Exploring economic empowerment and gender issues in Lesotho’s Child Grants Programme: a qualitative study

Abstract

Cash transfers have been increasingly used in low- and middle-income countries as a poverty reduction and social protection tool. Despite their potential for empowering vulnerable groups (especially women), the evidence for such outcomes remains unclear. Additionally, little is known about how this broad concept fits into and is perceived in such programs. For example, Lesotho’s Child Grant Program (CGP) is an unconditional cash transfer targeting poor and vulnerable households with children. The CGP has been presented as one of Lesotho’s flagship programs in developing the country’s social safety net system. Using the CGP’s early phases as a case study, this research aims to capture how program stakeholders understood and operationalized the concept of economic empowerment (especially women’s) in Lesotho’s CGP. The qualitative analysis relied on the triangulation of information from a review of program documents and semi-structured key informant interviews with program stakeholders. First, the program documents were coded deductively while the interview transcripts were coded inductively, then both materials were analyzed thematically. Finally, differences or disagreements within each theme were explored individually according to the program’s chronology, the stakeholders’ affiliation, and their role in the CGP. The complexity of economic empowerment was reflected in the diversity of definitions found in the desk review and interviews. Economic empowerment was primarily understood as improving access to economic resources and opportunities, and less so, as agency and social and economic inclusion. There were stronger disagreements on other definitions as they seemed to be a terminology primarily used by specific stakeholders. This diversity of definitions impacted how these concepts were integrated into the program, with particular gaps between the strategic vision and operational units as well as between the role this concept was perceived to play, and the effects evaluated so far.

Using cash transfers to promote child health equity: an analysis of Lesotho’s Child Grants Program

“…Our study of the role of health equity and economic empowerment in Lesotho’s CGP shows that both were integrated to some degree in the CGP from its early phases ( Besnier et al , 2024 ). Second, as the economic empowerment of vulnerable groups was seen as a strategic objective and mechanism of action of the CGP, we would expect to see specific vulnerable groups (e.g.…”

“…The selection of variables for the model was guided by the outcomes of our previous E4HE qualitative study analysing how CGP stakeholders had defined and operationalized the concept of health equity ( Besnier et al , 2024 ). In this study, health was primarily defined as access to healthcare and, to a lesser extent, as nutrition and health status, as reported by the caregiver.…”

“…To explore the effect of the CGP on vulnerable subgroups, we based our selection of vulnerability variables on how CGP stakeholders had defined vulnerabilities but also economic empowerment and gender issues, in the E4HE qualitative studies ( Besnier et al , 2024 ). By discussing the role of economic empowerment, stakeholders identified households’ characteristics that should be particularly affected by the CGP.…”

“…Second, as the economic empowerment of vulnerable groups was seen as a strategic objective and mechanism of action of the CGP, we would expect to see specific vulnerable groups (e.g. female-headed households and more deprived households) benefitting more than comparatively less vulnerable groups ( Besnier et al , 2024 ).…”

“…Based on the CGP’s theory of change and building on the World Health Organization Commission on the Social Determinants Health (CSDH)’s conceptual framework ( Solar O and Irwin A, 2010 ; Pellerano et al , 2012 ), this unconditional CT programme could affect the health gap in child health outcomes between beneficiary and non-beneficiary both directly and indirectly. The conceptual background for the whole E4HE Lesotho case study is available in the E4HE qualitative studies ( Besnier et al , 2024 ). This conceptual background was used to support data analysis in the qualitative part of this case study, whose results informed the quantitative analysis presented here (see the section on Selection of variables).…”