Cash transfers recognized as most effective way to build resiliency among the poor 

Johannesburg/Addis Ababa- 15 November 2016 –  New evidence released today shows that social cash transfers are working in Africa, and that giving cash to families is leading to numerous positive outcomes, including reducing poverty among the most vulnerable.

 In a new book, From Evidence to Action: The Story of Cash Transfers and Impact Evaluations in Sub-Saharan Africa – launched in Johannesburg today – UNICEF, FAO, and other partners showcase the positive impacts cash transfer programmes have had in eight Sub-Saharan countries (Ethiopia, Ghana, Kenya, Lesotho, Malawi, South Africa, Zambia, and Zimbabwe).

“Cash transfers are enabling the poorest families to substantially increase food consumption and improve overall food security,” says Leila Gharagozloo-Pakkala, Regional Director for UNICEF in Eastern and Southern Africa Regional Office. “While cash alone is not enough to solve all problems, it is increasingly helping families avoid negative coping strategies, such as taking children out of school, or selling off assets.”

At the Mail & Guardian “Critical Thinking Forum” organized to launch the book, Government and UN representatives discussed what’s working and what challenges remain with national social protection programmes across the region.

The new evidence finds that government-run cash transfer programmes are expanding across the continent, with national social protection strategies often including a cash component. While cash transfers in Africa tend to be provided unconditionally, many countries do include programme messaging to encourage school enrolment and periodic health and nutrition checks for children.

For several years there have been concerns that beneficiaries would waste money, however UNICEF and FAO gathered evidence across a 10-year period through the so-called Transfer Project, which clearly indicates that the majority of recipients are utilising cash transfers to better the living standards of their families, especially children.

Gathered evidence has also fostered strong collaboration among policymakers, development partners and researchers and led to improved social cash transfer policies and practices in Africa. The book can be downloaded at http://bit.ly/2eqXgNo

The new book launched today in Johannesburg features a chapter on the evaluation of the pilot social cash transfer programme in Tigray region which started in 2011. Which was also named Best of UNICEF research for 2016

The programme was introduced by the Bureau of Labour and Social Affairs in Tigray region with support from UNICEF in two woredas (districts), Abi Adi and Hintalo Wajirat – with the aim to improve the quality of life for vulnerable children, older persons, and persons with disabilities.

0x5a3612In Ethiopia, the level of children’s deprivation remains high. In comparison with sub-Saharan Africa, Ethiopian children face one of the highest multidimensional deprivation rates. Of all the child well‑being dimensions used for comparison – nutrition, health, education, housing, water, sanitation, information and protection against violence – 43 million children in Ethiopia are deprived in at least two of the dimensions. An estimated 17.5 million children live on less than US$1.25 per day.

Ethiopia aims to build a comprehensive and integrated social protection system with the vision for all Ethiopians to enjoy social and economic well-being, security and social justice. The Government is committed to establishing the appropriate system, which will ensure the existing regulations and policies are implemented to address poverty and related vulnerabilities. UNICEF’s social protection programme is providing the required support to make the social protection system a reality.

UNICEF’s social protection programme collaborates with the Government of Ethiopia to establish an integrated social protection system that benefits all Ethiopians, particularly the most vulnerable children and their families. One of the key intervention includes providing support to the operationalization of Community Care Coalitions (CCCs) that identify and provide support in communities to vulnerable persons, including children. These are community-led groups that serve as a support mechanism for the vulnerable populations in the community. CCCs are hybrid organizations with representation from both government and civil society organizations.

In Ethiopia, the most common cause of death for children under five years of age is new-born death

Mother breastfeeding her new born for the first time
A mother breast feeds for the first time her new-born at Shire Clinic, Ethiopia ©UNICEF Ethiopia/2009/Tuschman

New York/Addis Ababa, 22 May 2014 – A ground-breaking series of papers released by The Lancet at UNICEF Headquarters today shows that the majority of the almost 3 million children who die before they turn one month old could be saved if they received quality care around the time of birth – with a particular focus on the most vulnerable and under-served.

New-born deaths account for a staggering 44 per cent of total mortality among children under five, and represent a larger proportion of under-five deaths now than they did in 1990. These deaths tend to be among the poorest and most disadvantaged populations.

“We have seen tremendous progress in saving children under five, but where the world has stumbled is with the very youngest, most vulnerable children,” said Dr Mickey Chopra, head of UNICEF’s global health programmes. “This group of children needs attention and resources. Focusing on the crucial period between labour and the first hours of life can exponentially increase the chances of survival for both mother and child.”

According to UNICEF, 2.9 million babies die each year within their first 28 days. An additional 2.6 million babies are still-born, and 1.2 million of those deaths occur when the baby’s heart stops during labour. The first 24 hours after birth are the most dangerous for both child and mother – almost half of maternal and new-born deaths occur then.

The Lancet’s Every Newborn Series identifies the most effective interventions in saving new-borns, including breastfeeding; new-born resuscitation; ‘kangaroo care’ for premature babies – that is, prolonged skin-to-skin contact with the mother; and preventing and treating infections. More funding and adequate equipment are also vital.

Countries that have made the most progress in saving new-born lives have paid specific attention to this group as part of the overall care extended to mothers and under-fives. Rwanda – alone among sub-Saharan African countries – halved the number of new-born deaths since 2000. Some low and middle-income countries are making remarkable progress by, among other methods, training midwifes and nurses to reach the poorest families with higher quality care at birth, especially for small or ill new-borns.

In Ethiopia, Neonatal Mortality Rate (NMR) has reduced from 54 in 1990 to 29 (per 1000 deaths) in 2012 according to the Inter-agency Group of Child Mortality Estimation 2013.

“Despite progress in child survival, the single most important remaining cause of death among children less than five years of age is new-born deaths – deaths within the first 28 days of life,” said Dr Peter Salama, UNICEF Representative to Ethiopia. “The government of Ethiopia is rapidly expanding access to basic health services to communities to prevent maternal and new-born deaths. With the strong commitment of the government and the sustained support of all our partners, we can speed up the reduction of maternal and newborn death even further.”

New Born baby taken care off by his nurse
A nurse takes care of a newborn baby at Shire Clinic, Ethiopia ©UNICEF Ethiopia/2009/Tuschman

To increase access, the Federal Ministry of Health has committed to the improvement of services based on the Health Sector Development Programme (HSDP) including the construction of 800 district hospitals (one per each woreda (district)). At present, over 120 hospitals are providing comprehensive emergency obstetric and neonatal care (CEmONC) services including caesarean sections, blood transfusions and emergency laparotomy for the entire population of the country.

A survey of 51 countries with the highest burden of new-born deaths found that if the quality of care received by the richest were to become universal, there would be 600,000 fewer deaths per year – an almost 20 per cent reduction.

The highest numbers of new-born deaths per year are in South Asia and sub-Saharan Africa, with India (779,000), Nigeria (267,000) and Pakistan (202,400) leading. For the highest burden countries, every $1 invested in a mother’s or baby’s health gives a nine-fold return on investment in social and economic benefit.

UNICEF and World Health Organization will roll out next month the Every Newborn Action Plan which aims to end preventable maternal and child deaths by 2035.

Lancet’s Every Newborn Series is co-authored by experts from UNICEF, the London School of Hygiene and Tropical Medicine, and the Agha Khan University, Pakistan, among others.

Find the press release here

Materials from the Lancet Every Newborn series launch are available at: http://www.thelancet.com/series/everynewborn