Do Conditional Cash Transfers Improve Mental Health? Evidence From Tanzania's Governmental Social Protection Program.

PURPOSE

Cash transfer interventions broadly improve the lives of the vulnerable, making them exceedingly popular. However, evidence of impacts on mental health is limited, particularly for conditional cash transfer (CCT) programs. We examined the impacts of Tanzania's government-run CCT program on depressive symptoms of youth aged 14-28.

METHODS

We utilized cluster randomized controlled trial data of 84 communities (48 intervention; 36 control). The intervention administered bimonthly CCTs to eligible households, while control communities were assigned to delayed intervention. The analysis included youth with measurements of depression (10-item Centre for Epidemiological Studies Depression Scale) at baseline and 18 months later. We determined impacts using analysis of covariance models, adjusting for youth characteristics (including baseline depression), district-level fixed effects, and community-level random effects. Differential effects by sex and baseline social support were also estimated.

RESULTS

Although no evidence was found to suggest that the intervention impacted depressive symptoms among the full sample (n = 880) (effect -.20, 95% confidence interval [CI] -.88 to .48, p = .562), subsample results indicated that depressive symptoms were reduced 1.5 points among males (95% CI -2.56 to -.04, p = .007) and increased 1.1 points among females (95% CI .11-2.09, p = .029). Females 18+ years old (effect 1.55, 95% CI .27-2.83, p = .018) and females with children (effect 1.32, 95% CI -.13 to 2.78, p = .074) drove this negative impact. Social support did not moderate impacts.

CONCLUSIONS

Despite no overall intervention effects, results suggest that receiving a CCT has differential effects on mental health by sex. Although males benefited from the intervention, conditions which rely on stereotypically female roles may result in negative consequences among women.