Cash transfer programs improve health outcomes across low- and middle-income countries – News-Medical

Report on the Impact of Government-Led Cash Transfer Programs on Sustainable Development Goals

Introduction: A Comprehensive Analysis

A study published in The Lancet by researchers at the University of Pennsylvania Perelman School of Medicine provides substantial evidence that large-scale, government-led cash transfer programs in Low- and Middle-Income Countries (LMICs) are a powerful tool for advancing the United Nations Sustainable Development Goals (SDGs). The research, conducted between 2000 and 2019 across 37 LMICs, demonstrates that these programs yield significant population-wide improvements in health and well-being, directly contributing to SDG 1 (No Poverty), SDG 2 (Zero Hunger), SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities).

Advancements in SDG 3: Good Health and Well-being

The study’s primary findings highlight a direct and positive correlation between cash transfer programs and key health indicators, aligning with the targets of SDG 3.

Maternal and Reproductive Health (Targets 3.1 & 3.7)

• Improved Prenatal Care: A greater number of women received healthcare services early in their pregnancies.
• Safer Births: There was a significant increase in the number of babies born in dedicated health facilities and attended by trained health workers.
• Reproductive Autonomy: Women demonstrated an enhanced ability to plan pregnancies and utilize birth control, supporting universal access to reproductive health services.

Child Health and Nutrition (Target 3.2)

1. Enhanced Nutrition: The programs led to higher rates of exclusive breastfeeding and ensured more young children received adequate healthy food.
2. Disease Prevention: A notable increase in measles vaccination coverage was observed.
3. Reduced Morbidity: The initiatives successfully lowered the incidence of diarrhea and the number of children reported as underweight.

Contributions to SDG 1 (No Poverty) and SDG 2 (Zero Hunger)

By providing direct financial support, cash transfer programs are a fundamental strategy for poverty alleviation (SDG 1). This is critical in a global context where over 700 million people subsist on less than $2.15 per day. The economic stability provided by these programs directly translates into improved food security, addressing the core aims of SDG 2.

• Poverty Alleviation: The programs directly combat extreme poverty, a situation exacerbated by the COVID-19 pandemic.
• Ending Malnutrition (Target 2.2): The documented improvements in child nutrition, including reduced underweight prevalence and better feeding practices, are key indicators of progress toward ending all forms of malnutrition.

Empowering Women and Reducing Inequalities (SDG 5 & SDG 10)

The research underscores the role of cash transfers in promoting gender equality and reducing systemic inequalities. By placing financial resources directly in the hands of households, these programs empower women and create more equitable health outcomes across the population.

• Gender Equality (SDG 5): Increased control over reproductive health decisions empowers women and is a critical component of achieving gender equality.
• Reduced Inequalities (SDG 10): The study found that programs with the broadest reach had the strongest effects, delivering population-wide health improvements that extended even to non-beneficiaries, thereby reducing overall health disparities within nations.

Research Scope and Policy Implications

Methodology

The conclusions are based on a robust analysis of comprehensive data sets:

1. Data Pool: The study analyzed national survey data from more than two million live births and nearly one million children under the age of five.
2. Geographic Scope: Data was collected from 37 LMICs, of which 20 had introduced large-scale cash transfer programs during the study period.
3. Evaluated Outcomes: Seventeen distinct outcomes were evaluated across maternal health, reproductive decision-making, child health, and nutrition.

Policy Recommendations

The evidence strongly supports the expansion of cash transfer programs as an effective policy for achieving multiple SDGs. The findings are relevant not only for LMICs but also for ongoing policy debates in high-income countries regarding social safety nets and guaranteed income programs. The research provides policymakers with clear data demonstrating that investing in cash transfers yields a broad array of health and social benefits for mothers, children, and entire communities.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 1: No Poverty
   • The article directly addresses poverty by discussing cash transfer programs in low- and middle-income countries (LMICs) and mentioning global poverty statistics, such as “700 million survive on less than $2.15 per day.” The cash transfer programs are a direct intervention aimed at alleviating financial hardship for the poorest populations.
2. SDG 2: Zero Hunger
   • The article connects cash transfers to improved nutrition. It states that these programs led to better child nutrition outcomes, such as babies being “more likely to be fed only breast milk,” “more young children got enough healthy food,” and a reduction in the number of children who were “reported as underweight.”
3. SDG 3: Good Health and Well-being
   • This is the central theme of the article. It extensively details how cash transfer programs “drove significant improvements in health outcomes.” Specific examples include better maternal health care, increased facility-based births, improved child health (vaccinations, reduced diarrhea), and enhanced reproductive health services. The article also references a prior study showing these programs “led to large declines in mortality rates among women and children.”
4. SDG 5: Gender Equality
   • The article highlights the empowerment of women in making their own health decisions. It notes that through these programs, “women were more likely to plan pregnancies as they wished, and more women were also able to get and use birth control when they needed it,” which points to increased autonomy and access to reproductive rights.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 1 (No Poverty):
   • Target 1.3: Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable. The article’s entire focus on “large-scale, government-led cash transfer programs” that “reached a greater share of the population” is a direct example of implementing such social protection systems.
2. Under SDG 2 (Zero Hunger):
   • Target 2.2: By 2030, end all forms of malnutrition… and address the nutritional needs of… pregnant and lactating women and [children]. The article’s findings that cash transfers helped lower the number of underweight children and ensured “more young children got enough healthy food” directly relate to ending malnutrition.
3. Under SDG 3 (Good Health and Well-being):
   • Target 3.1: By 2030, reduce the global maternal mortality ratio. The article supports this target by showing an increase in key determinants of maternal survival, such as more women receiving “health care early in their pregnancies,” more “babies… born in health facilities,” and more “births… attended by trained health workers.” It also references a study showing “large declines in mortality rates among women.”
   • Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age. The article mentions that the programs led to “large declines in mortality rates among… children” and improved child health through increased measles vaccinations and reduced diarrhea, which are major causes of child mortality.
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning. The finding that “more women were also able to get and use birth control when they needed it” and could “plan pregnancies as they wished” directly aligns with this target.
4. Under SDG 5 (Gender Equality):
   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. This target is addressed by the article’s statement that cash transfers enabled women to better “plan pregnancies as they wished” and access birth control, indicating an improvement in their reproductive autonomy and rights.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 1, Target 1.3:
   • Indicator: Proportion of the population covered by social protection floors/systems. The article implies this by mentioning cash transfer programs that “reached a greater share of the population” in 37 LMICs.
2. For SDG 2, Target 2.2:
   • Indicators: Prevalence of underweight children; proportion of infants exclusively breastfed. The article explicitly mentions a reduction in children “reported as underweight” and an increase in babies “fed only breast milk.”
3. For SDG 3, Targets 3.1, 3.2, and 3.7:
   • Indicators:
     • Proportion of births attended by skilled health personnel (implied by “more births were attended by trained health workers”).
     • Proportion of women who received antenatal care (implied by “More women received health care early in their pregnancies”).
     • Proportion of children receiving vaccinations (explicitly “more children overall were vaccinated against measles”).
     • Maternal and child mortality rates (referenced from a prior study showing “large declines in mortality rates among women and children”).
     • Proportion of women with a need for family planning who have their need satisfied with modern methods (implied by “more women were also able to get and use birth control when they needed it”).
4. For SDG 5, Target 5.6:
   • Indicator: Proportion of women who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care. This is implied by the finding that “women were more likely to plan pregnancies as they wished.”

4. Summary Table of SDGs, Targets, and Indicators

Source: news-medical.net