Suchergebnisse

Among policymakers, a common perception surrounding the effects of cash transfer programmes, particularly unconditional programmes targeted to households with children, is that they induce increased fertility. We evaluate the Zambian Child Grant Programme, a government unconditional cash transfer targeted to households with a child under the age of five and examine impacts on fertility and household composition. The evaluation was a cluster randomized control trial, with data collected over four years from 2010 to 2014. Our results indicate there are no programme impacts on overall fertility. Our results contribute to a small evidence base demonstrating that there are no unintended incentives related to fertility due to cash transfers.

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low-and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. The tables in this report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. The quintiles are based on an asset index constructed using principal components analysis. Benefit-Incidence Analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor. The distribution of subsidies depends on the assumptions made to allocate subsidies to households. Under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service divided by the number of units of utilization.

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. This report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. Benefit-incidence analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor the distribution of subsidies depends on the assumptions made to allocate subsidies to households. This reports whether overall health financing, as well as the individual sources of finance, is regressive (i.e. a poor household contributes a larger share of its resources than a rich one), progressive (i.e. a poor household contributes a smaller share of its resources than a rich one) or proportional.

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low-and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. The tables in this report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. The quintiles are based on an asset index constructed using principal components analysis. Benefit-Incidence Analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor. The distribution of subsidies depends on the assumptions made to allocate subsidies to households. Under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service divided by the number of units of utilization.

Purpose: Cash transfer interventions broadly improve the lives of the vulnerable, making them exceedingly popular. However, evidence of impacts on mental health is limited, particularly for conditional cash transfer (CCT) programs. We examined the impacts of Tanzania's government-run CCT program on depressive symptoms of youth aged 14–28. Methods: We utilized cluster randomized controlled trial data of 84 communities (48 intervention; 36 control). The intervention administered bimonthly CCTs to eligible households, while control communities were assigned to delayed intervention. The analysis included youth with measurements of depression (10-item Centre for Epidemiological Studies Depression Scale) at baseline and 18 months later. We determined impacts using analysis of covariance models, adjusting for youth characteristics (including baseline depression), district-level fixed effects, and community-level random effects. Differential effects by sex and baseline social support were also estimated. Results: Although no evidence was found to suggest that the intervention impacted depressive symptoms among the full sample (n = 880) (effect −.20, 95% confidence interval [CI] −.88 to .48, p = .562), subsample results indicated that depressive symptoms were reduced 1.5 points among males (95% CI −2.56 to −.04, p = .007) and increased 1.1 points among females (95% CI .11–2.09, p = .029). Females 18+ years old (effect 1.55, 95% CI .27–2.83, p = .018) and females with children (effect 1.32, 95% CI −.13 to 2.78, p = .074) drove this negative impact. Social support did not moderate impacts. Conclusions: Despite no overall intervention effects, results suggest that receiving a CCT has differential effects on mental health by sex. Although males benefited from the intervention, conditions which rely on stereotypically female roles may result in negative consequences among women.

Purpose: Inequitable attitudes toward men's and women's roles, rights, and responsibilities are associated with poor health–related outcomes, particularly for girls and women. Yet, we know relatively little about what interventions work to improve gender-equitable attitudes among adolescents in low-income countries. This study examines the impact of a government-implemented "cash plus" intervention on gender-equitable attitudes among adolescents in Tanzania. The intervention includes discussions and activities related to gender norms, embedded in broader life skills, livelihoods, and health training. Methods: The study utilizes a cluster randomized design, using data from 1,933 males and females aged 14–19 years at baseline who took part in the baseline (2017), midline (2018), and endline (2019) surveys. Gender attitudes were measured using 24 items from the Gender-Equitable Men (GEM) Scale. We estimate intent-to-treat impacts on the GEM scale and four subscales (violence, sexual relationships, reproductive health, and domestic chores). Results: The "cash plus" intervention had a significant impact on the overall GEM scale at midline. The intervention increased gender-equitable attitudes on the domestic chores subscale at both midline and endline. The intervention improved gender-equitable attitudes among males on the overall GEM scale and three subscales at midline and on two subscales at endline, but it had no impacts among females. Conclusions: Gender transformative social protection is currently being advocated as a way to address the gendered nature of poverty and its consequences. Initiatives such as the one studied here, which address the multifaceted drivers of gender inequities, could be a promising way forward.