Perceived impact of Ghana's conditional cash transfer on child health

Abstract

A plethora of studies from sub-Saharan Africa indicate that orphaned and vulnerable children are exposed to adverse health, education and other social outcomes. Across diverse settings, conditional cash transfer (CCT) programmes have been successful in improving health outcomes amongst vulnerable children. This study explored the pathways of CCTs' impact on the health of orphans and vulnerable children in rural Ghana. Due to the multi-dimensional nature of CCTs, the programme impact theory was used to conceptualize CCTs' pathways of impact on child health. A qualitative descriptive exploratory approach was used for this study. This study drew on the perspectives of 18 caregivers, 4 community leaders and 3 programme implementers from two rural districts in Ghana. Semi-structured individual interviews were conducted with the participants. Thematic content analysis was conducted on the interview transcripts to pull together core themes running through the entire data set. Five organizing themes emerged from the interview transcripts: improved child nutrition, health service utilization, poverty reduction and social transformation, improved education and improved emotional health and well-being demonstrating the pathways through which CCTs work to improve child health. The results indicated that CCTs offer a valuable social protection instrument for improving the health of orphans and vulnerable children by addressing the social determinants of child health such as nutrition, access to health care, child poverty and education.

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review

“… My child is 14 years old, he sometimes asks for it [cash grant], and if he sees something at the shop he will say: ‘Mom, don’t forget that the 1 st is pay day, there is something at the shops and I need it, so put me on the budget.’ If I say: ‘I don’t have money’, he will tell me: ‘You will use my CSG money’ ( DSD et al 2011 ). ⊕⊕⊕⊕ High Education School attendance School enrolment Jones and Samuels (2015) , DSD et al (2011) , Miller et al (2010 , 2012a ), OPM (2013a , b , 2014a , b , c ), Owusu-Addo (2016) , Roelen et al (2015) , Skovdal et al (2013) , Bukuluki and Watson (2012) Yes, yes, yes, I can say that the community has really benefited so much and we are seeing a big change in the community. Caregivers have been able to foster more orphans in their families […] and I can say that enrolment in schools has been high, retention of OVC in schools has been high ( Onyango-Ouma and Samuels, 2012 ).…”

“… They used to miss school very often but they now have those needs and miss no days [Male, 42] ( Miller and Tsoka 2012b ). ⊕⊕⊕⊝ Moderate Meet direct/indirect educational cost Health-care utilisation Alleviate financial barriers to access health care Owusu-Addo (2016) , DSD et al (2011) , Miller (2010) , Miller and Tsoka 2012b , OPM (2014a) , Roelen et al (2015) , Skovdal et al (2013) , Bukuluki and Watson (2012) When the money came, I went and made a health insurance card for the children. Now I can take them to the hospital when they are sick.…”

“…Now I can take them to the hospital when they are sick. With the money too, I buy medicine for them and take care of their health needs ( Owusu-Addo 2016 ). Children are vaccinated in greater numbers.…”

“…What about the sickness?’ This meeting means more to them than just money ( Bukuluki and Watson 2012 ). ⊕⊕⊕⊕ High Civic engagement Reciprocity Nutrition Food security Miller (2010 , 2012a ), OPM (2013a , b , 2014a , b , c ), Owusu-Addo (2016) , Roelen et al (2015) , Bukuluki and Watson (2012) , Selvester et al (2012) We are not starving anymore because they buy us food everyday (female, unknown age). ; We are happy now… in the past we were not eating in the afternoon and sometimes in the evening.…”

Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province

“…In recent years, the effectiveness of conditional cash transfers (CCTs) for improving nutrition and health status among low-income people has gradually come into focus [ 5 , 6 ]. CCTs are a form of social security in which beneficiaries must carry out certain actions (such as improving health, education, or nutrition levels) as a precondition for receiving cash subsidies, which reduce low-income families’ out-of-pocket expenditure [ 7 , 8 ]. The cash transfer has potential to increase the household’s purchasing power for better quality food in greater quantities, and to reduce transport costs for accessing public health services for LBC.…”