Summary of findings 2. Conditional cash transfers compared to no intervention for food security.
| Conditional cash transfers compared to no intervention for food security | ||||
| Patient or population: children, adults, households Setting: poor urban and rural communities in LMICs Intervention: CCTs 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 spent on food follow‐up: 9 months to 2 years | 1 study showed a clear effect potentially favouring the control and 1 study showed an unclear effect favouring the control. Data not pooled. | 4760 households (2 RCTs) | ⊕⊕⊕⊕ High | CCTs result in little to no difference in the proportion of household expenditure on food. |
| Food security | — | — | — | 0 included studies measured this outcome. |
| Dietary diversity assessed with: Food Consumption Score follow‐up: 7 months to 2.5 years | Meta‐analysis of 2 studies showed a clear effect favouring CCTs (MD 0.45, 95% CI 0.25 to 0.65) | 3937 households (2 RCTs) | ⊕⊕⊕⊝ Moderatea | CCTs probably slightly improve dietary diversity |
| Stunting assessed with: HAZ < –2SD follow‐up: range 20 months to 3 years | 3 studies showed an unclear effect potentially favouring CCTs and 1 study showed an unclear effect potentially favouring the control. A meta‐analysis of 3 of these studies showed an unclear effect favouring CCTs (MD –2.51, 95% CI –7.78, 2.75) |
3529 children (4 RCTs) | ⊕⊕⊝⊝ Lowa,b | CCTs may make little or no difference to the proportion of stunted children. |
| Wasting assessed with: WHZ < –2SD follow‐up: 2 years | A meta‐analysis of 2 studies showed an unclear effect favouring CCTs (MD –2.50 95% CI –8.04 to 3.04) | 2116 children (2 RCTs) | ⊕⊕⊝⊝ Lowb,c | CCTs may make little or no difference in wasting. |
| Cognitive function and development assessed with: cognitive test scores; cognitive and socioemotional outcomes scores follow‐up: range 9 months to 2 years | A meta‐analysis of 2 studies showed a slight improvement with CCTs (SMD 0.13, 95% CI 0.09 to 0.18) | 5383 children (2 RCTs) | ⊕⊕⊕⊕ High | CCTs slightly improve cognitive function in children. |
| *No meta‐analyses carried out. CCT: conditional cash transfer; CI: confidence interval; HAZ: height‐for‐age z‐score; MD: mean difference; RCT: randomised controlled trial; SD: standard deviation; SMD: standardised mean difference; 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 imprecision: wide confidence intervals. cDowngraded one level for inconsistency: wide variation in point estimates.