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 .
The impact of cash transfers on social determinants of health and health inequalities in Sub-Saharan Africa: a systematic review protocol
Background There is increasing pressure to address the social determinants of health ( SDoH ) and health inequities through the implementation of culturally acceptable interventions particularly in Sub-Saharan Africa ( SSA ) where health outcomes are generally poor . Available evaluation research on cash transfers ( CTs ) suggests that the programs may influence the wider determinants of health in SSA ; yet , there has been no attempt to synthesize the evidence regarding their contribution to tackling the SDoH and health inequalities . To date , nearly all the review s on CTs ' impact on health have predominantly featured evidence from Latin America with limited transferability to the social , cultural , and political environments in SSA . Therefore , the aim of this study is to undertake a systematic review to assess the role of CTs in tackling the wider determinants of health and health inequalities in SSA . Methods / design A systematic review of published and unpublished literature on CTs ’ impact on health and health determinants covering the period 2000–2016 will be undertaken . Studies will be considered for inclusion if they present quantitative or qualitative data , including all relevant study design s. The SDoH conceptual framework will be used to guide the data extraction process . EPPI Review er software will be used for data management and analysis . Studies included in the review will be analyzed by narrative synthesis and /or meta- analysis as appropriate for the nature of the data retrieved . Discussion This review will provide empirical evidence on the impact of CTs on SDoH to inform CT policy , implementation , and research in SSA . The protocol follows the Preferred Reporting Items for Systematic Review and Meta- Analysis Protocol s ( PRISMA -P ) . Systematic review registration This protocol has been registered with the PROSPERO international prospect i ve register of systematic review s , reference CRD42015025015
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 .