Profiles

Cash transfers are a type of social protection that help to reduce the effects of poverty. They are typically delivered in the form of cash or vouchers that beneficiaries can use for various expenses in the same way as earned income. While cash-transfer programmes have shown positive effects on important first-order outcomes, such as food security, household consumption and education, there are limits to the effectiveness of cash transfers alone in addressing all development needs. Many interventions have had inconsistent or no impact on other important well-being outcomes, such as child nutrition, early marriage, health-seeking behaviour, and sexual and reproductive health. In order to improve the effectiveness of social protection in addressing these multidimensional needs, cash transfers are modified to cash-plus interventions by combining them with additional elements, such as in-kind resources, behaviour change interventions and links to other social services. SBC components of cash-plus interventions aim to address the drivers of behaviours that affect children’s well-being. The aims of this rapid evidence assessment are: • Assess the effectiveness of cash transfers combined with social and behaviour change (SBC) components to improve outcomes for children • Identify which types of SBC are effective in improving outcomes • Identify the contextual factors that are necessary to successfully deliver cash-plus interventions with SBC components

The rise of social protection into the limelight of social policy has opened up space for understanding how it can act as a key interface between states and citizens. This paper rethinks social protection through the lens of citizenship. It considers how the design and implementation of social protection can be shifted away from discretionary and technocratic forms, to forms which stimulate vulnerable citizens to make justice-based claims for their rights and demand accountability for the realization of those rights. It puts forward a conceptual framework for social protection with three modalities through which citizens can be engaged: as shapers and makers; as users and choosers; and as passive consumers.

Childhood malnutrition remains a significant global health concern. In order to implement effective policies to address the issue, it is crucial to first understand the mechanisms underlying malnutrition. This paper uses a unique dataset from Northern Ghana to explain the underlying causes of childhood malnutrition. It adopts an empirical framework to model inputs in the production of health and nutrition, as a function of child, household and community characteristics. The findings suggest that child characteristics are important in explaining inputs and nutritional outcomes, and that maternal agency and health contribute to improved health status. Household resources in the form of consumption are positively associated with food intake and nutritional outcomes. Simulations show that income growth, improving maternal care and avoiding sudden price shocks have a positive but rather limited effect on the reduction of malnutrition. Effects are greater in children under two. Hence, policies that address underlying determinants simultaneously, and target the youngest population of children, could have the largest effect on reducing malnutrition in this population.

The paper provides an examination of the relevance of ethics to poverty reduction. It argues that linking the shared values that define the social arrangements and institutions, which we refer to as ‘ethical perspectives’, to the emerging welfare institutions addressing poverty in developing countries provides a window into these processes of justification at a more fundamental level.

This brief documents the impact evaluation design of the Ghana Livelihood Empowerment against Poverty (LEAP) 1000 programme which is being piloted in ten districts in two regions and targets about 6,000 households initially.

This Brief summarizes findings from the impact evaluation of the Ghana Livelihood Empowerment Against Poverty (LEAP) programme on schooling outcomes overall and for various subgroups: by sex, age group and cognitive ability.The findings underscore the importance of going beyond average treatment effects to analyse impacts by subgroup in order to unpack the programme effect

The paper uses data from a quasi-experimental evaluation to estimate the impact of the Ghanaian Government’s unconditional cash transfer programme on schooling outcomes. It analyses the impacts for children by various subgroups – age, gender, cognitive ability – and finds consistent impacts. There are differences across gender, especially on secondary schooling, with enrolment significantly higher for boys 13 years or older. For girls, the effect of the Livelihood Empowerment Against Poverty (LEAP) programme is to improve current attendance among those who are already enrolled in school (across all age groups). The authors found a significant effect on the expenditure on schooling items such as uniforms and stationary for these groups, which helps to explain the pathway of impact because these out-of-pocket costs are typically important barriers to schooling in rural Ghana and most of Africa.

This paper aims to provide a comprehensive overview of the impacts of cash transfer programmes on the immediate and underlying determinants of child nutrition, including the most recent evidence from impact evaluations across sub-Saharan Africa. The paper finds that the evidence to date on the immediate determinants of child nutrition is mixed with respect to whether cash transfers can positively impact growth-related outcomes among children, particularly in sub-Saharan Africa.

During a recent trip to Ghana, we presented the baseline findings from an impact evaluation of the "LEAP 1000" cash transfer programme to UNICEF colleagues, government and development partners. LEAP 1000, an extension of Ghana's Livelihood Empowerment Against Poverty programme, targets households with young children. It is designed to improve the nutritional status of children in  the first 1000 days of life. Implementers are up for a tough challenge, as most of the evidence to date does not show consistent positive impacts of cash transfers on child nutrition. Why is this the case? Cash transfers have become an increasingly popular development intervention. An estimated 89 programmes are currently operating in Africa alone, most of them launched in the last 5 years. Cash has become a popular policy tool because rigorous studies have shown that they can have consistent impacts on the well-being of beneficiaries. For example, findings from the Transfer Project in sub-Saharan Africa (SSA) demonstrate a broad range of impacts on household consumption, food security, human capital and productive activity. But what about impacts on child nutrition? During the latest Transfer Project workshop in Addis Ababa, participants debated the question of why relatively few impacts on child nutrition emerge from evaluations across the African continent while in Latin America cash programmes have shown strong effects on nutrition. But is this actually the case? In reality, the impacts of the Latin American programmes on nutrition are not as widespread as one might think. A meta-analysis by Manley, Gitter and Slavchevska identified 79 impact estimates from 8 countries on the height-for-age z-score of children, an indicator of chronic malnutrition. It turns out that only 12 of these estimates were statistically significant, and these impacts came from Mexico (5), Colombia (5), Ecuador (1) and Nicaragua (1). The vast majority of programmes did not significantly improve child nutrition. These  conclusions are consistent with other evidence reviews conducted in recent years. But what explains such limited impacts on nutrition? In a recent paper, we use a conceptual model which shows the pathways that lead to better nutrition and we present evidence on how cash transfers could impact on these pathways. In this framework, household income is an underlying determinant of nutrition, and can only have an effect through one of the three pathways at the household level: 1) improved food security, 2) improved care for mothers and children, or 3) improved health environment. These three pathways lead to improvements in dietary intake and health of the child, which together determine the nutritional status. So, for a cash payment to have an impact on nutrition, there need to be changes at the household level, which should lead to improved nutritional status. One can see that this process can be quite complex and a lot of the impact can be 'lost along the way'. Of course, there have been some cash transfer programmes showing positive effects on nutrition. What can we learn from them? The impacts observed in Mexico and Colombia are often attributed to the size of the cash grant, which is relatively large, about 25-30 er cent of the household's pre-programme expenditures. Also in the Philippines, where the Pantawid Pamilya programme reduced severe stunting by 10 per cent, the grant constituted about 23 per cent of beneficiaries' income. However, a later report, using a different methodology and looking at a longer time horizon did not find any impacts. Nevertheless, it makes sense that more cash in the hands of households may have a stronger effect on the pathways laid out in the framework, as well as potential to affect multiple pathways at the same time. Furthermore, supply-side interventions like health infrastructure and providing market access to diverse types of food help recipients to make the most of their cash. For example, the Child Grant in Zambia had an impact on stunting, but only for households with a protected source of water in the home. For the research community, it is important to pay attention to the mechanisms through which cash transfers affect pathways to better nutrition, instead of looking at the direct impacts. By understanding the way programmes can affect the underlying determinants of nutrition, we can disentangle the relationship between getting cash on the one hand, and improving nutrition of children on the other. Moreover, the lack of consistent impacts on nutrition has motivated programme designers to implement nutritional interventions on top of their programmes, such as nutrition information sessions, communication efforts or health insurance. This is a smart move, as cash transfers can offer an effective entry point to deliver complementary health and nutrition services. Fortunately, Ghana LEAP 1000 is among the programmes using this cash plus approach, with linkages to the national health insurance scheme, providing free health insurance to all beneficiaries. We are excited to follow this and other programmes to evaluate their impact, along with the added effect of the "plus" components in addressing malnutrition. Richard de Groot holds a Master's degree in International Economics Studies and is currently a PhD fellow at the Maastricht Graduate School of Governance. He has experience implementing evaluations and quantitative research in collaboration with Plan International, the World Bank and UNICEF. The Office of Research - Innocenti is UNICEF's dedicated research centre undertaking research on emerging and current priorities to shape policy and practice for children. Subscribe to UNICEF Innocenti emails here. 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