Food Should not be Forgotten: Impacts of Combined Cash Transfer Receipt and Food Security on Child Education and Cognition in South Africa and Malawi

Abstract

Social protection can take many forms. Both cash transfers and food security may have important contributions to child cognitive development. This study examines the potential impact of combinations of cash transfers and food security status on child cognitive development and educational outcomes. Cross-sectional data for 796 HIV-affected children in the Child Community Care study were utilised for this analysis. Children and caregivers completed interview schedules comprised of standardised items on socio-demographics, household data, cash grant receipt and food security status, school achievement, and cognition. A series of logistic and linear regression models and marginal effects analyses were undertaken to explore the impacts of differing levels of social protection (none; either cash grant receipt or food secure status or, both in combination) on child educational and cognitive outcomes. Although all children lived in poverty-stricken households, 20% (157/796) of children did not live in a household in receipt of a cash grant and did not report food security; 32.4% (258/796) reported either component of social protection and, 47.9% (381/796) received both measures of social protection in combination. Compared to no social protection, being in receipt of either component of social protection was found to be significantly associated with being in the correct class for age, higher scores of non-verbal cognition, and higher working memory scores. Receiving both social protection measures in combination was found to be significantly associated with reduced educational risk scores, improved odds of being in the correct class for age, regular school attendance, missing less than a week of school in the previous two weeks, higher scores on measures of nonverbal cognition, higher working memory scores, and learning new things more easily. Educational and cognitive outcomes for children can be bolstered by social protection measures (cash grant receipt or food security). Benefits are enhanced when social protection is received in combination. Such findings support the notion of synergistic social protection responses for children living in environments impacted by high levels of HIV burden and deprivation.

Accelerating progress towards improved mental health and healthy behaviours in adolescents living in adversity: findings from a longitudinal study in South Africa

“…This study supports other recent findings (Mebrahtu et al, 2021;Sherr et al, 2021) on the importance of food security and safe environments in the mental health and healthy behaviour of adolescents. It provides initial evidence on the potential benefits of combining these two accelerators, at a high-quality level, in mitigating adverse outcomes in adolescents in South Africa.…”

“…Living in a safe environment was associated with healthy peer relationships, no internalizing behaviour and no substance use. These findings are in line with previous accelerator studies that report being food secure and living in a safe environment having positive effects on mental health and healthy behaviours (Mebrahtu et al, 2021;Sherr et al, 2021). This highlights the importance of improving food security, as food security not only reduces hunger, but also improves physical and mental health.…”

“…The stepwise improvements also highlight the importance of the quality of these accelerators when aiming to improve mental health and health behaviour outcomes. Overall, these findings are in line with a recent study, that found that the presence of 2-3 accelerators could lead to substantial improvements across a range of SDG outcomes including indicators relating to mental health (Sherr et al, 2021).…”

“…It provides initial evidence on the potential benefits of combining these two accelerators, at a high-quality level, in mitigating adverse outcomes in adolescents in South Africa. Food security can be attained through various interventions such as providing nutritional support and enhancing access to food sources (De Groot et al, 2017;Sherr et al, 2021). An integrated approach should be taken to address the safety in communities, which includes addressing the underlying drivers of crime and violence (e.g., substance abuse and unemployment), and strengthening the criminal justice system and the police (Kruger et al, 2016).…”

Understanding accelerators to improve SDG-related outcomes for adolescents—An investigation into the nature and quantum of additive effects of protective factors to guide policy making

“…Current interventions are frequently delivered in a siloed manner [4], such as cash transfers to reduce poverty, or parenting interventions to reduce child violence experience. However, there is a growing body of evidence suggesting that combined interventions provide fundamental and sustained benefits, such as combinations including cash grants (e.g., cash plus care) [5,6] or food programmes together with parenting [7]. Based on such encouraging findings, recent work has aimed to identify potential accelerators for achieving SDG outcomes [8].…”