Article Text
Abstract
Introduction Although cash transfer programmes are not explicitly designed to improve mental health, by reducing poverty and improving the life chances of children and young people, they may also improve their mental health. This systematic review and meta-analysis assessed the evidence on the effectiveness of cash transfers to improve the mental health of children and young people in low-income and middle-income countries.
Methods We searched Pubmed, EBSCOhost, Scientific Electronic Library Online, ISI Web of Science and Social Sciences Citation Index and grey literature (from January 2000 to July 2020) for studies which quantitatively assessed the impact of cash transfers on mental health in young people (aged 0–24 years), using a design that incorporated a control group. We extracted Cohen’s d effects size and used a random-effects model for the meta-analysis on studies that measured depressive symptoms, I2 statistic and assessment of study quality.
Results We identified 12 116 articles for screening, of which 12 were included in the systematic review (covering 13 interventions) and seven in the meta-analysis assessing impact on depressive symptoms specifically. There was high heterogeneity (I2=95.2) and a high risk of bias (0.38, 95% CIs: −5.08 to 5.85; p=0.86) across studies. Eleven interventions (85%) showed a significant positive impact of cash transfers on at least one mental health outcome in children and young people. However, no study found a positive effect on all mental health outcomes examined, and the meta-analysis showed no impact of cash transfers on depressive symptoms (0.02, 95% CIs: −0.19 to 0.23; p=0.85).
Conclusion Cash transfers may have positive effects on some mental health outcomes for young people, with no negative effects identified. However, there is high heterogeneity across studies, with some interventions showing no effects. Our review highlights how the effect of cash transfers may vary by social and economic context, culture, design, conditionality and mental health outcome.
- health policy
- systematic review
- child health
- mental health & psychiatry
- health economics
Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study. Data extracted from studies are available directly from published work. Data extraction tables generated for the purposes of this review are available upon request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study. Data extracted from studies are available directly from published work. Data extraction tables generated for the purposes of this review are available upon request.
Supplementary materials
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Footnotes
Handling editor Seye Abimbola
Contributors AZ designed the study, conducted the review and analysis and prepared the manuscript. EG conducted the review and analysis and helped design the study and advise on the manuscript. CL designed the study and supervised the review, analysis and write-up. DMD and A-LP conducted the grey literature review and advised on the manuscript. MA-P and RA supervised the review, analysis and write-up. SEL PH, YD, AM, AB, CSP and CZ helped design the study and all authours red and commented on the the manuscript.
Funding This study is an output of the CHANCES-6 study. This work was supported by the UKRI’s Global Challenges Research Fund (ES/S001050/1). The support of the Economic and Social Research Council (ESRC) is gratefully acknowledged. MA-P is additionally supported by the ESRC Centre for Society and Mental Health at King's College London (ESRC Reference: ES/S012567/1).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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