The Impact of Cash Transfers on Mental Health in Children and Young People in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Annie Zimmerman ◽  
Emily Garman ◽  
Mauricio Avendano ◽  
Ricardo Araya ◽  
Sara Evans-Lacko ◽  
...  
2021 ◽  
Vol 6 (4) ◽  
pp. e004661
Author(s):  
Annie Zimmerman ◽  
Emily Garman ◽  
Mauricio Avendano-Pabon ◽  
Ricardo Araya ◽  
Sara Evans-Lacko ◽  
...  

IntroductionAlthough cash transfer programmes are not explicitly designed to improve mental health, by reducing poverty and improving the life chances of children and young people, they may also improve their mental health. This systematic review and meta-analysis assessed the evidence on the effectiveness of cash transfers to improve the mental health of children and young people in low-income and middle-income countries.MethodsWe searched Pubmed, EBSCOhost, Scientific Electronic Library Online, ISI Web of Science and Social Sciences Citation Index and grey literature (from January 2000 to July 2020) for studies which quantitatively assessed the impact of cash transfers on mental health in young people (aged 0–24 years), using a design that incorporated a control group. We extracted Cohen’s d effects size and used a random-effects model for the meta-analysis on studies that measured depressive symptoms, I2 statistic and assessment of study quality.ResultsWe identified 12 116 articles for screening, of which 12 were included in the systematic review (covering 13 interventions) and seven in the meta-analysis assessing impact on depressive symptoms specifically. There was high heterogeneity (I2=95.2) and a high risk of bias (0.38, 95% CIs: −5.08 to 5.85; p=0.86) across studies. Eleven interventions (85%) showed a significant positive impact of cash transfers on at least one mental health outcome in children and young people. However, no study found a positive effect on all mental health outcomes examined, and the meta-analysis showed no impact of cash transfers on depressive symptoms (0.02, 95% CIs: −0.19 to 0.23; p=0.85).ConclusionCash transfers may have positive effects on some mental health outcomes for young people, with no negative effects identified. However, there is high heterogeneity across studies, with some interventions showing no effects. Our review highlights how the effect of cash transfers may vary by social and economic context, culture, design, conditionality and mental health outcome.


BMJ ◽  
2014 ◽  
Vol 348 (apr15 6) ◽  
pp. g2267-g2267 ◽  
Author(s):  
E. K. Gough ◽  
E. E. M. Moodie ◽  
A. J. Prendergast ◽  
S. M. A. Johnson ◽  
J. H. Humphrey ◽  
...  

2020 ◽  
Author(s):  
Joel McGuire ◽  
Caspar Kaiser ◽  
Anders Bach-Mortensen

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.


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