Can Cash Transfers Save Lives? Evidence from a Large-Scale Experiment in Kenya

We estimate the impacts of large-scale unconditional cash transfers on child survival. One-time transfers of USD 1000 were provided to over 10,500 poor households across 653 randomized villages in Kenya. We collected census data on over 100,000 births, including on mortality and cause of death, and detailed data on health behaviors. Unconditional cash transfers (accounting for spillovers) lead to 48% fewer infant deaths before age one and 45% fewer child deaths before age five. These improvements appear to arise from better maternal health and nutrition, a 53% reduction in labor supply around the time of childbirth, and a 45% increase in hospital delivery. There is a transient 10% increase in fertility, but mortality reductions are largest in households receiving transfers after pregnancies began, ruling out selection bias. Mortality effects dissipate rapidly when cash is distributed more than three months from the birth. Mortality reductions are concentrated among households with limited (monetary) consumption gains, suggesting a trade-off between financial and health investments.