The Effect of Cash Transfer on Maternal and Child Health Outcomes: A Systematic Review in Sub-Saharan Africa

Background: Evidence-based policies are critical to navigate the time post-COVID-19. Improving maternal and child health is core to any recovery strategy. Cash Transfer programs can improve maternal and child health outcomes in low- and middle-income countries. However, studies assessing the effectiveness of these programs on maternal and child health outcomes, beyond service utilization, remain inconclusive. This synthesis fills a gap in the existing literature on the effectiveness of these programs in improving mothers and children’s health outcomes beyond service utilization and suggests a framework for reporting such health outcomes. We focused on Sub-Saharan Africa because of substantial operational differences between regions, and the need for maternal and child health advancement in this region. Methods: This review searched PubMed Central and Google Scholar, and supplemented with a backward citation search, for studies conducted in Sub-Saharan Africa using a combination of MeSH terms and key words for the period between 2000 – 2021. The review included only studies on cash transfer programs that reported health outcomes beyond service utilization among women of reproductive age and children below 18 years old. Findings: The synthesis pulled data from 17 articles conducted in 6 Sub-Saharan African countries. All studies reported health outcomes measures other than service utilization, and programs targeted women of reproductive age and children under 18 years of age. Of the 17 articles, 1 reported measures of mortality, 9 reported measures of functional status; 3 reported subjective measures of well-being, and 4 reported behavioral health outcomes. Across all categories of reported measures, evidence emerges that cash transfer programs are associated with improved health outcomes (e.g., improved infant and child survival, reduced incidence of illnesses, improved cognitive and motor development, improved general health, delayed sexual debut, lower transactional sex, etc.). Conclusion: Cash Transfer programs are effective, with great potential to improve maternal and child health outcomes in Sub-Saharan African countries. However, further research is needed to address implementation challenges, which include data collection, and program management.