More evidence on cash transfers and child nutritional outcomes: a systematic review and meta-analysis.


Journal

BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275

Informations de publication

Date de publication:
04 2022
Historique:
received: 08 12 2021
accepted: 15 02 2022
entrez: 2 4 2022
pubmed: 3 4 2022
medline: 6 4 2022
Statut: ppublish

Résumé

Cash transfer (CT) programmes are an increasingly common approach to alleviate poverty and inequality and improving child health and nutrition, as well as supporting other goals such as education. Evidence indicates that CTs can be effective, but overall impacts are small in magnitude. This paper substantially updates the evidence base on the effectiveness of CTs and moderating factors. Building on a prior search done in 2018, we searched articles published between January 2018 and March 2021 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years conducted with clear counterfactuals in countries with gross domestic product below US$10 000 at baseline. We performed meta-analysis using random effects models to assess the impact of CT programme on selected child nutrition outcomes. Out of 1561 articles identified, 55 additional articles were eligible for inclusion for a total of 129 estimates. We find that CTs have significant although modest effects on height-for-age z-scores (HAZ) (0.024, 95% CI 0.004 to 0.044; p<0.02); stunting (-1.35%, 95% CI -2.35 to - 0.35; p<0;01); wasting (-1.31%, 95% CI -2.16% to 0.46%; p<0.01); animal-source foods (6.72%, 95% CI 5.24% to 8.20%; p<0.01); diet diversity (0.55, 95% CI 0.30 to 0.81; p<0.01) and diarrhoea incidence (- 1.74%, 95% CI -2.79% to -0.68%; p<0.05). There was no significant effect of CTs on weight-for-height (WHZ) or weight-for-age z-scores (WAZ). Well-targeted behaviour change communication was also effective in improving HAZ and decreasing the prevalence of diarrhoea. CT programmes improved linear growth among young children, reducing wasting and stunting, but effects are heterogeneous and somewhat small overall. More evidence indicates that effects on dietary diversity and the consumption of animal-source foods are increasingly pronounced.

Sections du résumé

BACKGROUND
Cash transfer (CT) programmes are an increasingly common approach to alleviate poverty and inequality and improving child health and nutrition, as well as supporting other goals such as education. Evidence indicates that CTs can be effective, but overall impacts are small in magnitude. This paper substantially updates the evidence base on the effectiveness of CTs and moderating factors.
METHODS
Building on a prior search done in 2018, we searched articles published between January 2018 and March 2021 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years conducted with clear counterfactuals in countries with gross domestic product below US$10 000 at baseline. We performed meta-analysis using random effects models to assess the impact of CT programme on selected child nutrition outcomes.
FINDINGS
Out of 1561 articles identified, 55 additional articles were eligible for inclusion for a total of 129 estimates. We find that CTs have significant although modest effects on height-for-age z-scores (HAZ) (0.024, 95% CI 0.004 to 0.044; p<0.02); stunting (-1.35%, 95% CI -2.35 to - 0.35; p<0;01); wasting (-1.31%, 95% CI -2.16% to 0.46%; p<0.01); animal-source foods (6.72%, 95% CI 5.24% to 8.20%; p<0.01); diet diversity (0.55, 95% CI 0.30 to 0.81; p<0.01) and diarrhoea incidence (- 1.74%, 95% CI -2.79% to -0.68%; p<0.05). There was no significant effect of CTs on weight-for-height (WHZ) or weight-for-age z-scores (WAZ). Well-targeted behaviour change communication was also effective in improving HAZ and decreasing the prevalence of diarrhoea.
INTERPRETATION
CT programmes improved linear growth among young children, reducing wasting and stunting, but effects are heterogeneous and somewhat small overall. More evidence indicates that effects on dietary diversity and the consumption of animal-source foods are increasingly pronounced.

Identifiants

pubmed: 35365481
pii: bmjgh-2021-008233
doi: 10.1136/bmjgh-2021-008233
pmc: PMC8977747
pii:
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

BMJ Glob Health. 2020 Dec;5(12):
pubmed: 33355262
Lancet. 2021 Apr 10;397(10282):1400-1418
pubmed: 33691095
J Health Popul Nutr. 2013 Dec;31(4 Suppl 2):48-66
pubmed: 24992803
Am J Clin Nutr. 2019 Dec 1;110(6):1476-1490
pubmed: 31562508
Dev Policy Rev. 2017 Summer;35(5):621-643
pubmed: 31363343
PLoS Med. 2021 Sep 28;18(9):e1003698
pubmed: 34582447
BMJ Open. 2019 Oct 3;9(10):e026449
pubmed: 31585969
BMC Med. 2019 Aug 28;17(1):173
pubmed: 31462230
Lancet. 2021 Apr 10;397(10282):1388-1399
pubmed: 33691094
PLoS One. 2018 Apr 25;13(4):e0195904
pubmed: 29694431

Auteurs

James Manley (J)

Economics, Towson University, Towson, Maryland, USA jamesmanley32@gmail.com.

Harold Alderman (H)

Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA.

Ugo Gentilini (U)

Global Lead for Social Assistance, Social Protection and Jobs Global Practice in the World Bank Group, Washington, District of Columbia, USA.

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Classifications MeSH