Can cash transfer interventions increase contraceptive use and reduce adolescent birth and pregnancy in low and middle income countries? A systematic review and meta-analysis

PLOS Glob Public Health. 2023 Nov 9;3(11):e0001631. doi: 10.1371/journal.pgph.0001631. eCollection 2023.

Abstract

Becoming pregnant and giving birth under the age of 20 is associated with a range of adverse social, socioeconomic and health outcomes for adolescent girls and their children in Low and middle income countries. Cash transfers are an example of a structural intervention that can change the local social and economic environment, and have been linked with positive health and social outcomes across several domains. As part of a wider review of structural adolescent contraception interventions, we conducted a systematic review on the impact of cash transfers on adolescent contraception and fertility. Fifteen studies were included in the review with eleven studies providing evidence for meta-analyses on contraception use, pregnancy and childbearing. The evidence suggests that cash transfer interventions are generally ineffective in raising levels of contraceptive use. However, cash transfer interventions did reduce levels of early pregnancy (OR 0.90, 95% CI 0.81 to 1.00). There was suggestive evidence that conditional, but not unconditional, cash transfers reduce levels of early childbearing. Given that much of the evidence is drawn from interventions providing cash transfers conditional on school attendance, supporting school attendance may enable adolescent girls and young women to make life choices that do not involve early pregnancy.

Grants and funding

This project was funded by the Centre of Excellence for Development Impact and Learning (CEDIL), supported by UK aid from the UK Government. The views expressed in this research project paper do not necessarily reflect the UK Government's official policies or CEDIL. The sponsors had no role in the design, execution, interpretation, or writing of the study.