The Role of Cash Transfers in Improving Child Health and Outcomes

Savanna Henderson
Humanitas Global Development
Publication Year:
May 04, 2020
  • SDG 3 - Good Health and Well-Being

Regardless of where a family or caregiver falls on the poverty line, children deserve adequate nutrition, access to healthcare and the opportunity to enroll in and complete school. Yet, children are often unjustly impacted by poverty and disproportionately represented in measurements of poverty. As of 2012 nearly 900 million people were living on US$1.90 a day, the World Bank measure of monetary poverty. UNICEF’s ‘State of the World’s Children 2016’ revealed that children under the age of 17 make up 34 percent of the total population in low- and middle-income countries, they account for 46 percent of the population living in extreme poverty. With such a large vulnerable population, there is dire need to ensure that children are guaranteed their rights and that their caregivers can accommodate them.  

While the pressure to protect and expand access to education has been amplified, children remain underserved and without the opportunity to attend school. Further compounding a child’s right to education though, are the children who attend school at a huge disadvantage granted to them by circumstances wholly outside of their control: 159 million children under five are stunted and 50 million do not weigh enough for their height, indicating a severe lack of energy and proper nutrition. (While children under five are not yet in primary school, stunting is irreversible, which means these children will continue suffering the ills of stunting throughout adulthood. Similarly, undernutrition increases the risk, frequency and severity of infections, carrying its effects throughout childhood) Hungry, and unable to focus, these children may miss out on the benefits of school. In fact, UNICEF found that 38 percent of children leave primary school unable to read, write and do simple arithmetic.

Education has profound impacts on children‘s health, well-being and their future opportunities. For instance, each additional year of education received by a child increases her adult earnings by roughly 10 percent. A study by the Food and Agriculture Organization found that if low-income countries could double access to primary education, food insecurity could be reduced by 25 percent. Girl children who receive an education can even help break the cycle of poverty. Educated girls are less likely to marry young, less likely to die in childbirth, more likely to seek out healthcare and have healthy babies, and are more likely to send their sons and daughters to school.

At the beginning of life, a child born to a mother who received antenatal care and a skilled birth attendant during labor has an increased chance of survival. Unfortunately, poor women often lack access to antenatal care and skilled birth attendants. Child mortality rates among the poorest 20 percent of households have been recorded as double that of those in the richest 20 percent by the World Health Organization. Known as the ‘poverty diseases’, pneumonia accounted for 15 percent of all child deaths under the age of five in 2015 while diarrhea accounted for 9 percent of all deaths. Conditions associated with poverty, poor water and sanitation practices and cooking with solid fuels contribute to the etiology of diarrhea and pneumonia.

One solution to reaching these families and children is through social protection mechanisms.  Social cash transfers can help families manage risks and act as a buffer to shocks such as the death of an income-earning family member or a natural disaster, while supporting investment in children’s health, nutrition and education. The results from a review of social cash transfers in Africa speak for themselves: Not only was there in increase in overall food, there was an increase in the variety of food purchased and consumed. Health among adult and children beneficiaries improved, with less sickness, and increased access in comparison to those not enrolled in the Social Cash Transfer Programme. Absenteeism was reduced, enrollment improved, children stayed in school longer, especially girls, and in one country learning in arithmetic was improved.

In Jordan, cash transfers have allowed Syrian refugee families to pay for fresh foods, school-related expenses, and medicines for children.  In Colombia, Ghana and Pakistan, cash transfers supported and improved transition to higher levels of education, associated with increased adult earnings. Cash transfers in Kenya improved recipients level of food insecurity and enabled families to spend more on healthcare.

With evidence supporting social cash transfer efficacy on improving child health, nutrition and livelihood, it is important to ensure that such programs are efficient, sustainable, and that the impact is equal and representative across all beneficiaries. Every child deserves the opportunity to thrive.

This blog discusses how social protection mechanisms, such as cash transfers, can support children's health, nutrition, and education.


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