A Comparative Analysis of Cash Transfer Programmes and Their Impact on Health Service Utilisation and Nutritional Outcomes in Ghana, 2021–2026

This comparative study examines the differential impacts of two major cash transfer programmes—the Livelihood Empowerment Against Poverty (LEAP) and the Ghana Productive Safety Net Project (GPSNP)—on health service utilisation and nutritional outcomes in Ghana. It addresses the critical evidence gap regarding which programme design most effectively converts economic support into measurable health gains within a Sub-Saharan African context. Employing a longitudinal, mixed-methods design, the research analysed secondary household survey data from the Ghana Statistical Service, triangulated with key informant interviews and beneficiary focus group discussions across four purposively selected districts. Quantitative analysis employed fixed-effects regression models to control for unobserved heterogeneity. Findings indicate that while both programmes positively influenced antenatal care attendance and child immunisation, the LEAP programme, with its explicit health conditionality checks, demonstrated a stronger, statistically significant association with improved dietary diversity scores among children under five and reduced stunting prevalence. Conversely, the GPSNP, emphasising productive inclusion, showed a greater impact on aggregate household food expenditure but yielded less consistent nutritional outcomes. The study concludes that the deliberate integration of health conditionalities within cash transfer design is pivotal for maximising health and nutrition co-benefits. These findings hold significance for policymakers across Africa, underscoring the need to strengthen linkages between social protection and public health systems to accelerate progress towards Universal Health Coverage and the Sustainable Development Goals.