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Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia.

ABSTRACT: Cash transfer programs are rapidly becoming a key component of the social safety net of many countries in Sub-Saharan Africa. The primary aim of these programs is to help households improve their food security and smooth consumption during periods of economic duress. However, beneficiary households have also been shown to use these programs to expand their microentrepreneurial activities. Cluster-randomized trials carried out during the rollout of large-scale programs in Malawi and Zambia reveal that children may increase their work in the household enterprise through such programs. Both programs increased forms of work that may be detrimental to children, such as activities that expose children to hazards in Malawi and excessive working hours in Zambia. However, both programs also induced positive changes in other child well-being domains, such as school attendance and material well-being, leading to a mixed and inconclusive picture of the implications of these programs for children.

SUBMITTER: de Hoop J

PROVIDER: S-EPMC9997202 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia.

de Hoop Jacobus J Groppo Valeria V Handa Sudhanshu S

The World Bank economic review 20191102 3

Cash transfer programs are rapidly becoming a key component of the social safety net of many countries in Sub-Saharan Africa. The primary aim of these programs is to help households improve their food security and smooth consumption during periods of economic duress. However, beneficiary households have also been shown to use these programs to expand their microentrepreneurial activities. Cluster-randomized trials carried out during the rollout of large-scale programs in Malawi and Zambia reveal ...[more]

PMID: 36909737

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Project description:BackgroundNigeria suffers from the highest burden of mother-to-child transmission worldwide. To increase retention in care and prevention programmes, we piloted and evaluated a conditional cash transfer (CCT) programme for preventing mother-to-child transmission (PMTCT) in Akwa Ibom, Nigeria.MethodsIn a randomised controlled trial, pregnant women testing positive for HIV during antenatal care registration at three public hospitals were randomised to one of two study arms: (1) offered enrolment into the CCT programme or (2) continue in standard care for (PMTCT). In the CCT programme, women could receive a compensation package totaling 33,300 Naira (~US$114) for enroling, delivering at the facility, and obtaining a newborn early infant diagnosis (EID) test. The intent-to-treat (ITT) and per protocol (PP) effects of the programme on the primary outcomes of facility delivery and EID testing and on the secondary outcome of nevirapine administration were estimated with logistic regressions.ResultsFrom August 1, 2015 to April 19, 2017, 554 pregnant women tested positive for HIV; 273 were randomised to standard care and 281 were offered enrolment into the CCT intervention. Women offered the CCT programme were more likely to give birth at the facility (n = 109/263; 41.4%) compared to women in standard care (n = 80/254; 31.5%), an absolute difference of 9.9% (OR = 1.54, 95% CI: 1.07-2.21, p = 0.019). For EID testing there was an absolute difference of 12.8% between those offered the CCT intervention (n = 69/263; 26.2%) and those in standard care (n = 34/254; 13.4%; OR = 2.30, 95% CI 1.46-3.62, p = 0.000). PP results show larger differences for both facility deliveries (16.7% absolute difference; OR = 2.02, 95% CI 1.38-2.98, p = 0.000) and EID testing (18.9% absolute difference; OR = 3.09, 95% CI 1.93-4.94, p = 0.000) among intervention enrolees. Over 86% of the facility-delivered newborns received nevirapine, and ITT and PP estimates were similar to those for facility deliveries.ConclusionsResults show that CCTs improved the likelihood of HIV-positive women giving birth at a facility, of nevirapine being administered to their newborn, and of undergoing EID testing in Akwa Ibom, Nigeria. Effects are especially large among those who agreed to participate in the CCT intervention.Trial registrationClinicalTrials.gov NCT02447159 , May 18, 2015.

Dataset Information

Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia.

Publications

Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia.

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