More evidence on the impact of government social protection in sub‐Saharan Africa: Ghana, Malawi, and Zimbabwe

Handa, Sudhanshu; Otchere, Frank; Sirma, Paul

doi:10.1111/dpr.12576

Cited by 30 publications

(28 citation statements)

References 21 publications

(22 reference statements)

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“…Ethiopia's Productive Safety Net Programme is one of earlier major CT programmes in sub-Saharan Africa ( Garcia & Moore, 2012 ). Currently, 46 sub-Saharan Africa countries have state-sponsored social protection programmes ( Handa et al, 2021 ). The CCTs have been studied for their impacts related to health, education, nutrition, and food security in low- and middle-income counters.…”

Section: Related Literaturementioning

confidence: 99%

Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia

Mussa

Agegnehu²,

Nshakira‐Rukundo

2022

SSM - Population Health

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Ethiopia has been implementing its flagship social protection programme, Productive Safety Net Programme (PSNP), since 2005, mainly in drought prone and chronically food insecure woredas. In 2011, the country also launched Community-Based Health Insurance (CBHI). However, the two large-scale social protection programmes are not integrated well. This study examines the impact of participation in the conditional cash transfer (CCT) component of the PSNP (Public Works or PW) on enrolment in the CBHI among female-headed households in Amhara region. Data for the study generated through a cross-sectional survey collected from 365 PW-participating and non-participating female-headed households in south Gondar zone, Ebinat woreda (district). Inverse-probability-weighted regression adjustment (IPWRA) estimator is used to evaluate the impact of participating in PW component on CBHI enrolment decisions. Enrolment in CBHI among female-headed households is 63.6%. Data also show that 61.2% of insured and 27.1% of non-insured households receive CCTs. The study finds that participating in PSNP's CCT component increases the probability of CBHI enrolment among female-headed households by 16.3 percentage points. The finding informs efforts in integrating social protection programmes among most vulnerable households in rural Ethiopia. It also gives useful insights on the role of PSNP's CCT component to achieving universal health coverage through increasing insurance enrolment among most vulnerable households in Ethiopia.

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Section: Related Literaturementioning

confidence: 99%

Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia

Mussa

Agegnehu²,

Nshakira‐Rukundo

2022

SSM - Population Health

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“…It is estimated that around 20% of children eligible for anti-poverty social grants in South Africa do not access this support (23,24). Regional evidence supports the effectiveness of cash grants to address food security (25,26); and evidence from South Africa supports the potential of community initiatives to link eligible households to social grants (27). Therefore, in our analysis, we modelled the impact of a community outreach intervention implemented over 17 months during which paraprofessional social workers would actively liaise with community leaders and networks to screen for households that are eligible for the CSG in the community.…”

Section: Intervention 1: Outreach Intervention To Link Households Tha...mentioning

confidence: 99%

“…Estimates for intervention effectiveness were drawn from the academic literature, S3 Appendix. For community grant outreach, we generated a pooled estimate for the effect of cash transfers on food security by meta-analysis of two studies identified using a rigorous literature review, S4 Appendix (25,26). For parenting support, we used effect estimates for caregiver supervision taken from the original randomised evaluation of the PLH Teen intervention in South Africa (30).…”

Section: Intervention 3: Integrated Parenting Support Intervention Pl...mentioning

confidence: 99%

Assessing the cost-effectiveness of economic strengthening and parenting support for preventing violence against adolescents in South Africa: an economic modelling study using non-randomised data

Rudgard¹,

Obiesie²,

Desmond³

et al. 2023

Preprint

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There is limited evidence around the cost-effectiveness of interventions to prevent violence against children in low- and middle-income countries. We developed a decision-analytic model to estimate the cost-effectiveness of 1) a community outreach intervention to link eligible households to anti-poverty cash grants, and 2) a group-based parenting support intervention, and 3) a group-based parenting support ‘plus’ linkage of eligible households to anti-poverty cash grants intervention for preventing adolescent violence victimisation in Mpumalanga province, South Africa. The target population was families with an adolescent living below the national food poverty line. Modelled violence outcomes were emotional, physical, and sexual abuse. Intervention effectiveness was conditional on interventions’ effect on two evidence-based protective factors for adolescent violence: food security and caregiver supervision. Cost-effectiveness ratios were expressed per DALY averted and evaluated against a South Africa-specific willingness-to-pay threshold. We varied model parameters to consider routine service delivery versus trial-based costing, and population-average versus high prevalence of violence. For routine service delivery costing, both community grant outreach and parenting support interventions were cost-effective at population-average prevalence (ACER=USD2,650, and ACER=USD2,830 per DALYs averted, respectively), and high prevalence of violence (ACER=USD1,330 and ACER=USD2,305 per DALYs averted, respectively). The incremental cost-effectiveness of adding grant linkage to parenting support was USD271 and USD177 at population-average and high prevalence of violence, respectively. For trial-based costing, none of the interventions were cost-effective at population-average prevalence of violence, and only community grant outreach was cost-effective at high prevalence of violence (ACER=USD2400 per DALY averted). Cost-effectiveness estimates are expected to be conservative based on our only modelling intervention effects on three violence outcomes via two protective factors. Findings indicate that investments in community grant outreach, and parenting support interventions are likely to be cost-effective for preventing adolescent violence. Adding a grant linkage component to parenting support would enhance this approaches cost-effectiveness.

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“…Well-being will be measured by the Cantril Scale [25], alcohol use will be measured by the Audit-C scale [26] which is scored on a scale of 0-12 (higher values represent worse outcomes), food insecurity will be measured by the Household Food Insecurity Access Scale [27], financial security will be measured by the Financial Security Scale [28], and stress level will be measured by Cohen's Perceived Stress Scale [29]. In addition to using the validated scales above, some questions in our questionnaire were adapted from the World Bank's Living Standards Measurement Survey [30], the Transfer Project's surveys [31], and the Kenya Demographic and Health Surveys [32].…”

Section: Data Collection Management and Safetymentioning

confidence: 99%

A savings intervention to reduce men’s engagement in HIV risk behaviors: study protocol for a randomized controlled trial

Egbe

Omollo

Wesonga

et al. 2022

Trials

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Background In much of eastern and southern Africa, the incidence of HIV and other sexually transmitted infections (STIs) remains high despite the scale-up of promising biomedical and behavioral interventions. Studies have documented the crucial role of transactional sex—the exchange of money, material support, or goods, in sexual relationships—and heavy alcohol use in contributing to men’s and women’s health outcomes. Existing policy responses to this challenge have largely focused on women, through the provision of pre-exposure prophylaxis (PrEP) or structural interventions such as education subsidies and cash transfers. However, the effectiveness of these interventions has been hindered by the relative lack of interventions and programs targeting men’s behavior. We describe the protocol for a study that will test an economic intervention designed to reduce men’s engagement in HIV/STI-related risk behaviors in Kenya. Methods We will conduct a randomized controlled trial among income-earning men in Kenya who are aged 18–39 years and self-report alcohol use and engagement in transactional sex. The study will enroll 1500 participants and randomize them to a control group or savings group. The savings group will receive access to a savings account that includes lottery-based incentives to save money regularly, opportunities to develop savings goals/strategies, and text message reminders about their savings goals. The control group will receive basic health education. Over a period of 24 months, we will collect qualitative and quantitative data from participants and a subset of their female partners. Participants will also be tested for HIV and other STIs at baseline, 12, and 24 months. Discussion The findings from this study have the potential to address a missing element of HIV/STI prevention efforts in sub-Saharan Africa by promoting upstream and forward-looking behavior and reducing the risk of acquiring HIV/STIs in a high HIV/STI burden setting. If this study is effective, it is an innovative approach that could be scaled up and could have great potential for scientific and public health impact in Kenya. Trial registration ClinicalTrials.govNCT05385484. Registered on May 23, 2022

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More evidence on the impact of government social protection in sub‐Saharan Africa: Ghana, Malawi, and Zimbabwe

Cited by 30 publications

References 21 publications

Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia

Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia

Assessing the cost-effectiveness of economic strengthening and parenting support for preventing violence against adolescents in South Africa: an economic modelling study using non-randomised data

A savings intervention to reduce men’s engagement in HIV risk behaviors: study protocol for a randomized controlled trial

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