Cash transfers and the social determinants of health: a conceptual framework

被引:20
作者
Owusu-Addo, Ebenezer [1 ,2 ]
Renzaho, Andre M. N. [3 ]
Smith, Ben J. [1 ,4 ]
机构
[1] Monash Univ, Sch Publ Hlth & Prevent Med, 553 St Kilda Rd, Melbourne, Vic 3004, Australia
[2] Kwame Nkrumah Univ Sci & Technol, Bur Integrated Rural Dev, KNUST Kumasi, Private Mail Bag,Univ PO, Kumasi, Ghana
[3] Western Sydney Univ, Sch Social Sci & Psychol, Locked Bag 1797, Penrith, NSW 2751, Australia
[4] Univ Sydney, Sydney Sch Publ Hlth, Sydney, NSW 2006, Australia
关键词
cash transfers; conceptual framework; evaluation; health inequity; social determinants of health; MIDDLE-INCOME COUNTRIES; POLITICAL-ECONOMY; TRANSFER PROGRAM; IMPACT; POLICY; PREREQUISITES; UNDERSTAND; PROVISION; BEHAVIOR; RISK;
D O I
10.1093/heapro/day079
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Cash transfers (CTs) can play a significant role in tackling the social determinants of health (SDoH), but to date there is a lack of conceptual framework for understanding CTs linkages to the SDoH. This article proposes a framework that identifies the linkages between CTs and SDoH, discusses its implications, and argues for active involvement of health promoters in CT design, implementation and evaluation. The development of the framework followed two stages: evidence review and stakeholder involvement. The evidence review entailed a systematic literature search to identify published and unpublished impact evaluation studies of CTs in sub-Saharan Africa. Critical reflection on the evidence synthesized from the literature formed the basis for the development of the framework. Interviews with CT policy makers, managers and development partners were also carried out to help refine the framework. Interviews were audio-recorded and transcripts were analysed using thematic framework analysis. The study finds that there is limited recognition of SDoH in CT policy making and implementation. The evidence reviewed, however, points to strong impacts of CTs on SDoH. The framework thus conceptualizes how CTs work to influence a broad range of SDoH and health inequities. It also highlights how CT architecture and contexts may influence program impacts. The proposed framework can be used by policy makers to guide CT design, adaptation and operations, and by program managers and researchers to inform CTs' evaluations, respectively. The framework suggests that to optimize CT impact on SDoH and reduce health inequities, health promoters should be actively engaged in terms of the programs design, implementation and evaluation.
引用
收藏
页码:E106 / E118
页数:13
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