Dataset Information

Ghana's Livelihood Empowerment Against Poverty (1000) Program Seasonally Impacts Birthweight: A Difference-in-Differences Analysis.

ABSTRACT: Objectives: Low birthweight (LBW) prevalence remains high in African countries and evidence of cash transfer impacts on birthweight, particularly by season of infant birth, is limited. This study examines overall and seasonal cash transfer impacts on LBW in rural Ghana. Methods: Data come from a longitudinal, quasi-experimental impact evaluation of the Livelihood Empowerment Against Poverty (LEAP) 1,000 unconditional cash transfer program for impoverished pregnant or lactating women in rural districts of Northern Ghana. LEAP1000 program impacts on average birthweight and LBW were estimated for a multiply imputed sample of 3,258 and a panel sample of 1,567 infants using differences-in-differences models and triple difference models to assess impacts by season. Results: LEAP1000 decreased LBW prevalence by 3.5 and 4.1 percentage points overall and in the dry season, respectively. LEAP1000 increased average birthweight by 94, 109, and 79 g overall, in the dry season, and in the rainy season, respectively. Conclusion: Our findings of positive LEAP1000 impacts on birthweight across seasons and on LBW in the dry season demonstrate the need to take seasonal vulnerabilities into account when designing and implementing programs for rural populations in Africa.

SUBMITTER: Quinones S

PROVIDER: S-EPMC9986251 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Ghana's Livelihood Empowerment Against Poverty (1000) Program Seasonally Impacts Birthweight: A Difference-in-Differences Analysis.

Quinones Sarah S Mendola Pauline P Tian Lili L Lin Shao S Novignon Jacob J Angeles Gustavo G Palermo Tia T

International journal of public health 20230220

<b>Objectives:</b> Low birthweight (LBW) prevalence remains high in African countries and evidence of cash transfer impacts on birthweight, particularly by season of infant birth, is limited. This study examines overall and seasonal cash transfer impacts on LBW in rural Ghana. <b>Methods:</b> Data come from a longitudinal, quasi-experimental impact evaluation of the Livelihood Empowerment Against Poverty (LEAP) 1,000 unconditional cash transfer program for impoverished pregnant or lactating wome ...[more]

PMID: 36891221

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Project description:BackgroundSocial assistance in the form of cash transfer or in-kind has been recognised as a social protection strategy in many developing countries to tackle poverty and provide protection for individuals and households. Ghana's cash grant programme, Livelihood Empowerment Against Poverty (LEAP), was introduced in 2008 to support selected households with vulnerable persons including older people 65 years and above, and persons with disabilities. This paper examined the coverage of non-receipt of LEAP, and the associated factors among older persons (65+ years) in the Mampong Municipality, Ghana.MethodsData were extracted from the Ageing, Social Protection and Health Systems (ASPHS) survey carried out between September 2017 and October 2017 among older persons residing in LEAP-targeted communities. Data were analysed using descriptive and sequential logistic regression model techniques.ResultsThe mean age of respondents was 77.0 years and 62.3% were females. Rural residents constituted 59.0%. About 42.0% had no formal education and only 20.5% had no form of caregiving. Non-receipt of LEAP was 82.7% among study respondents. The fully adjusted model showed that being married (AOR = 3.406, CI 1.127-10.290), residing in an urban location (AOR = 3.855, CI 1.752-8.484), having attained primary level of education (AOR = 0.246, CI 0.094-0.642), and not residing in the same household with a primary caregiver (AOR = 6.088, CI 1.814-20.428) were significantly associated with non-receipt of cash grant among older persons.ConclusionThese results provide the first quantitative estimates of non-receipt coverage and its associated factors with the LEAP programme, which can inform the design of government policies related to cash transfers for older persons. The need for further research using different approaches to understand and explain the impact of cash grants on older persons' well-being is crucial in strengthening old age social support care mechanisms in Ghana.

Project description:BackgroundBirthweight is an important indicator of maternal and fetal health globally. The multifactorial origins of birthweight suggest holistic programs that target biological and social risk factors have great potential to improve birthweight. In this study, we examine the dose-response association of exposure to an unconditional cash transfer program before delivery with birthweight and explore the potential mediators of the association.MethodsData for this study come from the Livelihood Empowerment Against Poverty (LEAP) 1000 impact evaluation conducted between 2015 and 2017 among a panel sample of 2,331 pregnant and lactating women living in rural households of Northern Ghana. The LEAP 1000 program provided bi-monthly cash transfers and premium fee waivers to enroll in the National Health Insurance Scheme (NHIS). We used adjusted and unadjusted linear and logistic regression models to estimate the associations of months of LEAP 1000 exposure before delivery with birthweight and low birthweight, respectively. We used covariate-adjusted structural equation models (SEM) to examine mediation of the LEAP 1000 dose-response association with birthweight by household food insecurity and maternal-level (agency, NHIS enrollment, and antenatal care) factors.ResultsOur study included a sample of 1,439 infants with complete information on birthweight and date of birth. Nine percent of infants (N = 129) were exposed to LEAP 1000 before delivery. A 1-month increase in exposure to LEAP 1000 before delivery was associated with a 9-gram increase in birthweight and 7% reduced odds of low birthweight, on average, in adjusted models. We found no mediation effect by household food insecurity, NHIS enrollment, women's agency, or antenatal care visits.ConclusionsLEAP 1000 cash transfer exposure before delivery was positively associated with birthweight, though we did not find any mediation by household- or maternal-level factors. The results of our mediation analyses may serve to inform program operations and improve targeting and programming to optimize health and well-being among this population.Trial registrationThe evaluation is registered in the International Initiative for Impact Evaluation's (3ie) Registry for International Development Impact Evaluations (RIDIESTUDY- ID-55942496d53af) and in the Pan African Clinical Trial Registry (PACTR202110669615387).

Dataset Information

Ghana's Livelihood Empowerment Against Poverty (1000) Program Seasonally Impacts Birthweight: A Difference-in-Differences Analysis.

Publications

Ghana's Livelihood Empowerment Against Poverty (1000) Program Seasonally Impacts Birthweight: A Difference-in-Differences Analysis.

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