Peer-reviewed article
Cash transfers and child nutritional outcomes: a systematic review and meta-analysis
James Manley, Yarlini Balarajan, Shahira Malm, Luke Harman, Jessica Owens et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examined whether cash transfer programmes improve child nutrition outcomes in low-income countries. The analysis of 74 studies found that cash transfers modestly improved children's height and reduced stunting by about 2%, and also increased dietary diversity and consumption of animal-source foods while reducing diarrhoea. However, cash transfers did not significantly affect weight gain or wasting. The researchers conclude that when designed well, cash transfers can support better linear growth in young children, likely through improved diet quality.
Key points
- Cash transfers reduced stunting by 2.1% (95% CI -3.5% to -0.7%) and improved height-for-age z-scores by 0.03
- Cash transfers increased consumption of animal-source foods by 4.5% (95% CI 2.9% to 6.0%)
- Cash transfers increased dietary diversity with an effect of 0.73 (95% CI 0.28 to 1.19)
- Cash transfers reduced diarrhoea incidence by 2.7% (95% CI -5.4% to -0.0%)
- Cash transfers did not significantly improve weight-for-age z-scores or reduce wasting
Limitations
The review included only studies in countries with very low GDP per capita and targeted households with children under 5, so findings may not apply to other settings or older children. The effect sizes, while statistically significant, were generally modest, and the review cannot determine which specific programme design features are most effective.
Abstract
BACKGROUND: Cash transfer (CT) programmes are implemented widely to alleviate poverty and provide safety nets to vulnerable households with children. However, evidence on the effects of CTs on child health and nutrition outcomes has been mixed. We systematically reviewed evidence of the impact of CTs on child nutritional status and selected proximate determinants. METHODS: We searched articles published between January 1997 and September 2018 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years old conducted in countries with gross domestic product per capita below US$10 000 at baseline. We conducted meta-analysis using random-effects models to assess the impact of CT programmes on selected child nutrition outcomes and meta-regression analysis to examine the association of programme characteristics with effect sizes. RESULTS: Out of 2862 articles identified, 74 articles were eligible for inclusion. We find that CTs have significant effects of 0.03±0.03 on height-for-age z-scores (p<0.03) and a decrease of 2.1% in stunting (95% CI -3.5% to -0.7%); consumption of animal-source foods (4.5%, 95% CI 2.9% to 6.0%); dietary diversity (0.73, 95% CI 0.28 to 1.19) and diarrhoea incidence (-2.7%, 95% CI -5.4% to -0.0%; p<0.05). The effects of CTs on weight-for-age z-scores and wasting were not significant (0.02, 95% CI -0.03 to 0.08; p<0.42) and (1.2%, 95% CI: -0.1% to 2.5%; p<0.07), respectively. We found that specific programme characteristics differentially modified the effect on the nutrition outcomes studied. CONCLUSION: We found that CT programmes targeted to households with young children improved linear growth and contributed to reduced stunting. We found that the likely pathways were through increased dietary diversity, including through the increased consumption of animal-source foods and reduced incidence of diarrhoea. With heightened interest in nutrition-responsive social protection programmes to improve child nutrition, we make recommendations to inform the design and implementation of future programmes.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Cash transfer programmes targeted to households with children under 5 years old
- Population
- Households with children under 5 years old in countries with GDP per capita below US$10,000
Key finding
Height-for-age z-scores improved by 0.03 (p<0.03)