This paper analyzes the complex effects and risks of social protection programmes in Ghana and Kenya on poor people's human wellbeing, voice and empowerment and interactions with the social protection regulatory framework and policy instruments. For this purpose, it adopts a comprehensive Inclusive Development framework to systematically explore the complex effects of cash transfers and health insurance at the individual, household and community level. The findings highlight the positive provisionary and preventive effects of social protection, but also illustrate that the poorest are still excluded and that promotive effects, in the form of enhanced productivity, manifest themselves mainly for the people who are less resource poor. They can build more effectively upon an existing asset base, capabilities, power and social relations to counter the exclusionary mechanisms of the system, address inequity concerns and offset the transaction costs of accessing and benefitting from social protection. The inclusive development framework enables to lay these complex effects and interactions bear, and points to areas that require more longitudinal and mixed methodology research.

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While social protection has become an important policy field in many low-and middle-income countries (LICs and MICs), 55 per cent of the world's population are still not even covered by one social protection benefit, with 87 per cent of people uncovered in Sub-Saharan Africa and 61 per cent in Asia and the Pacific (ILO 2017). Next to undercoverage, there are other factors that lower the efficiency, effectiveness and social justice of social protection in many countries, such as the lack of a joint vision and policy strategy, fragmented social protection programmes, duplication of administrative systems and efforts and irrational prioritisation in spending. These all call for a stronger systems approach to social protection. This handbook is therefore dedicated to social protection systems, highlighting the relevance but also the challenges that are related to a harmonised and coordinated approach across different social protection instruments, institutions, actors and delivery mechanisms. It takes the reader through all possible aspects of social protection systems.It understands social protection as the entirety of policies and programmes that protect people against poverty and risks to their livelihoods and well-being. This definition is based on the way in which universal social protection has been defined by a consortium of bi-and multilateral actors of development policy in 2019:Universal social protection is achieved through a nationally defined system of policies and programmes that provide equitable access to all people and protect them throughout their lives against poverty and risks to their livelihoods and well-being. This protection can be provided through a range of mechanisms, including in cash or in-kind benefits, contributory or non-contributory schemes, and programmes to enhance human capital, productive assets, and access to jobs.

Consideration of the socioeconomic ripple effects of the HIV/AIDS pandemic, the impact of the 'triple F' (food, fuel and finance) crisis, the failure of economic growth to impact broadly on poverty reduction and the increasing pressure to show progress towards the Millennium Development Goals (MDGs), would seem to make social protection the policy instrument of choice in low-income countries. Yet, in some of the countries with the worst chronic poverty, scepticism regarding social protection appears to prevail, despite exposure visits to Latin America, tailor-made training courses, much generation and communication of evidence regarding the positive impacts of social protection initiatives and increasing donor commitments. Zambia, in particular, has been criticised for a lack of government commitment to social protection generally, but especially to social cash transfers (SCT). SCT started in Zambia in Kalomo district as a donor-funded initiative in 2003, and was later extended to five districts. This pilot project aimed to generate evidence and offer government and the Ministry responsible-Community Development and Social Services (MCDSS)-the necessary information and skills to demonstrate the value of social protection for citizens who have limited or no productive capacity. The SCT was proposed alongside other social protection interventions, as illustrated by the first national Social Protection Strategy in 2005.

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Purpose To investigate how completing vocational re-training influenced income and employment days of working-age people with disabilities in the first 8 years after program admission. The investigation also included the influence of vocational re-training on the likelihood of receiving an earnings incapacity pension and on social security benefit receipt. Methods This retrospective cohort study with 8 years follow up was based on data from 2399 individuals who had completed either a 1-year vocational re-training program (n = 278), or a 2-year vocational re-training program (n = 1754) or who were admitted into re-training but never completed the program (n = 367). A propensity score-based method was used to account for observed differences and establish comparability between program graduates and program dropouts. Changes in outcomes were examined using the inverse probability-weighted regression adjustment method. Results After controlling for other factors, over the 8 years after program admission, graduates of 1-year re-training, on average, were employed for an additional 405 days, 95% CI [249 days, 561 days], and had earned €24,260 more than without completed re-training, 95% CI [€12,805, €35,715]. Two-year program completers, on average, were employed for 441 additional days, 95% CI [349 days, 534 days], and had earned €35,972 more than without completed re-training, 95% CI [€27,743, €44,202]. The programs also significantly reduced the number of days on social-security and unemployment benefits and lowered the likelihood of an earnings incapacity pension. Conclusion Policies to promote the labor market re-integration of persons with disabilities should consider that vocational re-training may be an effective tool for sustainably improving work participation outcomes.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Social cash transfers (SCTs) are considered a priority in least-developed countries, where the gap between the need for basic social protection and existing provisions is greatest. This study represents one of the first comprehensive treatments of the impact of social cash transfers in low-income sub-Saharan Africa, and the first for Zambia's oldest SCT scheme. The results, based on propensity score matching and fully efficient odds-weighted regression, and data from the Kalomo SCT pilot scheme, confirm positive SCT effects on per capita consumption expenditure. We also discover threshold effects with SCT mostly impacting food expenditure among poorer beneficiary households and non-food expenditure among wealthier beneficiaries.