The review found that CTs can be effective in tackling structural determinants of health such as financial poverty , education , household resilience , child labour , social capital and social cohesion , civic participation , and birth registration .
The review further found that CTs modify intermediate determinants such as nutrition , dietary diversity , child deprivation , sexual risk behaviours , teen pregnancy and early marriage .
In conjunction with their influence on SDoH , there is moderate evidence from the review that CTs impact on health and quality of life outcomes .
The review also found many factors relating to intervention design features , macro-economic stability , household dynamics and community acceptance of programs that could influence the effectiveness of CTs .
The external validity of the review findings is strong as the findings are largely consistent with those from Latin America .
Cash transfers ( CTs ) are now high on the agenda of most governments in low- and middle-income countries .
Within the field of health promotion , CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health ( SDoH ) and health inequalities .
A systematic review was conducted to synthesis e the evidence on CTs ' impacts on SDoH and health inequalities in sub-Saharan Africa , and to identify the barriers and facilitators of effective CTs .
Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial
Summary Background Cash-transfer programmes can improve the wellbeing of vulnerable children , but few studies have rigorously assessed their effectiveness in sub-Saharan Africa . We investigated the effects of unconditional cash transfers ( UCTs ) and conditional cash transfers ( CCTs ) on birth registration , vaccination uptake , and school attendance in children in Zimbabwe . Methods We did a matched , cluster-r and omised controlled trial in ten sites in Manical and , Zimbabwe . We divided each study site into three clusters . After a baseline survey between July , and September , 2009 , clusters in each site were r and omly assigned to UCT , CCT , or control , by drawing of lots from a hat . Eligible households contained children younger than 18 years and satisfied at least one other criteria : head of household was younger than 18 years ; household cared for at least one orphan younger than 18 years , a disabled person , or an individual who was chronically ill ; or household was in poorest wealth quintile . Between January , 2010 , and January , 2011 , households in UCT clusters collected payments every 2 months . Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing . Eligible households in all clusters , including control clusters , had access to parenting skills classes and received maize seed and fertiliser in December , 2009 , and August , 2010 . Households and individuals delivering the intervention were not masked , but data analysts were . The primary endpoints were proportion of children younger than 5 years with a birth certificate , proportion younger than 5 years with up-to- date vaccinations , and proportion aged 6–12 years attending school at least 80 % of the time . This trial is registered with Clinical Trials.gov , number NCT00966849 . Findings 1199 eligible households were allocated to the control group , 1525 to the UCT group , and 1319 to the CCT group . Compared with control clusters , the proportion of children aged 0–4 years with birth certificates had increased by 1·5 % ( 95 % CI −7·1 to 10·1 ) in the UCT group and by 16·4 % ( 7·8–25·0 ) in the CCT group by the end of the intervention period . The proportions of children aged 0–4 years with complete vaccination records was 3·1 % ( −3·8 to 9·9 ) greater in the UCT group and 1·8 % ( −5·0 to 8·7 ) greater in the CCT group than in the control group . The proportions of children aged 6–12 years who attended school at least 80 % of the time was 7·2 % ( 0·8–13·7 ) higher in the UCT group and 7·6 % ( 1·2–14·1 ) in the CCT group than in the control group . Interpretation Our results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa , but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region . Funding Wellcome Trust , the World Bank through the Partnership for Child Development , and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children
The review found that CTs can be effective in tackling structural determinants of health such as financial poverty , education , household resilience , child labour , social capital and social cohesion , civic participation , and birth registration .
The review further found that CTs modify intermediate determinants such as nutrition , dietary diversity , child deprivation , sexual risk behaviours , teen pregnancy and early marriage .
In conjunction with their influence on SDoH , there is moderate evidence from the review that CTs impact on health and quality of life outcomes .
The review also found many factors relating to intervention design features , macro-economic stability , household dynamics and community acceptance of programs that could influence the effectiveness of CTs .
The external validity of the review findings is strong as the findings are largely consistent with those from Latin America .
Cash transfers ( CTs ) are now high on the agenda of most governments in low- and middle-income countries .
Within the field of health promotion , CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health ( SDoH ) and health inequalities .
A systematic review was conducted to synthesis e the evidence on CTs ' impacts on SDoH and health inequalities in sub-Saharan Africa , and to identify the barriers and facilitators of effective CTs .