Abstract
Social protection can take many forms. Both cash transfers and food security may have important contributions to child cognitive development. This study examines the potential impact of combinations of cash transfers and food security status on child cognitive development and educational outcomes. Cross-sectional data for 796 HIV-affected children in the Child Community Care study were utilised for this analysis. Children and caregivers completed interview schedules comprised of standardised items on socio-demographics, household data, cash grant receipt and food security status, school achievement, and cognition. A series of logistic and linear regression models and marginal effects analyses were undertaken to explore the impacts of differing levels of social protection (none; either cash grant receipt or food secure status or, both in combination) on child educational and cognitive outcomes. Although all children lived in poverty-stricken households, 20% (157/796) of children did not live in a household in receipt of a cash grant and did not report food security; 32.4% (258/796) reported either component of social protection and, 47.9% (381/796) received both measures of social protection in combination. Compared to no social protection, being in receipt of either component of social protection was found to be significantly associated with being in the correct class for age, higher scores of non-verbal cognition, and higher working memory scores. Receiving both social protection measures in combination was found to be significantly associated with reduced educational risk scores, improved odds of being in the correct class for age, regular school attendance, missing less than a week of school in the previous two weeks, higher scores on measures of nonverbal cognition, higher working memory scores, and learning new things more easily. Educational and cognitive outcomes for children can be bolstered by social protection measures (cash grant receipt or food security). Benefits are enhanced when social protection is received in combination. Such findings support the notion of synergistic social protection responses for children living in environments impacted by high levels of HIV burden and deprivation.
Highlights
Children face many obstacles across the life course
This study examines associations between a combination of cash transfers and food security status on child development outcomes—operationalised as educational outcomes and child cognitive development— to explore potential contributors to child outcomes and the unlocking of child potential within the sub-Saharan African region
A trend for group differences relating to HIV status was identified; a greater proportion of children living with HIV were identified in the group classified as receiving no cash grant and being food insecure (19.9%) compared to those classified as receiving a cash grant and/or being food secure (12.6%/12.0%; see Table 1)
Summary
Children face many obstacles across the life course. Child survival is contingent on multiple factors including safe birth, avoidance of infections and illnesses, stimulating early environments, access to health care, education, nutrition [1, 2], and good parenting [3, 4]. Extended author information available on the last page of the article protection is a fundamental priority for children. In HIVendemic countries, parental illness and child infection has compounded these challenges [5, 9, 1]. As such— from a life course perspective—the acquisition of skills and opportunities throughout a lifetime are built on the foundational capacities established during early childhood [10].
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