Summary of findings 1. Unconditional cash transfers compared to no intervention for food security.
| Unconditional cash transfers compared to no intervention for food security | ||||
| Patient or population: children, adults, households Setting: poor rural and urban households in LMICs Intervention: UCTs Comparison: no intervention | ||||
| Outcomes | Impact | № of participants (studies) | Certainty of the evidence (GRADE) | Comments |
| Prevalence of undernourishment | — | — | — | 0 included studies measured this outcome. |
| Proportion of household expenditure on food follow‐up: range 1–2 years | 1 study showed a clear effect favouring UCTs, 2 studies showed unclear effect potentially favouring UCTs and 2 studies showed clear effect favouring the control. Data not pooled. | 11271 households (5 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c | Evidence is very uncertain about the effects of UCTs on the proportion of household expenditure on food. |
| Food security assessed with: proportion of households consuming > 1 meal per day; modified HFIAS; FSI follow‐up: range 1–2 years | 6 studies showed a clear effect favouring UCTs. A meta‐analysis of 3 of these studies showed a small improvement in food security scores (SMD 0.18, 95% CI 0.13 to 0.23; 6209 households) |
10,251 households, 7604 children (6 RCTs) | ⊕⊕⊕⊕ High | UCTs improve food security. |
| Dietary diversity assessed with: dietary diversity scores (i.e. number of food groups consumed); proportion with minimum dietary diversity follow‐up: range 1–2 years | 5 studies showed a clear effect favouring UCTs and 5 studies show an unclear effect potentially favouring UCTs. Data not pooled. |
12,631 households, 890 children (10 RCTs) | ⊕⊕⊝⊝ Lowa,b | UCTs may increase dietary diversity. |
| Stunting assessed with: HAZ < –2SD follow‐up: 2 years | 1 study showed a clear effect favouring UCTs, 2 studies showed an unclear effect favouring UCTs and 1 study showed an unclear effect favouring the control. A meta‐analysis of 2 of these studies showed a reduction in stunting with UCTs (OR 0.62, 95% CI 0.46 to 0.84; 2914 children) |
4713 children (4 RCTs) | ⊕⊕⊝⊝ Lowa,b | UCTs may reduce stunting. |
| Wasting assessed with: WHZ < –2SD follow‐up: range 2 years | 1 study showed an unclear effect potentially favouring UCTs and 3 studies showed an unclear effect potentially favouring the control. Data not pooled. | 6396 children (4 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c | We are uncertain whether UCTs reduce wasting. |
| Cognitive function and development assessed with: cognitive test scores, language scores follow‐up: 2 years | 3 studies reported unclear effect potentially favouring intervention. | 10,813 children (3 RCTs) |
⊕⊕⊕⊕ High | UCTs make little or no difference on cognitive function and development. |
| *No meta‐analyses carried out. CI: confidence interval; FSI: Food Security Index; HAZ: height‐for‐age z‐score; HFIAS: Household Food Insecurity Access Scale; LMIC: low‐ and middle‐income country; OR: odds ratio; RCT: randomised controlled trial; SD: standard deviation; SMD: standardised mean difference; UCT: unconditional cash transfer; WHZ: weight‐for‐height z‐score. | ||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||
aDowngraded one level for risk of bias: at least one study was at high overall risk of bias due to selection or attrition bias, or both. bDowngraded one level for inconsistency: there was wide variance of point estimates. cDowngraded one level for imprecision: wide confidence intervals.