SummaryBackgroundCash-transfer programmes can improve the wellbeing of vulnerable children, but few studies have rigorously assessed their effectiveness in sub-Saharan Africa. We investigated the effects of unconditional cash transfers (UCTs) and conditional cash transfers (CCTs) on birth registration, vaccination uptake, and school attendance in children in Zimbabwe.MethodsWe did a matched, cluster-randomised controlled trial in ten sites in Manicaland, Zimbabwe. We divided each study site into three clusters. After a baseline survey between July, and September, 2009, clusters in each site were randomly assigned to UCT, CCT, or control, by drawing of lots from a hat. Eligible households contained children younger than 18 years and satisfied at least one other criteria: head of household was younger than 18 years; household cared for at least one orphan younger than 18 years, a disabled person, or an individual who was chronically ill; or household was in poorest wealth quintile. Between January, 2010, and January, 2011, households in UCT clusters collected payments every 2 months. Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing. Eligible households in all clusters, including control clusters, had access to parenting skills classes and received maize seed and fertiliser in December, 2009, and August, 2010. Households and individuals delivering the intervention were not masked, but data analysts were. The primary endpoints were proportion of children younger than 5 years with a birth certificate, proportion younger than 5 years with up-to-date vaccinations, and proportion aged 6–12 years attending school at least 80% of the time. This trial is registered with ClinicalTrials.gov, number NCT00966849.Findings1199 eligible households were allocated to the control group, 1525 to the UCT group, and 1319 to the CCT group. Compared with control clusters, the proportion of children aged 0–4 years with birth certificates had increased by 1·5% (95% CI −7·1 to 10·1) in the UCT group and by 16·4% (7·8–25·0) in the CCT group by the end of the intervention period. The proportions of children aged 0–4 years with complete vaccination records was 3·1% (−3·8 to 9·9) greater in the UCT group and 1·8% (−5·0 to 8·7) greater in the CCT group than in the control group. The proportions of children aged 6–12 years who attended school at least 80% of the time was 7·2% (0·8–13·7) higher in the UCT group and 7·6% (1·2–14·1) in the CCT group than in the control group.InterpretationOur results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa, but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region.FundingWellcome Trust, the World Bank through the Partnership for Child Development, and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children.

Elements of attachment theory have been embraced by practitioners endeavouring to assist foster and adopted children and their parents. Attachment theory articulates the potential risks of experiencing multiple caregivers; emphasizes the importance of close social relationships to development; and recognizes that substitute parents may not always have close relationships with children who have experienced adversities before joining them. Attachment theory offers concerned parents what they believe to be a scientific explanation about their lack of the close, satisfying parent–child relationship they desire. Yet the scientific base of attachment theory is limited both in terms of its ability to predict future behaviours, and especially with regard to its use as the underpinning theory for therapeutic intervention with children experiencing conduct problems. There is a critical need to review the role of attachment theory in child and family services and to consider its place among other explanations for children's disturbing behaviour. An important step towards pursuing alternative approaches is for researchers and practitioners to understand the reasons the attachment paradigm appeals to so many adoptive and foster parents, given the apparent widespread prevalence of attachment‐based interventions. Such understanding might assist in the development of adoption‐sensitive uses of appropriate evidence‐based treatment approaches.

This study explores the multiple factors that account for peer influence processes of adolescent delinquency and depression using data from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Random-effects longitudinal negative binomial models were used to predict depression and delinquency, controlling for social connection variables to account for selection bias. Findings suggest peer depression and delinquency are both predictive of youth delinquency, while peer influences of depression are much more modest. Youth who are more connected to parents and communities and who are more popular within their networks are more susceptible to peer influence, while self-regulating youth are less susceptible. We find support for theories of popularity-socialization as well as weak-ties in explaining social network factors that amplify or constrain peer influence. We argue that practitioners working with youth should consider network-informed interventions to improve program efficacy and avoid iatrogenic effects.

From a life course perspective, studies of cumulative disadvantage often identify early risk factors as predictors of poor outcomes. This study examined the influence of prenatal substance exposure on children's externalizing behaviors at 14 years postadoption. Using Wave 4 data from the California Long-Range Adoption Study, the authors employed growth curve modeling to examine behavioral trajectories of 275 children as influenced by foster care status, age at adoption, and gender. Outcomes are measured using a shortened Behavioral Problem Index. Prenatal exposure predicted elevated behavior problems that increased normatively compared with nonexposed children, and were not found to trigger the negative behavior sequelae once feared. Foster children tended to fare better over the life course than those adopted through other means, except for children adopted at older ages. Adopted children's problem behaviors may be directly associated with the success of their placements. The authors discuss implications for practice and future research.

Refugees experience limited access to adequate education at all levels, but opportunities for higher education are especially lacking. Yet, evidence suggests that education plays an important protective role in helping refugee individuals and communities cope with their daily existence during protracted waiting periods, and the United Nations refugee agency (UNHCR) recently recognised tertiary education as a basic human right.delivery. Key areas for future growth of the programme include curriculum transformation, integrated service delivery and university engagement.