A Phenomenological Exploration of Conditional Cash Transfer As a Psychosocial Resilience Mechanism

Background: Cash transfer (CT) programs have gained global prominence as social protection strategies aimed at reducing poverty and enhancing well-being. While its prominence in Africa has culminated in extensive evidence of its economic outcomes, little evidence of its contribution to social and psychosocial well-being exists. Given the importance of such evidence to foster holistic well-being beyond economic outcomes among low-income households and communities, the urgent need for understanding non-economic outcomes associated with CT is relevant. Driven by the social determinants of health theory, this study explored the social and psychological contributions of the Livelihood Empowerment Against Poverty (LEAP) program, the flagship poverty alleviation program in Ghana. Engaging administrators and beneficiaries of the program, the study was guided by the following research question: How has CT contributed to the social and psychosocial well-being of its beneficiaries?

Methods: This study adopted a phenomenological design, as the research team sought to construct meaning based on participants’ interpretation of the social and psychosocial outcomes of the LEAP program. Given that the program has been operational in the Accra Metropolitan Area for over fifteen years, the study engaged 15 beneficiaries and four administrators who were purposively sampled based on their in-depth knowledge about the effect of the program. Utilizing interviews and observation, detailed data was collected from the participants using English and Twi, depending on participants’ proficiency in these languages. Using ATLAS.ti, obtained data were analyzed using Braun and Clarke’s thematic analytical framework.

Results: The LEAP program has directly or indirectly contributed to social and psychological outcomes, signifying its crucial role in holistic well-being. Socially, LEAP has contributed to increased school enrollment, health promotion, enhanced community interaction and support, and improvement in housing. Additionally, by fostering beneficiaries’ sense of security, self-esteem, and positive future orientation, it has advanced their mental health. The findings also highlight conditionalities as drivers for observed social and psychosocial contributions and point to their potentially crucial role if they are targeted at the evidenced poverty-associated non-economic needs of low-income populations. Furthermore, it shows that despite the CT program’s primary focus on poverty alleviation, it is a key social determinant of health, fostering positive mental well-being of beneficiaries.

Implications and Conclusion: This study highlights the value of integrating social and psychosocial goals into CT program design and underscores the potential of conditional CTs to address multidimensional poverty. Future research should examine long-term educational outcomes, demographic differences in program impact, and opportunities to incorporate explicit mental health components into CT programming. Additionally, beyond educational enrollment, future studies should assess school retention and academic performance among children from CT beneficiary households. Furthermore, given that the conditionalities in CT are requirements without which people cannot access the benefits, administrators should institute them based on the evidenced non-financial needs of the targeted low-income population to foster the fulfillment of such needs. Again, beyond cash transfer beneficiaries’ physical health, administrators should also explore including mental health components, given its prevalence among the low-income population.