AIDS.

Despite the fact that these initiatives pursue different objectives, the common goal of connecting local communities with services has been used in several countries including India through the International HIV/AIDS Alliance, in Swaziland with the support of USAID, and in Kenya where AMREF and partners oriented their efforts to provide access to prevention, care, treatment, and support for people living with HIV/AIDS.

Relevant cases, such as the Prospera Program for Social Inclusion in Mexico, are focused on linking communities with institutional services to increase employability, financial inclusion, and nutrition advocacy.

Social services are also represented in programs such as Bolsa Familia in Brazil, (which was expanded to promote the access of beneficiaries to literacy courses, housing programs, energy, or women empowerment through professional training).

The recipe for success

All these experiences prove that L&R are becoming valuable tools to support and complement other Social Protection programs.

To design an L&R system, it is essential to shift from informal relationships to formal linkages; hence, a strong protocol design is necessary to make the engine work.

All successful L&R systems have invested resources and time assessing and strengthening organizational infrastructure to boost the capacity of the system.

It is also mandatory to develop and implement referral-specific policies and protocols to make these systems sustainable through time.

    Experiences from the field

    When Ayala Consulting was hired to implement an L&R pilot in Malawi to assist beneficiaries of the Social Cash Transfer Program (SCTP)
    to access existing social services, three main processes were designed:

  • Supply Capacity Analysis: Available service providers were identified and a service directory was developed based on gathered data.
  • Referrals: Every beneficiary household member’s needs were identified and referred to the service provider matching the case.
  • Follow-up and Monitoring: The beneficiary household members were revisited or met at the Cash Transfer payment point to follow-up their access to the service.

Now it is your turn to make a difference. Are you interested in helping people in need to access services? Then, use a Linkages and Referrals system.