Exploring health equity in Lesotho's child grants program
Kathryn Beck 6,7,8
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Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science/ Department of Public Health and Nursing, Norwegian University of Science and Technology , Norway
National University of Lesotho, Lesotho
University of Hull, United Kingdom
UNICEF Lesotho country office, Lesotho
Centre for Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway
Centre for Global Health Inequalities Research (CHAIN), Norway
Centre for Fertility and Health, Norway
Norwegian Institute of Public Health, Norwegian University of Science and Technology, Norway
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A748
Despite their growing popularity, little is known about how cash transfers can affect health disparities in targeted communities. Lesotho’s Child Grant Program (CGP) is an unconditional cash transfer targeting poor and vulnerable households with children. Started in 2009, the CGP is one of Lesotho’s key programs in developing the country’s social protection system. Using the CGP’s early phases as a case study, this research Aims to capture how program stakeholders understood and operationalized the concept of health equity in Lesotho’s CGP. The qualitative analysis relied on a desk review and semi-structured key informant interviews with program stakeholders. The program documents were coded deductively while the interview transcripts were coded inductively. Both materials were analyzed thematically before comparing their Findings. When differences or disagreements arose within a theme, we explored potential determining factors for these variations according to the program’s chronology, the stakeholders’ affiliations and their role(s) in the CGP. The definitions of health equity in the context of the CGP reflected the complexity and multi-dimensional (or even debated) nature of the concept. This concept was overwhelmingly defined as focusing on children’s access to health services for the most disadvantaged households. There was less agreement about other definitions of the concept, which seemed to be terminologies primarily used by specific stakeholders. These discrepancies in the definitions were further reflected in the role this concept played in the CGP, as the least common definitions were also comparatively less integrated into the program. Even the most common definitions of this concept didn’t seem fully operationalized throughout the program, especially in the day-to-day operations and reporting at the local level. This operationalization gap not only affected the study of selected health spillover effects of the CGP but also might have undermined other program impacts related to specific health disadvantages or gaps.
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