Do Conditional Cash Transfers Improve Mental Health? Evidence From Tanzania’s Governmental Social Protection Program

Abstract

Cash transfer interventions broadly improve the lives of the vulnerable, making them exceedingly popular. However, evidence of impacts on mental health is limited, particularly for conditional cash transfer (CCT) programs. We examined the impacts of Tanzania's government-run CCT program on depressive symptoms of youth aged 14e28. Methods: We utilized cluster randomized controlled trial data of 84 communities (48 intervention; 36 control). The intervention administered bimonthly CCTs to eligible households, while control communities were assigned to delayed intervention. The analysis included youth with measurements of depression (10-item Centre for Epidemiological Studies Depression Scale) at baseline and 18 months later. We determined impacts using analysis of covariance models, adjusting for youth characteristics (including baseline depression), district-level fixed effects, and community-level random effects. Differential effects by sex and baseline social support were also estimated. Results: Although no evidence was found to suggest that the intervention impacted depressive symptoms among the full sample (n ¼ 880) (effect À.20, 95% confidence interval [CI] À.88 to .48, p ¼ .562), subsample results indicated that depressive symptoms were reduced 1.5 points among males (95% CI À2.56 to À.04, p ¼ .007) and increased 1.1 points among females (95% CI .11e2.09, p ¼ .029). Females 18þ years old (effect 1.55, 95% CI .27e2.83, p ¼ .018) and females with children (effect 1.32, 95% CI À.13 to 2.78, p ¼ .074) drove this negative impact. Social support did not moderate impacts.

The impacts of free school lunch policies on adolescent BMI and mental health: Evidence from a natural experiment in South Korea

“…It is shown that both conditional and unconditional cash transfers weakly increase the dietary diversity; moreover, unconditional cash transfers weakly increase cognitive ability of children. Similarly, Prencipe et al (2021) find that conditional cash transfers in Tanzania decreased depressive symptoms among children.…”

“…Another strand of literature related to our paper uses experimental and quasi-experimental designs to study the impacts of social interventions on body weight and mental health outside the Western world. Prencipe et al (2021) , for example, focus on the impact of cash transfers on depressive symptoms of youth aged 14–28 in Tanzania. The meta-analysis by Durao et al (2020) examines how cash transfers help reducing food insecurity in low and middle income countries.…”

Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

“…More recently, research studies evaluating the impact of unconditional cash transfer programs in South Africa, Tanzania and Malawi found that unconditional cash transfers have stronger benefits for improving mental health, reducing symptoms of depression, and improving education and social support than conditional cash transfer programs (30)(31)(32). These are promising ways to address the socio-economic determinants of mental health, and highlight the importance of a multi-pronged approach to AMH research.…”

Effects of Adolescent-Focused Integrated Social Protection on Depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania’s Cash Plus Intervention

“…In a recent systematic review and meta-analysis, Zimmerman et al ( 8 ) found that while cash transfers may improve some mental health outcomes for children and young people, they had a null effect on depressive symptoms. Among studies carried out in Africa, impacts of cash transfers on depressive symptoms were largely heterogeneous, with differential effects by school enrollment ( 9 ), household wealth ( 10 ), and sex ( 11 , 12 ).…”