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The purpose of this paper is to apply Bronfenbrenner's ecological systems theory to explore the literature on how Conditional Cash Transfer (CCT) and Unconditional Cash Transfer (UCT) programs might support positive mental health outcomes. The paper begins with transnational considerations of stress, such as poverty and COVID-19, and their impact on mental health. Bronfenbrenner's theory is applied to better understand the mechanisms by which CCT and UCT programs can potentially lead to positive outcomes for children and families who face such stressors. The implications of cash transfer programs are subsequently discussed in terms of how they might promote positive mental health outcomes among families globally. This theoretical application paper concludes with a call for transnational research to explore connections between cash transfer programs and mental health outcomes for children/adolescents and their parents/caregivers. [ABSTRACT FROM AUTHOR]

Background: In high income countries one in five children still lives in poverty, which is known to adversely shape the life course health trajectory of these children. However, much less is understood on whether social and fiscal policies have the capacity to reverse this damage, which intervention is likely to be most effective and when these interventions should be delivered to maximise their impact. This systematic review attempts to address these questions by looking at the impact of income-support interventions, delivered during the first 1,000 days of life, on cardiovascular, metabolic, respiratory and mental health outcomes. Methods: The review was restricted to experimental or quasi experimental studies conducted in high income countries. Studies were retrieved from multidisciplinary databases as well as health, economic, social sciences-specific literature browsers. All papers retrieved through the search strategy were double screened at title, abstract and full text stage. Relevant data of the selected studies were extracted and collected in tables, then summarised via narrative synthesis approach. Robustness of findings was assessed by tabulating impact by health outcome, type of intervention and study design. Results: Overall, 16 relevant papers were identified, including 15 quasi-experimental studies and one randomized control trial (RCT). Income-support interventions included were unconditional/conditional cash transfers, income tax credit and minimum wage salary policies. Most studies were conducted in United States and Canada. Overall, the evidence suggested limited effect on mental health indicators but a positive, albeit small, effect of most policies on birth weight outcomes. Despite this, according to few studies that tried to extrapolate the results into public health terms, the potential number of negative outcomes averted might be consistent. Conclusions: Income-support interventions can positively affect some of the health outcomes of interest in this review, including birth weight and mental health. Given the large number of people targeted by these programs, one could infer that – despite small – the observed effect may be still relevant at population level. Nonetheless, the limited generalisability of the evidence gathered hampers firm conclusions. For the future, the breadth and scope of this literature need to be broadened to fully exploit the potential of these interventions and understand how their public health impact can be maximised. [ABSTRACT FROM AUTHOR]

Purpose: Although the last two decades have witnessed the implementation of several poverty reduction strategies in developing countries, many have failed to achieve their goal partly because of defective implementation strategies. This paper examines the implementation of one of Ghana's flagship poverty reduction programs, the Livelihood Empowerment Against Poverty (LEAP), with a focus on how leadership at the sub-national level influences the implementation of the program. Design/methodology/approach: Using qualitative research approach, the study selected research participants from two Municipal Assemblies in the Greater Accra Region of Ghana. Using a combination of Focus Group Discussions, Key Informant Interviews and Participant Observation, data were collected from a total of 44 respondents including beneficiaries, officials from the local government (district) and community level actors. Findings: The paper shows that leaders at the sub-national level were more reactionary than proactive, thereby playing passive roles in the implementation of the LEAP program. It shows that the interaction between LEAP beneficiaries and district officials is rather low, which among others limits the effective utilization of the cash grant by the beneficiaries. It maintains that, for the LEAP program to achieve its overall goal of reducing poverty, leaders at the sub-national level ought to deploy more transformational leadership tendencies to incite beneficiaries to leap out of poverty through skill and human capital development. Originality/value: The empirical literature is largely silent on the role of leadership in the implementation of cash transfer programs, such as Ghana's LEAP program at the sub-national level. This study therefore explains the extent to which district level leaders contribute to the effective utilization of cash transfer grants and the human capital development of LEAP beneficiaries in Ghana. [ABSTRACT FROM AUTHOR]

Purpose -- This paper addresses the pitfalls in conditional cash transfer in Nigeria and suggested the best practices to enhance the performance of the social policy instrument in Nigeria. Research method -- This paper is library research which evaluates the issue at stake using documentary evidence from secondary means of data collection such as textbooks, journal articles, newspapers and so on. Result -- The paper found that conditional cash transfer in Nigeria is characterized with several anomalies. These among others identified in the study include diversion of funds by the beneficiaries for purposes other than investing in what it was originally meant for, the improper definition of exit and entry period (a period of one year is allowed in Nigeria) and this translates to nothing meaningful. It was found that beneficiaries are randomly selected in Nigeria, thus leading to obvious errors of exclusion and inclusion. Recommendations -- This paper recommends among others that a formidable system of entry and exit rules, monitoring and evaluation mechanism, cash disbursement mechanism as well as grievance redress mechanism be put in place as practised in other climes. These systems will no doubt enhance the service quality, value for money, transparency and accountability of the social protection policy, culminating in the social-economic development of the Nigerian states. [ABSTRACT FROM AUTHOR]

This paper offers a methodology to improve targeting design and assessment when two or more groups need to be considered, and trade-offs exist between using different targeting mechanisms. The paper builds from the multidimensional targeting challenge facing conditional cash transfers (CCTs). I analyze whether a common CCT targeting mechanism, namely, a proxy means test (PMT), can identify the poor and future school dropouts effectively. Despite both being key target groups for CCTs, students at risk of dropping out are rarely considered for CCT allocation or in targeting assessments. Using rich administrative data sets from Chile to simulate different targeting mechanisms, I compare the targeting effectiveness of a PMT and other mechanisms based on a predictive model of school dropout. I build this model using machine learning algorithms. Using two novel metrics, I show that combining the outputs of the predictive model with the PMT increases targeting effectiveness except when the social valuation of the poor and future school dropouts differs to a large extent. More generally, public officials who value their key target groups equally may improve policy targeting by modifying their allocation procedures. [ABSTRACT FROM AUTHOR]

Copyright of Desarrollo y Sociedad is the property of Universidad de los Andes and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Pantawid Pamilyang Pilipino Program (4Ps) is a conditional cash transfer (CCT) program to alleviate socio-economic conditions in the Philippines, addressing Sustainable Development Goals (SDGs) 1 (No Poverty) and 4 (Quality Education). It attempts to address poverty, which is a risk factor to education among Filipinos. However, the program impact on education and economy remains understudied. This paper investigated the recipients of the CCT and analyzed parental involvement and its influence on students' academic achievement. In this study, parental involvement refers to parenting, learning at home, volunteering, school decision-making, collaborating, and communicating, while academic achievement pertains to the students' academic performance in the core learning areas: Science, Mathematics, English, and Filipino. Using a descriptive-correlation method, the respondents were randomly selected comprising 306 parents and 306 students in Tarragona District, Davao Oriental, Philippines. The data were analyzed using Spearman Rho Correlation and Confirmatory Factor Analysis (CFA). The results showed there was no statistical correlation between parental involvement and student's academic achievement. Parents had low involvement in learning at home, volunteering, and school decision-making. On the other hand, the students demonstrated high academic achievement in the core learning areas. The significant step of the Philippine government for education through the CCT is an effective approach to keeping children in school. Emphasis must be placed on strengthening parental involvement in children's education to ensure academic success. [ABSTRACT FROM AUTHOR]

Purpose: The paper aims to examine whether conditional cash transfer (CCT) program has effect on educational aspirations of poor parents for their children. Specifically, it investigates the effect of Indonesian CCT program, Family Hope Program, on the number of schooling years parents aspire their children to attain. Design/methodology/approach: This paper uses data from the Indonesian Family Life Survey (IFLS) 2007 and 2014 to capture periods before and after the implementation of the Family Hope Program. Propensity score matching and difference-in-differences are employed to estimate the impact of the CCT program on parental education aspirations. Findings: This research finds that CCT program increases parents' aspiration of their children's education up to one schooling year. This impact is robust across all matching specifications. Research limitations/implications: There is a limited sample size of the program participants as identified in the data set which would likely reduce statistical power of the estimator. The result is also potentially sensitive to hidden bias; hence it should be cautiously interpreted. Social implications: From a policy viewpoint, the program is able to change parents' desire for their children to acquire more education. Given the program's concern on human capital of the children, this is a good sign that if the transfers were ceased the education of subsequent children would be less likely to return to pre-program levels. Originality/value: Since the existing literature focuses on Latin America, no empirical evidence is found in other developing countries with different institutional setting. This paper makes important contributions by examining whether CCT program increases parents' educational aspirations in Indonesia, a lower middle-income country in Southeast Asia with salient sociodemographic status as the largest Muslim population and fourth most populous country in the world. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to critically analyse the relevance of directly targeted poverty reduction programmes in Muslim countries by means of conditional cash transfers (CCTs). The paper analyses the best practices and lessons learnt to date and explores the practical issues to implement CCT poverty reduction programmes in Muslim countries.Design/methodology/approach The methodology is based on the qualitative assessment drawn from CCTs implementation in Muslim countries, namely Bangladesh, Indonesia, Pakistan and Turkey. The methodology also identifies the practical issues including the use of Islamic instruments to implement CCT poverty reduction programmes.Findings The analysis in Muslim countries suggests that CCT programmes have had a positive effect and that the costs are relatively affordable if implemented with appropriate programme designs. In many cases, there have been positive secondary effects over and above the primary goal of poverty reduction. The paper also argues that the concept of CCTs is in line with the underlying principle of Islam to eradicate poverty via cash distribution approach.Originality/value A decade long experience in some Muslim countries demonstrates that social cash transfers (including CCTs) have a significant impact on reducing poverty and vulnerability and promoting human development. Since none of CCT programmes in Muslim countries explore and integrate the potential of Islamic instruments (Zakat, Sadaqat, Awqaf and Qard Al-Hassan), it is timely for governments, multinational development institutions and non-profit organizations to utilize these instruments to tackling poverty. [ABSTRACT FROM AUTHOR]

Latin American governments swiftly implemented income assistance programs to sustain families' livelihoods during COVID-19 stay-at-home orders. This paper analyzes the potential coverage and generosity of these measures and assesses the suitability of current safety nets to deal with unexpected negative income shocks in 10 Latin American countries. The expansion of pre-existing programs (most notably conditional cash transfers and non-contributory pensions) during the COVID-19 crisis was generally insufficient to compensate for the inability to work among the poorest segments of the population. When COVID-19 ad hoc programs are analyzed, the coverage and replacement rates of regular labor income among households in the first quintile of the country's labor income distribution increase substantially. Yet, these programs present substantial coverage challenges among families composed of fundamentally informal workers who are non-poor, but are at a high risk of poverty. These results highlight the limitations of the fragmented nature of social protection systems in the region. [ABSTRACT FROM AUTHOR]

In several Latin American countries, conditional cash transfer programmes are a proven means of alleviating poverty in the short term and promoting education of children from disadvantaged families in the longer run. While the effectiveness of the Brazilian Bolsa Família for children's education outcomes up to 15 years of age has been widely documented, its contribution to the promotion of students of secondary school age has not been fully explored in light of the programme's expansion to 16-17 years olds in 2008. In this paper, I draw on Brazilian National Household Sample Survey data and use a difference-in-differences approach already applied in research in the context of Bolsa Família extension. Whereas these data were previously examined to detect intent-to-treat (ITT) effects due to insufficient information on treatment status, in this study I rely on a classifier method to additionally estimate average treatment effects on the treated who belong to families supposedly receiving Bolsa Família cash transfers. The results suggest that school attendance rates for 16-year-olds are particularly increased in the Brazilian Northeast, although the estimates are not significant when further time periods are taken into account. As comparably poor but non-recipient households have larger and consistently significant gains of school attendance, the effect on adolescent's education directly caused by the expansion of Bolsa Família remains ambiguous and thus cast doubt on the specific parallel trend assumption. In addition, no long-run ITT effects of the programme's expansion on school participation among 16 year old teenagers are found. [ABSTRACT FROM AUTHOR]

Transnational policy transfer is a well‐documented phenomenon with studies from across many disciplines. However, the literature tends to over‐theorize but under‐operationalize what is transferred and how it is transferred. A significant issue in this regard concerns 'agency': that is, who is supplying and who is demanding policy lessons and examples. This paper highlights a relatively new concept in comparative policy studies, that of the 'instrument constituency', within the framework of transnational policymaking. It argues that instrument constituencies or groups of actors unified by their strong affinity with a specific policy tool are key agents in the transfer process, acting as suppliers and brokers of policy ideas, constantly searching to match their preferred solutions to policy problems. As this paper will show, incorporating such constituencies into policy transfer studies allows a better understanding of transfer as part of a sequential process of diffusion, and how knowledge about a policy instrument is assembled and transferred. [ABSTRACT FROM AUTHOR]

Previous studies of conditional cash transfer (CCT) programmes employed an ethnographic approach to investigate the gendered impacts of these programmes on women in different contexts and found that these programmes reinforce gender inequality and burden women. This paper investigates a CCT programme by focusing on the intersecting gendered practices of the LEAP CCT programme authorities in Ghana alongside the gendered practices of the programme community focal persons (males and females) in the specific context of the Asante matrilineal society. The paper uses an ethnographic-based critical discourse study methodology inspired by Foucault's notions of discourse and power and Fairclough's approach to critical discourse studies. Thus, it draws on modality and interactional control features to investigate the accounts of social actors in the domains of the programme and the specific local community. The analysis demonstrates that the LEAP CCT programme reproduces unequal gender power relations in Asante matrilineal society and that women community focal persons in the Asante matrilineal society reproduce and assert unequal gender relations in the CCT programme within Asante society. In addition, it reveals that the reproduction and assertion of unequal gender relations in the translation of the CCT programme excludes the voices and articulations of men in specific contexts. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate whether isolated illiteracy generates a barrier to knowledge about the Brazilian Federal Government's Single Registry for social programs. Design/methodology/approach: Based on information contained in the Brazilian National Household Sample Survey (Pesquisa Nacional por Amostra de Domicilios – PNAD) 2014, the propensity score matching method was combined with the algorithm proposed by Imbens (2015). The analyzed sample consists of two groups of illiterate individuals: isolated illiterates (IILs) (treatment group), which consists of only illiterate individuals who live with other illiterates; and proximate illiterates (PILs) (control group), which consists of illiterates who live with someone who is literate in the household. Findings: Evidence indicates that IIL individuals are, on average, less likely to know about the single registry than PIL people. Research limitations/implications: The main limitation relates to the database since the only information available in the PNAD on the access to the single registry is for the year 2014. Practical implications: The evidence found in the study reinforces the need to invest in the fight against illiteracy in Brazil. Social implications: Results show that a portion of the possible beneficiaries of social programs are still "invisible" to the government's social protection networks, and this highlights the existence of possible errors of exclusion. Originality/value: The paper compares two groups of illiterate people, a group that lives in an isolated illiteracy situation and the other that does not. It also assesses the effect of literacy externalities on the access to the Brazilian Single Registry. [ABSTRACT FROM AUTHOR]

Public works programs have long been a popular policy tool to reduce poverty and build productive infrastructure. Although an extensive literature has documented the effect of these programs on poverty, there is virtually no evidence on the productive effect of the infrastructure. This paper attempts to start filling this gap in the context of the Productive Safety Net Program—a large‐scale public works program implemented in Ethiopia since 2005. Under the program, millions of beneficiaries received social transfers conditional on their participation in activities such as land improvements and soil and water conservation measures. We examine the value of these activities using a satellite‐based indicator of agricultural productivity and (reweighted) difference‐in‐differences estimates. Results show that the program is associated with limited changes in agricultural productivity. The upper bound of the main estimate is equivalent to a 2.2% increase in agricultural yield. This contrasts with existing narratives and calls for more research on the productive effects of public works. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper seeks to gauge the impact of the Red de Oportunidades programme on the school attendance of children from households that participate in the programme. Design/methodology/approach: In order to measure the impact of the programme, the authors apply propensity score matching, a quasi-experimental technique that allows us to find an appropriate control group to compare with the treatment group. Findings: Results show that the programme does not always manage to bring into line school attendance of children from families involved in the programme with that of children from families who are not. Nevertheless, differences are still evident in terms of age, gender and geographical area. Practical implications: Conditional cash transfer programmes should be designed carefully, taking into account a great variety of factors such as geographical characteristics, educational resources and infrastructure, not only to replicate programmes that have proved to be effective in other countries. In this sense, it seems that the impact of cash transfers on primary school attendance can be wholly attributed to the programme, implying that it is better to allocate more resources to groups in terms of age and gender where education is still not universal. Originality/value: To the best of the authors' knowledge, this is the first time the impact of conditional cash transfers on school attendance has been examined in a country that still displays major geographical differences in terms of poverty, namely, Panama. The Red de Oportunidades programme has barely been studied. [ABSTRACT FROM AUTHOR]

Brazil's Bolsa Família Programme (BFP) aims to combat poverty and social inequalities through monetary transfers to families. A much-discussed indirect effect of the programme was its correlation to the fertility of the beneficiary families. In this paper, we use a cohort fertility approach with parity progression ratios that differs from existing literature, which mainly used period fertility measures, to better understand the relationship between fertility and the BFP. This study analyses the relationship between the BFP and the reproduction of Brazilian women. We use data from the 2010 Brazilian micro-censuses, the only census after the start of the BFP in 2004, to reconstruct the childbirth history of women with incomplete reproductive cycles (women aged 25 to 29), and estimate parity progression ratios (PPRs) and cohort fertility rates (CFR). In addition, we estimate propensity score matching (PSM) models comparing fertility outcomes of beneficiaries and non-beneficiaries of the programme. Our results show distinct differences in CFRs and PPRs. On average, BFP beneficiaries had more children than women not covered by the programme. This finding remained consistent even after controlling for educational gradients and other covariates. Our empirical findings show that women opt for a "rational" strategy, where they tend to have children in more rapid succession up until three children. These findings contradict the recent literature that has not found any correlation between BFP and fertility. The results also suggest that cohort analyses may fill certain gaps left by previous studies of period fertility. This paper is one of a few that have analysed the relationship between a conditional income transfer programme and cohort measures in Brazil. [ABSTRACT FROM AUTHOR]

The study characterizes the mainly subsistence fishing communities surrounding Laguna Lake and provides empirical evidence of the economic deprivation that they are experiencing using survey data. Following a multi-dimensional approach, the paper focuses on consumption expenditures as the prime indicator of economic well-being - together with assets ownership, financial behavior, and social engagements. Regression analyses are conducted to identify the factors underlying consumption and to determine how different forms of household capital (physical, financial, and social) and fishing activities affect the capacity to generate income or livelihood. The study finds that: 1) food consumption (mainly rice) accounts for half of the household's total expenditures, is very income-inelastic, and is mainly determined by household size; 2) all consumption expenditures are income-inelastic and are therefore basic necessities, except for mobile phone load, the only luxury consumption expenditure for these low-income fishing households; (3) while derived income (sum of all expenditures and savings) is not significantly determined by any form of capital, it is significantly higher for households undertaking aquaculture; and (4) the conditional cash transfer of the government significantly contributes to household consumption as an income augmentation measure but does not significantly lower food shortage vulnerability of the household. [ABSTRACT FROM AUTHOR]

This paper provides evidence that exposure to illegal labor markets during childhood leads to the formation of industry‐specific human capital at an early age, putting children on a criminal life path. Using the timing of U.S. antidrug policies, I show that when the return to illegal activities increases in coca suitable areas in Peru, parents increase the use of child labor for coca farming, putting children on a criminal life path. Using administrative records, I show that affected children are about 30% more likely to be incarcerated for violent and drug‐related crimes as adults. No effect in criminality is found for individuals that grow up working in places where the coca produced goes primarily to the legal sector, suggesting that it is the accumulation of human capital specific to the illegal industry that fosters criminal careers. However, the rollout of a conditional cash transfer program that encourages schooling mitigates the effects of exposure to illegal industries, providing further evidence on the mechanisms. [ABSTRACT FROM AUTHOR]

Decreases in labor supply among cash transfer recipients are often cited as potential drawbacks of social assistance programs. However, cash transfers can also increase employment. Using variation across cohorts and over time in the eligibility criteria of a nationwide conditional cash transfer program in Bolivian public schools, this paper shows that employment increases among parents of eligible children, particularly for females. The increase in employment coincides with increases in self-employment and in the probability of investing in family businesses. These effects are mostly driven by females from areas with limited access to financial services. As mothers work more, overworked fathers reduce work hours. The results suggest that there are (positive) unintended consequences of cash transfer programs targeting households with school-age children: cash transfers may relax liquidity constraints and boost entrepreneurship and also relieve overworked adults. [ABSTRACT FROM AUTHOR]

The role of social norms in forming aspirations is very important in developing countries where the women are mainly confined within the household. This has created a lack of demand for education among adolescent girls and a tendency to marry early. While governments have tried to remove gender disparity by increasing educational infrastructure for girls, it is well acknowledged that changing the sticky mindset is much more difficult and designing policies for this is a huge challenge. This paper tries to address this issue and estimates the impact of a celebrated conditional cash transfer (CCT), named Kanyashree Prakalpa (KP), on the aspirations of adolescent girls in West Bengal, India. KP, the conditional cash transfer scheme in West Bengal, India offers INR 25,000 (equivalent to US$330) to all girls who continue their education and remain unmarried till their 18th birthday. The study involves the use of both quantitative (like propensity score matching) and qualitative methods to establish that the CCT, through financial inclusion of adolescent girls, created a significant improvement in their aspiration scores. On the basis of a primary survey on 1050 households situated in three selected districts of the state, the study compares the aspiration scores of beneficiaries of the scheme, with those not availing the program after propensity score matching between the treatment and control groups. The study shows that the CCT, which was intended to prevent underage marriage and dropout among adolescent girls between thirteen to eighteen actually managed to change their mindset and enabled them to dream beyond marriage and envisage a future where they would be studying or working at the age of twenty five. The qualitative analysis complemented the quantitative results and found that KP eased the internal constraints of the adolescent girls through giving them access to their very own money in their bank account and this helped them to dream big. This paper, unlike other impact evaluations of CCTs, traces the impact of a aptly designed economic instrument of CCT on the mindsets of beneficiaries rather than economic outcomes. Though the pathway is essentially economic, it succeeded in assuaging a profound social and cultural barrier, thus offering new windows for policy makers in any developing country. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this paper was twofold-revisiting the in-kind public distribution system (PDS) – India's flagship food security intervention and seeking beneficiary perspectives on its efficacy. The feasibility of cash transfers as an alternative mechanism is also examined, especially in the context of the COVID-19 pandemic. Design/methodology/approach: Primary and secondary data from the southern Indian state of Tamil Nadu were used. In-depth interviews with beneficiaries using phenomenology were conducted to evaluate their perception and willingness to shift to a cash-based PDS in the pre and post-pandemic periods. Secondary district-level data were also used to ascertain institutional preparedness for this shift. Findings: In-depth interviews of 105 beneficiaries revealed valuable insights, which seem to have significantly changed post-pandemic. Beneficiaries in the post-pandemic period seem much more inclined toward cash transfers, though a combination of cash plus in-kind benefits seems to be strongly preferred. Secondary results pointed out to the lack of institutional preparedness in financial inclusion. The research suggested that while the existing PDS needs to be overhauled, policymakers should look at a model of cash plus in-kind transfers as a probable alternative to pure cash transfers. Originality/value: There is a dearth of in-depth state-specific studies on beneficiary perception of PDS, and this is important since the economic and sociocultural milieu in each region is unique. Being the only state with universal food security, its experience could yield important insights for other states or even middle or low-income countries similar to India. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected. [ABSTRACT FROM AUTHOR]

Conditional Cash Transfer (CCT) programs, started in the late 1990s in Latin America, have become the antipoverty program of choice in many developing countries in the region and beyond. This paper reviews the literature on their long-term impacts on human capital and related outcomes observed after children have reached a later stage of their life cycle, focusing on two life-cycle transitions. The first includes children exposed to CCTs in utero or during early childhood who have reached school ages. The second includes children exposed to CCTs during school ages who have reached young adulthood. Most studies find positive long-term effects on schooling, but fewer find positive impacts on cognitive skills, learning, or socio-emotional skills. Impacts on employment and earnings are mixed, possibly because former beneficiaries were often still too young. A number of studies find estimates that are not statistically different from zero, but for which it is often not possible to be confident that this is due to an actual lack of impact rather than to the methodological challenges facing all long-term evaluations. Developing further opportunities for analyses with rigorous identification strategies for the measurement of long-term impacts should be high on the research agenda. As original beneficiaries age, this should also be increasingly possible, and indeed important before concluding whether or not CCTs lead to sustainable poverty reduction. [ABSTRACT FROM AUTHOR]

Empirical evidence on conditional cash transfers (CCTs) in the education domain suggests increases in school participation but minimal effects on learning. In this paper, we find strong evidence for intrahousehold spillover effects of a CCT programme on children's academic performance, but interestingly, the CCT was not conditioned on education. We study a flagship health and safe motherhood programme from India, and by exploiting plausible exogenous variation in exposure to the programme, show positive effects on reading, writing and maths test scores for non‐targeted elder children in the household whose mothers or aunts were potentially exposed to the policy. Our results can be viewed as intergenerational effects of CCTs because the estimated benefits accrue to the future generations of the potential recipients of the transfer payments. We identify higher expenditure on private tutoring as a potential mediating channel for the effects. We also find changes in fertility preferences of women, suggesting a longer‐term mediating channel applicable in a standard quantity–quality trade‐off setting. [ABSTRACT FROM AUTHOR]

Subsidies in the form of direct transfers from the government to citizens constitute a powerful mechanism for crisis mitigation and for the alleviation of economic inequalities. However, the connection between direct transfers of cash assistance to selected individual beneficiaries and the prosperity of their immediate surrounding local economy has not been sufficiently explored. This paper presents a case study which analyzes the effects of allocating cash assistance in the form of a local currency. It shows that, under certain conditions, such a transfer not only provides the beneficiaries with additional purchasing power to satisfy their needs but also that the monetary injection benefits local SMEs by generating additional turnover. Using transactional data from the system, some indicators are proposed to analyze the properties of the system, namely, user satisfaction, total and average income generated by local businesses, the local multiplier, the recirculation of the local currency, and the velocity of its circulation. Our findings indicate that cash assistance provided in the REC local currency could contribute to local economic development and financial stability by sustaining local commerce, while preserving most of the original positive effects of cash assistance in a legal tender. [ABSTRACT FROM AUTHOR]

Copyright of Revista Trabajo Social is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Poverty is a global socio-economic phenomenon. It is always a problem in all countries include developing countries and developed countries. In Vietnam, the poverty rate has been decreasing while the urbanization has happened rapidly over the past 20 years. Handling the dual problems of urbanization and poverty is important to be able to attain sustainable development. Therefore, this study is to analyze the impact of urbanization on poverty reduction in Vietnam. Using Driscoll and Kraay's method and D-GMM method to estimate the provinces' panel data in the period 2006–2016, we confirm that there exists a U-shape relationship between the level of urbanization and the poverty level in Vietnam. Moreover, the estimated thresholds of urbanization from the perspective of poverty reduction are 40.19% and 43.68% in the static and dynamic model, respectively. In addition, our results exhibit that the gross regional domestic product, human capital, and agricultural value have the effect of reducing poverty, but government spending and export value increases the poverty rate in Vietnam. The paper has relevant implications for policymakers. [ABSTRACT FROM AUTHOR]

This paper studies the role of incentives for mothers and health care workers in the use of maternal and child health services. Using variations in date of birth, eligibility, and transfer size for a conditional cash transfer program in India, I find that overall delivery at a health care facility for eligible women increased by 5 percentage points. The incentives also significantly increased the use of pre- and postnatal care services and immunization. The program reduced early-neonatal deaths but had no impact on late-neonatal mortality. I also find that larger incentives to health workers are associated with relatively higher utilization rates compared with larger incentives to mothers. [ABSTRACT FROM AUTHOR]

In this paper, we estimate the impact on female labor force participation of a massive conditional cash transfer program-Universal Child Allowance, AUH-launched in Argentina in 2009. We identify the intention-to-treat effect by comparing eligible and non-eligible women over time through a diff-in-diff methodology. The results suggest a negative and economically significant effect of the program on female labor force participation. The disincentive to participate is present for married women, while the effect is not statistically significant for unmarried women with children. We also find evidence on the heterogeneity of the effect depending on woman's education, husband's employment status, number and age of children, and whether the woman is the main responsible of domestic chores. The relatively large value of the benefit and the fact that transfers are mostly directed to mothers may explain the sizeable effect of the program on female labor supply. The welfare implications of the results are not clear and deserve further inspection. JEL Classification: H53, I38, J16, J22 [ABSTRACT FROM AUTHOR]

Objectives: The "Bolsa-Família" Program (PBF) is a Brazilian conditional cash-transfer program in which families should comply with health, education, and social assistance conditionalities. The program aims to fight poverty and hunger, promoting nutrition and health services for low-income populations. This paper presents a database on the coverage of monitoring and compliance with the PBF health conditionalities in Brazil from January 2005 to July 2021. Data description: Database on the PBF conditioning cash-transfer program coverage in Brazil from 2005 to 2021. It comprises information on the number of families benefited, health conditionalities, and the follow-up on vaccination and nutrition of children under seven years old. The cities and semesters are the minimal aggregation units. [ABSTRACT FROM AUTHOR]

Copyright of RAP: Revista Brasileira de Administração Pública is the property of RAP: Revista Brasileira de Administracao Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gestión y Análisis de Políticas Públicas, Nueva Época (GAPP) is the property of Instituto Nacional de Administracion Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper introduces distributional regression also known as generalized additive models for location, scale and shape (GAMLSS) as a modeling framework for analyzing treatment effects beyond the mean. In contrast to mean regression models, GAMLSS relate each distributional parameter to covariates. Therefore, they can be used to model the treatment effect not only on the mean but on the whole conditional distribution. Since they encompass a wide range of different distributions, GAMLSS provide a flexible framework for modeling non-normal outcomes in which additionally nonlinear and spatial effects can easily be incorporated. We elaborate on the combination of GAMLSS with program evaluation methods including randomized controlled trials, panel data techniques, difference in differences, instrumental variables, and regression discontinuity design. We provide practical guidance on the usage of GAMLSS by reanalyzing data from the Mexican Progresa program. Contrary to expectations, no significant effects of a cash transfer on the conditional consumption inequality level between treatment and control group are found. [ABSTRACT FROM AUTHOR]

This paper examines the prices of basic staples in rural Mexico. We document that nonlinear pricing in the form of quantity discounts is common, that quantity discounts are sizable for basic staples, and that the well‐known conditional cash transfer program Progresa has significantly increased quantity discounts, although the program, as documented in previous studies, has not affected unit prices on average. To account for these patterns, we propose a model of price discrimination that nests those of Maskin and Riley (1984) and Jullien (2000), in which consumers differ in their tastes and, because of subsistence constraints, in their ability to pay for a good. We show that under mild conditions, a model in which consumers face heterogeneous subsistence or budget constraints is equivalent to one in which consumers have access to heterogeneous outside options. We rely on known results to characterize the equilibrium price schedule, which is nonlinear in quantity. We analyze the effect of nonlinear pricing on market participation as well as the impact of a market‐wide transfer, analogous to the Progresa one, when consumers are differentially constrained. We show that the model is structurally identified from data on prices and quantities from a single market under common assumptions. We estimate the model using data on three commonly consumed commodities from municipalities and localities in Mexico. Interestingly, we find that relative to linear pricing, nonlinear pricing is beneficial to a large number of households, including those consuming small quantities, mostly because of the higher degree of market participation that nonlinear pricing induces. We also show that the Progresa transfer has affected the slopes of the price schedules of the three commodities we study, which have become steeper as consistent with our model, leading to an increase in the intensity of price discrimination. Finally, we find that a reduced form of our model, in which the size of quantity discounts depends on the hazard rate of the distribution of quantities purchased in a village, accounts for the shift in price schedules induced by the program. [ABSTRACT FROM AUTHOR]

How much happiness could be gained if the world's wealth were distributed more equally? Despite decades of research investigating the relationship between money and happiness, no experimental work has quantified this effect for people across the global economic spectrum. We estimated the total gain in happiness generated when a pair of high-networth donors redistributed US$2 million of their wealth in $10,000 cash transfers to 200 people. Our preregistered analyses offer causal evidence that cash transfers substantially increase happiness among economically diverse individuals around the world. Recipients in lower-income countries exhibited happiness gains three times larger than those in higher-income countries. Still, the cash provided detectable benefits for people with household incomes up to $123,000. [ABSTRACT FROM AUTHOR]

Background: Achievement of improved maternal and child health (MCH) outcomes continues to be an issue of international priority, particularly for sub-Saharan African countries such as Nigeria. Evidence suggests that the use of Community Health Workers (CHWs) can be effective in broadening access to, and coverage of, health services and improving MCH outcomes in such countries.Methods/design: In this paper, we report the methodology for a 5-year study which aims to evaluate the context, processes, outcomes and longer-term sustainability of a Nigerian CHW scheme. Evaluation of complex interventions requires a comprehensive understanding of intervention context, mechanisms and outcomes. The multidisciplinary and mixed-method realist approach will facilitate such evaluation. A favourable policy environment within which the study is conducted will ensure the successful uptake of results into policy and practice. A realist evaluation provides an overall methodological framework for this multidisciplinary and mixed methods research, which will be undertaken in Anambra state. The study will draw upon health economics, social sciences and statistics. The study comprises three steps: (1) initial theory development; (2) theory validation and (3) theory refinement and development of lessons learned. Specific methods for data collection will include in-depth interviews and focus group discussions with purposefully identified key stakeholders (managers, service providers and service users), document reviews, analyses of quantitative data from the CHW programme and health information system, and a small-scale survey. The impact of the programme on key output and outcome indicators will be assessed through an interrupted time-series analysis (ITS) of monthly quantitative data from health information system and programme reports. Ethics approvals for this study were obtained from the University of Leeds and the University of Nigeria.Discussion: This study will provide a timely and important contribution to health systems strengthening specifically within Anambra state in southeast Nigeria but also more widely across Nigeria. This paper should be of interest to researchers who are interested in adapting and applying robust methodologies for assessing complex health system interventions. The paper will also be useful to policymakers and practitioners who are interested in commissioning and engaging in such complex evaluations to inform policies and practices. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the extent to which the Indonesian conditional cash transfer (CCT), known as the Family Hope Program (FHP), impacts the probability of children engaging in labour activities. Design/methodology/approach: This study utilizes data from the Indonesian Family Life Survey in 2014, focussing on periods following the implementation of the FHP. To estimate the impact of FHP on child labour in Indonesia, the authors employ a propensity score matching strategy to balance the characteristics observed between the participant and non-participant groups. Findings: The estimates show that FHP has no statistical impact on child labour across all matching techniques. This implies that receiving the CCT does not always help poor households decrease the probability of stopping their children from participating in labour activities. Social implications: The conditions applied to the beneficiaries, which only require children to attend school without requiring them to stop working, may not effectively address the issue of child labour. The current structure and design of the FHP need to be re-evaluated and improved to effectively combat child labour. Originality/value: Despite numerous studies examining the impact of CCT on child labour which remains inconclusive in Indonesia, this study contributes to the existing literature by considering children participating in labour activities across all types of work without focussing on specific education levels or regions. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-07-2023-0580 [ABSTRACT FROM AUTHOR]

Social safety nets are expanding in Sub-Saharan Africa. While proponents perceive them as a means to combat poverty and vulnerability, opponents view them as wasteful use of scarce public resources and do not significantly overcome poverty. Previous studies have primarily focused on assessing the impact of these policies on current poverty levels, with insufficient evidence available regarding their impact on future poverty, which deserves equal attention. We drew on the Tanzanian 2017–18 Household Budget Survey, comprising 9,463 households to evaluate the impact of productive social safety net (PSSN) program on households' vulnerability to poverty (VP). The VP was evaluated using vulnerability as expected poverty (VEP), whereas the impact was estimated using Instrumental Variable (IV) method. We found that PSSN reduces household VP by 13.4%, suggesting that it is an effective policy instrument for reducing poverty and vulnerability. Notably, the estimated impacts were greater for households enrolled in conditional cash transfer (CCT) and public work (PW) combined, suggesting that a package of CCT and PW is likely to have a more substantial impact within the realm of social safety nets. Our findings offer evidence in favor of policies that promote the broader expansion of social safety nets as anti-poverty policy instruments. [ABSTRACT FROM AUTHOR]

The effects of conditional cash transfers (CCTs) on poverty and well-being have been widely studied. However, there is limited knowledge on how a CCT should respond to the dynamics of poverty. How should program administrators treat beneficiaries that exit poverty in period t-1, but exhibit a high probability of falling into poverty in period t? This is a relevant, yet unanswered question. This paper provides an analysis of the implications of poverty dynamics in the implementation of graduation strategies of CCTs, taking Mexico's Progresa-Oportunidades-Prospera (POP) program as reference case. We propose a Markovian transition model that allows to control for unobserved heterogeneity, state dependence, and attrition. The model provides a framework for a generic graduation condition that can be applied to cash transfer programs that follow well-defined eligibility income thresholds. Overall, we find that only one-third of program beneficiaries that were poor in 2002 exhibited low probabilities of becoming poor in 2009–12 and therefore could be regarded as true 'graduates' of the program. We also find that the 'recertification' process of POP—which takes place every three years—would be more efficient if it took place every 3.7 and 5.1 years in urban and rural areas, respectively. [ABSTRACT FROM AUTHOR]

Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program. Our results provide information to support the optimal utilization of facilities at different levels of the healthcare system for childbirth. Data was collected from 96 facilities (74 public) and 720 rural mothers who delivered at these facilities were interviewed. Multilevel logistic regression was used to analyze the data. Facility obstetric care functionality was assessed by the number of emergency obstetric care (EmOC) signal functions performed in the last three months. Thirty eighth percent of the mothers bypassed the nearest public facility for their current delivery. Primiparity, higher education, arriving by hired transport and a longer distance from home to the nearest facility increased the odds of bypassing a public facility for childbirth. The variance partition coefficient showed that 37% of the variation in bypassing the nearest public facility can be attributed to difference between facilities. The number of basic emergency obstetric care signal functions (AOR = 0.59, 95% CI 0.37–0.93), and the availability of free transportation at the nearest facility (AOR = 0.11, 95% CI 0.03–0.31) were protective factors against bypassing. The variation between facilities (MOR = 3.85) was more important than an individual’s characteristics to explain bypassing in MP. This multilevel study indicates that in this setting, a focus on increasing the level of emergency obstetric care functionality in public obstetric care facilities will allow more optimal utilization of facilities for childbirth under the JSY program thereby leading to better outcomes for mothers. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Economía del Rosario is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Noncommunicable diseases (NCDs) are among the largest health emergencies nowadays. Although a large proportion of NCDs can be prevented effectively via good life habits, these remain ubiquitous and one main reason is people's self‐control problem caused by time‐inconsistent, present‐biased preferences. In this situation, we wonder whether a "long‐term" conditional cash transfer (CCT) program, which is known to be effective in shaping people's behaviors but expensive, can be a viable solution. We establish a model which can be fine‐tuned by many parameters, and show that our results are robust in a wide range of parameters. We identify the optimal CCT scheme which helps people achieve their long‐term plan while generating the lowest cash flow. Our results suggest interesting managerial insights like that the amount of necessary financial incentives can depend on people's age, and that the government's optimal CCT scheme does not depend on the level of people's naivete. Also, it is profitable for companies to hold such a program and sell enrollment to customers as self‐commitment devices. However, companies may exploit customers' naivete to maximize their profit while hurting social welfare. We also examine situations that people's behaviors can only be monitored indirectly through inaccurate signals and that people are heterogeneous in how present‐biased they are. [ABSTRACT FROM AUTHOR]

This paper investigates the long-term effects of conditional cash transfers on school attainment and child labor. To this end, we construct a dynamic heterogeneous agent model, calibrate it with Brazilian data, and introduce a policy similar to the Brazilian Bolsa Família. Our results suggest that this type of policy has a very strong impact on educational outcomes, sharply increasing primary school completion. The conditional transfer is also able to reduce the share of working children from 22% to 17%. We then compute the transition to the new steady state and show that the program actually increases child labor over the short run, because the transfer is not enough to completely cover the schooling costs, so children have to work to be able to comply with the program's schooling eligibility requirement. We also evaluate the impacts on poverty, inequality, and welfare. ( JEL O11, I25, J24) [ABSTRACT FROM AUTHOR]

Background: International migration to middle-income countries is increasing and its health consequences, in particular increasing transmission rates of tuberculosis (TB), deserve consideration. Migration and TB are a matter of concern in high-income countries and targeted screening of migrants for active and latent TB infection is a main strategy to manage risk and minimize transmission. In this paper, we discuss some aspects of TB control and migration in the context of middle-income countries, together with the prospect of responding with equitable and comprehensive policies.Main Body: TB rates in middle-income countries remain disproportionally high among the poorest and most vulnerable groups in large cities where most migrant populations are concentrated. Policies that tackle migrant TB in high-income countries may be inadequate for middle-income countries because of their different socio-economic and cultural scenarios. Strategies to control TB in these settings must take into account the characteristics of middle-income countries and the complexity of TB as a disease of poverty. Intersectoral policies of social protection such as cash-transfer programs help reducing poverty and improving health in vulnerable populations. We address the development of new approaches to improve well-established strategies including contact tracing and active and latent TB screening as an 'add on' to the existing health care guidelines of conditional cash transfer programs. In addition, we discuss how it might improve health and welfare among both poor migrants and locally-born populations. Authorities from middle-income countries should recognise that migrants are a vulnerable social group and promote cooperation efforts between sending and receiving countries for mitigation of poverty and prevention of disease in this group.Conclusions: Middle-income countries have long sent migrants overseas. However, the influx of large migrant populations into their societies is relatively new and a growing phenomenon and it is time to set comprehensive goals to improve health among these communities. Conditional cash transfer policies with TB screening and strengthening of DOTS are some strategies that deserve attention. Reduction of social and health inequality among migrants should be incorporated into concerted actions to meet TB control targets. [ABSTRACT FROM AUTHOR]

Background: Timely, appropriate, and equitable access to quality healthcare during pregnancy is proven to contribute to better health outcomes of birthing individuals and infants following birth. Equity is conceptualized as the absence of differences in healthcare access and quality among population groups. Healthcare policies are guides for front-line practices, and despite merits of contemporary policies striving to foster equitable healthcare, inequities persist. The purpose of this umbrella review is to identify prenatal healthcare practices, summarize how equities/inequities are reported in relation to patient experiences or health outcomes when accessing or using services, and collate equity reporting characteristics. Methods: For this umbrella review, six electronic databases were searched (Medline, EMBASE, APA PsychInfo, CINAHL, International Bibliography of the Social Sciences, and Cochrane Library). Included studies were extracted for publication and study characteristics, equity reporting, primary outcomes (prenatal care influenced by equity/inequity) and secondary outcomes (infant health influenced by equity/inequity during pregnancy). Data was analyzed deductively using the PROGRESS-Plus equity framework and by summative content analysis for equity reporting characteristics. The included articles were assessed for quality using the Risk of Bias Assessment Tool for Systematic Reviews. Results: The search identified 8065 articles and 236 underwent full-text screening. Of the 236, 68 systematic reviews were included with first authors representing 20 different countries. The population focus of included studies ranged across prenatal only (n = 14), perinatal (n = 25), maternal (n = 2), maternal and child (n = 19), and a general population (n = 8). Barriers to equity in prenatal care included travel and financial burden, culturally insensitive practices that deterred care engagement and continuity, and discriminatory behaviour that reduced care access and satisfaction. Facilitators to achieve equity included innovations such as community health workers, home visitation programs, conditional cash transfer programs, virtual care, and cross-cultural training, to enhance patient experiences and increase their access to, and use of health services. There was overlap across PROGRESS-Plus factors. Conclusions: This umbrella review collated inequities present in prenatal healthcare services, globally. Further, this synthesis contributes to future solution and action-oriented research and practice by assembling evidence-informed opportunities, innovations, and approaches that may foster equitable prenatal health services to all members of diverse communities. [ABSTRACT FROM AUTHOR]

Ethiopia introduced its flagship poverty-targeted social protection program, the Productive safety net program (PSNP), in 2005 and Community-Based Health Insurance (CBHI) in 2011. Although both programs operate in several districts with some overlaps, evidence is scarce on how these large-scale programs jointly affect the food security of vulnerable groups. This study examines the impacts of a combination of these programs on food security outcomes among female-headed households in a chronically food-insecure and drought-prone district. Cross-sectional data were collected from 365 female-headed households selected through multi-stage sampling technique and analyzed using Inverse-probability-weighted regression adjustment (IPWRA) strategy to assess the effect of the programs on food security. The results show that while 63.6% of sample households are enrolled in CBHI and 48.8% are beneficiaries of PSNP's conditional cash transfer (CCT) component, membership in both social protection programs was 38.9%. The IPWRA analysis finds that inclusion in the CCT combined with CBHI, on average, increased dietary diversity score by 0.918 (95% CI 0.779–1.057) and food consumption score by 0.576 (95% CI 0.464–0.688). It also reduced household food insecurity access scale by 8.658 (95% CI -9.775 – -7.541). In all assessments, a combination of CBHI and CCT always produced results of a larger magnitude than each of CBHI and CCT alone. The findings provide evidence of the potentials of integrating social protection programs to increase food security outcomes among the most vulnerable and marginalized groups in a developing country. In addition, the results have also useful implications to achieve sustainable development goals related to ending hunger and achieving food security among vulnerable groups. [ABSTRACT FROM AUTHOR]

Energy poverty represents a critical challenge in Latin America today, given the social disparities the region faces. In this context, this study focuses on exploring the effects of remittances on the energy poverty of 13 Latin American countries during the period 2000–2020. Panel estimations with fixed and random effects, along with the generalized method of moments, are employed to address potential endogeneity issues. The results suggest that remittances play a significant role in mitigating energy poverty in the Latin American region, particularly in rural areas. Furthermore, it is observed that economic growth and financial development act as mediators, allowing remittances to indirectly contribute to mitigating energy poverty. Although inequality was examined as a potential mediator, the findings suggest that it does not play a significant role in this context. It is concluded that remittances are an appropriate mechanism to improve the quality of life of the population, and their impact is strengthened in a more robust economic environment. [ABSTRACT FROM AUTHOR]

Objective: Most people with epilepsy (PWE) could live seizure‐free if treated with one or more antiseizure medications (ASMs). The World Health Organization (WHO) estimates that 75% of PWE in low‐resource settings lack adequate antiseizure treatment. Limited education surrounding epilepsy and the out‐of‐pocket costs of ASMs in particular pose barriers to managing epilepsy in resource‐poor, low‐income settings. The aim of this study is to implement and test a novel strategy to improve outcomes across the epilepsy care cascade marked by (1) retention in epilepsy care, (2) adherence to ASMs, and (3) seizure reduction, with the measured goal of seizure freedom. Methods: A randomized, double‐blinded clinical trial will be performed, centered at the Ignace Deen Hospital in Conakry, Republic of Guinea, in Western Sub‐Saharan Africa. Two hundred people with clinically diagnosed epilepsy, ages 18 years and above, will receive education on epilepsy and then be randomized to (i) free ASMs versus (ii) conditional cash, conditioned upon return to the epilepsy clinic. Participants will be followed for 360 days with study visits every 90 days following enrollment. Significance: We design a randomized trial for PWE in Guinea, a low‐resource setting with a high proportion of untreated PWE and a nearly completely privatized healthcare system. The trial includes a conditional cash transfer intervention, which has yet to be tested as a targeted means to improve outcomes for people with a chronic neurological disorder. The trial aims to provide an evidence base for the treatment of epilepsy in such settings. Plain Language Summary: We present a clinical trial protocol for a randomized, blinded study of 200 people with epilepsy in the low‐resource African Republic of Guinea, providing an educational intervention (E), and then randomizing in a 1:1 allocation to either free antiseizure medication (m) or conditional cash (c2) for 360 days. Measured outcomes include (1) returning to outpatient epilepsy care, (2) adherence to antiseizure medications (ASMs), and (3) reducing the number of seizures. This study is an initial look at giving small amounts of cash for desired results (or "nudges") for improving epilepsy outcomes in the sub‐Saharan African and brain disorder contexts. [ABSTRACT FROM AUTHOR]