Journal Articles

The new global Sustainable Development Goals (SDGs), agreed to by governments of the world in 2015, present an unprecedented opportunity for social progress for the new generation of children and young people (UNICEF and Global Coalition to End Child Poverty 2017). Goal 1 calls for “reducing at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions” (Target 1.2) by 2030 (United Nations 2015). The wording of Target 1.2 is significant because for the first time a global poverty goal includes children explicitly and recognizes the multidimensional nature of poverty. It is also the first time that a global poverty goal applies equally to rich and poor countries and refers explicitly to national definitions.

This paper describes and reviews the process of constructing a Multidimensional Child Poverty Measure in three sub-Saharan Africa countries: Mali, Malawi, and Tanzania. These countries recently (in 2015 and 2014) constructed a measure of multidimensional child poverty using UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) methodology and conducted a comprehensive child poverty study including both deprivation and monetary poverty. This work describes how the methodology was adapted in the different contexts, discussing critical issues that arose during the study process, and compares the results of the three studies. The goal is to offer an overview of the different national processes and determine how similar or different factors influence the results.

This study applied UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) framework to adolescents (aged 11, 13 and 15) in 37 European countries and Canada using data from the 2013/14 Health Behaviour in School-aged Children survey. It is one of the first applications of MODA based entirely on data collected from adolescents themselves rather than from household reference persons on their behalf. Unlike most other multidimensional child poverty studies, the present analysis focuses on non-material, relational aspects of child poverty. Substantial cross-country variation was found in the prevalence of adolescent deprivations in nutrition, perceived health, school environment, protection from peer violence, family environment and information access. These single dimensions of poverty did not closely relate to national wealth and income inequality. However, when we looked at deprivation in three or more dimensions (i.e., multidimensional poverty), we found association with income inequality. In most countries, girls were at a higher risk of multidimensional poverty than boys. In addition, adolescents who lived with both parents in the household or reported higher family wealth were consistently less poor than other adolescents, in both single and multiple dimensions. The results of this study show the interconnectedness of social (family, school support) and psychological (health and violence) dimensions of poverty for adolescents in higher income countries. Children poor in the domains of family and school environment are also likely to be poor in terms of perceived health and protection from peer violence.

Programs that increase the economic capacity of poor women can have cascading effects on children’s participation in school and work that are theoretically undetermined. We present a simple model to describe the possible channels through which these programs may affect children’s activities. Based on a cluster-randomized trial, we examine how a program providing capital and training to women in poor rural communities in Nicaragua affected children. Children in beneficiary households are more likely to attend school 1 year after the end of the intervention. An increase in women’s influence on household decisions appears to contribute to the program’s beneficial effect on school attendance.

Childhood malnutrition remains a significant global problem, with an estimated 162 million children under the age of five suffering from stunted growth. This article examines the extent to which cash transfer programmes can improve child nutrition. It adopts a framework that captures and explains the pathways and determinants of child nutrition. The framework is then used to organize and discuss relevant evidence from the impact evaluation literature, focusing on impact pathways and new and emerging findings from sub-Saharan Africa to identify critical elements that determine child nutrition outcomes as well as knowledge gaps requiring further research, such as children's dietary diversity, caregiver behaviours and stress.

Child mortality is one of the most pressing global health and policy issues in the developing world. The leading drivers of death—pneumonia, diarrhea and malaria—are preventable and treatable. However, these illnesses are exacerbated by a lack of accessible nutrition, water, basic and preventive health services, and sanitary living conditions—all factors which are more likely to disproportionately impact the poor. We examine whether Kenya’s largest social protection impacts children’s incidence of upper respiratory illness. The Kenya Cash Transfer for Orphans and Vulnerable Children was designed to support orphans affected by HIV/AIDS and has covered over 240,000 households as of 2014. Using longitudinal, cluster-randomized program data from 2007 to 2009, we run a generalized linear latent and mixed method estimation model on a sample of children 0–7 years and under-5 years of age. We find that the program is associated with a decrease in illness in children 0–7 years of age (P < 0.05), but found no effects on a stratified sample of under-5 children. Furthermore, no impacts on health care seeking in the event of illness were detected. This study is one of few examining children’s health using data from a large scale unconditional cash transfer program. With the widespread adoption of over 123 cash transfer programs across sub-Saharan Africa, these findings suggest social cash transfer programs are capable of promoting the multidimensional well-being for the world’s most vulnerable populations.

This study applies UNICEF’s rights-based multiple overlapping deprivation analysis framework to a single country case study—Bosnia and Herzegovina (BiH). Using data from the Extended Living Standards Measurement Survey 2011 for children aged 5–15, the paper analyses the incidence and intensity of multidimensional child deprivation and examines its relationship to household-based monetary poverty, drawing on differences between rural and urban areas. Seven dimensions of deprivation have been identified using the child rights framework: Nutrition, Clothing, Educational Resources, Leisure, Social Participation, Information and Housing. We find that the majority of school-age children in BiH are deprived in one or more dimensions and one in four are deprived in three or more dimensions out of seven. Children in consumption poor households are more likely to be deprived in every dimension analysed separately and in a greater number of dimensions at once. Nevertheless, the degree of overlap between poverty and multidimensional deprivation is moderate, suggesting that child deprivation cannot be eradicated solely by increasing households’ consumption capacity. Finally, the study finds no significant differences by type of area in multidimensional deprivation rates for consumption-poor children aged 5–15. In contrast, non-poor children in rural areas are substantially more likely to be deprived in three or more dimensions at once than their counterparts in urban areas. Overall, these results call for a multifaceted policy approach targeting both the demand for and supply of children’s goods and services.

As many as one billion children experience violence every year, and household- and community-level poverty are among the risk factors for child protection violations. Social safety nets (SSNs) are a main policy tool to address poverty and vulnerability, and there is substantial evidence demonstrating positive effects on children’s health and human capital. This paper reviews evidence and develops a framework to understand linkages between non-contributory SSNs and the experience of childhood emotional, physical and sexual violence in low- and middle-income countries. We catalogue 14 rigorous impact evaluations, 11 of which are completed, analysing 57 unique impacts on diverse violence indicators. Among these impacts, approximately one in five represent statistically significant protective effects on childhood violence. Promising evidence relates to sexual violence among female adolescents in Africa, while there is less clear evidence of significant impacts in other parts of the developing world, and on young child measures, including violent discipline. Further, few studies are set up to meaningfully unpack mechanisms between SSNs and childhood violence; however, those most commonly hypothesized operate at the household level (through increases in economic security and reductions in poverty-related stress), the interpersonal level (improved parental behaviours, caregiving practices, improved psychosocial well-being) and at the child-level (protective education and decreases in problem or risky behaviours). It is important to emphasize that traditional SSNs are never designed with violence prevention as primary objectives, and thus should not be considered as standalone interventions to reduce risks for childhood violence. However, SSNs, particularly within integrated protection systems, appear to have potential to reduce violence risk. Linkages between SSNs and childhood violence are understudied, and investments should be made to close this evidence gap.

The empowerment of women, broadly defined, is an often-cited objective and benefit of social cash transfer programs in developing countries. Despite the promise and potential of cash transfers to empower women, the evidence supporting this outcome is mixed. In addition, there is little evidence from programs at scale in sub-Saharan Africa. We conducted a mixed-methods evaluation of the Government of Zambia’s Child Grant Program, a poverty-targeted, unconditional transfer given to mothers or primary caregivers of young children aged zero to five. The quantitative component was a four-year longitudinal clustered-randomized control trial in three rural districts, and the qualitative component was a one-time data collection involving in-depth interviews with women and their partners stratified on marital status and program participation. Our study found that women in beneficiary households were making more sole or joint decisions (across five out of nine domains); however, impacts translated into relatively modest increases in the number of decision domains a woman is involved in, on average by 0.34 (or a 6% increase over a baseline mean of 5.3). Qualitatively, we found that changes in intrahousehold relationships were limited by entrenched gender norms, which indicate men as heads of household and primary decision makers. However, women’s narratives showed the transfer increased financial empowerment as they were able to retain control over transfers for household investment and savings for emergencies. We highlight methodological challenges in using intrahousehold decision making as the primary indicator to measure empowerment. Results show potential for unconditional cash transfer programs to improve the financial and intrahousehold status of female beneficiaries, however it is likely additional design components are need for transformational change.

Introduction

Poverty is a chronic stressor that can lead to poor physical and mental health. This study examines whether two similar government poverty alleviation programs reduced the levels of perceived stress and poverty among poor households in Zambia.

Method

Secondary data from two cluster randomized controlled trials were used to evaluate the impacts of two unconditional cash transfer programs in Zambia. Participants were interviewed at baseline and followed over 36 months. Perceived stress among female caregivers was assessed using the Cohen Perceived Stress Scale (PSS). Poverty indicators assessed included per capita expenditure, household food security, and (nonproductive) asset ownership. Fixed effects and ordinary least squares regressions were run, controlling for age, education, marital status, household demographics, location, and poverty status at baseline.

Results

Cash transfers did not reduce perceived stress but improved economic security (per capita consumption expenditure, food insecurity, and asset ownership). Among these poverty indicators, only food insecurity was associated with perceived stress. Age and education showed no consistent association with stress, whereas death of a household member was associated with higher stress levels.

Conclusion

In this setting, perceived stress was not reduced by a positive income shock but was correlated with food insecurity and household deaths, suggesting that food security is an important stressor in this context. Although the program did reduce food insecurity, the size of the reduction was not enough to generate a statistically significant change in stress levels. The measure used in this study appears not to be correlated with characteristics to which it has been linked in other settings, and thus, further research is needed to examine whether this widely used perceived stress measure appropriately captures the concept of perceived stress in this population.