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Government of Malawi's unconditional cash transfer improves youth mental health

Gustavo Angeles, Jacobus de Hoop, Sudhanshu Handa, Kelly Kilburn, Annamaria Milazzo, Amber Peterman

Published: 2019
We explore the impacts of Malawi's national unconditional cash transfer program targeting ultra-poor households on youth mental health. Experimental findings show that the program significantly improved mental health outcomes. Among girls in particular, the program reduces indications of depression by about 15 percentage points. We investigate the contribution of different possible pathways to the overall program impact, including education, health, consumption, caregiver's stress levels and life satisfaction, perceived social support, and participation in hard and unpleasant work. The pathways explain from 46 to 65 percent of the program impact, advancing our understanding of how economic interventions can affect mental health of youth in resource-poor settings. The findings underline that unconditional cash grants, which are used on an increasingly large scale as part of national social protection systems in Sub-Saharan Africa, have the potential to improve youth mental wellbeing and thus may help break the vicious cycle of poverty and poor mental health.
Effects of a Large-scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya: A cluster randomized trial

Kelly Kilburn, Harsha Thirumurthy, Carolyn Tucker Halpern, Audrey Pettifor, Sudhanshu Handa

Published: 2016


This study investigates the causal effect of Kenya's unconditional cash transfer program on mental health outcomes of young people.


Selected locations in Kenya were randomly assigned to receive unconditional cash transfers in the first phase of Kenya's Cash Transfer Program for orphans and Vulnerable Children. In intervention locations, low-income households and those with orphans and vulnerable childrens began receiving monthly cash transfers of $20 in 2007. In 2011, 4 years after program onset, data were collected on the psychosocial status for youth aged 15–24 years from households in intervention and control locations (N = 1960). The primary outcome variable was an indicator of depressive symptoms using the 10-question Center for Epidemiologic Studies Depression Scale. Secondary outcomes include an indicator for hopefulness and physical health measures. Logistic regression models that adjusted for individual and household characteristics were used to determine the effect of the cash transfer program.


The cash transfer reduced the odds of depressive symptoms by 24 percent among young persons living in households that received cash transfers. Further analysis by gender and age revealed that the effects were only significant for young men and were larger among men aged 20–24 years and orphans.


This study provides evidence that poverty-targeted unconditional cash transfer programs, can improve the mental health of young people in low-income countries.

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