scholarly journals Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003698 ◽  
Author(s):  
Madison T. Little ◽  
Keetie Roelen ◽  
Brittany C. L. Lange ◽  
Janina I. Steinert ◽  
Alexa R. Yakubovich ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Child Protection ◽  
Meta Analysis ◽  
Well Being ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Middle Income ◽  
Middle Income Countries ◽  
Psychosocial Stimulation ◽  
Health And Well Being

Background To strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention’s complementary (“plus”) components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being. Methods and findings Forty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child’s life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = −0.13 (−0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = −0.06 (−0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings. Conclusions In this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

scholarly journals The impact of cash transfers on subjective well-being and mental health in low- and middle- income countries: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Joel McGuire ◽  
Caspar Kaiser ◽  
Anders Bach-Mortensen
Keyword(s):  
Mental Health ◽  
Meta Analysis ◽  
Well Being ◽  
Spillover Effects ◽  
Cash Transfers ◽  
Subjective Well Being ◽  
Average Effect ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact

Background: A large body of evidence evaluates the impact of cash transfers (CTs) on physical health and economic indicators. A growing amount of research on CTs contains measures of subjective well- being (SWB) and mental health (MH) but no attempt has been made to systematically synthesize this work.Methods/design: We undertook a systematic review and meta-analysis of RCTs and quasi- experimental studies, including peer-reviewed publications and grey literature (e.g. reports, pre-prints, and working papers), conducted over the period 2000-2020, examining the impact of CTs on self- reported SWB and MH outcomes.Results: Two authors (JM and CK) double-screened 1,147 records of potentially relevant studies, finding 38 studies suitable for inclusion in our meta-analysis, covering 100 outcomes and a total sample of n=114,274 individuals. The average effect size (Cohen’s d) of 38 CT studies on our composite outcome of MH and SWB is 0.10 standard deviations (SDs) (95% CI: 0.8, 0.13) for an average time until follow-up of two years. However, there is a substantial amount of heterogeneity in the estimated effects (I-squared = 64% and 95% Prediction interval: 0.0021, 0.215). CT value, both in absolute terms and relative to previous income, are significant predictors of the effect size. We find only weak evidence that the impact diminishes over time. Four randomized controlled trials in our sample were designed to identify the spillover effects of CTs on the SWB and MH outcomes of non-recipients. Two found negative spillovers but the average effect is not statistically significant and is close to zero.Discussion: Cash transfers significantly increase MH and SWB in low- and middle-income countries. More research on the long run (5+ years) effects is needed, as well as further analysis of the community and household spillover effects of cash transfers on MH and SWB outcomes. We encourage the inclusion of MH and SWB metrics in impact evaluations of interventions to enable the assessment of their relative cost-effectiveness at improving lives compared to cash transfers.

The Impact of Cash Transfers: A Review of the Evidence from Low- and Middle-income Countries

2018 ◽  
Vol 48 (03) ◽  
pp. 569-594 ◽  
Author(s):  
FRANCESCA BASTAGLI ◽  
JESSICA HAGEN-ZANKER ◽  
LUKE HARMAN ◽  
VALENTINA BARCA ◽  
GEORGINA STURGE ◽  
...  
Keyword(s):  
Evidence Base ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Future Research ◽  
Unintended Effects ◽  
Screening Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Impact ◽  
Low And Middle Income

AbstractThis article presents the findings of a review of the impact of non-contributory cash transfers on individuals and households in low- and middle-income countries, covering the literature of 15 years, from 2000 to 2015. Based on evidence extracted from 165 studies, retrieved through a systematic search and screening process, this article discusses the impact of cash transfers on 35 indicators covering six outcome areas: monetary poverty; education; health and nutrition; savings, investment and production; work; and empowerment. For most of the studies, cash transfers contributed to progress in the selected indicators in the direction intended by policymakers. Despite variations in the size and strength of the underlying evidence base by outcome and indicator, this finding is consistent across all outcome areas. The article also investigates unintended effects of cash transfer receipt, such as potential reductions in adult work effort and increased fertility, finding limited evidence for such unintended effects. Finally, the article highlights gaps in the evidence base and areas which would benefit from additional future research.

scholarly journals AGING IN LATIN AMERICA: A FOCUS ON MIDDLE-INCOME COUNTRIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S787-S788
Author(s):  
Catherine Garcia ◽  
Maria P Aranda
Keyword(s):  
Latin America ◽  
Latin American ◽  
Cognitive Aging ◽  
Well Being ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
National Quality ◽  
Using Data ◽  
Health And Well Being

Abstract Population aging is occurring rapidly across Latin America, a region that includes some of the world’s most racially, ethnically, and culturally diverse populations. Aging in this region is occurring in a context of high levels of poverty and income inequality, which has implications for disease risk, cognitive health, and overall well-being. This symposium focuses on Mexico and Colombia, two of Latin America’s largest middle-income countries, which have recently undergone rapid epidemiological and demographic transitions. The papers in this symposium examine a variety of health dimensions among older Latinos that include physiological functioning, cognition, and psychological and physical well-being. García uses the Mexican Health and Aging Study (MHAS) and the Health and Retirement Study (HRS) to examine biomarkers known to predict health risk among Mexican-origin populations: Mexico-born living in Mexico, Mexico-born living in the U.S., and U.S.-born Mexican-Americans. Saenz examines the importance of education on late-life cognitive ability among Mexicans using data from the MHAS Cognitive Aging Ancillary Study. Using data from the Colombian Survey of Health, Well-Being, and Aging (SABE-Colombia), Ailshire examines variation in biological risk across key subgroups of the population. Osuna uses data from the Colombian National Quality of Life Survey (ENCV) to determine if social and economic inequalities are reflected in unequal health and well-being among older adults. Results highlight which Latin American populations have increased risk for poorer health, which merit further research and policy attention. The findings highlight the importance of understanding health and well-being in the rapidly growing older adult populations of Latin America.

Polyvictimization Among Children and Adolescents in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 19 (3) ◽  
pp. 323-342 ◽  
Author(s):  
Minh T. H. Le ◽  
Sara Holton ◽  
Lorena Romero ◽  
Jane Fisher
Keyword(s):  
Children And Adolescents ◽  
English Language ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Well Being ◽  
Health Risk Behaviors ◽  
Local Data ◽  
Middle Income ◽  
Middle Income Countries ◽  
Meta Analyses

Background: Most of the world’s children and adolescents live in low- and lower-middle-income countries (LALMIC), but there is limited evidence about polyvictimization (experiences of multiple forms of victimization) among them. The aims of this article were to systematically review the evidence from LALMIC about the overall prevalence of polyvictimization and to identify the associations between polyvictimization and health and well-being among children and adolescents. Method: A systematic search of the English-language peer-reviewed literature to identify empirical, quantitative studies conducted in LALMIC between 2005 and 2015, assessing at least four forms of victimization among young people aged up to 19 years. Where prevalence of any victimization and of polyvictimization were reported, meta-analyses were performed. Results: A total of 30/8,496 articles were included in the review. Evidence was available from 16/84 LALMIC and methodology and quality varied. Pooled prevalence of experiences of any victimization was 76.8% (95% confidence interval (CI) [64.8%, 88.9%]). Prevalence of polyvictimization ranged from 0.3% to 74.7% with an overall estimate of 38.1% (95% CI [18.3%, 57.8%]). None of the studies examined the associations between polyvictimization and physical or reproductive health or quality of life. Polyvictimization was associated with increased likelihood of mental health problems and involvement in health risk behaviors. Conclusions: Experiences of polyvictimization among children and adolescents in LALMIC are more prevalent than in high- and upper-middle-income countries and contribute to the burden of poor health among children and adolescents. Most LALMIC lack local data, and research is required to address this knowledge gap.

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