© WFP/Georgina Goodwin

Research Snapshots
Impacts of cash transfers on maternal andchild health outcomes in sub-Saharan Africa
This is a summary of the following paper: Ngamasana E & Moxie J (2024) Cash transfer,maternal and child health outcomes: A scoping review in sub-Saharan Africa. Global Health
Action, 17, 1, 2309726. https://doi.org/10.1080/16549716.2024.2309726

C

ash transfer programmes are poverty alleviation interventions that policymakers and funders can draw onto improve maternal and child healthoutcomes in low- and middle-income countries.
There is, however, a lack of evidence on the effectiveness of such programmes to positively
impact these outcomes. Most evaluations tend
to focus on the utilisation of healthcare services
and other social determinants of health. Specific health outcomes related to mortality, individuals’ capacity to function, or the subjective senseof well-being are often overlooked. In a time ofcompeting priorities, the allocation of scarce resources needs to rely on a strong evidence base.
The authors therefore conducted a review of evidence in sub-Saharan African countries, wherethere are substantial operational differences withother regions (e.g. Latin America).
Authors synthesised current empirical evidence by searching PubMed Central and Google
Scholar and supplemented this database searchwith a backward citation search for studies con-ducted in sub-Saharan Africa for the period
2000–2021. They identified 21 peer-reviewed articles that reported on studies conducted in six
sub-Saharan African countries – Malawi, Kenya, South Africa, Nigeria, Tanzania, and Zambia.
Among the 21 articles included, only one reported on mortality. In this study from Nigeria,
the provision of cash transfers was associatedwith substantial increases in child survival thatwas driven by a large decrease in foetal deaths(a 29% absolute decrease in the treatment groupcompared to the control). Potential causal mechanisms included conditionalities attached to thecash payment, whereby pregnant women had toattend at least three antenatal care visits, a healthfacility delivery, and one postnatal visit.
Thirteen articles reported on health outcomes related to individual capacities to function – episodes of illness, assessment of depressive symptoms, and incidence of HIV andherpes virus. Participants who received conditional cash transfers reported reduced likeli-Navigating school health programmes
amidst COVID-19: A scoping review
This is a summary of the following paper: Carducci B, Dominguez G, Kidd E et al (2024) Pivoting
school health and nutrition programmes during COVID-19 in low- and middle-income countries:
A scoping review. Journal of Global Health, 14. https://doi.org/10.7189%2Fjogh.14.05006

Nutrition profoundly influences thedevelopment of children and adolescents aged 5–19 years. Recognising its significance, the International Commission on Financing Global Education
Opportunity prioritised health and nutrition interventions for improved learning outcomes.
This scoping review addresses the gap in the literature concerning school health and nutrition
programme adaptations during the COVID-19
pandemic, aiming to synthesise evidence on
strategies, impacts, and challenges. The goal wasto guide stakeholders on immediate and longterm responses to mitigate adverse effects onchildren and adolescents in low- and middle-income countries due to reduced access to essential school-based resources. The review searched
literature from January 2020 to June 2023, focusing on primary and secondary studies conducted in low- and middle-income countries involving children and adolescents aged 5–19 years.
This review encompasses 23 studies, eachpresenting different adaptation strategies andprogramme emphases. These include access toschool meals (n=8), health services such as immunisations, eye health, and water, sanitation,and hygiene activities (n=4), physical activity
curriculum and exercise training (n=3), mental
health counselling and curriculum (n=3), andmulti-component approaches (n=5). Importantly, there was a notable absence of quantitative
data on modified programme coverage, utilisation, and related impacts on children and adolescents' health and nutrition.
Findings revealed that multi-component
programmes in various countries adopted diverse strategies in response to the COVID-19
pandemic. Some continued in-school nutrition
programmes with adjustments for physical distancing, while others shifted entirely to virtual
platforms or distributed services outside schools.
School feeding programmes faced suspension
challenges, prompting alternative approaches
like distributing meals and food kits to students'
homes or providing financial compensation. Inschool health services were mostly halted, leaving students vulnerable to infectious diseases.
Physical activity programmes shifted to virtu-hood of illness episodes in the past 30 days andreduced likelihood of difficulties in performing
normal activities due to illness. Lack of conditional cash transfers was associated with higher
school dropouts, which in turn were associatedwith a higher risk of HIV and herpes. Unconditional cash transfers were associated with a lower likelihood of reporting depressive symptoms.
Three studies reported outcome measures related to participants’ well-being. Unconditional
cash transfer programmes were found to be associated with improved quality of life and studies reported positive effects on a few subjective
outcomes such as self-reported overall satisfaction with life.
Protective health promoting behaviours werereported in four of the articles. Three studies reported a positive effect of conditional cash transfer programmes on the incidence of HIV andother sexually transmitted infections throughbehavioural mechanisms. One study reported anincreased likelihood of receiving the tetanus toxoid vaccine during the perinatal period.
The main limitation of this review was thelimited number of studies reporting on someof the outcomes of interest. However, the quality of evidence was high as most studies wererandomised controlled trials. Overall, the review suggests that conditional cash transfer programmes are effective in improving child survival and functional health status and in promoting
healthy behaviours, whereas unconditional cashtransfers are more effective for impacting measures of well-being.

al formats, showing promise in reducing anxiety and improving physical fitness. Mental healthprogrammes adapted to virtual counselling, facing challenges in maintaining student engagement and support.
This review underscores the scarcity of evidence concerning school health and nutrition
programming during the pandemic. It stresses the necessity of monitoring such programmes
regularly, both in ordinary times and during crises, to gauge the effectiveness of adapted initiatives and inform evidence-based policymaking.
While adhering to World Health Organization
global standards and indicators is essential at national and school levels, future research should
prioritise establishing a comprehensive monitoring and evaluation framework for schools, utilising existing data sources to track key health andnutrition indicators for children and adolescents.
Following this review, the authors concluded
that if we are to learn one thing from the COVID-19 pandemic and its impact on the health andwell-being of children and adolescents, it is that:“The continued provision ofeducational, health, andnutrition services should be ofparamount concern forstakeholders and policymakers
across all sectors and levels ofgovernment.”

FIELD EXCHANGE ISSUE 73, July 2024 www.ennonline.net/fex37