Effects Of Cash Transfer Programs Research Articles

The effects of cash transfer programmes on HIV/AIDS prevention and care outcomes: a systematic review and meta-analysis of intervention studies

Poverty and social inequality are risk factors for poor health outcomes in patients with HIV/AIDS. In addition to eligibility, cash transfer programmes can be divided into two categories: those with specific requirements (conditional cash transfers [CCTs]) and those without specific requirements (unconditional cash transfers). Common CCT requirements include health care (eg, undergoing an HIV test) and education (eg, children attending school). Trials assessing the effect of cash transfer programmes on HIV/AIDS outcomes have yielded divergent findings. This review aimed to summarise evidence to evaluate the effects of cash transfer programmes on HIV/AIDS prevention and care outcomes. For this systematic review and meta-analysis, we searched PubMed, EMBASE, Cochrane Library, LILACS, WHO IRIS, PAHO-IRIS, BDENF, Secretaria Estadual de Saúde SP, Localizador de Informação em Saúde, Coleciona SUS, BINACIS, IBECS, CUMED, SciELO, and Web of Science up to Nov 28, 2022. We included randomised controlled trials (RCTs) that evaluated the effects of cash transfer programmes on HIV incidence, HIV testing, retention in HIV care, and antiretroviral therapy adherence, and conducted risk of bias and quality of evidence assessments using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations approach. A random-effects meta-analysis model was used to combine studies and calculate risk ratios (RRs). Subgroup analyses were performed using conditionality types (ie, school attendance or health care). The protocol was registered with PROSPERO, CRD42021274452. 16 RCTs, which included 5241 individuals, fulfilled the inclusion criteria. Of these, 13 studies included conditionalities for receiving cash transfer programmes. The results showed that receiving a cash transfer was associated with lowered HIV incidence among individuals who had to meet health-care conditionalities (RR 0·74, 95% CI 0·56-0·98) and with increased retention in HIV care for pregnant women (1·14, 95% CI 1·03-1·27). No significant effect was observed for HIV testing (RR 0·45, 95% CI 0·18-1·12) or antiretroviral therapy adherence (1·13, 0·73-1·75). Lower risk of bias was observed for HIV incidence and having an HIV test. The strength of available evidence can be classified as moderate. Cash transfer programmes have a positive effect on mitigating HIV incidence for individuals who have to meet health-care conditionalities and on increasing retention in HIV care for pregnant women. These results show the potential of cash transfer programmes for HIV prevention and care, especially among people in extreme poverty, and highlight that cash transfer programmes must be considered when developing policies for HIV/AIDS control, as indicated by the UNAIDS 95-95-95 target of the HIV care continuum. National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.

To give or not to give: what is the evidence?

Social inequality is precipitated by insufficient access to resources such as money, education, jobs, growth opportunities, social connections, and networks, resulting in poverty. Under the effects of clusters of social and economic disadvantages, affected populations are unable to manage their health conditions. 1 McGrail K Morgan J Siddiqi A Looking back and moving forward: addressing health inequities after COVID-19. Lancet Reg Health Am. 2022; 9100232 Google Scholar Inequity transpired ruthlessly during the COVID-19 pandemic. 2 Nana-Sinkam P Kraschnewski J Sacco R et al. Health disparities and equity in the era of COVID-19. J Clin Transl Sci. 2021; 5: e99 Crossref PubMed Scopus (31) Google Scholar Millions of people in poverty lost their lives, although access to oxygen, timely testing, vaccines, and treatment could potentially have saved them. The effects of cash transfer programmes on HIV/AIDS prevention and care outcomes: a systematic review and meta-analysis of intervention studiesCash transfer programmes have a positive effect on mitigating HIV incidence for individuals who have to meet health-care conditionalities and on increasing retention in HIV care for pregnant women. These results show the potential of cash transfer programmes for HIV prevention and care, especially among people in extreme poverty, and highlight that cash transfer programmes must be considered when developing policies for HIV/AIDS control, as indicated by the UNAIDS 95-95-95 target of the HIV care continuum. Full-Text PDF

Migração, Trabalho Doméstico e Políticas Públicas de Cuidados de Longo Prazo na Espanha

Abstract: This article explores the impact of the Covid-19 pandemic on the labour conditions of migrant workers who provide care to elderly and dependent persons in Spain. Using data from the Active Population Survey, we analyse the effects of the health crisis on the precariousness of this labour sector (measured through unemployment, underemployment and temporary employment). The figures shed light on the degradation of working conditions during the health crisis, the situation of social vulnerability experienced by female workers and the absence of effective policy responses to reverse this inequality during the pandemic. This situation of subordination is structured around the connection between the demand for care workers in private homes and the philosophy behind the public welfare system. Special emphasis is given to the effect of cash transfer programs in the process of the commodification of care.

The effects of cash transfer programmes on HIV-related outcomes in 42 countries from 1996 to 2019.

Many countries have introduced cash transfer programmes as part of their poverty reduction and social protection strategies. These programmes have the potential to overcome drivers of HIV risk behaviours and usage of HIV services, but their overall effects on HIV-related outcomes remain unknown. Here we evaluate the effects of cash transfer programmes covering >5% of the impoverished population on country- and individual-level HIV-related outcomes in 42 countries with generalized epidemics. Cash transfer programmes were associated with a lower probability of sexually transmitted infections among females (odds ratio, 0.67; 95% confidence interval (CI), 0.50-0.91; P = 0.01), a higher probability of recent HIV testing among females (odds ratio, 2.61; 95% CI, 1.15-5.88; P = 0.02) and among males (odds ratio, 3.19; 95% CI, 2.45-4.15; P < 0.001), a reduction in new HIV infections (incidence rate ratio, 0.94; 95% CI, 0.89-0.99; P = 0.03) and delayed improvements in antiretroviral coverage (3%; 95% CI, 0.3-5.7 at year 2; P = 0.03) and AIDS-related deaths (incidence rate ratio, 0.91; 95% CI, 0.83-0.99 at year 2; P = 0.03). Anti-poverty programmes can play a greater role in achieving global targets for HIV prevention and treatment.

Selective inclusion in cash transfer programs: Unintended consequences for social cohesion

Debates over universal versus selective or targeted provision of benefits in social protection programming have gained traction in recent years. In some cases, poverty targeting has been found to benefit communities, creating positive economic spillover effects even for non-recipients. However, targeted programs can also reconfigure social relations, carrying a social stigma that bifurcates communities. Drawing from rich qualitative data from a cash transfer program in Chad, we explore both the economic and social implications of targeting in cash transfer programs in contexts with widespread poverty. We find significant positive economic effects on non-beneficiaries. At the same time, not only does participation engender considerable social costs, but several punitive and economic costs arise for recipients as a result of their inclusion in the program, with repercussions for the transfer’s productivity. We conclude that in contexts where everyone is poor, targeting can create new fissures within a community, stemming from a combination of jealousy and skepticism with regard to the perceived deservingness of transfer recipients vis-à-vis other village inhabitants. When budgets are insufficient to cover all poor, the positive effects of cash transfer programs may be enhanced by reducing the geographic focus of social safety net programs to ensure all inhabitants can access benefits.

Cash Transfer Programmes For Reducing Poverty And Vulnerabilities: Effects On Children’s Health In Sub-Saharan Africa And Latin America

This paper summarizes the arguments and counterarguments within the scientific discussion on cash transfers and child health. The main purpose of the research is to assess the effects of cash transfers on children’s health and development outcomes in sub-Saharan Africa and Latin America. Systematization of the literary sources indicates that studies have justified cash transfer as social-income support that addresses a vital social determinant of health (income) for children in low-and-middle-income countries. The methodological basis of this study is a systematic review that searched a wide range of electronic databases such as PubMed, ResearchGate and ScienceDirect. Studies included in this review included randomized controlled trials (RCTs), cluster-RCTs, quasi-experimental and mixed methods studies of cash transfer interventions in children 0-18 years. Inclusion criteria were met by eight studies, four from Africa and four from Latin America. The systematic review presents the results of data synthesis of the included studies that mainly reported the effects of cash transfer programmes on child anthropometry outcomes, cognitive development, morbidity, and healthcare utilization. The review found cash transfer programmes to improve these variables among children in households receiving cash transfers. This systematic review has added to the debate on cash transfers and children’s health outcomes. In general, the systematic review indicates that cash transfer programmes intended for children are effective at improving anthropometric, health, and cognitive outcomes, as well as access to healthcare. However, there is a need for more research to clarify the multiple pathways by which cash transfers can improve children’s health and nutritional outcomes. It is also necessary to clarify what factors explain the variety of effects of cash transfer programs on child health and nutritional status. Finally, cash transfer interventions are not permanent mechanisms for promoting access to healthcare. Policymakers in developing countries should borrow ideas on how to finance healthcare services for improving the socio-economic wellbeing of citizens.

Electoral Dividends from Programmatic Policies: A Theoretical Proposal Based on the Brazilian Case

Recent controversies in the literature on the electoral effects of cash transfer programs reveal the limitations of traditional models associating public policies to voting. Why would beneficiaries reward parties for programmatic policies when the government has no control over the distribution of the benefits? Are they guided by short-term retrospective voting in favor of the incumbent without forming durable links? By studying the Brazilian case, based on the Bolsa Escola-Program, formulated by the PSDB, and the Bolsa-Família Program, formulated by the PT, I test different theories and propose an alternative approach. My thesis is that the long-term electoral effect of programmatic policies is a consequence of credit-claiming efforts made by the competing parties, resulting in reciprocity from voters. My argument is built on the examination of parliamentary deliberations throughout the formulation of these programs and on the analysis of public opinion surveys conducted in 2005, a transitional moment when there were beneficiaries of both programs, and in 2018, the year of the first presidential election with the Bolsa-Família Program being implemented with the PT as an opposition party. The data show that party leaders came to the defense of these social programs to varying degrees and in different moments of their terms in office and that these different mobilization strategies reflected on voting behavior.

Cash transfers for HIV prevention: A systematic review.

Given the success of cash programs in improving health outcomes and addressing upstream drivers of HIV risk such as poverty and education, there has been an increasing interest in their potential to improve HIV prevention and care outcomes. Recent reviews have documented the impacts of structural interventions on HIV prevention, but evidence about the effects of cash transfer programs on HIV prevention has not been systematically reviewed for several years. We did a systematic review of published and unpublished literature to update and summarize the evidence around cash programs for HIV prevention from January 2000 to December 17, 2020. We included studies with either a cash transfer intervention, savings program, or program to reduce school costs. Included studies measured the program's impact on HIV infection, other sexually transmitted infections (STIs), or sexual behaviors. We screened 1,565 studies and examined 78 in full-text review to identify a total of 45 peer-reviewed publications and reports from 27 different interventions or populations. We did not do a meta-analysis given the range of outcomes and types of cash transfer interventions assessed. Most studies were conducted in sub-Saharan Africa (N = 23; South Africa, Tanzania, Malawi, Lesotho, Kenya, Uganda, Zimbabwe, Zambia, and eSwatini) followed by Mexico (N = 2), the United States (N = 1), and Mongolia (N = 1)). Of the 27 studies, 20 (72%) were randomized trials, 5 (20%) were observational studies, 1 (4%) was a case-control study, and 1 (4%) was quasi-experimental. Most studies did not identify a strong association between the program and sexual behaviors, except sexual debut (10/18 finding an association; 56%). Eight of the 27 studies included HIV biomarkers, but only 3 found a large reduction in HIV incidence or prevalence, and the rest found no statistically significant association. Of the studies that identified a statistically significant association with other STIs (N = 4/8), 2 involved incentives for staying free of the STI, and the other 2 were cash transfer programs for adolescent girls that had conditionalities related to secondary schooling. Study limitations include the small number of studies in key populations and examining interventions to reduce school costs and matched saving programs. The evidence base for large-scale impacts of cash transfers reducing HIV risk is limited; however, government social protection cash transfer programs and programs that incentivize school attendance among adolescent girls and young women show the greatest promise for HIV prevention.

Long Term Effects of Cash Transfer Programs in Colombia

Conditional Cash transfer (CCT) programs have been shown to have positive effects on a variety of outcomes including education, consumption and health visits, amongst others. We estimate the long-run impacts of the urban version of Familias en Accion, the Colombian CCT program on crime, teenage pregnancy, high school dropout and college enrollment using a Regression Discontinuity design on administrative data. ITT estimates show a reduction on arrest rates of 2.7pp for men and a reduction on teenage pregnancy of 2.3pp for women. High school dropout rates were reduced by 5.8pp and college enrollment was increased by 1.7pp for men.

Long Term Effects of Cash Transfer Programs in Colombia

Conditional Cash transfer (CCT) programs have been shown to have positive ei¬€ects on a variety of outcomes including education, consumption and health visits, amongst others. We estimate the long-run impacts of the urban version of Familias en AcciA³n, the Colombian CCT program on crime, teenage pregnancy, high school dropout and college enrollment using a Regression Discontinuity design on administrative data. ITT estimates show a reduction on arrest rates of 2.7pp for men and a reduction on teenage pregnancy of 2.3pp for women. High school dropout rates were reduced by 5.8pp and college enrollment was increased by 1.7pp for men.

Cash Transfers and Contraceptive Use: A Regression Discontinuity Analysis.

Conditional cash transfers (CCTs) have become important components of social protection policies in Latin America. By establishing coresponsibilities tied to health and education, CCTs may reduce poverty and encourage human capital investment. While CCT programs can have unintended effects on sexual and reproductive health outcomes, such effects have been mixed and poorly documented in South America. This study examines the impact of Ecuador's CCT program, Bono de Desarrollo Humano, on contraceptive behavior among women of childbearing age who are sexually active and do not wish to become pregnant. We analyze nationally representative data in a regression-discontinuity quasi-experimental design. Using an instrumental variable approach and a set of robustness checks, our study finds no significant effects of the CCT program on contraceptive use. Our results offer important considerations for the ongoing policy debate in South America regarding the effects of cash transfer programs on beneficiaries.

Why Cash Transfer Programs Can Both Stimulate and Slow Down Job Finding

Abstract This article analyzes the behavioral effects of cash transfer programs when jobless people need to have access to a minimum consumption level. Our model reconciles recent evidence about negligible or favorable effects of cash transfers on job-finding rates and the more standard view of negative effects. When unemployment compensation, if any, is low enough, we argue that cash transfer programs can raise the hiring probability. Our framework is flexible enough to generate the standard conclusion as well. Looking specifically at unemployment compensation, its optimal level is generally higher than when a lower bound on consumption is ignored.

Cash Transfer and the Economic Well-Being of Persons with Severe Disability in Wajir County, Kenya

Social interventions such as cash transfers provide the much needed support to vulnerable people. People living with disabilities continue to remain economically deprived, experiencing high levels of poverty. In Wajir County, this crisis is more exacerbated by the nomadic setting where disabled persons are left behind as other individuals move. They are left to cater for themselves due to their mobility constraints. The welfare of these people continue to deteriorate since they are unable to work and highly depend on others and hence do not have the capacity of self-sufficiency. These people remain dependent on the government and non-governmental agencies. The effect of cash transfer programs however, is not fully known. This study sought to assess the effect of cash transfer on the economic well-being of people with severe disabilities in Wajir County. The study is founded on the Maslow’s theory of needs, the sustainable livelihoods framework and the rights-based approach. The study employed mixed methods research design and targeted all family heads for all the 183 under the Persons with Severe Disabilities Cash Transfer in Wajir North and Tarbaj sub-Counties as at 2015 and 19 senior officials working with the sub-counties’ social development offices. The study used primary data obtained through semi-structured questionnaires and interview guides. Data analysis methods that be employed involved quantitative and qualitative approaches. The qualitative data was analysed using content analysis where the information obtained was reported in a narrative form and direct quotes. Quantitative data was analyzed using descriptive statistical methods. Quantitative data analysis was facilitated by the Statistical Package for Social Sciences Version 20. Descriptive statistics such as the rate of response, frequency distribution, mean and standard deviation were used. Inferential statistics generated included correlation and regression analysis. The study findings showed that cash transfer supported household income, healthcare access, investment in productive activities and empowerment had positive and significant effect on the economic wellbeing of persons living with disabilities in Wajir County. The study concluded that if the cash transfer programme was to achieve its objectives and transform the economic wellbeing of the beneficiary households, the aforementioned support areas needed to be adequately embedded in the programme’s plan. The study made several recommendations among them that the Ministry of Labour, Social Security and Services Programmes should consider increasing the monthly disbursements given to persons living with disabilities so that they can venture in to activities that would give them supplementary incomes. There can be other activities within the programme meant to support the beneficiaries to be self-reliant so that they do not have to rely on the transfers throughout. The study also recommends that the officials overseeing the cash transfer programme for persons living with disabilities should have follow up programs especially for beneficiaries who have ventured in to productive activities so that they can support them to expand their income generation activities. The programme can partner with other development partners such as donors and NGOs and also the county government to create a fund where beneficiaries can get more assistance both financial and non-financial in order to expand their activities. The study further recommends that the programme should provide networking programs were beneficiary households can interact with various organizations so as to secure livelihood opportunities such as employment among others.

Unintended Labor Supply Effects of Cash Transfer Programs: New Evidence from South Africa’s Pension†

Abstract Using South Africa’s first nationally representative panel data set, I find that the presence of pension recipients in the household reduces the probability of employment of both previously employed and unemployed prime-aged adults. Exploiting institutional features of the disability grant to isolate the pension’s income effect suggests that the effects operate through the income mechanism. By contrast, there is no evidence that pensioners enable household members to work by providing childcare as concluded by previous studies.

Health profile differences between recipients and non-recipients of the Brazilian Income Transfer Program in a low-income population.

We investigated the relationship between living in a household that receives the Brazilian Income Transfer Program (Bolsa Família, in Portuguese - BF), a Brazilian conditional cash transfer program, and aspects of health and whether these relationships are heterogeneous across the 27 Brazilian states. According to data from the 2013 Brazilian National Health Survey, 18% of households participated in BF. Among households with household per capita income below BRL 500, many aspects of health differed between people living in BF and non-BF houses. For example, BF households were less likely to have medical coverage but more likely to have visited the doctor in the last 12 months as well as being more likely to smoke and less likely to do exercise. They ate nearly one less serving of fruits and vegetables a week but were less likely to substitute junk food for a meal. They reported worse self-rated health but did not differ importantly on reporting illnesses. Moderate amounts of heterogeneity in the difference in health characteristics were found for some variables. For instance, medical coverage had an I2 value of 40.7% and the difference in coverage between BF and non-BF households ranged from -0.09 to -0.03. Some illnesses differed qualitatively across states such as high cholesterol, asthma and arthritis. This paper is the first to outline the health profile of people living in households receiving payments from a cash transfer program. It is also the first to find geographic heterogeneity in the relationship between a cash transfer program and health variables. These results suggest the possibility that the effect of cash transfer programs may differ based on the population on which it is implemented.

Are cash transfers the answer for child nutrition in sub‐Saharan Africa? A literature review

AbstractEarly evidence is ambiguous on the effects of cash transfer programmes on children, but until the last few years there has been little focus on Africa. We review the literature on 20 cash transfer schemes, including 12 from sub‐Saharan Africa. Such interventions have shown improvements in household diet and, in some cases, to agriculture, but have not always improved child health. However, a larger perspective focusing on two key time periods for nutrition—adolescence and the first 1,000 days of life reveals more opportunities for impact. In particular, the opportunity to empower young women to access secondary education and the reduction of adolescent pregnancy rates can improve the health of African children. Cash transfer programmes show promise, though there is room for improvement.

The effect of cash transfer programs on educational mobility.

In this paper I develop a model to reproduce the phenomenon of high intergenerational correlations in education observed in Latin American Countries. The model is based on empirical evidence and implemented through agent based modeling techniques. The effect of conditional cash transfer programs on educational mobility is then analyzed. The results suggest that conditional cash transfer program can substantially increase intergenerational mobility in education. I find that using parental education as eligibility criterion and adapting the subsidies to the income level can improve the efficiency of a program in increasing educational mobility as compared to a purely income based program.

The relation of cash transfer programs and food insecurity among families with preschool children living in semiarid climates in Brazil

Abstract Background Food insecurity has important effects on human health, particularly in children’s. It continues to increase, with an estimated prevalence of 14.9% in the USA and 35% in Brazil. There have been few studies on the effect of cash transfer programs (CTPs) on the prevalence of food security in Brazil. Objective Evaluate the association between cash transfer programs and reductions in inequity and food insecurity. Method Population-based cross-sectional study in the state of Ceará, Northeast Brazil, with a sample of 8.000 households. Ceará is one of the poorest states. The state population of 8.5 million inhabitants, social security benefits and government grants, “ Bolsa Família”, have become the most stable source of income. The main outcomes measures were food insecurity and CTP participation. Multivariate logistic models were constructed to assess the association between participation in CTPs and food security. Results Participation in CTPs was found to be independently related to the prevalence of food security (APR 2.29 95% CI 1.57-3.33), as are education level, residential setting, and children’s nutritional status. Conclusions CTPs and investment in education are initiatives that might be used to reduce food insecurity.

The Racialized Effects of Social Programs in Brazil

AbstractStudies of the electoral effects of cash transfer programs in Latin America have largely treated the poor as a unitary group. This study considers how the effects of social benefits vary across groups among the targeted poor by exploring the consequences of race for the electoral effects of Brazil’s Bolsa Família program. A matching analysis of LAPOP survey data shows that race shapes baseline propensities to participate in elections and to support the incumbent PT at the polls; these tendencies then shape the mechanisms through which cash transfers boost support for the incumbent. Benefits mobilize Afro-Brazilians to participate but have little effect on their vote choice. By contrast, benefits have little effect on whites’ participation but persuade them to support the PT over the opposition. This article deepens understanding of how social benefits affect the electoral behavior of recipients and highlights how race shapes political behavior among the poor.

Questioning the Effectiveness of Cash Transfer Programme for Orphans and Vulnerable Children in Supporting Orphaned Children with Disabilities.

Questioning the Effectiveness of Cash Transfer Programme for Orphans and Vulnerable Children in Supporting Orphaned Children with Disabilities.