through improved feeding and reductions in wasting.<sup>85</sup> This evidence suggests that transfers can have the potential to enable some immediate health outcomes and this finding is also supported by some indicators around food security and dietary diversity. Yet our meta‐analysis shows that the results so far for health expenditures are not on average significant and where positive impacts are obtained, it is hard to determine why.

The impact on safety nets and early childhood development is an emergent area of focus of programs and their accompanying evaluations. To date the literature has placed considerable interest on nutrition status, as measured by different anthropometric measures. Again, however, this is an outcome where the impact evaluation literature shows mixed results. Under Kenya’s HSNP and CTOVC programs there is little evidence on child nutritional status, although in both cases the results are presented with considerable caution.<sup>86</sup> Ward et al (2010) conclude that anthropometric status, will reflect complex and multiple influences, and take time; whereas other outcomes occur more quickly. Merttens et al (2013) highlight: (i) reservations on quality of anthropometric data gathered, which is widely acknowledged as a challenge, (ii) time‐varying external factors, and (iii) sample size is relatively small making it hard to detect significant effects. Notably, there are several impact evaluations where anthropometric information has not been collected, for example, in Tanzania’s CB‐CCT.<sup>87</sup> Over time, programs have evolved with a more deliberate focus on early childhood aspects with programs such as Niger’s NSPP showing how behavioral accompanying measures lead to changes in nutrition practices related to exclusive breastfeeding and complementary feeding, which contribute to improve food security among children.<sup>88</sup> There is no evidence for safety net programs dis‐incentivizing own farm work and other forms of self‐ employment (see Figure 8). Our meta‐analysis considered whether safety net programs had impacts on own‐farm self‐employment and business ownership. For own‐farm self‐employment, 6 programs reported findings with a mean increase of 2%, relative to baseline levels, but this finding was not significant [95% CI: ‐8 to 13%].<sup>89</sup> For business ownership, multiple studies (10) reported on this and there was a high degree of heterogeneity in impacts. Although, the mean effect was insignificant ‐ 69% increase [95% CI: ‐12 to 149%]<sup>90</sup> , several studies find sizeable positive impacts, such as Sierra Leone’s CFW and Zambia’s CGP.<sup>91</sup> It is Malawi’s SCTP that finds the strongest impacts on own‐farm work, which increases by 15 percentage points, from a baseline level of 64% self‐employed.<sup>92</sup> Reflecting back on the discussion on resilience, we observe that there are some correlations between programs that see decreased

> 85 Seidenfeld et al. 2013 (Zambia ZCGP).

> 86 Merttens et al. (2013), Ward et al (2010).

> 87 Evans et al. 2014 (Tanzania CB‐CCT).

> 88 Premand and Del Ninno 2016 (Niger NSNP).

> 89 Sources: Boone et al., 2013 (Malawi SCTP), Daidone et al, 2014 (Lesotho LCGP), Seidenfeld et al. 2013 (Zambia ZCGP), Merttens et al. (2013), Haushofer and Shapiro 2016 (Kenya GIVE), Asfaw et al., 2014 (Kenya CTOVC). 90 Sources: Rosas and Sabarwal 2016 (Sierra Leone CFW), Merttens et al. (2013), Gilligan et al., 2009 (Ethiopia PSNP), Seidenfeld et al. 2013 (Zambia ZCGP), Abdoulayi et al. 2015 (Malawi SCTP), Asfaw et al., 2014 (Kenya CTOVC), Haushofer and Shapiro 2016 (Kenya GIVE), Handa and Park 2013 (Ghana LEAP), Daidone et al, 2014 (Lesotho LCGP), Berhane et al., 2015 (Ethiopia SCTPP).

> 91 Rosas and Sabarwal 2016 (Sierra Leone CFW), Seidenfeld et al. 2013 (Zambia ZCGP).

> 92 Boone et al., 2013 (Malawi SCTP).

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