The effects of cash transfers on adult and child mortality in low- and middle-income countries

Richterman, Aaron; Millien, Christophe; Bair, Elizabeth F.; Jérôme, Gregory; Suffrin, Jean Christophe Dimitri; Behrman, Jere R.; Thirumurthy, Harsha

doi:10.1038/s41586-023-06116-2

Cited by 14 publications

(5 citation statements)

References 55 publications

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“…In Table 8, we do find a small drop in the number of children who ever died by 2.5% points, similar to the Richterman et al. (2023) study. The average effect is borderline statistically significant at 10% and small in magnitude relative to the decrease that we find in the total number of children.…”

Section: Resultssupporting

confidence: 87%

“…Another potential mechanism for the decrease in the number of children is that Juntos, by increasing income and healthcare utilization, decreased child mortality. Richterman et al (2023) use the DHS from 37 countries to show that cash transfers (averaged across conditional, mixed, and unconditional types) have led to a 8% decrease in child mortality under the age of 5, with smaller and statistically insignificant effect of 3% for conditional cash transfer programs only. A decrease in child mortality in our setting could, in turn, decrease the total number of pregnancies and children ever born needed to reach the ideal number of living children.…”

Section: Alternative Explanation: Child Mortalitymentioning

confidence: 99%

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Conditional cash transfers and women's reproductive choices

Laszlo,

Majid,

Renée

2023

Health Economics

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We study potential non‐targeted effects of a large‐scale national conditional cash transfer program—Peru's Juntos—on the fertility and reproductive decisions of adult beneficiaries. We use an event study design, exploiting time and geographic variation in the rollout of the program, to identify the causal effects of the program. We find that Juntos decreases the number of children that adult beneficiaries have and that these effects persist over time. We explore various mechanisms and find that Juntos does not affect fertility preferences but rather empowers women to avoid unwanted births. We provide evidence that this decrease is most likely due to better access to and more extensive use of modern birth control methods.

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Section: Resultssupporting

confidence: 87%

Section: Alternative Explanation: Child Mortalitymentioning

confidence: 99%

Conditional cash transfers and women's reproductive choices

Laszlo,

Majid,

Renée

2023

Health Economics

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“…[ 12 ] which found that higher SES groups showed greater declines in HIV incidence from 1997 to 2018 in rural Uganda. More recently, the COVID‐19 pandemic has widened wealth inequality around the world, including in sub‐Saharan Africa [ 13 , 14 ], and our research adds to growing calls for structural anti‐poverty measures to improve population health [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Community‐ and individual‐level correlates of HIV incidence in HPTN 071 (PopART)

Skalland,

Ayles,

Bock

et al. 2023

J Int AIDS Soc.

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IntroductionUniversal HIV testing and treatment aims to identify all people living with HIV and offer them treatment, decreasing the number of individuals with unsuppressed HIV and thus reducing HIV transmission. Longitudinal follow‐up of individuals with and without HIV in a cluster‐randomized trial of communities allowed for the examination of community‐ and individual‐level measures of HIV risk and HIV incidence.MethodsHPTN 071 (PopART) was a three‐arm cluster‐randomized trial conducted between 2013 and 2018 that evaluated the use of two combination HIV prevention strategies implemented at the community level to reduce HIV incidence compared to the standard of care. The trial, conducted in 21 communities in Zambia and South Africa, measured HIV incidence over 36 months in a population cohort of ∼2000 randomly selected adults per community aged 18–44. Multilevel models were used to assess the association between HIV incidence and community‐ and individual‐level socio‐demographic and behavioural risk factors, as well as prevalence of detectable virus (PDV) defined as the estimated proportion of the community with unsuppressed viral load.ResultsOverall HIV incidence was 1.49/100 person‐years. Communities with less financial wealth and communities with more individuals reporting having sex partners outside of the community or two or more sexual partners had higher HIV incidence. PDV at 2 years of study was 6.8% and was strongly associated with HIV incidence: for every 50% relative reduction in community PDV, there was a 49% (95% confidence interval [CI]: 37%–58%, p < 0.001) relative decrease in HIV incidence. At the individual level; socio‐economic status, AUDIT score, medical male circumcision and certain sexual behaviours were associated with HIV risk.ConclusionsUsing data from the PopART randomized trial, we found several associations of HIV incidence with community‐level measures reflecting the sexual behaviour and socio‐economic make‐up of each community. We also found a strong association between community PDV and HIV incidence supporting the use of PDV as a tool for monitoring progress in controlling the epidemic. Lastly, we found significant individual‐level factors of HIV risk that are generally consistent with previous HIV epidemiological research. These results have the potential to identify high high‐incidence communities, inform structural‐level interventions, and optimize individual‐level interventions for HIV prevention.Clinical Trial NumberClinicalTrials.gov number, NCT01900977, HPTN 071 [PopArt]

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“…60 Comprehensive evidence from low-and middleincome countries suggests that cash transfers lower mortality for women and children younger than 5 years of age. 61 Quasi-experimental studies of the Earned Income Tax Credit have shown improvements in birth outcomes when income support amounts increased. 62 An evaluation of the SSI program using a regression discontinuity found that infants receiving SSI have reduced rates of both acute and chronic conditions across childhood, 63 though other evidence suggests that SSI payments during early childhood do not impact longer-term outcomes.…”

Section: Direct Cash Transfers: Consistent With Health System Values ...mentioning

confidence: 99%

Prescription for Cash? Cash Support to Low‐Income Families in Maternal and Pediatric Health Care Settings

MCCONNELL,

AGARWAL,

HANSON

et al. 2023

Milbank Quarterly

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Policy Points Pregnancy and childhood are periods of heightened economic vulnerability, but current policies for addressing health‐related social needs, including screening and referral programs, may be insufficient because of persistent gaps, incomplete follow‐up, administrative burden, and limited take‐up. To bridge gaps in the social safety net, direct provision of cash transfers to low‐income families experiencing health challenges during pregnancy, infancy, and early childhood could provide families with the flexibility and support to enable caregiving, increase access to health care, and improve health outcomes.

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The effects of cash transfers on adult and child mortality in low- and middle-income countries

Abstract: We performed analyses of changes in adult and child mortality associated with implementation of cash transfer programmes between 2000 to 2019, a study period when many countries introduced cash transfer programmes.

Cited by 14 publications

References 55 publications

Conditional cash transfers and women's reproductive choices

Conditional cash transfers and women's reproductive choices

Community‐ and individual‐level correlates of HIV incidence in HPTN 071 (PopART)

Prescription for Cash? Cash Support to Low‐Income Families in Maternal and Pediatric Health Care Settings

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