The Behavioral Economics and Global Health Insights (BEGIN) Lab

The Effects of Large-Scale, Government-Led Cash Transfer Programs on Health Outcomes in Low- and Middle-Income Countries

Poverty is an important social determinant of health associated with poor health outcomes, including increased risk of death, across the life course. Extreme poverty (living on less than $1.90 per day) continues to affect about 10% of the world’s population. Many governments have sought to combat poverty with cash transfer programs that provide money to people to spend as they wish, with or without behavioral conditions like school attendance. These programs have become even more common during the COVID-19 pandemic, with a 2022 World Bank report identifying 962 cash transfer programs in 203 countries, with 672 newly introduced during the pandemic. Cash transfer programs have been broadly shown to have a number of benefits, but there is limited evidence about the overall effects of these programs on health-related outcomes.

In this project, we constructed a new dataset using publicly available information from a variety of sources in order to list all government-led cash transfer programs in low- and middle-income countries, including their start and end dates as well as their size in terms of population covered and cash transfer amounts provided. We combine this dataset with country-level data reported by organizations like UNAIDS, and with individual-level data from national Demographic and Health Surveys, to evaluate the effects of these programs on health outcomes like HIV incidence and all-cause mortality. We use a difference-in-differences design to estimate the causal effects of these programs using observational data, by comparing differences in outcomes between intervention and comparison groups during pre-intervention and post-intervention periods.

At a time when many countries are considering scaling back or expanding cash transfer programs, this project has the potential to have timely public health and policy impact by producing a comprehensive, global assessment of the causal effects of cash transfer programs on key population health outcomes.