Dataset Information

Impact of Cash Transfers on the Use of Oral Health Services and Oral Health Outcomes: A Systematic Review.

ABSTRACT:

Objective

The 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 methods

9 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.

Results

Three 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.

Conclusion

There 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.

Registration

The protocol was registered in PROSPERO (CRD42021268234).

SUBMITTER: Hernandez-Vasquez A

PROVIDER: S-EPMC9369780 | biostudies-literature | 2022 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of Cash Transfers on the Use of Oral Health Services and Oral Health Outcomes: A Systematic Review.

Hernández-Vásquez Akram A Azañedo Diego D Vargas-Fernández Rodrigo R Basualdo-Meléndez Gianfranco W GW Barón-Lozada Francisco A FA Comandé Daniel D

Journal of International Society of Preventive & Community Dentistry 20220501 3

<h4>Objective</h4>The 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.<h4>Materials and methods</h4>9 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 transfe ...[more]

PMID: 35966906

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Project description:BACKGROUND:Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China. METHODS:We designated two different sets of villages and households that were used as comparisons against which outcomes of the treated households could be assessed. In 2014, we conducted a large-scale survey of 1522 households in 75 villages (including 25 treatment and 50 comparison) from nine nationally designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). RESULTS:Overall, the uptake of MCH services in the sample households were low, especially in terms of postpartum care visits, early breastfeeding, exclusive breastfeeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. The results from both the ITT and ATT analyses showed that the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers of MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes. CONCLUSIONS:The CCT program generated modest improvements in the uptake of MCH services and mothers' knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two potential reasons: poor CCT implementation and the low quality of rural health facilities.

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.

Project description:Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health (SDoH) and health inequalities. A systematic review was conducted to synthesise the evidence on CTs' impacts on SDoH and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs. Twenty-one electronic databases and the websites of 14 key organizations were searched in addition to grey literature and hand searching of selected journals for quantitative and qualitative studies on CTs' impacts on SDoH and health outcomes. Out of 182 full texts screened for eligibility, 79 reports that reported findings from 53 studies were included in the final review. The studies were undertaken within 24 CTs comprising 11 unconditional CTs (UCTs), 8 conditional CTs (CCTs) and 5 combined UCTs and CCTs. The review found that CTs can be effective in tackling structural determinants of health such as financial poverty, education, household resilience, child labour, social capital and social cohesion, civic participation, and birth registration. The review further found that CTs modify intermediate determinants such as nutrition, dietary diversity, child deprivation, sexual risk behaviours, teen pregnancy and early marriage. In conjunction with their influence on SDoH, there is moderate evidence from the review that CTs impact on health and quality of life outcomes. The review also found many factors relating to intervention design features, macro-economic stability, household dynamics and community acceptance of programs that could influence the effectiveness of CTs. The external validity of the review findings is strong as the findings are largely consistent with those from Latin America. The findings thus provide useful insights to policy makers and managers and can be used to optimise CTs to reduce health inequalities.

Project description:Background: Conditional cash transfers (CCTs) are interventions which provide assistance in the form of cash to specific vulnerable groups on the condition that they meet pre-defined requirements. The impact of conditional cash transfers on children's access to health services and on their overall health has not been established in sub-Saharan Africa. Method: We conducted a systematic review aimed at summarising the available information on the impact of conditional cash transfers on health service utilisation and child health in sub-Saharan Africa. We searched databases for peer-reviewed articles, websites of organisations involved in implementing conditional cash transfer programmes, and Google scholar to identify grey literature. Records were selected based on predefined eligibility criteria which were drawn from a programme impact framework. Records were eligible if one of the following outcomes was evaluated: health services utilisation, immunisation coverage, growth monitoring, anthropometry, illness reported, and mortality. Other records which reported on important intermediate outcomes or described mechanisms significantly contributing to impact were also included in the review. Data items were extracted from eligible records into an extraction form based on predefined data items. Study quality indicators were also extracted into a quality assessment form. Results: Thematic narrative synthesis was conducted using data from nine included records. The review included five cluster randomised evaluations, one quasi-experimental clustered study, one randomised trial at the individual level, one mixed-method study and one purely qualitative study. There was insufficient evidence of an impact of conditional cash transfers on health service utilisation. There was also not enough evidence of an impact on nutritional status. No impact was observed on health status based on illness reports, nor on immunisation rates. None of the included records evaluated the impact on childhood mortality. Conclusions: The findings of this review suggest that a positive impact may be observed in health service utilisation and nutrition, however, this may not translate into improved child health. Further research is needed to understand the mechanisms and pathways by which these interventions work, explore the effect of contextual factors on their impact, and assess their cost implication especially within resource-constrained settings.

Project description:BackgroundTo strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention's complementary ("plus") components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being.Methods and findingsForty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child's life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = -0.13 (-0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = -0.06 (-0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings.ConclusionsIn this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

Dataset Information

Impact of Cash Transfers on the Use of Oral Health Services and Oral Health Outcomes: A Systematic Review.

Objective

Materials and methods

Results

Conclusion

Registration

Publications

Impact of Cash Transfers on the Use of Oral Health Services and Oral Health Outcomes: A Systematic Review.

Similar Datasets

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