Sub-Saharan Africa: Cash transfers have a positive impact on social determinants of health

Sub-Saharan Africa: Cash transfers have a positive impact on social determinants of health

A systematic review has been published that looks at the effects of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa.

 

Researchers considered both quantitative (both experimental and quasi-experimental) and qualitative studies to be included in the review. To be eligible for inclusion quantitative studies needed: to be conducted in a population of people in sub-Saharan Africa; to investigate the effect of conditional or unconditional cash transfers when compared with other cash transfers, or no cash transfers; report at least one of the prespecified socio-economic outcomes. Qualitative studies that looked at barriers and facilitators to a successful cash transfer intervention were included. Further details of the review methods can be found in the review protocol.

 

Fifty-three studies were included: 3 randomised controlled trials (RCTs), 22 cluster-RCTs, 8 quasi-experimental studies and 20 qualitative studies. The studies were conducted in 14 countries across sub-Saharan Africa. Due to the diversity of populations and outcomes reported, the researchers did not conduct meta-analysis, instead opting for a narrative synthesis following the approach recommended by Popay et al. (2006). For the qualitative studies, thematic synthesis was carried out to combine the data, following the Thomas and Harden (2008) approach.

 

The review found that cash transfers can be effective in tackling structural determinants of health such as poverty, education, household resilience, child labour, social capital, civic participation, and birth registration. The review further reported an impact on intermediate determinants including material circumstances (e.g. nutrition, savings), psychosocial circumstances (e.g. self-esteem, reduced stress and anxiety), sexual risk behaviours among adolescents and adolescent empowerment. For this analysis the researchers lumped together unconditional and conditional cash transfer interventions when compared to a control group who did not receive any cash transfers.

 

Little evidence was reported in the review that compared unconditional and conditional cash transfers. Three studies found that conditional cash transfers were more effective than unconditional cash transfers in increasing school attendance (Baird et al 2011, Robertson et al 2012, Akresh et al 2013, 2016). On the other hand, one study in Malawi found significantly reduced psychological distress among adolescent schoolgirls who received unconditional cash transfers compared to conditional cash transfers (Baird et al. 2013).

 

More information at:

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review”, Health Policy and Planning, 2018

Ontario, Canada: Portrait series of people taking part in the cancelled Ontario Basic Income Pilot

Ontario, Canada: Portrait series of people taking part in the cancelled Ontario Basic Income Pilot

Jessie Golem, a photographer from Hamilton, is one of the 4000 people who were taking part in the Ontario Basic Income Pilot, which was cancelled earlier this year.

 

Golem has created a series of portraits called Humans of Basic Income, a collection of portraits taken of the people who were affected by the cancellation of the pilot, and has since become active in the movement for basic income in Ontario. She has said that she is “glad I’m able to give people a voice” and to “add a human element to a very divisive political issue”.

 

More information at:

HumansBasic, Twitter

India: IMF supports basic income, recognising existing welfare programmes as “inefficient”

India: IMF supports basic income, recognising existing welfare programmes as “inefficient”

The International Monetary Fund (IMF) has published a report suggesting that basic income would be better than their welfare system at supporting low income households in India. Similar evidence has been found for both Indonesia and Peru, where basic income was found to be beneficial compared to current welfare systems.

The report uses 2011-12 National Sample Survey data to analyse the Public Distribution System (PDS) in India, where subsidies for food (wheat, rice, sugar) and energy (kerosene) are provided at different levels according to a person’s position in relation to the poverty line. This welfare system was found to be both inefficient, with leakage in the procurement-transportation-distribution chain, and inequitable, in that around 20% of low income households do not receive any subsidy

The analysis compared PDS to a model of basic income. Their analysis found that a basic income outperforms PDS in terms of coverage, as basic income is universal. However, the analysis showed that the introduction of basic income would mean reduced targeting and generosity for lower income groups. At the lower end of the income scale, some households will gain in terms of relative benefits, whereas some will lose out. In the bottom decile the analysis found a greater share of losing households (58% losers compared to 42% gainers).

The authors noted that basic income would bring about a benefit in eliminating current operational inefficiencies in the PDS. They suggested that savings from this could be used to fund a more generous basic income that could mitigate the losses in lower income deciles. They ran another analysis with a higher basic income and found a greater share of gainers than losers in the bottom decile (60% gainers compared to 40% losers), suggesting a higher basic income would be more beneficial for this group. Alternatively, the authors also discuss the possibility of introducing additional programmes for households in this group, to supplement basic income and ensure they do not lose out.

 

More information at:

David Coady, Delphine Prady, “Universal Basic Income in Developing Countries: Options, and Illustration for India”, IMF Working Papers, July 31st2018

Rema Hanna, Benjamin A. Olken, “Universal Basic Incomes vs. Targeted Transfers: Anti-Poverty Programs in Developing Countries”, National Bureau of Economic Research Working Paper Nº24939, August 2018

Debate over universal basic income steps up as IMF weighs impacts”, Development Pathways, August 14th2018

Growing debate around universality” sees diverging estimates of basic income”, Development Pathways, September 3rd2018

David Graeber: New book “Bullshit jobs”

David Graeber: New book “Bullshit jobs”

David Graeber. Picture credit to: RSA.

David Graeber, a professor of anthropology at the London School of Economics, has recently published a new book “Bullshit Jobs: A Theory”. This book is an investigation of his ideas previously outlined in an article written in Strike! Magazine in 2013, where he posits the existence of ‘bullshit jobs’, jobs that are primarily or entirely made up of tasks which the person doing them considers to be pointless, unnecessary or even pernicious, being secretly aware of this. He also argues that these bullshit jobs have been created just for the sake of keeping us all working.

 

In the book, the author outlines how bullshit jobs came to be about and how they turned out to be so prolific, investigating their psychological and political effects. Towards the end of the book, the author suggests giving people a basic income, one that is sufficient to live on, as a potential solution to this phenomenon. This, it is argued, would detach livelihood from work, allowing people to work when they want to, in what they wished, or even not at all. This would mean that people could choose not to take on bullshit jobs, which, assuming the former wanted to do something more meaningful with their lives, would lead to the elimination of the latter.

 

David Graeber, “Bullshit jobs – A theory”, Simon & Schuster, May 2018

 

More information at:

Eliane Glaser, “Bullshit Jobs: A Theory by David Graeber review – the myth of capitalist efficiency”, The Guardian, May 25th 2018

United Kingdom: RSA releases report on how to conduct to Basic Income experiments

United Kingdom: RSA releases report on how to conduct to Basic Income experiments

The RSA, a UK-based charity that aims to unleash human potential for enterprise and creativity, released a report discussing how basic income can be studied in the UK. The report is a toolkit for basic income study designs, highlighting fundamental features of a basic income study, potential outcomes and outlining four potential study designs. The report builds on previous research by the RSA, such as the Creative Citizen, Creative State report, and is released after the findings from the Welfare Conditionality Report found that welfare conditionality does little to increase people’s motivation to work.

 

The report suggests a minimum sample size of 1000 people or more to achieve statistical significance. Studies should have a duration of 2 years or more in order to assess the medium-term effects of basic income, such as changes in behaviour, community culture, poverty and inequality. Mixed methods are suggested for data collection, including the collection of demographic data and use of qualitative interviews. It also highlights the importance of identifying a group of key stakeholders, including community leaders and people working in non-governmental organisations and the public sector, to assist with the study design and the analysis of the results. This would ensure that relevant outcomes are identified and the collected data is properly understood and translated into relevant policy.

 

Interestingly, the report also includes a list of potentially relevant outcomes divided into direct, shorter term and indirect, medium term outcomes. The choice of outcomes is to be aligned with the policy objectives of the study and can be informed by stakeholder engagement. The authors include relevant references to studies where these outcomes have been looked at before and can provide a blueprint for measurement. Direct incomes include those related to health, lifestyle and the community; personal development; labour and work; personal finances; and poverty, feelings of security and prejudice. Indirect outcomes include community; economic impacts; and costs/savings for the government.

 

The report also outlines four potential experiments, which are based on past, current and future basic income studies, including summaries of the costs for each experiment. Of the four studies, only scenario 1 and 3 investigate basic income as defined by BIEN as the sole intervention.

 

  1. Scenario 1 is a mid-scale saturation site where all the people in a given area, such as a council ward, receive basic income payments compared to a similar population who do not receive basic income payments. Case study example: Dauphin, Manitoba, Canada;
  1. Scenario 2 is a targeted cohort study looking at a specific targeted population who may experience difficulties entering or sustaining work such as young adults, older adults, unemployed people and people receiving welfare or people with a low income. Case study example: Kela, Finland;
  1. Scenario 3 is a microsite which looks at a very small population, such as a council estate or distinct residential neighbourhood. The intervention is basic income payments with additional payments where basic income falls short of currently received welfare payments (such as in cases where people are in receipt of welfare for children) in order to ensure no one is worse off. Case study example: Homeless pilot, City of London, UK;
  1. Scenario 4 is a study of combined basic income and additional interventions (such as rent support, rent controls, temporary job placement) compared to a control group with no interventions, or to a group who receive the additional intervention only. Case study example: Barcelona, Spain.

 

More information at:

Charlie Young, “Realizing basic income experiments in the UK”, RSA Action and Research Centre, August 2018