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We test if 3534 beneficiaries of PROSPERA, Mexico’s cash transfer program, smooth food consumption before and after the date of the transfer receipt, and if consumption smoothing is costly. The transfer is an anticipated and transitory income shock and, thus, the PIH predicts that consumption should be smooth before and after its receipt. We find that food consumption does not change the days before and after the transfer date and we find no evidence that households bear costs to smooth consumption. The transfer’s cost of access, which encompasses participants’ distaste for using debit cards and costly ATM withdrawals, may help time-inconsistent and less experienced debit card holders smooth consumption.

The impacts of cash transfers on women empowerment vary significantly with transfer context and design, including beneficiary targeting, transfer magnitude, timing, and conditions. Our study contributes to this literature by examining a maternal cash transfer programme in India where pregnant and lactating women received a substantial amount of money, in instalments, after fulfilling conditions related to maternal and infant health which required visits to public health centres. Using a matched-pair difference-in-differences design, we find that the programme reduced Intimate Partner Violence (IPV), particularly physical violence and subsequent injuries. Additionally, we find increases in women's participation in household decision-making, physical mobility, interaction with peers and health workers, economic standing, healthcare access, and less tolerant attitudes towards IPV, which not only indicate an improvement in women's position in the household but are also pathways for reduced IPV. Also, we document positive effects on the birth registration and primary education only for female children of eligible women. [ABSTRACT FROM AUTHOR]

Launched in 2013 in West Bengal, India, Kanyashree Prakalpa is a conditional cash transfer program incentivizing girls to stay in school and delay marriage. The program provides annual scholarships to 13–18-year-old girls for remaining enrolled in school, and a lump-sum transfer upon attaining adulthood, conditional on remaining unmarried and pursuing education. Using pre- and post-program data and cohort-specific eligibility rules for 15–35-year-old women and by employing double-differences and triple-difference frameworks, we find that exposed women experience 7 to 8 percentage points higher likelihood of independent movement outside the home and have a lower tolerance for domestic violence. We find the affected cohort to have a 4 to 5 percentage points lower likelihood of justifying wife-beating by husbands. We find suggestive evidence of these results being mediated by access to bank accounts and increased schooling. This underscores the importance of education and financial independence as a pathway to women's empowerment. [ABSTRACT FROM AUTHOR]

The research on redistributive strategies to secure support has been dominated by a core and swing voter model, which pits two parties against each other in a costly race for support. What are other options beyond targeting either swing or one's own core voters? This paper identifies a political scenario where core supporters from other parties are viable targets and sets out to test three dimensions that indicate when actors can effectively target them. This paper's main expectation is that by accounting for voters' ideological affinity, levels of fragmentation, and the potential to deliver their votes, parties can effectively target other parties' core supporters. The case of Brazil's Bolsa Família delivers evidence for the hypotheses. [ABSTRACT FROM AUTHOR]

Indonesia's Conditional Cash Transfer (CCT) program, Program Keluarga Harapan (PKH), aims to alleviate poverty and improve access to essential services. However, its effectiveness in addressing the root causes of poverty, malnutrition, and stunting has been subject to criticism, as it primarily focuses on alleviating immediate financial constraints. This literature review critically analyses the existing research on the PKH program's effectiveness in addressing nutritional issues in Indonesia. Literature selection, data extraction, and analysis were employed. Based on the literature search strategy and criteria, four key papers were collected. These studies indicated that CCT/PKH could not stand alone in tackling nutritional problems. There are several supporting components that should be taken into consideration in implementing the programme, including 1) the requirement of a standardized healthcare facility; 2) focusing on quality in small numbers rather than covering a wide scale with minimum impact; 3) supplementing CCT/PKH with health education and promotion programme; and 4) improving access to health and nutritional services. A whole-system approach, involving various stakeholders and integrating targeted interventions, has the potential to break the intergenerational cycle of poverty and ensure a healthier future for all Indonesians.

Abstract Background There is some evidence that differentiated service delivery (DSD) models, which use a client-centered approach to simplify and increase access to care, improve clinical outcomes among people living with HIV (PLHIV) in high HIV prevalence countries. Integrating economic strengthening tools (e.g., microcredit, cash transfers, food assistance) within DSD models can help address the poverty-related barriers to HIV antiretroviral therapy (ART). Yet there is minimal evidence of the cost-effectiveness of these types of multilevel care delivery models, which potentially prohibits their wider implementation. Methods Using a qualitative systematic review, this article synthesizes the literature surrounding the cost-effectiveness of differentiated service delivery models that employ economic strengthening initiatives to improve HIV treatment adherence in low- and middle-income countries. We searched three academic databases for randomized controlled trials and observational studies published from January 2000 through March 2024 in Sub-Saharan Africa. The quality of each study was scored using a validated appraisal system. Results Eighty-nine full texts were reviewed and 3 met all eligibility criteria. Two of the three included articles were specific to adolescents living with HIV. Economic strengthening opportunities varied by care model, and included developmental savings accounts, microenterprise workshops, and cash and non-cash conditional incentives. The main drivers of programmatic and per-patient costs were ART medications, CD4 cell count testing, and economic strengthening activities. Conclusion All economic evaluations in this review found that including economic strengthening as part of comprehensive differentiated service delivery was cost-effective at a willingness to pay threshold of at least 2 times the national per capita gross domestic product. Two of the three studies in this review focused on adolescents, suggesting that these types of care models may be especially cost-effective for youth entering adulthood. All studies were from the provider perspective, indicating that additional evidence is needed to inform the potential cost-savings of DSD and economic strengthening interventions to patients and society. Randomized trials testing the effectiveness of DSD models that integrate economic strengthening should place greater emphasis on costing these types of programs to inform the potential for bringing these types of multilevel interventions to scale.

The issue of stigma has long been a central topic of discussion regarding the low uptake rate of targeted welfare programs. However, empirical evidence examining this claim within Global South countries remains scarce, particularly in Indonesia. Our study employed a qualitative approach, utilizing data from 33 interviews conducted in two areas with high poverty rates, evaluating the extent of institutionalized stigma that deters individuals from claiming Conditional Cash Transfer (CCT/PKH) benefits. Contrary to prevailing assumptions, our study found no clear link between stigma and the uptake of CCT/PKH programs. We found that the direct experiences of the interviewee with the repeated mistargeting of CCT distribution in sites under examination have eroded the significance of stigma, leading to unashamed claims by beneficiaries, regardless of their eligibility. Furthermore, our research unveiled that the CCT/PKH distribution is not merely an institutional process; it is highly interdependent, influenced by complex personalized meanings among beneficiaries with diverse goals. For example, some beneficiaries use the CCT as collateral to access loans from informal financial institutions, while others use it for socio-cultural purposes. This research contributes to the social policy literature by emphasizing the dysfunction of institutionalized stigma in affecting the decisions of (non-)eligible individuals to access welfare benefits. [ABSTRACT FROM AUTHOR]

Background: There is some evidence that differentiated service delivery (DSD) models, which use a client-centered approach to simplify and increase access to care, improve clinical outcomes among people living with HIV (PLHIV) in high HIV prevalence countries. Integrating economic strengthening tools (e.g., microcredit, cash transfers, food assistance) within DSD models can help address the poverty-related barriers to HIV antiretroviral therapy (ART). Yet there is minimal evidence of the cost-effectiveness of these types of multilevel care delivery models, which potentially prohibits their wider implementation. Methods: Using a qualitative systematic review, this article synthesizes the literature surrounding the cost-effectiveness of differentiated service delivery models that employ economic strengthening initiatives to improve HIV treatment adherence in low- and middle-income countries. We searched three academic databases for randomized controlled trials and observational studies published from January 2000 through March 2024 in Sub-Saharan Africa. The quality of each study was scored using a validated appraisal system. Results: Eighty-nine full texts were reviewed and 3 met all eligibility criteria. Two of the three included articles were specific to adolescents living with HIV. Economic strengthening opportunities varied by care model, and included developmental savings accounts, microenterprise workshops, and cash and non-cash conditional incentives. The main drivers of programmatic and per-patient costs were ART medications, CD4 cell count testing, and economic strengthening activities. Conclusion: All economic evaluations in this review found that including economic strengthening as part of comprehensive differentiated service delivery was cost-effective at a willingness to pay threshold of at least 2 times the national per capita gross domestic product. Two of the three studies in this review focused on adolescents, suggesting that these types of care models may be especially cost-effective for youth entering adulthood. All studies were from the provider perspective, indicating that additional evidence is needed to inform the potential cost-savings of DSD and economic strengthening interventions to patients and society. Randomized trials testing the effectiveness of DSD models that integrate economic strengthening should place greater emphasis on costing these types of programs to inform the potential for bringing these types of multilevel interventions to scale. [ABSTRACT FROM AUTHOR]

In Chile, a conditional cash transfer (CCT) programme was established by a left-wing government in 2004 and then re-established by a right-wing coalition in 2014. Despite some revisions and adjustments, Ingreso Ético Familiar maintained the core characteristics of its predecessor Chile Solidario. This reflected a wider trend of CCT adoption by an ideologically diverse group of governments. Against this background, it is obvious that the CCT policy model appeals to political decision-makers on a wide scale, or at least makes it acceptable to them. However, questions remain: how was this model embraced by the ideologically opposing coalitions in Chile? And more broadly: how do CCTs appeal to such a wide range of policymakers? The article explores the argumentation of Chilean Members of Parliament and examines how the ideological and political consensus around these programmes was discursively attained. Through this case, the article also sheds light on how domestic policy dynamics interact with global policy processes. The analysis revealed points of confluence, which serve to illustrate the CCT model's capacity to convey different meanings to different people – allowing it to be interpreted to fit a variety of different perspectives. I define this quality as discursive malleability and argue that it is an important quality not only in explaining how a policy model can resonate among or appeal to such a wide range of policymakers, but also in the process where a global model is adopted in a country and becomes part of the domestic political debate. [ABSTRACT FROM AUTHOR]

Abstract Background Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births, including their severity categories, and explored how this association differs according to prenatal care and the quality of Bolsa Familia Programme management. Methods A retrospective cohort study was performed involving the first live singleton births to mothersenrolled in the 100 Million Brazilian Cohort from 2004 to 2015, who had at least one child before cohort enrollment. Only the first birth during the cohort period was included, but born from 2012 onward. A deterministic linkage with the Bolsa Familia Programme payroll dataset and a similarity linkage with the Brazilian Live Birth Information System were performed. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age

Abstract Background In the Lake Victoria basin of western Kenya, malaria remains highly endemic despite high coverage of interventions such as mass distribution of long-lasting insecticidal nets (LLIN), indoor residual spraying (IRS) programs, and improvement of availability and accessibility of rapid diagnostic tests (RDT) and artemisinin-based combination therapy (ACT) at community healthcare facilities. We hypothesize that one major cause of the residual transmission is the lack of motivation among residents for malaria prevention and early treatment. Methods This study will aim to develop a demand-side policy tool to encourage local residents’ active malaria prevention and early treatment-seeking behaviors. We examine the causal impact of a financial incentive intervention complemented with malaria education to residents in malaria-prone areas. A cluster-randomized controlled trial is designed to assess the effect of the financial incentive intervention on reducing malaria prevalence in residents of Suba South in Homa Bay County, Kenya. The intervention includes two components. The first component is the introduction of a financial incentive scheme tied to negative RDT results for malaria infection among the target population. This study is an attempt to promote behavioral changes in the residents by providing them with monetary incentives. The project has two different forms of incentive schemes. One is a conditional cash transfer (CCT) that offers a small reward (200 Ksh) for non-infected subjects during the follow-up survey, and the other is a lottery incentive scheme (LIS) that gives a lottery with a 10% chance of winning a large reward (2000 Ksh) instead of the small reward. The second component is a knowledge enhancement with animated tablet-based malaria educational material (EDU) developed by the research team. It complements the incentive scheme by providing the appropriate knowledge to the residents for malaria elimination. We evaluate the intervention’s impact on the residents’ malaria prevalence using a cluster-randomized control trial. Discussion A policy tool to encourage active malaria prevention and early treatment to residents in Suba South, examined in this trial, may benefit other malaria-endemic counties and be incorporated as part of Kenya’s national malaria elimination strategy. Trial registration UMIN000047728. Registered on 29th July 2022.

This qualitative study explores the experiences and attitudes of welfare recipients towards Indonesia's conditional cash transfer (CCT/PKH) program. The specific objectives of our paper include examining the program's impact on impoverished families, their response to stereotyping, and the implications of stereotyping for government policy among Indonesian low‐income families. We conducted twenty in‐depth interviews with key stakeholders (program professionals, community leaders, program facilitators) and end‐users (beneficiaries). Despite the attached stereotype, our findings show that not all beneficiaries with improved socioeconomic conditions wish to leave the program. In many cases, this occurs as beneficiaries use their CCT/PKH accounts as collateral to borrow from unregulated lenders and repay their debts. A few instances where we found self‐voluntary withdrawal from the program were only caused by the shame of receiving stickers attached to their homes – not because of their social‐economic status improvement – leading to difficulty affording their necessities afterwards. Overall, the finding that individuals, whether eligible or not, are not ashamed to claim PKH, despite the stigma attached to the program, contrasts with studies on welfare stigma, claiming that stigma can prevent individuals from claiming their welfare rights. [ABSTRACT FROM AUTHOR]

India has put efforts into the prevention and control of tuberculosis (TB) for more than 50 years. Nikshay Poshan Yojna (NPY) is one of the schemes of conditional cash transfers (CCTs) by the Government of India. The CCT schemes mostly address the demand side constraints. Governments could use this in developing nations as a tool to divert financial resources toward societal development. In India, NPY is more directed toward providing monetary support for a nutritional diet and reducing the catastrophic expenditure of TB patients. Several studies highlighted challenges in implementing cash transfer schemes and provided different operational models. A country like India should address the challenges with defined strategies to ensure its last-mile reach. A present commentary discussing challenges and possible solutions that policy-makers can adapt and set up a support structure to ensure that supportive actions are implemented in response to patient and system side issues.

Abstract Background This study aimed to investigate the association between inclusion to Pantawid Pamilyang Pilipino Program (4Ps), a CCT program in the Philippines, and malnutrition in children and adolescents and examine the perceptions and experiences of parents and other stakeholders on how 4Ps influenced child nutrition. Methods A concurrent mixed-method study was conducted in the Caraga Region, Philippines. Quantitative data from 5541 children and adolescents aged 3 to 19 were analyzed using multilevel mixed-effect logistic models. To allow in-depth understanding of the programmatic components that support the findings from the quantitative study, eight focused group discussions (FGDs) were concurrently conducted, cumulating 33 participants, including 4Ps parents, school coordinators/teachers, and school nurses. A constructivist grounded theory approach was used for analysis, and joint displays were employed to integrate quantitative and qualitative results. Results Quantitative findings revealed high rates of malnutrition, with significant rates of stunting (12.0%), wasting/thinness (9.4%), and overweight/obesity (16.4%) among children and adolescents. 4Ps beneficiaries had higher odds of stunting and overweight/obesity compared to non-4Ps beneficiaries (AOR = 1.43, 95%CI: 1.08–1.91; AOR = 1.21, 95%CI: 1.01–1.45, respectively). However, no significant association was observed between inclusion to 4Ps and concurrent stunting and wasting/thinness or overweight/obesity (AOR = 1.05, 95%CI: 0.72–1.55). Geographic variations were observed, with 4Ps children in Agusan del Sur having lower odds of stunting than those in Agusan del Norte (AOR = 0.41, 95%CI: 0.23–0.71). Age and gender also showed significant associations with malnutrition. The qualitative analysis provided insights into the challenges contributing to malnutrition, including child labor, sickness, long distances to school, limited access to healthy food, and larger families. Unintended consequences such as cash card mismanagement, inappropriate cash grant allocation, and falsification of school attendance were identified. However, teachers and parents demonstrated resilience by implementing adaptive approaches to enhance child nutrition. Conclusions While 4Ps beneficiaries exhibit higher odds of stunting and overweight/obesity, the program’s association with malnutrition was significantly influenced by geographic variations. It is crucial for social protection programs to prioritize comprehensive support strategies that effectively counter unintended consequences and challenges faced by beneficiaries and other stakeholders and address malnutrition in children and adolescents.

This study investigates the impact of the conditional cash transfer program or locally known as Pantawid Pamilyang Pilipino Program (4Ps) on the socio-economic status of selected household beneficiaries in Hilongos Leyte, Philippines. This study aimed to compare the household income and education expenditure between household beneficiaries and non-beneficiaries. The pooled regression analysis was applied to assess the determinants of household income and education expenditure. Education expenditure is significantly affected by parental education, employment status and number of children. The method of difference in difference shows that the impact of the conditional cash transfer on the household income is positive and significant. However, result for the education expenditure is not significant suggesting no statistical difference in education expenditure between beneficiaries and non-beneficiaries. Key informant interviews revealed that children under the 4Ps program were able to attend more school days as compared to the non-beneficiaries. To further document the impact of the program, the local government unit should allocate more time for monitoring and evaluation to maximize the benefits from the program.

Background: This study aimed to investigate the association between inclusion to Pantawid Pamilyang Pilipino Program (4Ps), a CCT program in the Philippines, and malnutrition in children and adolescents and examine the perceptions and experiences of parents and other stakeholders on how 4Ps influenced child nutrition. Methods: A concurrent mixed-method study was conducted in the Caraga Region, Philippines. Quantitative data from 5541 children and adolescents aged 3 to 19 were analyzed using multilevel mixed-effect logistic models. To allow in-depth understanding of the programmatic components that support the findings from the quantitative study, eight focused group discussions (FGDs) were concurrently conducted, cumulating 33 participants, including 4Ps parents, school coordinators/teachers, and school nurses. A constructivist grounded theory approach was used for analysis, and joint displays were employed to integrate quantitative and qualitative results. Results: Quantitative findings revealed high rates of malnutrition, with significant rates of stunting (12.0%), wasting/thinness (9.4%), and overweight/obesity (16.4%) among children and adolescents. 4Ps beneficiaries had higher odds of stunting and overweight/obesity compared to non-4Ps beneficiaries (AOR = 1.43, 95%CI: 1.08–1.91; AOR = 1.21, 95%CI: 1.01–1.45, respectively). However, no significant association was observed between inclusion to 4Ps and concurrent stunting and wasting/thinness or overweight/obesity (AOR = 1.05, 95%CI: 0.72–1.55). Geographic variations were observed, with 4Ps children in Agusan del Sur having lower odds of stunting than those in Agusan del Norte (AOR = 0.41, 95%CI: 0.23–0.71). Age and gender also showed significant associations with malnutrition. The qualitative analysis provided insights into the challenges contributing to malnutrition, including child labor, sickness, long distances to school, limited access to healthy food, and larger families. Unintended consequences such as cash card mismanagement, inappropriate cash grant allocation, and falsification of school attendance were identified. However, teachers and parents demonstrated resilience by implementing adaptive approaches to enhance child nutrition. Conclusions: While 4Ps beneficiaries exhibit higher odds of stunting and overweight/obesity, the program's association with malnutrition was significantly influenced by geographic variations. It is crucial for social protection programs to prioritize comprehensive support strategies that effectively counter unintended consequences and challenges faced by beneficiaries and other stakeholders and address malnutrition in children and adolescents. [ABSTRACT FROM AUTHOR]

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]

In 2005, India launched the National Health Mission (NHM) to achieve equity in access to primary and secondary healthcare, with special focus on maternal and child healthcare (MCH). Studies have shown that NHM has increased access to MCH services; however, the access is still low among low socioeconomic population groups. Since outreach among target population is crucial to improve access to MCH, we analyzed the level and the inter‐ and intra‐state socioeconomic inequity in the outreach in two major NHM components: conditional cash‐transfer program‐JSY, and community health workers‐ASHAs and ANMs. We used administrative records and nationally representative cross‐sectional sample surveys in the early‐ and after the targeted full‐implementation phases of NHM, and employed descriptive and multivariate methods. We found that the NHM had covered only less than one‐half of the eligible women, with considerable inter‐state variations. For instance, in the high‐focus states in 2015–16, the receipt of JSY benefits, ASHAs services, and ANMs services among eligible women was 41.5%, 40.6%, and 48.8%, respectively, whereas the respective outreach among the bottom wealth quintile was 39.8%, 45.1%, and 44.4%. However, there was attenuation in inequity overtime, favoring the poor in the outreach of JSY benefits and ASHAs services. Furthermore, underscoring the importance of program outreach, we find that district with higher level of program outreach was associated with increased uptake of MCH services among target population. Our findings imply for implementing policy measures for wider program outreach so that the NHM could serve as pathway to attain universal health‐care coverage for India. [ABSTRACT FROM AUTHOR]

We study an at-scale natural experiment in which debit cards were given to cash transfer recipients who already had a bank account. Using administrative account data and household surveys, we find that beneficiaries accumulated a savings stock equal to 2% of annual income after two years with the card. The increase in formal savings represents an increase in overall savings, financed by a reduction in current consumption. There are two mechanisms. First, debit cards reduce transaction costs of accessing money. Second, they reduce monitoring costs, which led beneficiaries to check their account balances frequently and build trust in the bank.

Stunting merupakan masalah kesehatan pada tumbuh kembang anak yang mendapatkan perhatian khusus dari negara-negara di dunia. Hal ini karena stunting bukan hanya memberikan dampak buruk pada sektor kesehatan tetapi juga pada sektor ekonomi dengan meningkatkan angka pengangguran, kemiskinan dan ketimpangan. Indonesia merupakan salah satu negara dengan tingkat prevalensi stunting yang sangat tinggi, dibutuhkan berbagai inovasi untuk menurunkan angka stunting menjadi terkendali. Conditional Cash Transfer (CCT) merupakan salah satu model distribusi dana bantuan sosial yang terbukti mampu menurunkan angka stunting. Baitul Maal Aceh merupakan satu- satunya lembaga filantropi Islam berperan dalam mendistribusikan dana zakat dengan model CCT untuk mencegah stunting di Aceh. Penelitian ini bertujuan untuk menjelaskan bagaimana bentuk dari distribusi dana zakat dengan model CCT untuk mencegah stunting pada Baitul Maal Aceh. Penelitian menggunakan metode kualitatif dengan pendekatan studi kasus. Hasil dari penelitian ini menunjukkan bahwa Baitul Maal Aceh menerapkan beberapa karakteristik CCT dalam distribusi dana zakat. Karakteristik tersebut terdapat pada latar belakang program, kriteria penerima bantuan, persyaratan penerima bantuan, jenis dan nominal bantuan, serta tahapan implementasi program. Hasil dari penelitian ini diharapkan bermanfaat bagi stakeholder yang berkecimpung dalam pengendalian stunting baik dalam dunia akademik maupun praktik.

AbstractStunting has become a global problem that contributes to many deaths in children and is an indicator of inequality in human development. This study seeks to explain the pathways by which the Indonesian conditional cash transfer (CCT), namely, the Family Hope Program (FHP), can help reduce the stunting rates in Bima City, West Nusa Tenggara, Indonesia. In Bima City, the stunting rate decreased by more than half within the last five years from 36.5% in 2017 to 14.81% in 2022. Using thematic analysis, this study identifies the possible mechanisms of how the FHP can influence child nutrition based on semi-structured in-depth interviews with 15 beneficiary households of FHP throughout five subdistricts in Bima City. This study finds that some pathways of FHP contribute to reducing stunting in Bima City, such as through cash transfers to women, micronutrient intervention, education in health and nutrition from program facilitators, and health visits as a program conditionality. The external environment also matters in supporting the stunting reduction in Bima City, for example, the existence of applications to report stunting, field visits from health workers, and the role of higher education institutions.

Stunting has become a global problem that contributes to many deaths in children and is an indicator of inequality in human development. This study seeks to explain the pathways by which the Indonesian conditional cash transfer (CCT), namely, the Family Hope Program (FHP), can help reduce the stunting rates in Bima City, West Nusa Tenggara, Indonesia. In Bima City, the stunting rate decreased by more than half within the last five years from 36.5% in 2017 to 14.81% in 2022. Using thematic analysis, this study identifies the possible mechanisms of how the FHP can influence child nutrition based on semi-structured in-depth interviews with 15 beneficiary households of FHP throughout five subdistricts in Bima City. This study finds that some pathways of FHP contribute to reducing stunting in Bima City, such as through cash transfers to women, micronutrient intervention, education in health and nutrition from program facilitators, and health visits as a program conditionality. The external environment also matters in supporting the stunting reduction in Bima City, for example, the existence of applications to report stunting, field visits from health workers, and the role of higher education institutions. [ABSTRACT FROM AUTHOR]

This paper investigates India's nationwide health reform to understand its various channels of effect. The reform entitled socio-economically backward mothers with cash transfer if they chose to give birth at public health institutions, and simultaneously employed ASHAs as a direct link between pregnant women and the public healthcare delivery system. Using variations in mothers' eligibility and differential implementation of ASHAs across states, birth-related outcomes are evaluated in a difference-in-difference framework. Results show that eligible mothers with both cash transfer and ASHA's guidance outperformed those receiving only cash transfer, in institutional birth rate and timely initiation of breastfeeding. An improved outcome in the ASHA's presence alongside the conditional cash transfer argues for the vitality of the former's role in spreading information on the importance of health and the uptake of public healthcare. [ABSTRACT FROM AUTHOR]

Taking advantage of a reform that made Chile's most popular conditional cash transfer program substantially more generous, I study its impact on mothers' labor supply using a difference-in-difference strategy. Previous research has focused on these effects near the inauguration of CCTs, never before more than 20 years later. I find that older mothers respond to the reform by increasing their probability of working, but young mothers between 18 and 24 years old reduce their labor force participation. Meanwhile, intensive margin responses are always non-positive. This is policy-relevant information to many countries with CCTs today. [ABSTRACT FROM AUTHOR]

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In the last decades several Conditional Cash Transfers (CCTs) have been implemented to interrupt the intergenerational transmission of poverty. More recently, they have also been used as a policy response to provide support to households hit by the COVID crisis. CCTs are being deployed as a development tool to reduce local communities' vulnerability, increasing their resilience and capacity to adapt. In this context, this paper investigates if CCTs can reduce vulnerability to climate change by increasing the adaptative capacity of local communities. Indeed, while some literature has found that CCTs can reduce specific dimensions of vulnerability to socio-economic shocks, we argue that more research is necessary to understand their impact on vulnerability to climate change. Empirically, we use a panel of household survey data collected in Colombia in 2002 and 2006. We employ a difference-in-differences approach to analyse the impact of the CCT programme Familia en Acción (FA) CCTs on rural households. We consider seven components of vulnerability linked to climate change aggregated in an index: wealth, health, access to information, access to basic facilities, financial vulnerability, resilience to natural disasters, and nutrition. Our results differ from previous research and indicate that CCTs provided by the FA program do not decrease vulnerability to climate change. This finding suggests that CCTs are not a universal solution to reducing vulnerability to climate change and may be ineffective in specific contexts. The literature often assumes that CCTs can have a mitigating effect on vulnerability to climate change. Our research shows that in the context of Colombia, this assumption is incorrect. The idea that providing monthly payments to households can reduce vulnerability to climate change should be considered with caution, given limited empirical evidence. Policy makers and scholars should consider the multidimensional nature of vulnerability and design targeted interventions and avoid considering CCTs as a panacea to all aspects of vulnerability to climate change. Our models show that the FA programme failed to have a significant impact in reducing vulnerability to climate change using several different specifications. We show that CCTs do not have an impact on numerous essential components such as wealth, health, access to infrastructure, information and knowledge, financial coping mechanisms, food consumption, and exposure to natural disasters. [ABSTRACT FROM AUTHOR]

The policy responses to the COVID-19 pandemic varied widely between countries. Understanding how effective these responses were is important to improve preparedness for future crises. This paper investigates how one of largest scale conditional cash transfer COVID relief policies in the world—the Brazilian Emergency Aid (EA)—impacted poverty, inequality, and the labor market amidst the public health crisis. We use fixed-effects estimators to analyze the impact of the EA on labor force participation, unemployment, poverty, and income at the household level. We find that inequality, measured by per capita household income, reduced to a historical low and was accompanied by substantial poverty declines—even as compared to pre-pandemic levels. Furthermore, our results suggest that the policy has effectively targeted those in most need—temporarily reducing historical racial inequalities—while not incentivizing reductions in labor force participation. Absent the policy, adverse shocks would have been significant and are likely to occur once the transfer is interrupted. We also observe that the policy was not enough to curb the spread of the virus, suggesting that cash transfers alone are insufficient to protect citizens. [ABSTRACT FROM AUTHOR]

BackgroundHIV prevention for female entertainment and sex workers (FESW) may be optimized by addressing individual and structural risks. We examined the impact of a sequentially delivered intervention to decrease sexual risk, amphetamine-type stimulant (ATS) use, and improve economic well-being in Cambodian FESW.MethodsA cluster randomized stepped-wedge trial was conducted in 10 Cambodian provinces to test multi-level intervention in high risk FESW. After baseline screening in 1198 women, those screening positive for ATS use disorder were allocated to a 12-week conditional cash transfer intervention followed by a 4-week cognitive-behavioural aftercare group (CCT + AC). At six months, ATS abstinent participants were offered a microenterprise (ME) opportunity. Co-primary outcomes assessed in 600 FESW at each 6-, 12- and 18-month follow-up assessments, included: 1) number of sexual partners (past three months); and 2) ATS urine toxicology positive (Tox+) results. Secondary outcomes included indicators of economic well-being.ResultsRelative to baseline, FESW reported fewer sexual partners at all follow-up assessments with a significant 50% decrease at 12-months (Adjusted Rate Ratio [ARR] = 0.50; 95%CI: 0.25, 0.95). Women had 60% lower odds of being ATS Tox+ (Adjusted Odds Ratio [AOR] = 0.40; 95%CI: 0.25, 0.65) at 6-months, and continued but non-significant reductions at 12- and 18-months. Improvements in economic well-being indicators were observed at 12- and 18-months.ConclusionsFindings support the robust effectiveness of the sequentially delivered CCT + AC and ME interventions for boosting HIV prevention for Cambodian FESW. Further research is needed to inform the scale up and improve durability of this comprehensive approach with FESW in Southeast Asia.

We studied the impact of distributing nutritional information in the conditional cash transfer program on intrahousehold food expenditure allocation in the Philippines. Using the original randomized controlled trials dataset, which was collected 2 months after a social experiment to teach nutrition information, we found that providing nutrition information improved mothers’ nutrition knowledge, but no significant positive effects were found on the Engel coefficient. However, the provision of information to mothers with greater intrahousehold decision-making power tends to increase the consumption ratio of food. These results imply that not only raising awareness through information provision, but also female leadership and strong decision-making power within the household play an essential role in changing household budget allocations and improving child welfare.

The Pantawid Pamilya Pilipino Program (4Ps), the first conditional cash transfer (CCT) program of the Philippine government, has become a popular approach aimed at improving the health and educational status of disadvantaged households. Its implementation is expected to advance the government’s health agenda, particularly in terms of child mortality reduction and maternal health improvement. Despite the growing evidence on the positive health outcomes resulting from the implementation of CCT programs, evidence remains limited to the qualitative evaluation of health care service utilization among beneficiary households. In this regard, by employing key interviews and focus group discussion, this study aims to examine the impacts of 4Ps on health and nutrition as experienced and perceived by beneficiaries at a community-level implementation. After subjecting the interview transcripts to thematic network analysis, the results reveal six dominant themes: enhanced health practices, improved uptake of health care services, increased awareness on health issues, improved living conditions, responsive program implementation, and persisting implementation challenges. While it is evident that the positive impacts are reflective of the beneficiaries’ strict compliance to meet the program conditionalities, there is still much to be done to ensure the sustainability of the program. The provision for adequate health care should then be supplemented with reinforced delivery of the program’s learning component (family development session) and support mechanism to the implementers.

Mediation analysis can be applied to data from randomized trials of health and social interventions to draw causal inference concerning their mechanisms. We used data from a cluster-randomized trial in Nicaragua, fielded between 2000 and 2002, to investigate whether the impact of providing access to a conditional cash-transfer program on child nutritional outcomes was mediated by child health check-ups and household dietary diversity. In a sample of 443 children 6–35 months old, we estimated the controlled direct (CDE) effect of random assignment on measured height-for-age z scores had we intervened so that all children received a health check-up and had the same level of household dietary diversity, using inverse-probability weighted marginal structural models to account for mediator-outcome confounding. Sensitivity analyses corrected the CDE for potential nondifferential error in the measurement of dietary diversity. Treatment assignment increased height-for-age z score by 0.37 (95% CI: 0.05, 0.69) standard deviations. The CDE was 0.20 (95% CI: −0.17, 0.57) standard deviations, suggesting nearly one-half of the program's impact on child nutrition would be eliminated had we intervened on these factors, although estimates were relatively imprecise. This study provides an illustration of how causal mediation analysis can be applied to examine the mechanisms of multifaceted interventions. [ABSTRACT FROM AUTHOR]

This study aims to investigate the connection between conditional cash transfers (CCTs) and stunting and identify the factors contributing to stunting among Indonesia's poor. The analysis relies on the data collected in 2007 and 2009. Infants aged 0-36 months from families receiving CCTs were compared with a control group using the randomized controlled trial (RCT) method. These infants from poor households, who were stunted, and were not exclusively breastfed, were selected randomly. The data were analyzed using logistic regression with the STATA program (v.13). The research findings show that CCTs alone can not impact the prevalence of stunting. In order to optimize the effectiveness of the CCT scheme, factors related to the mother's age at childbirth, education, employment, the sex of the household head, and the geographic condition should be taken into account. This research would reinforce the need for CCT programs linked closely in design with effective social behavior change programs. The study recommends further research examining how CCT would impact stunting among groups in low-income families. [ABSTRACT FROM AUTHOR]

Background Cardiovascular disease (CVD) has a disproportionate effect on mortality among the poorest people. We assessed the impact on CVD and all-cause mortality of the world's largest conditional cash transfer, Brazil's Bolsa Família Programme (BFP). Methods We linked administrative data from the 100 Million Brazilian Cohort with BFP receipt and national mortality data. We followed individuals who applied for BFP between 1 January 2011 and 31 December 2015, until 31 December 2015. We used marginal structural models to estimate the effect of BFP on all-age and premature (30–69 years) CVD and all-cause mortality. We conducted stratified analyses by levels of material deprivation and access to healthcare. We checked the robustness of our findings by restricting the analysis to municipalities with better mortality data and by using alternative statistical methods. Results We studied 17 981 582 individuals, of whom 4 855 324 were aged 30–69 years. Three-quarters (76.2%) received BFP, with a mean follow-up post-award of 2.6 years. We detected 106 807 deaths by all causes, of which 60 893 were premature; and 23 389 CVD deaths, of which 15 292 were premature. BFP was associated with reductions in premature all-cause mortality [hazard ratio (HR) = 0.96, 95% CI = 0.94–0.98], premature CVD (HR = 0.96, 95% CI = 0.92–1.00) and all-age CVD (HR = 0.96, 95% CI = 0.93–1.00) but not all-age all-cause mortality (HR = 1.00, 95% CI = 0.98–1.02). In stratified and robustness analyses, BFP was consistently associated with mortality reductions for individuals living in the two most deprived quintiles. Conclusions BFP appears to have a small to null effect on premature CVD and all-cause mortality in the short term; the long-term impact remains unknown. [ABSTRACT FROM AUTHOR]

We investigate the effect of an educational cash transfer on schooling and working of the recipients and their non-recipient siblings in Indonesia, using a matched difference-in-differences strategy. We find that the cash transfer increases the probability of schooling for all recipients. Specifically, the likelihood of schooling for the senior secondary school children increases by 19 percentage points. However, there is no effect on the recipient's probability to work. Furthermore, there is no significant spill-over effect on non-recipient siblings' schooling. While the transfer reduces the incidence of child labour for non-recipient girls, it increases the probability of non-recipient boys to work. [ABSTRACT FROM AUTHOR]

India, which suffers from the largest number of infant deaths in the world, introduced the conditional maternity benefit programme, 'Indira Gandhi Matritva Sahyog Yojana' (IGMSY), to provide cash directly to pregnant and lactating women contingent on specified maternal and infant healthcare uses. This study estimates the impact of this programme on infant mortality for the first 12 months after birth, exploiting the pilot phase of IGMSY as a natural experiment in which 52 districts were randomly chosen as pilot districts. In the matched-pair difference-in-differences framework, the treatment effect on survival rate is estimated through the fully data-driven random survival forest approach. The results show that IGMSY reduced the infant mortality rate by 8.32% in treatment districts, with 1.53 fewer deaths per 1000 live births [95% prediction interval: 1.26-1.80]. The size of the effect substantially varies even within the first 12 months, indicating larger reductions in the neonatal period, and after the first 6 months. The results also reveal greater reductions among boys and children in urban areas. [ABSTRACT FROM AUTHOR]

Background: Adolescents living with HIV (ALHIV) have had worse outcomes compared to adults. They face enormous difficulty in accessing HIV care services. We hypothesize that conditional economic incentives (CEI) and motivational interviewing could increase retention in care, medication adherence and ultimately viral load suppression. Therefore, we evaluated the one-year impact of conditional economic incentives and motivational interviewing on the health outcomes of ALHIV in Anambra State, Nigeria. Methods: Using a cluster-randomised design, we examined the one-year (from December 1, 2018, to November 30, 2019), individual-level impact of an Incentive Scheme comprising conditional economic incentives and motivational interviewing on achieving undetectable viral load (primary outcome), CD4+ count, adherence to antiretroviral therapy and retention in care (secondary outcomes) by ALHIV in Anambra State, Nigeria. Twelve HIV treatment hospitals were stratified according to the type of clinic (secondary or tertiary) and randomly assigned to the intervention arm or control arm to receive the Incentive Scheme or routine care, respectively. ALHIV aged 10–19 years, initiated into HIV care for a minimum of 6 months, and who adhered poorly to medications (

Conditional Cash Transfer, known as Program Keluarga Harapan (PKH) in Indonesia, is a program that aims to increase maternal and child health. Women benefit directly from the improved obstetrical and reproductive health care and health information that form an integral part of the program. Many studies show the positive impact of conditional cash transfer on improving prenatal visits and birth weight. The objective of the research was to document the impact of Indonesia's conditional cash transfers (PKH) on prenatal visits and birth weight. We carried out a retrospective cohort study to assess the number of prenatal visits and birth weights among PKH beneficiaries. The data were collected through the KIA books belonging to 184 participants who gave birth between 2012-2017. The results indicate that the mean birth weight among PKH beneficiaries was slightly lower (23.7 g) compared to non-beneficiaries. The PKH program improved prenatal visits for women, but both beneficiaries and non-beneficiaries mostly had already made 8-9 times prenatal visits during their pregnancy. In other words, women in this community were already aware of the importance of prenatal visits even before the program. Incomplete data was the main obstacle to comparing the 6, 12, and 24-month-old babies' weights. This finding is irrelevant to other conditional cash transfer programs implemented which showed a significant effect of CCT on birth weight. [ABSTRACT FROM AUTHOR]

Conditional cash transfer policies tend to be seen as designed exclusively to combat poverty. In this article, it is argued that in reality, they are an instrument to keep wages depressed, but that also by establishing conditions as a counterpart they have served to induce behaviors in the beneficiaries. Specifically, it analyzes how the conditional transfers that are granted for higher education work are useful to introduce neoliberal policies in the academic sector. The analysis is carried out from the participant observation as coordinator of postgraduate studies, member of advisory and admission committees and, in National Quality Graduate Program (pnpc) evaluations. Among the findings, it is argued that the pressure in time to present the thesis, the automatic passage from one grade to another and the constraint to publish affect the decrease in the quality of scientific creation. [ABSTRACT FROM AUTHOR]

Conditional Cash Transfer, known as Program Keluarga Harapan (PKH) in Indonesia, is a program that aims to increase maternal and child health. Women benefit directly from the improved obstetrical and reproductive health care and health information that form an integral part of the program. Many studies show the positive impact of conditional cash transfer on improving prenatal visits and birth weight. The objective of the research was to document the impact of Indonesia’s conditional cash transfers (PKH) on prenatal visits and birth weight. We carried out a retrospective cohort study to assess the number of prenatal visits and birth weights among PKH beneficiaries. The data were collected through the KIA books belonging to 184 participants who gave birth between 2012−2017. The results indicate that the mean birth weight among PKH beneficiaries was slightly lower (23.7 g) compared to non-beneficiaries. The PKH program improved prenatal visits for women, but both beneficiaries and non-beneficiaries mostly had already made 8-9 times prenatal visits during their pregnancy. In other words, women in this community were already aware of the importance of prenatal visits even before the program. Incomplete data was the main obstacle to comparing the 6, 12, and 24-month-old babies’ weights. This finding is irrelevant to other conditional cash transfer programs implemented which showed a significant effect of CCT on birth weight.

Abstract Background Reducing poverty and improving access to health care are two of the most effective actions to decrease maternal mortality, and conditional cash transfer (CCT) programmes act on both. The aim of this study was to evaluate the effects of one of the world’s largest CCT (the Brazilian Bolsa Familia Programme (BFP)) on maternal mortality during a period of 11 years. Methods The study had an ecological longitudinal design and used all 2548 Brazilian municipalities with vital statistics of adequate quality during 2004–2014. BFP municipal coverage was classified into four levels, from low to consolidated, and its duration effects were measured using the average municipal coverage of previous years. We used negative binomial multivariable regression models with fixed-effects specifications, adjusted for all relevant demographic, socioeconomic, and healthcare variables. Results BFP was significantly associated with reductions of maternal mortality proportionally to its levels of coverage and years of implementation, with a rate ratio (RR) reaching 0.88 (95%CI 0.81–0.95), 0.84 (0.75–0.96) and 0.83 (0.71–0.99) for intermediate, high and consolidated BFP coverage over the previous 11 years. The BFP duration effect was stronger among young mothers (RR 0.77; 95%CI 0.67–0.96). BFP was also associated with reductions in the proportion of pregnant women with no prenatal visits (RR 0.73; 95%CI 0.69–0.77), reductions in hospital case-fatality rate for delivery (RR 0.78; 95%CI 0.66–0.94) and increases in the proportion of deliveries in hospital (RR 1.05; 95%CI 1.04–1.07). Conclusion Our findings show that a consolidated and durable CCT coverage could decrease maternal mortality, and these long-term effects are stronger among poor mothers exposed to CCT during their childhood and adolescence, suggesting a CCT inter-generational effect. Sustained CCT coverage could reduce health inequalities and contribute to the achievement of the Sustainable Development Goal 3.1, and should be preserved during the current global economic crisis due to the COVID-19 pandemic.

Abstract Background Malaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil. Methods A longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications. Results A one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence. Conclusions Higher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.

Introduction: Conditional cash transfers (CTs) augmented with other interventions are promising interventions for reducing HIV risk in adolescent girls and young women. Methods: A multi‐phase, quasi‐experimental study assessed the impact of a CT (ZAR300; $22) conditional on attending a skills building intervention, Women of Worth (WoW), designed to improve sexual and reproductive health (SRH) outcomes in Cape Town, South Africa from May 2017 to December 2019. The intervention entailed 12 sessions with encouragement to attend adolescent and youth‐friendly health services. Women aged 19–24 years were randomized 1:1 to receive the intervention with a CT ("cash + care" or C+C) or without a CT ("care"). The study included a pilot phase followed by a post‐modification phase with improved uptake and retention without changing programme content or CT. Self‐reported HIV prevalence and SRH/HIV vulnerability were assessed via a self‐administered questionnaire at baseline, after 11 sessions, and 6–30 months' post‐intervention for a subset. Mixed effect logistic regression models were fitted to estimate within‐subject changes in outcomes. Results: Of 5116 participants, 904 (452 participants per arm) were in the pilot and 4212 (2039 "care" participants and 2173 "C+C" participants) were in the post modified phase. There were 1867 (85.9%) and 135 (6,6%) participants in the "C+C" group and the "Care," respectively, that were WoW completers (≥ 11 sessions/retention). During the pilot phase, 194 (42.9%) and 18 (4.0%) participants in "C+C" and the "care" groups were retained. Receiving a CT sustained participation nearly 60‐fold (OR 60.37; 95% CI: 17.32; 210.50, p <0.001). Three‐hundred and thirty women were followed for a median of 15.0 months [IQR: 13.3; 17.8] to assess the durability of impact. Self‐reported new employment status increased more than three‐fold (p <0.001) at WoW completion and was sustained to the longer time point. Intimate partner violence indicators were reduced immediately after WoW, but this was not durable. Conclusions: Participants receiving CT had sustained participation in an SRH/HIV prevention skills building with improvement in employment and some SRH outcomes. Layered, "young woman centred" programmes to address HIV and SRH risk in young women may be enhanced with CT. [ABSTRACT FROM AUTHOR]