The impact of cash transfers on mental health in children and young people in low-income and middle-income countries: a systematic review and meta-analysis

Abstract

IntroductionAlthough cash transfer programmes are not explicitly designed to improve mental health, by reducing poverty and improving the life chances of children and young people, they may also improve their mental health. This systematic review and meta-analysis assessed the evidence on the effectiveness of cash transfers to improve the mental health of children and young people in low-income and middle-income countries.MethodsWe searched Pubmed, EBSCOhost, Scientific Electronic Library Online, ISI Web of Science and Social Sciences Citation Index and grey literature (from January 2000 to July 2020) for studies which quantitatively assessed the impact of cash transfers on mental health in young people (aged 0–24 years), using a design that incorporated a control group. We extracted Cohen’s d effects size and used a random-effects model for the meta-analysis on studies that measured depressive symptoms, I2 statistic and assessment of study quality.ResultsWe identified 12 116 articles for screening, of which 12 were included in the systematic review (covering 13 interventions) and seven in the meta-analysis assessing impact on depressive symptoms specifically. There was high heterogeneity (I2=95.2) and a high risk of bias (0.38, 95% CIs: −5.08 to 5.85; p=0.86) across studies. Eleven interventions (85%) showed a significant positive impact of cash transfers on at least one mental health outcome in children and young people. However, no study found a positive effect on all mental health outcomes examined, and the meta-analysis showed no impact of cash transfers on depressive symptoms (0.02, 95% CIs: −0.19 to 0.23; p=0.85).ConclusionCash transfers may have positive effects on some mental health outcomes for young people, with no negative effects identified. However, there is high heterogeneity across studies, with some interventions showing no effects. Our review highlights how the effect of cash transfers may vary by social and economic context, culture, design, conditionality and mental health outcome.

Conditional cash transfers and adolescent mental health in Brazil: Evidence from the 2004 Pelotas Birth Cohort

“…The results of the current study reinforce the need to further evaluate mental health outcomes of CCT in LMICs [ 13 , 67 ], and to identify which aspects of the programmes (eg, conditionalities, amount of money, length of benefit, and complementary health, social and educational interventions) can help to prevent or reduce the severity of mental health problems among young people. Our study also raises the need for replication in other Brazilian regions and to systematically use mixed-methods evaluations to verify if the BFP is improving mental health outcomes in young people.…”

Cash Transfer Programmes in Pakistan through a Child Well-Being Lens

“…In Kenya, mental health impacts were also limited despite the CTP being targeted to young people: the Cash Transfer Program for Orphans and Vulnerable Children achieved a reduction in depression as a result of receiving cash transfers that was only significant among young men aged 20-24 years (Kilburn et al 2016). A recent review of literature on the impacts of cash transfers on mental health in children and young people deduces that such programmes could have positive impacts on their mental health but did not find a direct connection between cash transfers and depression (Zimmerman et al 2021).…”

COVID-19 in Brazil: Opportunity to integrate mental health in the Programa Bolsa Família

“…Conditional cash transfer programs (CCTs) -which are widely used as a social protection measure and consist of making direct payments to people identified as living in poverty subject to complying with a defined set of behaviours -can have a range of positive effects not only on reducing poverty but on wider health and well-being (Fiszbein & Schady, 2009). These include better education through increased school attendance (a typical condition for CCTs) and improved economic circumstances and mental health for children and young people (Zimmerman et al, 2021).…”