When governments in low- and middle-income countries gave people cash, women sought prenatal care earlier, more babies were born in hospitals, and more children received vaccines. That is the striking conclusion of a new study from the University of Pennsylvania Perelman School of Medicine, published in The Lancet.
Analyzing data from over two million live births and nearly one million children under age five across 37 countries, including Haiti, Malawi, and Cambodia, researchers found that large-scale, government-led cash transfer programs measurably improved health outcomes. The benefits extended beyond direct recipients, signaling population-wide change.
Improved Maternal and Child Health
The team found that women in countries with cash transfer programs were more likely to plan pregnancies, receive early prenatal care, and deliver in health facilities attended by trained professionals. They were also better able to obtain and use birth control when they needed it. Babies were more likely to be exclusively breastfed, children were more likely to get nutritious diets, and rates of measles vaccination climbed.
These results built on the same research group’s earlier work in Nature, which showed that cash transfers led to steep declines in mortality rates among women and children. In the new analysis, the authors examined 17 health-related indicators across 20 countries that had adopted national cash transfer systems between 2000 and 2019.
“As many countries consider the future of their cash transfer programs, including approaches such as basic or guaranteed incomes, this research highlights the broad health benefits these programs can deliver,” said Aaron Richterman, MD, MPH, assistant professor of Infectious Diseases at the University of Pennsylvania and one of the study’s lead authors.
Cash transfer programs vary in size and design, but those that reached a greater share of the population produced the strongest health improvements. In statistical terms, countries with such programs saw higher rates of early antenatal care, more facility-based deliveries, longer intervals between births, fewer children reported as underweight, and lower rates of diarrheal disease.
Beyond Poverty Relief
The researchers emphasize that the impact extends far beyond traditional poverty metrics. More than 20 percent of the global population still lives on less than $3.65 a day, and about 700 million people survive on less than $2.15. The COVID-19 pandemic worsened those numbers, with tens of millions pushed into extreme poverty. By strengthening maternal and child health systems through financial stability, cash transfers may indirectly reduce long-term public health burdens.
Interestingly, the study’s findings also echo policy discussions in wealthier countries. The same research team previously showed that cuts to temporary Supplemental Nutrition Assistance Program (SNAP) benefits in the U.S. increased food insufficiency. Programs like Flint, Michigan’s Rx Kids initiative, offering $1,500 during pregnancy and $500 per month in the baby’s first year, mirror the global findings at a local level.
“The evidence from this study strengthens the case for countries to expand the coverage of cash transfers,” said Harsha Thirumurthy, PhD, Professor and Chief of the Division of Health Policy at Penn and co-author of the paper. “Cash transfer programs impacted not only mothers, but their children, and led to a broad array of health improvements.”
The research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health. By demonstrating how simple financial interventions can ripple through entire health systems, the study reframes the conversation about social policy: giving people money, it turns out, may be one of the most effective public health strategies available.
The Lancet: 10.1016/S0140-6736(25)02166-8
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