Investments in children’s health and the Kenyan cash transfer for orphans and vulnerable children: evidence from an unconditional cash transfer scheme

• Published in: Health policy and planning 2017-09, Vol.32 (7), p.943-955
• Main Authors: Huang, Carolyn, Singh, Kavita, Handa, Sudhanshu, Halpern, Carolyn, Pettifor, Audrey, Thirumurthy, Harsha
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Antipoverty programs; Child; Child Health - economics; Child Health - statistics & numerical data; Child mortality; Child, Orphaned - statistics & numerical data; Child, Preschool; Children; Childrens health; Contaminated water; Diarrhea; Female; Global health; Health care; Health services; Help seeking behavior; HIV; HIV Infections; Households; Human immunodeficiency virus; Humans; Illnesses; Infant; Infant, Newborn; Kenya; Living conditions; Longitudinal Studies; Malaria; Malaria - economics; Malaria - epidemiology; Male; Nutrition; Original; ORIGINAL ARTICLES; Orphans; Pneumonia; Policy analysis; Preventive medicine; Public Assistance - statistics & numerical data; Respiratory diseases; Respiratory Tract Infections - economics; Respiratory Tract Infections - epidemiology; Social programs; Social protection; Vector-borne diseases; Vulnerability; Vulnerable Populations - statistics & numerical data; Welfare state; Well being
• ISSN: 0268-1080; 1460-2237
• DOI: 10.1093/heapol/czw181

Child mortality is one of the most pressing global health and policy issues in the developing world. The leading drivers of death—pneumonia, diarrhea and malaria—are preventable and treatable. However, these illnesses are exacerbated by a lack of accessible nutrition, water, basic and preventive health services, and sanitary living conditions—all factors which are more likely to disproportionately impact the poor. We examine whether Kenya’s largest social protection impacts children’s incidence of upper respiratory illness. The Kenya Cash Transfer for Orphans and Vulnerable Children was designed to support orphans affected by HIV/AIDS and has covered over 240,000 households as of 2014. Using longitudinal, cluster-randomized program data from 2007 to 2009, we run a generalized linear latent and mixed method estimation model on a sample of children 0–7 years and under-5 years of age. We find that the program is associated with a decrease in illness in children 0–7 years of age (P < 0.05), but found no effects on a stratified sample of under-5 children. Furthermore, no impacts on health care seeking in the event of illness were detected. This study is one of few examining children’s health using data from a large scale unconditional cash transfer program. With the widespread adoption of over 123 cash transfer programs across sub-Saharan Africa, these findings suggest social cash transfer programs are capable of promoting the multidimensional well-being for the world’s most vulnerable populations. La mortalité infantile est l’un des plus pressants défis mondiaux en matière de santé et de politique dans les pays en développement. Les principales causes de mortalité - pneumonie, diarrhée et paludisme - sont évitables et traitables. Cependant, ces maladies sont exacerbées par les difficultés d’accès à la nutrition, à l’eau, aux services de santé essentiels et préventifs, et à de meilleures conditions sanitaires - tous ces facteurs qui sont les plus susceptibles de pénaliser les pauvres de manière disproportionnée. Nous examinons si le type de protection sociale le plus répandu au Kenya influe sur la fréquence des maladies respiratoires infantiles des voies supérieures. Les subventions en espèces en faveur des orphelins et des enfants vulnérables du Kenya ont été instaurées pour venir en aide aux orphelins touchés par le VIH/sida et couvrent plus de 240 000 ménages à compter de l’année 2014. Grâce aux données longitudinales aléatoires des programmes collectées de