Lambon-Quayefio et al. (2021). Government Unconditional Transfers and Safe Transitions into Adulthood Among Youth in Malawi. IUSSP virtual conference: https://ipc2021.popconf.org/sessions/13

1. Government
Unconditional Transfers
and Safe Transitions into
Adulthood Among Youth
In Malawi
Monica Lambon-Quayefio on behalf of the
Malawi Social Cash Transfer Evaluation Team
IUSSP VIRTUAL CONFERENCE
December 2021

2. Background and Motivation
• Africa youth are recognized as a key demographic critical to harness the
continent’s growth potential and achieve the SDGs
• The use of social safety nets (cash transfers) have become popular tools to
reach poor households and address SDG1
• There is limited research and evidence on the ability of cash transfers to
facilitate adolescent and youth safe transitions:
• Existing evidence is concentrated in Latin America
• Inter-generational impacts mostly focus on a few domains (education and labor force
participation) (Molina Millan et al. 2019)
• Evidence on broader domains comes mainly from smaller programs implemented by NGOs
or from the HIV sector (e.g. Pettifor et al. 2016)

3. Research Questions
Recent review argues social protection can contribute to a “pipeline of investments”
for at-risk youth (Cirillo et al. 2021). For future investment in cash transfers, it is
important to investigate:
• If national “at-scale” cash transfers have implications for youth that reside in participant
households
• Implications for inter-generational transmission of multi-dimensional poverty
Objectives of current study:
• Examines the effects of Malawi’s unconditional cash transfer program on safe
transitions to adulthood among youth aged 13 – 19 at baseline in ultra-poor
households over nearly three years.
• Uses a broad range of indicators across six domains and examines impacts
separately for male and female youth

4. Malawi Social Cash Transfer Program
• The Malawi SCT is implemented by the Ministry of Gender, Children, Disability and
Social Welfare and is currently operational in all 28 districts (started in 2006)
• Targeted population: Ultra-poor and labour-constrained households
• Transfer operational details:
• Bimonthly payments in cash through a local pay-point manager to caregiver
(primarily women – 84%)
• Unconditional
• Transfer value:
• Varying amounts (based on household size and the number of primary and
secondary school-aged children in the home)
• Equivalent to US$1.25 a month (US$60 per household annually)
• Payments represent 17 to 23% of median pre-program household consumption

5. Data and evaluation design
• Cluster randomized control trial (RCT)
• Districts: Salima and Mangochi
• Three waves: 2013 – 2014 – 2015
• Household survey administered to the primary
caregiver in all three waves
• Additional youth surveys: aged 13 to 19 years old
at baseline (by same sex enumerators)
• Analytical data (1,679 unique youth):
• Panel data on youth interviewed at baseline
and again at least one follow up wave
• Data collected on multiple domains
representing youth safe transitions
• Demographics and background characteristics
from household survey Map of study districts and village clusters in
Malawi: Mangochi [bottom] and Salima [top]

6. Modelling Approach
ANCOVA estimation (with DID robustness checks) pooling follow-up waves
• Overall impact: 𝑌𝑖𝑗1= 𝛽0 +𝛽1𝑇𝑟𝑒𝑎𝑡𝑗 +𝛽2𝑌𝑖𝑗0+𝛽3𝑋𝑖𝑗0+𝛾 + 𝜀𝑖𝑗1
• Heterogeneous impact (by gender of youth):
𝑌𝑖𝑗1= 𝛽0 +𝛽1𝑇𝑟𝑒𝑎𝑡𝑗 ∗ 𝐹𝑒𝑚𝑎𝑙𝑒𝑖𝑗 + 𝛽2𝑇𝑟𝑒𝑎𝑡𝑗 + 𝛽3𝐹𝑒𝑚𝑎𝑙𝑒𝑖𝑗 + 𝛽4𝑌𝑖𝑗0+𝛽5𝑋𝑖𝑗0+𝛾 + 𝜀𝑖𝑗1
• Control variables: Age of youth (year splines), gender of youth, female headed
household, household head age, household head ever attended school, household size,
district traditional authority fixed effects
• Baseline balance and attrition analysis show good internal validity – with the exception
of baseline balance of sexual and reproductive health driven by female youth (treatment
group is worse off at baseline)

7. Main Outcomes: Six Domains
Domain Indicators
1 Physical health (a) reported health; (b) morbidity; (c) use of mosquito net; (d) activities of
daily living
2 Emotional wellbeing
and mental health
(a) depressive symptoms; (b) aspirations; (c) social support
3 Education (a) enrollment; (b) highest grade completed; (c) attendance; (d)
expenditure on education
4 Time use and labor (a) time spent on economic activities; (b) hazardous labour; (c) time spent
on domestic activities
5 sexual and
reproductive health
(a) ever pregnant (females only); (b) currently partnered; (c) sexual debut;
(d) any sexual experience; (e) ever experienced forced sex
6 HIV risk (a) number of sexual partners; (b) age disparate sex; (c) transactional sex;
(d) concurrent partnerships; (e) number of sexual acts; (f) condom use
* Six Domains with 25 indicators
**All indicators are coded so more favorable transition outcomes is higher—transformed into a z-score
and aggregated into an index, standardized according to the control group by wave

8. Results: Overall impacts on domains by gender
• Significant impacts on 4 out of
6 domains—all except time
use and HIV risk
• Impacts are largest for
domains of mental health and
education
• Impacts overall are similar for
male and female youth –
however females have
significantly higher impacts on
physical health
* Figure shows 90% confidence intervals

9. Results: Impacts on Domains and Indicators (1)
* Figure shows 90% confidence intervals

10. Results: Impacts on Domains and Indicators (2)
* Figure shows 90% confidence intervals

11. Conclusion and Policy Implications
• Results indicate that adolescents living in ultra-poor households
improved outcomes after one and two years of household-receipt of
transfers
• Improvements go beyond domains directly related to receipts of cash
(e.g., education, physical health) to outcomes including mental health
and emotional wellbeing, as well as sexual and reproductive health
• No impacts on some domains and outcomes—in particular, time use and
labor. The lack of impacts may be due to increased household income
generation and productive activities (which youth may take part in)
• More can be done to intentionally design for, reach and evaluate impacts
for adolescents and youth populations, especially during times of shocks.

12. Thank you!
Co-Authors: Sudhanshu Handa, Amber Peterman, Adria
Molotsky, Frank Otchere, Peter Mvula, Maxton Tsoka, Jacob de
Hoop, Gustavo Angeles, Kelly Kilburn, Annamaria Milazzo
Acknowledgements: We thank the Government of Malawi for their
supportive engagement with the evaluation team, and for their time and
intellectual contributions, specifically Dr. Mary Shawa, Dr. Esmie Kainja,
Mr. Laurent Kansinjiro, Mr. Charles Chabuka and Mr. Gideon Kachingwe of
the Ministry of Gender, Children, Disabilities and Social Welfare, Mr. Harry
Mwamlima of the Ministry of Finance, Economic Planning and
Development, as well as the District Commissioner's Offices of Salima and
Mangochi. We would also like to acknowledge Chantal Elmont of Ayala
Consulting, and the research team CSR for their exceptional work. We
thank the European Union, the German Government through KfW, Irish
Aid, FAO, the International Initiative for Impact Evaluation (3ie), FCDO and
UNICEF Malawi for their financial contributions and support for the study.

13. • Carolina Population Center (CPC). 2016. Malawi Social Cash Transfer Programme endline impact
evaluation report. CPC: University of North Carolina at Chapel Hill (UNC).
https://transfer.cpc.unc.edu/wp-content/uploads/2015/09/Malawi-SCTP-Endline-Report_Final.pdf
• Cirillo C, Palermo T, & Viola F. 2021. Social Protection and Adolescents in Lower- and Middle-
Income Countries: A review of government programming and impacts. Working Paper.
• Molina Millan T, Barham T, Macours K, Maluccio JA & M Stampini. 2019. Long-term impacts of
conditional cash transfers: Review of the evidence. The World Bank Research Observer 34(1): 119-
159.
• Pettifor A, MacPhail C, Hughes JP, Selin A, Wang J, Gomez-Olive FX et al. 2016. The effects of a
conditional cash transfer on HIV incidence in young women in rural South Africa (HPTN 068): a
phase 3, randomized controlled trial. The Lancet Global Health 4(12): e978-e988.
• Slide 1: © FAO/IvanGrifi/19938536785_30eee0af63
• Slide 12: © UNICEF/UNI118064/Pirozzi
Works cited