Research press release





こうした文献の欠落に取り組むため、Aaron Richtermanらは、2000~2019年の低・中所得国における大規模な政府主導の現金給付プログラムが死亡率に及ぼす影響を評価した。今回の研究で分析対象になったのは合計37カ国で、サハラ以南のアフリカ29カ国、中南米・カリブ海諸国3カ国、アジア太平洋地域4カ国、北アフリカ1カ国が含まれていた。データセットには、合計432万5484人の成人と286万7940人の小児が含まれ、対象期間中に成人12万6714人と小児16万2488人の死亡が記録された。現金給付プログラムによって、18歳以上の女性の死亡リスクが20%低下し、5歳未満の小児の死亡リスクは8%低下した。死亡リスクに対する効果は、条件付き給付と無条件給付で同程度だった。死亡リスクの低下は、集団において受給対象者の占める割合が大きなプログラムと、給付額の多いプログラムの場合に顕著だった。


Government-led cash transfer programmes designed to reduce poverty are shown to reduce the risk of death among adult women and children under the age of five in low- and middle-income countries, a study in Nature reports.

Living in poverty is associated with detrimental health effects and a decrease in life expectancy. In an attempt to reduce poverty, more than 100 low- and middle-income countries have introduced cash transfer programmes — direct payments of money to families or individuals. Some initiatives offer this money without conditions (which is common in sub-Saharan Africa), whereas others may offer the money with conditions, such as encouraging school attendance. Although these programmes have been shown to reduce poverty and offer benefits such as improved education and nutrition, evidence about how these programmes affect population-level death rates is limited.

To address this gap in the literature, Aaron Richterman and colleagues assess the effects of large-scale, government-led cash transfer programmes on mortality in low- and middle-income countries between 2000 and 2019. A total of 37 countries were included in the analysis: 29 in sub-Saharan Africa, 3 in Latin America and the Caribbean, 4 in the Asia–Pacific region and 1 in northern Africa. A total of 4,325,484 adults and 2,867,940 children were included in the datasets, with 126,714 and 162,488 deaths recorded during the intervention period, respectively. They found that cash transfer programmes were associated with a 20% reduced risk of death among women over the age of 18 and an 8% reduced risk of death among children aged younger than 5 years old. The effects were similar for conditional and unconditional programmes. Reductions in the risk of death were greater when the programmes covered a larger proportion of the population and offered larger amounts of money.

The authors note that there are some limitations to their analyses. Adults over the age of 60 were underrepresented (around 1% of the adult dataset), so the findings may not apply to this age group. In addition, they were unable to assess some factors that may have affected the effectiveness of cash transfer programmes, such as how well they were implemented. However, these findings provide evidence to support the use of anti-poverty programmes to improve population health and reduce mortality, the authors conclude.

doi: 10.1038/s41586-023-06116-2

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