Cash Transfers and Contraceptive Use: A Regression Discontinuity Analysis.
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ABSTRACT:
SUBMITTER: Velasco MC
PROVIDER: S-EPMC8011311 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:In 2014, the Danish Government implemented an active labour market reform directed at unemployed young adults under 30 years of age with low educational qualifications. The reform replaced the (unemployment) cash benefits with a lower education benefit for many of the unemployed aged under 30 and obliged the low-skilled in this group to enrol in a regular general or vocational (VET) education program. This paper exploits the sharp discontinuity that occurs at age 30 to estimate the joint effect of higher benefits and the cessation of educational obligations on the share receiving cash benefits and the share enrolled in education. We estimate the effects by applying a regression discontinuity design. We report results for the group of low educated young adults and for subgroups facing different economic incentives. The results establish that reaching age 30 creates an incentive to apply for cash benefits, and we find strong evidence that a significant increase in the share of cash benefit recipients relates to a corresponding reduction in the share of young adults enrolled in education. When including subgroups the size of the effect increases, and the results demonstrate that the effects are strongest among previous education benefit recipients. This indicates that the results are mainly driven mainly by individuals reverting to cash benefits.
| S-EPMC7605669 | biostudies-literature
Project description:In many medical and scientific settings, the choice of treatment or intervention may be determined by a covariate threshold. For example, elderly men may receive more thorough diagnosis if their prostate-specific antigen (PSA) level is high. In these cases, the causal treatment effect is often of great interest, especially when there is a lack of evidence from randomized clinical trials. From the social science literature, a class of methods known as regression discontinuity (RD) designs can be used to estimate the treatment effect in this situation. Under certain assumptions, such an estimand enjoys a causal interpretation. We show how to estimate causal effects under the regression discontinuity design for censored data. The proposed estimation procedure employs a class of censoring unbiased transformations that includes inverse probability censored weighting and doubly robust transformation schemes. Simulation studies are used to evaluate the finite-sample properties of the proposed estimator. We also illustrate the proposed method by evaluating the causal effect of PSA-dependent screening strategies.
| S-EPMC9221554 | biostudies-literature
Project description:BackgroundGiven the success of cash programs in improving health outcomes and addressing upstream drivers of HIV risk such as poverty and education, there has been an increasing interest in their potential to improve HIV prevention and care outcomes. Recent reviews have documented the impacts of structural interventions on HIV prevention, but evidence about the effects of cash transfer programs on HIV prevention has not been systematically reviewed for several years.Methods and findingsWe did a systematic review of published and unpublished literature to update and summarize the evidence around cash programs for HIV prevention from January 2000 to December 17, 2020. We included studies with either a cash transfer intervention, savings program, or program to reduce school costs. Included studies measured the program's impact on HIV infection, other sexually transmitted infections (STIs), or sexual behaviors. We screened 1,565 studies and examined 78 in full-text review to identify a total of 45 peer-reviewed publications and reports from 27 different interventions or populations. We did not do a meta-analysis given the range of outcomes and types of cash transfer interventions assessed. Most studies were conducted in sub-Saharan Africa (N = 23; South Africa, Tanzania, Malawi, Lesotho, Kenya, Uganda, Zimbabwe, Zambia, and eSwatini) followed by Mexico (N = 2), the United States (N = 1), and Mongolia (N = 1)). Of the 27 studies, 20 (72%) were randomized trials, 5 (20%) were observational studies, 1 (4%) was a case-control study, and 1 (4%) was quasi-experimental. Most studies did not identify a strong association between the program and sexual behaviors, except sexual debut (10/18 finding an association; 56%). Eight of the 27 studies included HIV biomarkers, but only 3 found a large reduction in HIV incidence or prevalence, and the rest found no statistically significant association. Of the studies that identified a statistically significant association with other STIs (N = 4/8), 2 involved incentives for staying free of the STI, and the other 2 were cash transfer programs for adolescent girls that had conditionalities related to secondary schooling. Study limitations include the small number of studies in key populations and examining interventions to reduce school costs and matched saving programs.ConclusionsThe evidence base for large-scale impacts of cash transfers reducing HIV risk is limited; however, government social protection cash transfer programs and programs that incentivize school attendance among adolescent girls and young women show the greatest promise for HIV prevention.
| S-EPMC8668130 | biostudies-literature
Project description:BackgroundLack of nutrition, inadequate housing, low education and limited access to quality care can negatively affect children's health over their lifetime. Implemented in 2003, the Bolsa Familia ("Family Stipend") Program (PBF) is a conditional cash transfer program targeting poor households in Brazil. This study investigates the long-term benefits of cash transfers through intergenerational transmission of health and poverty by assessing the early life exposure of the mother to the PBF.MethodsWe used data from the 100M SINASC-SIM cohort compiled and managed by the Center for Data and Knowledge Integration for Health (CIDACS), containing information about participation in the PBF and socioeconomic and health indicators. We analyzed five measures of newborn health: low (less than 2,500 g) and very low (less than 1,500 g) birth weight, premature (less than 37 weeks of gestation) and very premature (less than 28 weeks of gestation) birth, and the presence of some type of malformation (according to ICD-10 codes). Furthermore, we measured the early life exposure to the PBF of the mother as PBF coverage in the previous decade in the city where the mother was born. We applied multilevel logistic regression models to assess the associations between birth outcomes and PBF exposures.ResultsResults showed that children born in a household where the mother received BF were less likely to have low birth weight (OR 0.93, CI; 0.92-0.94), very low birth weight (0.87, CI; 0.84-0.89), as well as to be born after 37 weeks of gestation (OR 0.98, CI; 0.97-0.99) or 28 weeks of gestation (OR 0.93, CI; 0.88-0.97). There were no significant associations between households where the mother received BF and congenital malformation. On average, the higher the early life exposure to the PBF of the mother, the lower was the prevalence of low birth weight, very low birth weight and congenital malformation of the newborn. No trend was noted for preterm birth.ConclusionThe PBF might have indirect intergenerational effects on children's health. These results provide important implications for policymakers who have to decide how to effectively allocate resources to improve child health.
| S-EPMC8801108 | biostudies-literature
Project description:There is increasing interest in the ability of cash transfers to facilitate safe transitions to adulthood in low-income settings; however, evidence from scaled-up government programming demonstrating this potential is scarce. Using two experimental evaluations of unconditional cash transfers targeted to ultra-poor and labor-constrained households over approximately three years in Malawi and Zambia, we examine whether cash transfers delayed early marriage and pregnancy among youth aged 14 to 21 years at baseline. Although we find strong impacts on poverty and schooling, two main pathways hypothesized in the literature, we find limited impacts on safe transition outcomes for both males and females. In addition, despite hypotheses that social norms may constrain potential impacts of cash transfer programs, we show suggestive evidence that pre-program variation in social norms across communities does not significantly affect program impact. We conclude with policy implications and suggestions for future research.
| S-EPMC6662603 | biostudies-literature
Project description:Cash transfers (CTs) are increasingly popular tools for promoting social inclusion and equity in children in sub-Saharan Africa. However, less is known about their implications for reducing the health gap between the beneficiary and non-beneficiary children in the community. Using Lesotho's Child Grants Program (CGP) as a case study, we aim to understand better the potential for CT programmes to reduce the gap in child health in the targeted communities. Using a triple difference model, we examine to what extent CGP improved child health outcomes in eligible households compared with non-eligible households in treatment communities vs control communities and to what extent this effect varied in different population subgroups. We find that the child health gap by beneficiary children's health outcomes catching-up on the health of non-beneficiary children narrowed but that eduction was not statistically significant. However, such a 'catch-up' effect among beneficiaries was observed for selected nutrition outcomes amongst female-headed households and subjective child health assessment for comparatively more food-secure households. This study highlights the potential and limitations of CT programmes like the CGP to address health inequalities in preschool children for selected population subgroups in the community.
| S-EPMC11020256 | biostudies-literature
Project description:ObjectiveThe objective of the present study was to summarize the evidence available on the impact of cash transfers on the use of oral health services and oral health outcomes.Materials and methods9 databases were searched for studies on cash transfers and oral health: PubMed, Embase, The Cochrane Library, CINAHL, EconLit, Dentistry and Oral Sciences Source, Scopus, Web of Science, and LILACS. We conducted a systematic review of studies that evaluated the impact of cash transfers on the use of oral health services and other oral health outcomes.ResultsThree studies with more than 13,000 participants conducted in Brazil and Argentina were included. One study from Brazil found that participants in the Bolsa Familia Program (BFP) were more likely not to use oral health services (aPR: 6.18; 95% CI: 3.07-12.45; P < 0.001) and had a higher probability of presenting dental caries (aPR: 2.00; 95% CI: 1.47-2.69) and severe caries (aRR: 1.53; 95% CI: 1.18-2.00). Another study conducted in Brazil found that the BFP was associated with fewer dental caries among those enrolled in the first 2 years of the BFP as well as after six years. On the other hand, the Argentina study found that the Universal Child Allowance program did not have a statistically significant average treatment effect (ATE = -0.05; P > 0.05) on the use of dental health services.ConclusionThere is a lack of evidence about the impact of CT on the use of oral health services and oral health outcomes. The evidence suggests that cash transfers might not have a positive impact on the use of oral health services. The results regarding the impact of receiving cash transfers on dental caries are contradictory. However, more evidence is needed to draw stronger conclusions for policy taking.RegistrationThe protocol was registered in PROSPERO (CRD42021268234).
| S-EPMC9369780 | biostudies-literature
Project description:BackgroundRegression discontinuity designs are non-randomized study designs that permit strong causal inference with relatively weak assumptions. Interest in these designs is growing but there is limited knowledge of the extent of their application in health. We aimed to conduct a comprehensive systematic review of the use of regression discontinuity designs in health research.MethodsWe included studies that used regression discontinuity designs to investigate the physical or mental health outcomes of any interventions or exposures in any populations. We searched 32 health, social science, and gray literature databases (1 January 1960 to 1 January 2019). We critically appraised studies using eight criteria adapted from the What Works Clearinghouse Standards for regression discontinuity designs. We conducted a narrative synthesis, analyzing the forcing variables and threshold rules used in each study.ResultsThe literature search retrieved 7658 records, producing 325 studies that met the inclusion criteria. A broad range of health topics was represented. The forcing variables used to implement the design were age, socioeconomic measures, date or time of exposure or implementation, environmental measures such as air quality, geographic location, and clinical measures that act as a threshold for treatment. Twelve percent of the studies fully met the eight quality appraisal criteria. Fifteen percent of studies reported a prespecified primary outcome or study protocol.ConclusionsThis systematic review demonstrates that regression discontinuity designs have been widely applied in health research and could be used more widely still. Shortcomings in study quality and reporting suggest that the potential benefits of this method have not yet been fully realized.
| S-EPMC7707156 | biostudies-literature
Project description:Conditional cash transfer (CCT) programs to increase primary-school enrollment and attendance among low-income households have been shown to benefit children and households, but to date little is known about who joins such programs. We test three hypotheses about predictors of CCT program participation in indigenous societies in Bolivia, focusing on attributes of the household (ethnicity), parents (modern human capital), and children (age, sex). We model whether children receive a transfer from Bolivia's CCT program (Bono Juancito Pinto), using data from 811 school-age children and nine ethnic groups. Children from the group least exposed to Westerners (Tsimane') are 18-22 percentage points less likely to participate in the program than children from other lowland ethnic groups. Parental modern human capital and child sex do not predict participation. We discuss possible mechanisms underlying the findings and conclude that the Tsimane's current lower returns to schooling are the most likely explanation.
| S-EPMC6472288 | biostudies-literature
Project description:Solutions to poverty and ecosystem degradation are often framed as conflicting. We ask whether Indonesia's national anti-poverty program, which transfers cash to hundreds of thousands of poor households, reduced deforestation as a side benefit. Although the program has no direct link to conservation, we estimate that it reduced tree cover loss in villages by 30% (95% confidence interval, 10 to 50%). About half of the avoided losses were in primary forests, and reductions were larger when participation density was higher. The economic value of the avoided carbon emissions alone compares favorably to program implementation costs. The program's environmental impact appears to be mediated through channels widely available in developing nations: consumption smoothing, whereby cash substitutes for deforestation as a form of insurance, and consumption substitution, whereby market-purchased goods substitute for deforestation-sourced goods. The results imply that anti-poverty programs targeted at the very poor can help achieve global environmental goals under certain conditions.
| S-EPMC7292618 | biostudies-literature