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A systematic review and meta-analysis of the impact of cash transfers on subjective well-being and mental health in low- and middle-income countries

Abstract

Cash transfers (CTs) are increasingly recognized as a scalable intervention to alleviate financial hardship. A large body of evidence evaluates the impact of CTs on subjective well-being (SWB) and mental health (MH) in low- and middle-income countries. We undertook a systematic review, quality appraisal and meta-analysis of 45 studies examining the impact of CTs on self-reported SWB and MH outcomes, covering a sample of 116,999 individuals. After an average follow-up time of two years, we find that CTs have a small but statistically significant positive effect on both SWB (Cohen’s d = 0.13, 95% confidence interval (CI) 0.09, 0.18) and MH (d = 0.07, 95% CI 0.05, 0.09) among recipients. CT value, both relative to previous income and in absolute terms, is a strong predictor of the effect size. Based on this review and the large body of existing research demonstrating a positive impact of CTs on other outcomes (for example, health and income), there is evidence to suggest that CTs improve lives. To enable comparisons of the relative efficacy of CTs to improve MH and SWB, future research should meta-analyse the effects of alternative interventions in similar contexts.

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Fig. 1
Fig. 2: Risk of bias assessments using RoB and ROBINS-I.
Fig. 3: Forest plot of the effects of CTs on SWB and MH for the 45 included studies.
Fig. 4: Funnel plot and p-curve for evidence of potential bias.
Fig. 5: Bivariate moderator relationships.

Data availability

As this is a systematic review and meta-analysis, all data are already available in published and unpublished manuscripts. The extracted data used to produce our results are available at https://osf.io/8fzax/.

Code availability

The statistical code used to create the results and figures in the manuscript and is available at https://osf.io/8fzax/.

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Acknowledgements

We thank M. Plant and C. Donaldson for helping to instigate the project and for providing extensive feedback on an earlier version of the manuscript. We also thank R. O’Keeffe-O’Donovan whose comments improved the paper. The authors received no specific funding for this work.

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J.M. undertook the study design, search implementation, abstract screening, data extraction, quality appraisal, data analysis and visualization, and manuscript writing. C.K. undertook the study design, abstract screening, data extraction, quality appraisal, data analysis and manuscript writing. A.M.B.-M. undertook the study design, data extraction, quality appraisal and manuscript writing.

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McGuire, J., Kaiser, C. & Bach-Mortensen, A.M. A systematic review and meta-analysis of the impact of cash transfers on subjective well-being and mental health in low- and middle-income countries. Nat Hum Behav 6, 359–370 (2022). https://doi.org/10.1038/s41562-021-01252-z

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