Unconditional government cash transfers in support of orphaned and vulnerable adolescents in western Kenya: Is there an association with psychological wellbeing?

Abstract

BackgroundOrphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is known about their impact on the psychological wellbeing of OVA.ObjectiveAmong OVA in western Kenya, we assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing.MethodsWe examined the likelihood of depression, anxiety, post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 years who lived in 300 randomly selected households in western Kenya that either received or did not receive unconditional monthly CTs.ResultsThe mean age was 14.0 (SD 2.4) years and 329 (50.2%) of the participants were female while 190 (29.0%) were double orphans whose biological parents were both deceased. After adjusting for socio-demographic, caregiver, and household characteristics and accounting for potential effects of participant clustering by sub-location of residence, OVA living in CT households were more likely to have a positive future outlook (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.08, 1.99), less likely to be anxious (OR 0.57, 95% CI 0.42, 0.78), and less likely to have symptoms of post-traumatic stress (OR 0.50, 95% CI 0.29, 0.89). We did not find statistically significant differences in odds of depression by CT group.ConclusionOVA in CT households reported better psychological wellbeing compared to those in households not receiving CTs. CT interventions may be effective for improving psychological wellbeing among vulnerable adolescents in socioeconomically deprived households.

What are the effects of cash transfers for refugees in the context of protracted displacement? Findings from Jordan

“…First, being able to pay the rent has a positive impact on recipients' own perceptions of their mental well‐being, for both men and women. Studies on cash transfers have shown that this type of social protection instrument can improve mental health and reduce stress and depressive symptoms (Haushofer and Shapiro, ) and have positive impacts on beneficiaries' psychosocial well‐being (Attah et al, ; Samuels and Stavropoulou, ; Shangani et al, ). Similarly, UNICEF's assessment of its child cash grant (CCG) for Syrian refugees reported that “one of the most notable outcomes of the focus group discussions is the number of participants that felt the child grant had a positive impact on their psychological state as well as that of other family members” (UNICEF, , p. 21).…”

“…Only a few studies have analysed the effect of cash transfers on the mental well‐being of populations that suffer poverty‐induced stress stemming from their lack of capacity to meet even their most immediate needs. Shangani et al (), for example, analysed the psychological outcomes of unconditional cash transfer programmes on the mental health of orphans and vulnerable adolescents (OVA) in Kenya and found that OVAs living in households that received the cash transfer were less likely to have anxiety and PTSD than those living in non‐recipient households, and youths living in recipient households were 24 per cent less likely to suffer depression. Although poverty and mental health are closely linked and increase vulnerability, the psychological outcomes of cash transfers on the poor – as well as refugees – are understudied.…”

“…The receipt of a reliable income can also reduce the need to resort to harmful coping mechanisms, for example selling assets, which may be needed to make a living, or sending children to work (de Janvry et al, ). Being able to meet a household's needs through a regular and reliable income source can also contribute to reducing stress levels and improving the psychosocial well‐being of beneficiary households, and strengthen the ability of beneficiaries to participate in communal activities and to focus on priorities beyond short‐term survival (see Attah et al, ; Shangani et al, ). Finally, receipt of a regular income can mean that beneficiaries can take the time and risk to search for (better) livelihood opportunities (Jacobsen and Fratzke, ).…”

Cash assistance programming and changes over time in ability to meet basic needs, food insecurity and depressive symptoms in Raqqa Governorate, Syria: Evidence from a mixed methods, pre-posttest

“…[39] Future research should determine whether there is a threshold or tipping point to achieve changes in mental wellbeing from cash assistance programming, as other studies have largely shown positive improvements. [40] For instance, a study in Kenya assessed the mental health effects of cash by testing participant levels of the stress hormone cortisol. Results from cortisol testing demonstrated no meaningful change overall, 17 but sub-analyses revealed additional details of how program design can affect the impact of cash on mental health.…”

The prevalence of mental health problems in sub-Saharan adolescents: A systematic review

“…Prevalence of posttraumatic stress disorder in the general population. Stansfeld et al [48] used the Harvard Trauma Questionnaire (HTQ) in a sample of 1 034 Grade 8 students (mean age 14.2) from Cape Town, South Africa and reported a prevalence for PTSD of 21.5%. The study found that those falling in the highest quartile of violence were most likely to score positive for symptoms of PTSD.…”