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- Beidelman, Erika T., et al.
(författare)
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Impact of the South African child support grant on memory decline and dementia probability in rural and low-income mothers, 2014–2021
- 2024
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 358
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Aging populations across sub-Saharan Africa are rapidly expanding, leading to an increase in the burden of Alzheimer's disease and related dementias (ADRD). Cash transfer interventions are one plausible mechanism to combat ADRD at a population-level in low-income settings. We exploited exogenous variation in eligibility for South Africa's Child Support Grant (CSG) to estimate the longitudinal association between potential CSG benefit and cognitive trajectories in rural mothers with <10 children (n = 1090).Methods: South Africa's CSG delivers monthly cash payments to primary caregivers, predominantly mothers, to offset the costs associated with child rearing. This study implemented a quasi-experimental design using data (2014–2022) from a rural, low-income cohort in the Agincourt research area, South Africa. We fit linear mixed effects models and generalized linear models to estimate the association of potential CSG benefit per eligible child with memory decline and dementia probability, respectively. We stratified all models by the mother's total number of children (1–4 and 5–9) and examined effect modification by household wealth and the mother's education level.Results: Having above median CSG per eligible child was associated with higher baseline memory scores (β = 0.12 SD units, 95% CI = 0.02, 0.22) but steeper memory decline (β = −0.02 SD units, 95% CI = −0.04, -0.00) compared to below median CSG. Within stratified analyses, this effect was primarily observed among mothers with 5–9 children. No associations were observed between potential CSG per eligible child and dementia probability.Conclusions: Our findings support the use of large-scale cash transfers as a promising intervention to promote healthy cognitive aging in mid-life women within rural, low-income settings. However, we found evidence that the CSG in its current structure may not be sufficient support for women to sustain measurable cognitive benefits over the long-term.
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| 2. |
- Chakraborty, Rishika, et al.
(författare)
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Child support grant expansion and cognitive function among women in rural South Africa : findings from a natural experiment in the HAALSI cohort
- 2024
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 19:3 March
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cash transfers are a promising but understudied intervention that may protect cognitive function in adults. Although South Africa has a rapidly ageing population, little is known about the nature of association between cash transfers and cognitive function in this setting. Objectives We leveraged age-eligibility expansions to South Africa's Child Support Grant (CSG) to investigate the association between duration of CSG eligibility and cognitive function of biological mothers of child beneficiaries in South Africa.Methods: We analysed 2014/2015 baseline data from 944 women, aged 40–59 years with at least one CSG-eligible child, enrolled in the population-representative HAALSI cohort in Agincourt, South Africa. Duration of CSG eligibility for each mother was calculated based on the birth dates of all their children and the CSG age-eligibility expansion years (2003–2012). Cognitive function was measured using a cognitive battery administered at the HAALSI baseline interview. Linear regression was used to estimate the association between duration of CSG eligibility, dichotomized as low (≤10 years) and high (>10 years) eligibility, and cognitive function z-scores of the mothers.Results: High vs. low duration of CSG eligibility, was associated with higher cognitive function z-scores in the full sample [β: 0.15 SD units; 95% CI: 0.04, 0.26; p-value = 0.01]. In mothers with one to four lifetime children, but not five or more, high vs. low duration of CSG eligibility, was associated with higher cognitive function z-scores [β: 0.19 SD units; 95% CI: 0.05, 0.34, p-value = 0.02].Conclusion: Government cash transfers given to support raising children may confer substantial protective effects on the subsequent cognitive function of mothers. Further studies are needed to understand how parity may influence this relationship. Our findings bring evidence to policymakers for designing income supplementation programmes to promote healthy cognitive ageing in low-income settings.
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