Social Protection Interventions Research Articles

Street Begging among School Age Children and Social Protection Policy in South western, Nigeria

This study discussed the factors that caused street begging among school age children and investigated social protection policies aimed at eradicating the menace in Southwestern, Nigeria. It also examined the impact of the social protection policies on street begging among school-age children and assessed the challenges confronting social protection interventions. The study’s primary data were sourced through multi-choice structured questionnaires and semi-structured interview guides. The study administered one hundred and fifty copies of questionnaires on teachers, parents, and school age children in Ondo, Oyo and Lagos States. Interviews were conducted with twelve 12 respondents on the basis of four from each state based on their experience of street begging by school-age children and social protection policies meant to tackle the menace. Purposively sampled interviewees were from ministries of education and schools, with two education officials from each of the three states and two school principals from each of the three states. Secondary data were from books, relevant journals, government publications, policy guides, gazettes, and online publications. We analyzed quantitative data with the use of descriptive and inferential statistical tools, and qualitative data with content analysis. The study showed poverty, unemployment, broken homes, and poor feeding and other factors as responsible for street begging among school age children. Some of the social protection policies that are in place to eradicate street begging by school-age children in Southwestern Nigeria include Zero Project, Better Education Service Delivery for All, Integrated Qur'anic and Tsangaya Education, and other domesticated policies of the federal government. Social protection policies in Southwestern, Nigeria are impactful in reducing street begging but poor funding, change in government, overstretched facilities, and corruption are some of the challenges militating against them. The study concluded that street begging by school age children in Southwestern, Nigeria is a social menace that requires intensification of existing social protection policies and serious government attention.

Persistent Food Insecurity and Material Hardships: A Latent Class Analysis of Experiences among Venezuelan Refugees and Migrants in Urban Colombia.

The causes and conditions of displacement often increase the vulnerability of migrant and refugee populations to food insecurity, alongside other material hardships. We aimed to examine the multidimensional aspects and patterns of food insecurity and other material hardships in a cross-sectional sample of 6221 Venezuelan refugees and migrants in urban Colombia using a latent class analysis. Using multinomial and logistic regression models, we investigated the demographic and migratory experiences associated with identified classes and how class membership is associated with multiple health outcomes among Venezuelan refugees and migrants, respectively. Approximately two thirds of the sample was comprised cisgender women, and the participants had a median age of 32 years (IQR: 26-41). Four heterogeneous classes of food insecurity and material hardships emerged: Class 1-low food insecurity and material hardship; Class 2-high food insecurity and material hardship; Class 3-high income hardship with insufficient food intake; and Class 4-income hardship with food affordability challenges. Class 2 reflected the most severe food insecurity and material hardships and had the highest class membership; Venezuelans with an irregular migration status were almost 1.5 times more likely to belong to this class. Food insecurity and material hardship class membership was independently associated with self-rated health, mental health symptoms, and recent violence victimization and marginally associated with infectious disease outcomes (laboratory-confirmed HIV and/or syphilis infection). Social safety nets, social protection, and other interventions that reduce and prevent material hardships and food insecurity among refugees and migrants, alongside the host community, may improve public health, support development, and reduce healthcare costs. In the long term, regularization and social policies for migrants aimed at enhancing refugees' and migrants' social and economic inclusion may contribute to improving food security in this population.

Combining social protection interventions for better food security: Evidence from female-headed households in Amhara region, Ethiopia.

Ethiopia introduced its flagship poverty-targeted social protection program, the Productive safety net program (PSNP), in 2005 and Community-Based Health Insurance (CBHI) in 2011. Although both programs operate in several districts with some overlaps, evidence is scarce on how these large-scale programs jointly affect the food security of vulnerable groups. This study examines the impacts of a combination of these programs on food security outcomes among female-headed households in a chronically food-insecure and drought-prone district. Cross-sectional data were collected from 365 female-headed households selected through multi-stage sampling technique and analyzed using Inverse-probability-weighted regression adjustment (IPWRA) strategy to assess the effect of the programs on food security. The results show that while 63.6% of sample households are enrolled in CBHI and 48.8% are beneficiaries of PSNP's conditional cash transfer (CCT) component, membership in both social protection programs was 38.9%. The IPWRA analysis finds that inclusion in the CCT combined with CBHI, on average, increased dietary diversity score by 0.918 (95% CI 0.779-1.057) and food consumption score by 0.576 (95% CI 0.464-0.688). It also reduced household food insecurity access scale by 8.658 (95% CI -9.775 - -7.541). In all assessments, a combination of CBHI and CCT always produced results of a larger magnitude than each of CBHI and CCT alone. The findings provide evidence of the potentials of integrating social protection programs to increase food security outcomes among the most vulnerable and marginalized groups in a developing country. In addition, the results have also useful implications to achieve sustainable development goals related to ending hunger and achieving food security among vulnerable groups.

Socioeconomic shocks, social protection and household food security amidst COVID-19 pandemic in Africa's largest economy.

Africa has been known to experience series of problems among which are poverty, food insecurity, lack of access to energy, lack of infrastructure among others. These problems were exacerbated by the COVID-19 pandemic, which has had a severe impact on the socioeconomic status of households in Africa. This paper examines the relationship between socioeconomic shocks, social protection, and household food security during the pandemic in Nigeria, the Africa's largest economy. Using the World Bank's COVID-19 national longitudinal baseline phone survey (2020) for the analysis and applied the multinomial logit regression, the study finds that socioeconomic shocks resulting from the pandemic have led to an increased level of food insecurity. Social protection programmes have played a crucial role in mitigating the impact of these shocks on households. However, the study also highlights the need for more targeted and effective social protection policies to ensure that vulnerable households are adequately protected from the adverse effects of the pandemic. The findings of this study have important implications for policymakers and stakeholders in Africa's largest economy, as they seek to address the challenges posed by the pandemic and promote household food security for the actualisation the United Nations (UN) Sustainable Development Goal (SDG) of food and nutrition security (SDG2). The study, therefore, recommends that efforts be made to preserve food supply chains by mitigating the pandemic's effect on food systems, increasing food production, and looking forward beyond the pandemic by building resilient food systems with the use of social protection interventions.

Feasibility of a social protection linkage program for individuals at-risk for tuberculosis in Uganda.

Social protection interventions have the potential to accelerate progress towards global tuberculosis (TB) targets. We piloted a screening and linkage program at four community health centers (HC) to enroll adults seeking TB diagnostic evaluation services into existing government-supported social protection programs in Uganda. From May-December 2021, health center staff were asked to screen adults being evaluated for TB for eligibility for government-supported social protection programs, and to refer eligible people to a sub-county community development office (CDO) responsible for enrolling community members into government-supported social protection programs. Linkage was facilitated with a transportation reimbursement via mobile money and referral documentation confirming program eligibility. We assessed feasibility using programmatic data and conducted post-intervention surveys to understand experiences with the linkage program. Of 855 people undergoing TB evaluation, 655 (76%) adults met criteria for at least one government-supported social protection program. 25 (4%) of those were not interested in referral; the rest were referred to their local CDO. While 386 (61%) of the 630 participants reported to the CDO seeking social protection enrolment, only 122 (32%) of those were ultimately enrolled into a social protection scheme, representing only 19% (n = 655) of those eligible. In surveys conducted among 97 participants, 46 of the 60 (77%) people who reported that they sought enrollment at the CDO were not enrolled into a social protection program. Reasons provided for non-enrollment among these 46 participants were either unknown (n = 25, 54%) or due to operational challenges at the CDO including a lack of human resources or available groups to join in the social protection program (n = 20, 43%). 61 survey participants (63%) indicated that they would not have sought social protection enrollment without the referral program. Overall, we found that most adults seeking TB diagnostic evaluation are eligible for and interested in obtaining government-supported social protection. We found facilitated linkage from HCs to CDOs offering social protection services to be feasible, however ultimate enrollment into programs was limited. Additional research is needed to identify strategies to improve access to existing social protection programs for eligible TB-affected individuals. Trial Registration: Pan African Clinical Trials Registry (PACTR201906852160014).

One for all and all for one: Increasing the adaptive capacity of households and communities through a public work programme

This article uncovers the mechanisms shaping the impact of the public work component of Ethiopia’s Productive Safety Net Programme (PSNP) on beneficiaries and communities’ food security and vulnerability to various shocks. Using three waves of a national representative household survey, this study provides quantitative evidence on the pathways through which the social protection intervention affects direct beneficiaries and their community peers. The empirical findings show that the PSNP beneficiaries are less likely to be food insecure and to experience harvest losses in the aftermath of droughts. Notably, the beneficial effects of the programme partially spill over to the direct participants’ community peers. This is likely to be due the nature of the public works implemented through the programme, such as the integrated community-based watershed development, including soil and water conservation measures and rangeland management in pastoral areas. Additionally, no significant impacts have been found when households self-report stresses unrelated to droughts. Our findings are expected to inform the debate on the effectiveness of the PSNP and other adaptive social protection programmes. From a policy perspective, they suggest the explicit integration of environmental and climate considerations into the design of social protection interventions targeting poor agricultural households highly vulnerable and exposed to weather shocks.

Effects of social protection programs on suicide mortality: a study in 81 LMICs between 2000-2019

Abstract By 2019, LMICs bore more than 77% of the global suicide burden worldwide. In addition, the consequences of the COVID-19 pandemic exacerbated the existing inequalities and social protection gap between high- and low- and middle-income countries (LMICs). The United Nations’ Sustainable Development Goals 2021 Agenda targeted, both, the promotion of social protection for all (target 1.3) and the reduction of suicide mortality by one-third (target 3.4) by 2030. These targets will not be met if current trends maintain. There is a lack of studies investigating the link between social protection and suicide in LMICs. This study aimed to help fill this knowledge gap by assessing the effects of social protection (SP) programs on the suicide mortality rates in 81 low- and middle-income countries (LMICs), over the period 2000-2019. Multivariable regression analyses using Poisson models were performed adjusting for relevant socioeconomic and healthcare factors. Robust standard errors and fixed-effects specifications were included to estimate the relationship between SP coverage and suicide rates. Our results showed that a 1% increase in the population covered by SP programs could reduce by 0.19% (IRR:0.83;95%CI:0.74-0.94) the suicide rates of the 81 LMICs over the 20 years studied. By disaggregating, the strongest suicide reductions were found among the youngest population of 10-24 years (a 0.21% suicide reduction when increasing SP coverage by 1%: IRR:0.81;95%CI:0.69-0.95). To our knowledge, this study shows for the first time in a large sample of LMICs, that social protection programs could reduce the suicide mortality in LMICs, especially among the youngest populations. Understanding the potential benefits that SP programs could have on reducing health inequalities in LMICs could guide policymakers to target more efficient interventions to prevent suicide and associated factors, quantify its public health cost, and create strategies to tackle stigma-related behaviors. Key messages • Promoting the expansion of social protection interventions could be an effective strategy to reduce the suicide burden over the next years in LMICs, especially among the youngest populations. • Advocating for the de-stigmatization and promotion of standardized methods to classify suicide should be a public health priority.

Social protection, community participation and state‐citizen relations: Evidence from a cash transfer program in south‐central Somalia

AbstractWe investigate whether social protection programs can increase participation in community‐driven development programs and examine how this affects state‐citizen relations. Using a randomized controlled trial in south‐central Somalia, we study the impacts of one‐time unconditional cash transfers to vulnerable households that were specifically designed to encourage participation in community development. While the cash transfer is relatively small as a share of annual household expenditure, it is more than sufficient to cover households' anticipated community development contributions. The transfers were funded by an NGO but delivered through state institutions. We collect survey data before and after the intervention with almost 600 individuals eligible to receive cash transfers. We find no substantial differences in participation in community development projects for cash transfer recipient households relative to non‐recipient households. However, we do find positive impacts of the cash transfers on citizen perceptions of clan elders and the local government. Our findings suggest that relatively small social protection interventions may face challenges in increasing vulnerable households' participation in community development and decision‐making, while also highlighting potential positive spillover effects for state‐citizen relations and beliefs about the capacity of local institutions where states institutions are involved in program delivery, even if they do not finance the program.

Evidences of Widespread Hunger in Gbeo Community, North East Region, Ghana; the Determinants of Malnutrition and Susceptibility to Extreme Hunger

Background: The global community aspires towards zero hunger and minimized prevalence of various metrics of malnutrition by 2030 and beyond. Despite mainstream routine nutrition/food surveillance interventions carried out by provincial, national and civil society bodies, the markers of global hunger are rife. This study sought to investigate with the aid of household food insecurity experience scale (HFIES) and nutrition indices, the evidence of hunger, child malnutrition and other forms of extreme household deprivation in Gbeo; a rural hard-to-reach community in the Mamprugu East Municipality, North East Region. Methods: This study was a case analysis of Gbeo community using cross-sectional modalities. Mother – child dyads from 235 systematically selected households were recruited for one-on-one interviews including anthropometric/dietary assessments. Data were obtained on household hunger (using HFIES as proxy), child (6 – 59 months) malnutrition and their potential predictors (SE characteristics, IYCF, WASH, etc.). Child anthropometric growth indices were computed in accordance with WHO (2017) revised standard protocols. Findings: Out of 235 children 34.4% were stunted, 18.8% underweight and 37.9% wasted; these are elevated above Ghana Demographic and Health Survey (GDHS) data for Northern Region, Ghana as a whole and WHO/UNICEF/World Bank (2021) latest global estimates. Four (1.8%) children had all growth failure and in 5.6% of cases, underweight co-occur with stunting and wasting. The proportion of HHs in the 3rd tertile [T3], 2nd tertile [T2] and 1st tertile [T1] of food insecurity were 33%, 29% and 38% respectively. Multiple logistic regression models showed that mean HFIES scores were higher among households that; has a female food-based decision maker [t (degrees of freedom=1, n=235) = 1.93, significance level p =.000], have not received any form of remittances within the past 12 months [t (1, 235) = 2.65, p = .016], source their food stuffs from predominantly purchasing [t (1, 235) = 2.65, p = .009] and has a caregiver or household head that is an alcoholic [t (1, 235) = 4.01, p = .000]. Conclusion: Food insecurity predicts acute child malnutrition. Social protection and economic empowerment interventions should be integrated with nutrition-based initiatives for holistic household improvement.

What matters most? A qualitative study exploring priorities for supportive interventions for people with tuberculosis in urban Viet Nam

IntroductionThe health and economic burden of tuberculosis (TB) in urban Viet Nam is high. Social protection and support interventions can improve treatment outcomes and reduce costs. However, evidence regarding optimal...

The impact of social protection interventions on treatment and socioeconomic outcomes of people with tuberculosis and their households: Protocol for a systematic review and meta-analysis.

Background: Tuberculosis (TB) is a leading cause of death due to infectious disease worldwide. People with TB and their households often suffer social and economic losses due to the cost of tuberculosis care. The World Health Organization 2015 End TB strategy called for socioeconomic support through social protection interventions. Social protection has the potential to enable people with TB and their households to break the cycle of TB and poverty, thereby improving both treatment and socioeconomic outcomes. This study aims to evaluate whether people with TB who are recipients of social protection interventions have better treatment and socioeconomic outcomes than those who are not recipients of social protection interventions. Methods: We will systematically review literature published in English between 2012 and 2021 from PubMed, Embase, and Web of Science, and grey literature from Google Scholar and selected, relevant databases. We will include studies that describe a social protection intervention (as defined by the World Bank) and report on TB treatment outcomes and/or socioeconomic outcomes. We will only include studies pertaining to populations in low-and-middle-income countries and/or countries with high TB burden. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality will be assessed using the Cochrane Risk of Bias for randomized controlled trials and the Newcastle Ottawa Scale for non-randomised controlled studies. If sufficient quantitative data are available, we will perform a meta-analysis of aggregated outcomes. Lastly, we will use the Grading Recommendations Assessment, Development, and Evaluation to describe the overall quality of evidence. Ethics and dissemination: Ethical approval is not required for this systematic review, as all data extraction and analysis will be conducted on published documents. We will disseminate this protocol through conference presentations. The systematic review has been registered prospectively in the PROSPERO database (registration number CRD42022382181).

Social Protection Interventions for TB-Affected Households: A Scoping Review.

Tuberculosis (TB) and poverty are inextricably linked. Catastrophic costs of TB illness drive TB-affected households into worsening impoverishment and hamper treatment success. The WHO's End TB Strategy recommends social protection for TB-affected households to mitigate financial shock and improve TB outcomes. This scoping review maps the landscape of social protection interventions for people with TB and their households in low- and middle-income countries with high TB burden. A systematic search of Medline, Embase, PubMed, and Web of Science for relevant articles was performed, supplemented with a gray literature search of key databases. Articles were included if they described social protection available to people with TB and TB-affected households in a low- or middle-income country. Data were synthesized in tabular form, and descriptive narrative outlined the successes and challenges of the social protection interventions identified. The search identified 33,360 articles. After abstract screening, 74 articles underwent full text screening, and 49 were included in the final analysis. Forty-three types of social protection were identified, of which 24 were TB specific (i.e., only people with TB were eligible). Varying definitions were used to describe similar social protection interventions, which limited cross-study comparison. Intervention successes included acceptability and increased financial autonomy among recipients. Challenges included delays in intervention delivery and unexpected additional bank transfer fees. A wide range of acceptable social protection interventions are available, with cash transfer schemes predominating. Use of standardized definitions of social protection interventions would facilitate consolidation of evidence and enhance design and implementation in future.

Experiences of conditional and unconditional cash transfers intended for improving health outcomes and health service use: a qualitative evidence synthesis.

It is well known that poverty is associated with ill health and that ill health can result in direct and indirect costs that can perpetuate poverty. Social protection, which includes policies and programmes intended to prevent and reduce poverty in times of ill health, could be one way to break this vicious cycle. Social protection, particularly cash transfers, also has the potential to promote healthier behaviours, including healthcare seeking. Although social protection, particularly conditional and unconditional cash transfers, has been widely studied, it is not well known how recipients experience social protection interventions, and what unintended effects such interventions can cause. OBJECTIVES: The aim of this review was to explore how conditional and unconditional cash transfer social protection interventions with a health outcome are experienced and perceived by their recipients. SEARCH METHODS: We searched Epistemonikos, MEDLINE, CINAHL, Social Services Abstracts, Global Index Medicus, Scopus, AnthroSource and EconLit from the start of the database to 5 June 2020. We combined this with reference checking, citation searching, grey literature and contact with authors to identify additional studies.We reran all strategies in July 2022, and the new studies are awaiting classification. We included primary studies, using qualitative methods or mixed-methods studies with qualitative research reporting on recipients' experiences of cash transfer interventions where health outcomes were evaluated. Recipients could be adult patients of healthcare services, the general adult population as recipients of cash targeted at themselves or directed at children. Studies could be evaluated on any mental or physical health condition or cash transfer mechanism. Studies could come from any country and be in any language. Two authors independently selected studies. DATA COLLECTION AND ANALYSIS: We used a multi-step purposive sampling framework for selecting studies, starting with geographical representation, followed by health condition, and richness of data. Key data were extracted by the authors into Excel. Methodological limitations were assessed independently using the Critical Appraisal Skills Programme (CASP) criteria by two authors. Data were synthesised using meta-ethnography, and confidence in findings was assessed using the Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. MAIN RESULTS: We included 127 studies in the review and sampled 41 of these studies for our analysis. Thirty-two further studies were found after the updated search on 5 July 2022 and are awaiting classification. The sampled studies were from 24 different countries: 17 studies were from the African region, seven were from the region of the Americas, seven were from the European region, six were from the South-East Asian region, three from the Western Pacific region and one study was multiregional, covering both the African and the Eastern Mediterranean regions. These studies primarily explored the views and experiences of cash transfer recipients with different health conditions, such as infectious diseases, disabilities and long-term illnesses, sexual and reproductive health, and maternal and child health. Our GRADE-CERQual assessment indicated we had mainly moderate- and high-confidence findings. We found that recipients perceived the cash transfers as necessary and helpful for immediate needs and, in some cases, helpful for longer-term benefits. However, across conditional and unconditional programmes, recipients often felt that the amount given was too little in relation to their total needs. They also felt that the cash alone was not enough to change their behaviour and, to change behaviour, additional types of support would be required. The cash transfer was reported to have important effects on empowerment, autonomy and agency, but also in some settings, recipients experienced pressure from family or programme staff on cash usage. The cash transfer was reported to improve social cohesion and reduce intrahousehold tension. However, in settings where some received the cash and others did not, the lack of an equal approach caused tension, suspicion and conflict. Recipients also reported stigma in terms of cash transfer programme assessment processes and eligibility, as well as inappropriate eligibility processes. Across settings, recipients experienced barriers in accessing the cash transfer programme, and some refused or were hesitant to receive the cash. Some recipients found cash transfer programmes more acceptable when they agreed with the programme's goals and processes. AUTHORS' CONCLUSIONS: Our findings highlight the impact of the sociocultural context on the functioning and interaction between the individual, family and cash transfer programmes. Even where the goals of a cash transfer programme are explicitly health-related, the outcomes may be far broader than health alone and may include, for example, reduced stigma, empowerment and increased agency of the individual. When measuring programme outcomes, therefore, these broader impacts could be considered for understanding the health and well-being benefits of cash transfers.

Mitigating poverty and undernutrition through social protection: A simulation analysis of the COVID‐19 pandemic in Bangladesh and Myanmar

AbstractThe COVID‐19 pandemic resulted in severe income losses, but little is known about its impacts on diets and nutritional adequacy, or the effectiveness of social protection interventions in mitigating dietary and nutritional impacts. We first assess the likely impacts of COVID‐19 shocks in Bangladesh and Myanmar on poverty and food and nutrient consumption gaps. We then analyze the estimated mitigating effects of five hypothetical social protection interventions of a typical monetary value: (1) cash transfers; (2) in‐kind transfers of common rice; (3) in‐kind transfers of fortified rice enriched with multiple essential micronutrients; (4) vouchers for a diversified basket of rice and non‐staple foods; and (5) food vouchers with fortified rice instead of common rice. The simulation results suggest modest effectiveness of the cash transfers for mitigating poverty increases and little effectiveness of all five transfers for preventing increasing food and nutrient consumption gaps among the poorest 40%. Rice fortification is, however, effective at closing key micronutrient consumption gaps and could be a suitable policy instrument for averting “hidden hunger” during economic crises.

Government social protection and households’ welfare during the Covid-19 pandemic in South Africa

PurposeThis study evaluates the impact of government social protection interventions on households’ welfare in South Africa.Design/methodology/approachThe study uses survey data comprising 393 observations and the multinomial logistic regression technique to analyse the effect of government interventions on households’ welfare. For robustness purposes, a negative binomial regression model is also estimated whose results corroborate the main results from the multinomial regression model.FindingsThe study’s findings show that government economic interventions through social protection significantly reduce the likelihood of a decrease in household income or consumption. COVID-19 grant/social relief of distress grant, unemployment insurance, tax relief and job protection and creation are all significant in sustaining household income and consumption.Practical implicationsThe findings have policy implications for social development. Specifically, the findings support the use of government social protection as a safety net for low-income groups in South Africa.Originality/valueThe study presents preliminary evidence on the effectiveness of several measures used to ameliorate the COVID-19-induced recession within the South African context.

Exploring the Role of Social Protection Interventions in Preventing Child Labour: Reinforcing the Case for a Human Rights-Based Model of Intervention

AbstractSocial protection measures have emerged as critical interventions to tackle child labour. However, the effectiveness of divergent models of social protection for preventing child labour is undertheorized by academic scholars, and the specific links between child labour and social protection policy generally are underexplored. To advance knowledge in this field, first, this article develops a conceptual framework to analyse evolving discourses relating to the design of social protection measures adopted by the World Bank (WB) and International Labour Organization (ILO). The analysis distinguishes between minimalist ‘safety-net and market-centred’ approaches to social protection (associated with the WB), and more fulsome ‘human rights-based’ interventions (associated with the ILO). The implications of these diverse models of social protection and their impact on children in economic exploitation are analysed. Second, the article engages in an innovative analysis of available empirical studies to measure the effectiveness in practice of different models of social protection. The article argues that interventions that are explicitly linked to broader socio-economic rights and align with a ‘human rights-based’ approach give rise to the most effective results. In contrast, interventions that adopt a ‘safety-net and market-centred’ approach can result in mixed outcomes, and/or increases in child labour. A further finding from the analysis reveals that the gendered burden of social reproduction work is a structural issue that cuts across all of the different social protection interventions and plays a crucial role in their varying outcomes. The article concludes with recommendations for policy makers that have implications for the design of ‘child-friendly’ social protection.

The discursive construction of gender identities and roles for women in cash transfer programmes: Implications for gender power relations

Cash transfer (CT) programmes in Global South countries do not only provide cash grants to extremely poor households to smoothen consumption and improve human capital development, but they also promote collective action, strengthen relation-building and social transformation. Ghana’s Livelihood Empowerment Against Poverty (LEAP) is one of many such programmes with considerable success in providing cash to extremely poor households, mostly with women as caregivers, but there are also some concerns worth highlighting. The questions are: first, how does Ghana’s LEAP CT programme perpetuate or transform gender power relations? Second, how do women caregivers exercise agency within the intersecting relations of the programme in the cultural context? Gender, power, and discourse are the theoretical underpinnings of the article with an ethnographic-discourse strategy inspired by a dialectical-relational approach to critical discourse analysis. The discursive analysis of the practices of the LEAP CT programme officials and the women caregivers demonstrate that the LEAP CT programme, at the institutional level, discursively reproduces and naturalises gender identities, roles and subject positions for women despite prioritizing women as the recipients of the cash. However, it also reveals nuances of women agency evident at the intersecting and participatory practices of women caregivers in the programme and in the socio-political contexts of the local communities. Whilst the first finding affects women negatively, the second presents a potential for transforming gender power relations in institutions and local communities in Global South countries as it challenges the taken-for-granted notions of gender relations for a better world. The study contributes to an improved situated understanding of unequal and pervasive gender power relations in Global South countries’ social protection interventions.

Conditional Cash Transfer to Improve TB Outcomes: Necessary but Not Sufficient Comment on "Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? - A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India".

Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected.

Evaluating spillovers and cost-effectiveness of complementary agricultural and social protection interventions: evidence from Lesotho

ABSTRACT We present findings from a study of the local-economy impacts of Lesotho’s Child Grants Programme and of a multi-faceted rural development intervention. We designed a micro-data parameterised general equilibrium model and used it to simulate the direct and indirect impacts of the two interventions, considering income and production spillovers. The Child Grants Programme, alone and in combination with the rural development programme, generates total discounted benefits that exceed discounted programme costs. Local-economy spillovers amplify the benefit-cost ratio of both cash transfers and productive interventions. By better integrating with outside markets, it is possible to attain substantial cost-effective income gains for local economies.

‘Finding My Own Way’: Mobilization of Cultural Capital through Migrant Organizations in Germany

Migrant organizations (MOs), as associations that are founded, managed, and led by people with migration biographies, have recently emerged as facilitators of social protection interventions. This article is devoted to this barely debated issue of MOs in the field of social protection, by emphasizing their role in facilitating the mobilization and access to cultural capital as an important determinant of protection and wellbeing of people with migration biographies. Specifically, we study how MOs promote the formation and mobilization of skills and resources to be used in different fields, in particular in the education and labor markets. We find that MOs facilitate various occasions for their members to generate migration-specific cultural capital, predominantly in the field of education and language skills. MOs also promote the creation and institutionalization of cultural capital on the labor market. In addition, our results show that people with a migration background appreciate their participation in migrants’ organizations, because they allow them to pursue their own projects and find their own way through the different phases of migration and settlement, in often challenging environments.