Abstract
Objectives
The review aimed to assess the effectiveness of conditional cash transfers (CCTs) in improving child health in low- and middle-income countries.
Methods
Seven electronic databases were searched for papers: MEDLINE, EMBASE, PubMed, PsychINFO, BIOSIS Previews, Academic Search Complete, and CSA Sociological Abstracts. The included studies comprised of randomised controlled trials and controlled before-and-after studies evaluating the impact of CCTs on child health. Due to the substantial heterogeneity of the studies, a narrative synthesis was conducted on the extracted data.
Results
Sixteen studies predominantly from Latin American countries met the inclusion criteria. The outcomes reported by the studies in relation to CCTs’ effectiveness in improving child health were reduction in morbidity risk, improvement in nutritional outcomes, health services utilisation, and immunisation coverage.
Conclusions
The review suggests that to a large extent, CCTs are effective in improving child health by addressing child health determinants such as access to health care, child and maternal nutrition, morbidity risk, immunisation coverage, and household poverty in developing countries particularly middle-income countries. Of importance to both policy and practice, it appears that CCTs require effective functioning of health care systems to effectively promote child health.
Similar content being viewed by others
References
Adato M, De La Briere B, Mindek D, Quisumbing A (2000b) The impact of PROGRESA on women’s status and intrahousehold relations. Report. International Food Policy Research Institute, Washington
Armstrong R, Waters E, Doyle J (eds) (2008) Chapter 21: reviews in public health and health promotion. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester
Attanasio O, Gómez LC, Heredia P, Vera-Hernández M (2005) The short-term impact of a conditional cash subsidy on child health and nutrition in Colombia. Report. Centre for the Evaluation of Development Policies, The Institute for Fiscal Studies, London
Barber SL, Gertler PJ (2008) The impact of Mexico’s conditional cash transfer programme, Oportunidades, on birthweight. Trop Med Int Health 13:1405–1414
Barham T (2005) The impact of the Mexican conditional cash transfer on immunization rates. Report. Department of Agriculture and Resource Economics, U.C, Berkeley
Barham T, Maluccio JA (2009) Eradicating diseases: the effect of conditional cash transfers on vaccination coverage in rural Nicaragua. J of Health Econ 28:611–621
Barham T, Brenzel LE, Maluccio JA (2007) Beyond 80%: are there new ways of increasing vaccination coverage? Evaluation of CCT Programs in Mexico and Nicaragua. Report. World Bank, Washington
Bassett L (2008) Can conditional cash transfer programs play a greater role in reducing child undernutrition? World Bank Discussion Paper Series. World Bank, Washington
Behrman JR, Hoddinott J (2005) Programme evaluation with unobserved heterogeneity and selective implementation: the Mexican PROGRESA impact on child nutrition. Oxf Bull Econ Stat 67(4):547–569
Bhutta ZA, Ahmed T, Black RE et al (2008) What works: interventions for maternal and child undernutrition and survival. Lancet 371:417–440
Bryce J, Boschi-Pinto C, Shibuya K, Black RE, The WHO child health epidemiology reference group (2005) WHO estimates of the causes of death in children. The Lancet 365:1147–1152
Case A, Fertig A, Paxson C (2005) The lasting impact of childhood health and circumstance. J Health Econ 24(2):365–389
Cattan M, White M, Bond J, Learmouth A (2005) Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Aging and Soc 25:41–67
Cechini S (2009) Do CCT Programmes work in low-income countries? One Pager 90. International Policy Centre for Inclusive Growth, United Nations Development Programme, New York
Centre for Reviews and Dissemination (2001) Undertaking systematic reviews of research on effectiveness: CRD’s guidelines for those carrying out or commissioning reviews. CRD, University of York, York
Centre for Reviews and Dissemination (2009) Systematic reviews: CRD’s guidance for undertaking reviews in health care. CRD, University of York, York
Claeson M, Waldman RJ (2000) The evolution of child health programmes in developing countries: from targeting diseases to targeting people. Bull World Health Organ 78:1234–1245
Cochrane Effective Practice and Organisation of Care Review Group (EPOC) (2002) Data Collection Checklist. [Internet]. http://www.epoc.cochrane.org/Files/Website%20files/Documents/Reviewer%20Resources/datacollectionchecklist.pdf. Accessed on 25 Oct 2013
Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. World Health Organization, Geneva
Currie J, Moretti E (2003) Mother’s education and the intergenerational transmission of human capital: evidence from college openings. Quart J Econ 118:1495–1532
Ellis M, Allen S (2006) Towards Millennium Development Goal Four. Arch Dis Child 91:728–730
EPPI-Centre (2002) Review guidelines for extracting data and quality assessing primary studies in educational research. Version 0.9.7: EPPI-Centre, Social Science Research Unit, London
Escalante-Izeta E, Bonvecchio A, Théodore F et al (2008) Facilitadores y barreras para el consumo del complemento alimenticio del Programa Oportunidades. Salud Publica Mex 50:316–324
Fernald LCH, Gertler PJ, Neufeld ML (2008) Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico’s Oportunidades. Lancet 371:827–837
Fiszbein A, Schady N, Ferreira HG et al (2009) Conditional cash transfers: reducing present and future poverty. A World Bank Policy Research Report, World Bank, Washington
Gaarder M, Glassman A, Todd J (2010) Conditional cash transfers and health: unpacking the causal chain. J Develop Effectiv 2:6–50
Galssman A, Gaarder M, Todd J (2006) Demand-side incentives for better health for the poor: Conditional cash transfer programs in Latin America and the Caribbean. Economic and Sector Study Series, IADB
Gertler P (2000) The impact of PROGRESA on health. Final report: International Food Policy Research Institute Washington
Gertler P, Fernald L (2004) The medium term impact of OPORTUNIDADES on child development in rural areas. Instituto Nacional de Salud Publica, Cuernavaca
Green J, South J (2006) Evaluation: key concepts for public health practice. Open University Press, Maidenhead
Higgins JP, Deeks JJ (eds) (2008) Chapter 7: Selecting studies and collecting data. In: Higgins JPT, Green S (eds) Cochrane handbook for systematic reviews of interventions: Wiley, Chichester pp. 168
Higgins J P, Green S eds. (2008) Cochrane Handbook for Systematic Reviews of Interventions (Version 5.0) updated February (2008) Oxford: The Cochrane Collaboration
Huerta MC (2006) Child health in rural Mexico: has PROGRESA reduced children’s morbidity risks? Soc PolicyAdmin 40:652–677
Jackson N, Waters E (2005) Criteria for systematic review of health promotion and public health interventions. Health Promot Int 20:367–374
Lagarde M, Haines A, Palmer N (2009) The impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries. A systematic review. Cochrane Database Syst Rev (4):CD008137
Leroy JL, Garci´a-Guerra A, Neufeld LM (2008a) The Oportunidades program increases the linear growth of children enrolled at young ages in urban Mexico. J Nutrition, 138: 793–779
Macours K, Schady N, Vakis R (2008) Cash Transfers, Behavioral Changes, and Cognitive Development in Early Childhood: Evidence from a Randomized Experiment. Impact Evaluation Series, 25
Maluccio JA, Flores R (2005) Impact evaluation of a conditional cash transfer program The Nicaraguan Red de Protección Social. IFPRI Research Report 141. International Food Policy Research Institute, Washington
Marmot Review Report (2010) Fair society, healthy lives: The Marmot Review—strategic review of health inequalities in England-post 2010. Department of Health, London
Morris SS, Olinto P, Flores R, Nilson EA, Figueiro AC (2004a) Conditional cash transfers are associated with a small reduction in the rate of weight gain of preschool children in Northeast Brazil. J Nutr 134:2336–2341
Morris SS, Flores R, Olinto P, Medina JM (2004b) Monetary incentives in primary health care and effects on use and coverage of preventive health care interventions in rural Honduras: cluster randomised trial. Lancet 364:2030–2037
Olinto P, Morris SS, Flores R, Veiga A (2003) The impact of the Bolsa Alimentacao programme on food consumption. In: Paper presented at annual meetings of the International Association of Agricultural Economist, Durban, South Africa
Petticrew M, Roberts H (2006) Systematic Reviews in the Social Sciences: A Practical Guide. Blackwell, Oxford
Popay J, Roberts H, Sowden A et al (2006) Guidance on the conduct of narrative synthesis in systematic reviews. ESRC Research Methods Programme. [Internet]. http://www.lancs.ac.uk/shm/research/nssr/research/dissemination/publications/NS_Synthesis_Guidance_v1.pdf. Accessed on 18 Nov 2013)
Rivera JA, Sotres-Alvarez D, Habicht J-P, Shamah T, Villalpando S (2004) Impact of the Mexican Programmefor Education, Health, and Nutrition (PROGRESA) on Rates of Growth and Anemia in Infants and Young Children: a randomized effectiveness study. J Am Med Assoc 291:2563–2570
Roberts H (2000) What works in reducing inequalities in child health. Barbardo’s, Barkingside
Robertson L, Mushati P, Eaton JW, Dumba L, Mavise G et al (2013) Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial. Lancet 381:1283–1292
Rogers P, Petrosino A, Hacsi T, Huebner T (2000) Program Theory Evaluation: Practice, Promise and Problems. In: Rogers P, Petrosino A, Hacsi T, Huebner T (eds) Program Theory Evaluation: Challenges and Opportunities, New Directions in Evaluation series. Jossey-Bass, San Francisco
Rossi PH, Lipsey MW, Freeman HE (2004) Evaluation: a systematic approach. 7th ed.Thousand Oaks, CA: Sage Publications
Shaffer P (2003) Social Protection: Lessons from a Save the Children Research Project, Report, London: Save the Children
Silva P (2009) Conditional cash transfer programmes and their impact on poverty reduction: lessons from Mexico and El Salvador. GTZ, Social Protection Department, The Hague
UNICEF (2009) State of the world’s children: maternal and newborn health. UNICEF, New York
World Health Organisation (2008) The World Health Report: primary health care—now more than ever. WHO, Geneva
World Health Organisation (2010) World Health Statistics 2010. WHO, Geneva
Acknowledgments
The authors are grateful to all the authors of the papers included in this review who responded to our emails to provide additional information about their studies.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Owusu-Addo, E., Cross, R. The impact of conditional cash transfers on child health in low- and middle-income countries: a systematic review. Int J Public Health 59, 609–618 (2014). https://doi.org/10.1007/s00038-014-0570-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-014-0570-x