Poverty alleviation policies, especially cash transfers, will not only improve the poor condition of the beneficiaries but can also play a role in strengthening the psychological health of people as well as improve the mental health of those living in poverty in low- and middle-income countries (LMICS), including Africa, a new study has said.
An example of these poverty alleviation programmes is the Livelihood Empowerment Against Poverty (LEAP), under Ghana’s ministry of gender, children and social protection for extremely poor and vulnerable households. This is made up of orphaned children, persons with severe disabilities without productive capacity as well as elderly persons who are 65 and above.
The aim is to improve, among other things, basic household consumption, and nutrition among children below two years of age and the aged. It is also intended to increase access to health care services among children below five years of age.
The study found more than 20,000 Africans, out of 26,794 people receiving these cash transfers under poverty alleviation programmes in six countries across Africa, admitted that this financial assistance does have some effect on their mental health.
A co-author of the study, Clara Wollburg, affiliated with the department of social policy and intervention, University of Oxford, Oxford, told IPS, “13 out of the 17 studies were conducted in Sub-Saharan Africa. Of those studies, four were located in Malawi, four in Kenya, two in South Africa, and one each in Zambia, Mali, and Uganda.”
The World Health Organization defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.” And in Africa, StrongMinds Uganda says “despite the high prevalence of mental illnesses across the continent, mental health remains under prioritized in many African countries.”
The study, “Do cash transfers alleviate common mental disorders in low- and middle-income countries? A systematic review and meta-analysis,” published in PLOS One journal on February 22, 2023, said their “findings lend weight to the hypothesis that poverty alleviation can play a role in strengthening psychological health of people living in poverty in Low and Middle-Income Countries (LMICs.)”
It said their “analysis shows that providing populations living in poverty with cash transfers leads to improvements of depression and anxiety disorders. However, these benefits may not be sustained once the financial support ends,” the authors said.
Nigerian-born associate professor in psychiatry living in the US, Andrews O Newton, said the recent Central Bank of Nigeria (CBN) decision that has denied a lot of people access to cash could lead to depression. “Depression is the commonest form of mental illness. However, most people do not know because sufferers are not seen outside. The chronic stress caused by governmental policies makes it more severe, and one terrible consequence is suicide,” Newton said. The CBN has since been legally obliged to delay its deadlines to redesign the currency.
He said, “extreme poverty dehumanizes,” adding that such a situation is likely to lead to “feeling sad and empty, poor concentration, lack of drive and motivation, poor sleep as well as lack of energy.
The study focused on people living in poverty, who are recipients of cash transfers, and participants in inactive control groups, who received no transfers or were enrolled at a later stage, served as a comparison group. Active control groups receiving alternative interventions were not included, as this makes a causal inference about the effects of the transfers difficult.
They included conditional and unconditional cash transfer programmes (CTPs) targeted at households living in poverty in LMICs but did not apply an absolute low-income/poverty threshold, relying only on the relative threshold for grant eligibility applied by the organizations administering the transfers.
“Our findings have important implications for policymakers in Africa as they show that providing cash transfers to people living in poverty not only improves poverty indicators and school attendance, for example, but also meaningfully impacts depression and anxiety outcomes of beneficiaries. This is especially true for unconditional cash transfers,” Wollburg said.
She said they analyzed cash transfer programs that were specifically targeted to low-income and/or deprived households as indicated by, e.g., low monthly household expenditure and consumption, inability to meet basic needs, food insecurity, low educational attainment and high HIV risk.
Esenam Abra Drah, a mental health advocate in the Ghanaian capital, Accra, said, “from personal experience if you don’t have money, it can be frustrating.” Esenam understands this because she was diagnosed with bipolar disorder in August 2015 at the time she was studying Bachelor of Arts degree in French and Linguistics at the University of Ghana.
Currently serving as an executive member of Psychosocial Africa, a grassroots mental health support group set up by, and for people with lived experience of mental illness, Drah admitted as the study showed that her situation affected her schoolwork though she was able to graduate.
The study cautioned that policies aiming to address the poverty-mental health cycle should consider unconditional, longer-term support to populations living in poverty.
IPS UN Bureau Report