Social Protection Research Articles

Building social equity and person-centred innovation into the end TB response.

Reducing systemic inequities in testing, access to care, social protection - and in the scientific process - is essential to end TB. Incorporating social science methods and expertise on inequity into the mainstream TB response would help ensure that political commitments to equity move beyond symbolic gestures. We convened a meeting between TB social scientists, people with lived experience, civil society and community members to discuss equity within the global TB response. Here, we propose five means by which a social science lens can strengthen equitable, person-centred responses and reconcile the public health significance of TB with the principles of social justice.

Protecting nutrition in a food crisis.

Food insecurity and malnutrition are rising worldwide due to disruptions in food systems related to interconnected health-, climate- and conflict-related crises. Although governments globally are committed to addressing nutritional challenges, policy responses have increasingly focused on food security and, particularly, on food affordability. However, these short-term measures often overlook the necessity of integrating nutritious foods into the food system to ensure improved long-term nutrition. By drawing on the United Nations Committee on World Food Security's Voluntary guidelines on food systems and nutrition, this article outlines opportunities for policy-makers to integrate nutrition into key elements of the crisis response. Key policy areas where nutrition could be further integrated include social protection, agricultural investment, trade policy and urban planning. Strengthening the focus of nutrition in these measures will be essential to establish long-term incentives that support food systems transformation for improved nutrition. Drawing on theories of the policy process, I propose that stronger governance and cross-sectoral dialogue will be critical to achieve sustained nutritional outcomes. Health policy-makers can play a leadership role in supporting cross-sectoral policy change by carefully framing the policy issues, advocating for institutional structures that promote collaboration across sectors to prioritize nutrition, and strengthening the management of conflicts of interest in food system policy-making.

Social Protection in Conflict and Conflict-Related Displacement Crises

In recent years, efforts to encourage the use of social protection in response to conflict and displacement have increased. Yet many of the lessons from social protection and shock-responsive programmes emerged in response to climate shocks and other disasters and are not necessarily transferable to conflict and displacement settings. Ultimately, the concern must be how to sustain support to the poorest and most vulnerable populations during conflict. This shifts the focus away from simply maintaining the functions and delivery capacities of state‑directed social protection towards how to harmonise multiple channels and providers of social assistance. State‑directed social protection may not be the most appropriate channel to address the needs of conflict-affected and displaced populations. This article considers the challenges to introducing, extending, and sustaining social protection in crises characterised by conflict and displacement.

Linking Social Protection and Humanitarian Systems to Respond to Forced Displacement

With displacement occurring at record levels and often on a protracted basis, there is increasing interest in the potential to link humanitarian displacement responses with social protection systems. This article discusses how social protection and humanitarian systems can work together to meet the needs of displacement-affected populations, based on the findings of a three-year research project that drew on global literature alongside mixed-methods data collected in 2021 in Cameroon, Colombia, and Greece. The article discusses five lessons: (1) displaced populations’ distinct needs and implications for social protection design and delivery; (2) inadequate social protection for host communities and implications for social cohesion; (3) the priority basis for evaluating linkage approaches; (4) the need for sustained international financing; and (5) the general importance of greater transparency and collaboration. It concludes with recommendations for further research to build the nascent evidence base on this topic.

Indigenous Peoples and Social Protection: The Case of the Peruvian Amazon

The persistence of indigenous poverty and exclusion is one of the main challenges for social policy in Latin America. Social protection programmes, in particular conditional cash transfers, have been among the main instruments used by governments over the past two decades to respond to the high incidence of poverty in indigenous contexts. The inclusion of indigenous peoples as social protection beneficiaries remains a largely unexplored topic, despite its relevance to understand social policy trajectories in the global South. This article discusses the expansion of poverty alleviation social programmes in the Peruvian Amazon. Although the expansion of these programmes increased the state’s capacity to deliver welfare services in historically excluded areas, it also revealed the limitations of existing social protection instruments to effectively respond to indigenous poverty and vulnerability. Addressing this challenge constitutes a key opportunity to promote transformative approaches in social protection systems in Latin America.

Introduction: Social Protection in a Time of Global Uncertainty

Social protection has established itself as a vibrant policy sector across the global South, and as a pillar of international development cooperation. Social protection features in numerous country policies and development agency strategies, as well as in several Sustainable Development Goals. However, the global context today is characterised by a range of emerging and intensifying challenges and uncertainties, including post-Covid-19 pandemic recovery; the cost-of-living crisis; unprecedented climate change; and rising numbers of protracted wars and political instability, leading to mass displacement and migration. What is the role of social protection in this shifting and uncertain global context? This article highlights challenges and opportunities for social protection at this crossroads moment, under the themes of politics, crises, innovation, and inclusion, as a way of introducing and framing the contributions to this IDS Bulletin. We argue that the need for social protection has never been greater, but its future trajectories need urgent reimagining.

Enacting Social Protection Laws in Jigawa and Zamfara States, Nigeria

Legal frameworks are important for institutionalising and strengthening social protection systems. Two states in Nigeria, Jigawa and Zamfara, have enacted social protection laws. This article explores how the process of enacting such a law is influenced by state-level politics and local contexts, and how the activities of a project financed by the Foreign, Commonwealth & Development Office (FCDO) contributed to much greater understanding and acceptance of social protection in both states. Primary data collected through in-depth interviews with state and non-state stakeholders and project staff was analysed to tease out the political, cultural, and power dynamics involved in enacting the laws. Findings show that a range of factors aimed at building the case for, and understanding of, social protection across a range of stakeholders was critical, and that a fairly standard package of tools employed in advocating for institutionalising social protection was influenced considerably by domestic political dynamics.

Social Protection: Aspirations and Limitations of an Expanding Agenda

This article unpacks the expanding social protection agenda, in which promotive objectives have been added to the original welfarist or safety net aim of protection. It draws out the resulting tensions, potentials and limits, to inform a discussion of where African social protection is and is headed. After tracing several initial drivers of social assistance in Africa – structural adjustment, food insecurity and famines, HIV and AIDS, and conflict – it shows how promotive effects were increasingly advocated along three pathways: investment of social transfers, building human capital, and linking social with economic support. International development agencies added their own priorities to this agenda, drawing on evidence of promotive impacts to convince national governments. Drawing on Zambia’s experience, we conclude that, while the expanded agenda redirects attention to questions of economic development, its transformative potential remains limited due to a persistent focus on the micro‑level and a failure to build effective linkages to other sectors.

Humanitarian Activism, Social Protection, and Emergent Citizenship in Myanmar

Through the confluent impacts of the Covid-19 pandemic and the 2021 military coup, Myanmar has become a failed state. Deliberate targeting of humanitarian actors by the military junta has severely constrained the activities of international non-governmental organisations and United Nations agencies. In the first three post-coup years, welfare provision to the distressed and displaced were mainly undertaken by local actors who adapted to new conditions of both insecurity and broader economic turmoil. This localised welfare is intertwined with emergent local governance mechanisms, using technology and data analysis to deliver transparent, accountable, and inclusive public service. In the absence of a coherent central state, the social contract of welfare develops at more local levels, generating smaller islands of citizenship from which to build future political communities.

Realigning Social Protection Across the Nexus: Reflections from Protracted Crises in the Arab Region

Humanitarian emergencies are increasingly protracted and characterised by multiple compounding crises. International social security standards provide a roadmap for building national social protection systems. In the Arab States region, the International Labour Organization has been critically assessing how to apply these standards across the humanitarian, development, and peace nexus when countries face protracted crises. This article presents case studies in four countries: Iraq, Jordan, Lebanon, and the Occupied Palestinian Territory. It addresses questions on how to strengthen humanitarian–development transitions using international standards, where entry points exist or challenges remain, and how these transitions may contribute to strengthening peace through social cohesion.

What’s pension got to do with it? Mortality inequality at older ages

Abstract Background The potential role of social protection systems and welfare states for population health and mortality has attracted increased interest in recent decades but mostly focused on overall characteristics or clusters of countries. Moreover, often neglecting older people even though the great majority of all deaths in high-income countries occur at later ages. We focus on the key social protection scheme for old adults: the generosity of the level of pensions. We compare pensions based on previous work history to basic minimum pensions. Our study is novel both by linking pension system to remaining life expectancy at age 65(LE65+), but also by studying the association to variation in LE65+, since that gives a measure of inequality. We do so across countries and over time. Methods and Materials Our sources of data are from the Human Mortality Database and the Social Policy Indicator Database. Data for OECD countries are matched over a long period of time and analysed by pooled time-series regression analyses with fixed effects. Results Although the results indicate that the generosity of pensions based on both pervious work history and basic minimum income our results primarily show the importance of basic minimum income. Here the effect sizes are larger and especially for women than for men (0.149*** vs. 0,.0715***). Concerning the variation in LE (65+) we find that more generous basic pensions are associated with reduced variation for women -4.64e-05**. Conclusions We provide new insights in how pension policies potentially influence mortality among older persons especially by extending our analyses also to inequality in mortality. Our results points to the importance of basic pensions. The gendered division of labour is a plausible explanation for the findings and to have an adequate pension for all should be of primary concern for public health. Key messages • Adequate basic pension for all of importance for remaining life expectancy among older people. • Adequate basic pension for all of importance for reducing mortality inequality among women.

Study on access to social protection policies by homeless people during the COVID-19 pandemic

Abstract The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector. Key messages • Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social. • Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.

Notes on Contributors

This is the Notes on Contributors for IDS Bulletin 55.2, Reimagining Social Protection.

Exploring Synergies Between Community Mobilisation and Cash Transfers in Bangladesh

This article presents insights from the Child Labour: Action-Research-Innovation in South and South-Eastern Asia (CLARISSA) social protection cash plus intervention in a low‑income neighbourhood in Dhaka, Bangladesh. Adopting a novel methodology, we use community mobilisers’ monthly narrative reports, so-called ‘micronarratives’, to understand synergies between implementation and outcomes of community mobilisation activities (the ‘plus’) and cash transfers. We find that households face many intersecting problems, including health issues, low income, and indebtedness, and community mobilisation lays a foundation for households to be heard and become more resilient in the face of these problems. The introduction of cash transfers facilitated individuals and households to act on the advice and ideas offered by the community mobilisers. Households became more willing to speak with community mobilisers even when they explained that the cash transfer was unconditional on their counselling service. Some households started income-generating activities with their savings.

The Political Economy of Shock-Responsive Social Protection: Analysis from Malawi

Using social assistance systems to address acute needs arising from wide-scale shocks – commonly known as ‘shock-responsive social protection’ (SRSP) – raises significant political economy questions. Previously, acute needs caused by disasters across sub-Saharan Africa have primarily been met by humanitarian actors alone. SRSP disrupts the status quo by reducing humanitarian actors’ access to and control over humanitarian funding. This raises significant political questions; likewise, the introduction by SRSP of greater accountability and transparency into the implementation of humanitarian responses. This article addresses a current gap in the literature: the politics of SRSP. Referencing the concept of political settlements, the article asks what explains the evolution of SRSP in Malawi by examining the actions of domestic and international actors. It finds that there is scant evidence of national ownership of SRSP and that lack of consensus among international actors is a key obstacle to the concept becoming embedded within the political settlement.

2008 economic crisis impact on perinatal and infant mortality in Southern European countries

Abstract Introduction The study of crisis events provides important lessons to prepare for upcoming events. The Great Recession’s impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems’ response to protecting the health of the most vulnerable groups. Objectives To assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain. Methods Associations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models. Results IMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018. Conclusions Our results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population’s health from the earliest days. Key messages • Mortality patterns refer to the internal variability of the crisis’ effect and to persistent spatial regional inequalities appealing to the need for attention in policymaking. • The relevance of considering the political economy of global health finance and macroeconomic volatility as a major influence on the association of mortality rates with socioeconomic indicators.

The Future Politics of Social Protection in Africa

International organisations and their local allies continue to press for the further expansion of social protection across Africa, often in the face of resistance. The future politics of social protection in Africa will be shaped by endogenous and exogenous changes. Endogenous changes involve feedback effects from the past and continuing expansion of social protection; these can be either positive or negative in terms of further expansion. Exogenous effects result from the changing structural context, including especially population growth, urbanisation, and climate change. As the Covid-19 pandemic and related lockdowns showed, even those exogenous shocks which reveal gaps in current provision need not prompt enduring expansions of social protection. Neither endogenous nor exogenous changes are likely to shift African countries off their current varied pathways; considerable political obstacles to the further expansion of social protection will persist.

Cellfare: Delivering Self-Targeted Social Protection Using Mobile Phones

This article proposes a new form of self-targeted social protection scheme: beneficiaries carry out a series of small tasks on their mobile phones, each linked to a small payment. Key advantages over traditional public works include potentially large reductions in leakage, costs, and delays. The proposed scheme may also be suitable to wider demographics as it does not require physical labour and can be availed from home. A prototype implementation of a ‘cellfare’ scheme was tested in rural India, and 42 participants with experience of the Mahatma Gandhi National Rural Employment Guarantee Act, a large Indian public works programme, favourably compared the proposed scheme to the existing one.

Beyond Design: Examining the Implementation of Gender-Responsive Social Protection in Ethiopia

Recent years have witnessed increased global attention and investment in inclusive and gender-responsive social protection programming in low- and middle-income countries. While high-level design commitments are important and welcome, in practice, they may not guarantee protection from vulnerabilities and a reduction in gender inequality. Programme implementation presents a critical, yet often underestimated, challenge. This article offers insights into the reality of implementing the gender provisions of Ethiopia’s Productive Safety Net Programme. Drawing on qualitative data from rural Ethiopia, it shows that the implementation of the gender provisions has generated implementation gaps and inconsistencies. The findings highlight the need to move beyond commitments on paper and allocate greater resources and attention to the implementation of gender-responsive social protection.

6.X.2. Food Insecurity in Europe: Voices from across Europe

Abstract Food insecurity (FI), “lack of regular access to enough safe and nutritious food for normal growth and development and an active and healthy life”, is a global public health issue. The United Nations (UN) have identified achieving food security as a key Sustainable Development Goal (SDG), where all people should “have access to safe, nutritious, and sufficient food all year round.” However, disasters related to the consequences of changing climates, pandemics, wars, displacement of populations, high inflation rates, changes in social protection systems, and food system changes challenge the achievement of this SDG. FI persists even in high-income countries including Europe. This workshop session will foster a knowledge, research and experience exchange on the situation of individuals / different population groups in the context of FI in different European countries. Starting with a contribution from Austria, the term food poverty is introduced and considered from a food system perspective / from an equity perspective. The second contribution illuminates the relationships between FI, shopping behaviours and social support among food bank users in Germany during the COVID-19 pandemic. The final third contribution comes from the Netherlands and explores the needs and perceptions regarding healthy eating among people at risk of FI. In all three studies, standardized measurement tools were applied to measure FI but recruiting methods and data collection methods varied considerably between and within the studies. The session enhances the knowledge on FI in Europe from different perspectives. Key messages • Food insecurity does exist in Europe: there is a need for regular, consistent monitoring across European countries. • Food insecurity involves more than just access to food; it also considers nutritious and climate-friendly options, addressing the link between climate, health, and equity.