The Social and Productive Impacts of Zambia's Child Grant

Accumulated evidence from dozens of cash transfer (CT) programs across the world suggests that there are few interventions that can match the range of impacts and cost‐effectiveness of a small, predictable monetary transfer to poor families in developing countries. However, individual published impact assessments typically focus on only one program and one outcome. This article presents two‐year impacts of the Zambian Government's Child Grant, an unconditional CT to families with children under age 5, across a wide range of domains including consumption, productive activity, and women and children's outcomes, making this one of the first studies to assess both protective and productive impacts of a national unconditional CT program. We show strong impacts on consumption, food security, savings, and productive activity. However, impacts in areas such as child nutritional status and schooling depend on initial conditions of the household, suggesting that cash alone is not enough to solve all constraints faced by these poor, rural households. Nevertheless, the apparent transformative effects of this program suggest that unconditional transfers in very poor settings can contribute to both protection and development outcomes.     

A potentially catastrophic outcome from a false-positive urinary drug screen immunoassay

Background: Urinary drug screens are routinely administered for patients returning from leave from forensic psychiatric wards, and are required to be negative for patients to continue to use their allocated leave. Case: A 35-year-old woman took leave from her low-secure psychiatric unit. On return, her urine screened positively for 3,4-Methylenedioxymethamphetamine (MDMA). She strongly denied she had taken it; however, all her leave was cancelled. Her clinical state greatly deteriorated, and she attempted to hang herself the following day. After stabilisation of the patient and continued denial of taking MDMA, the urine was sent for toxicology analysis. In the weeks that followed, she started self-harming and deteriorated to the point of needing electroconvulsive therapy. The toxicological report came back as a false-positive due to recently started Mebeverine. Conclusion: Clinicians must be mindful that urinary drug screens are not diagnostic, but also that not being believed can be devastating, especially for long-stay forensic inpatients.     

Identifying and managing evaluator biases in parenting plan evaluations

Psychologists and other professionals are often appointed by the courts to assist families in resolving post-separation disputes and to assist judges in making orders on behalf of the best interests of the child(ren). Although these evaluations provide valuable information to the court, they require assessing areas of human behavior that are imprecisely defined or lacking professional consensus. As parents separate, their disputes may become more challenging, and they may act in uncharacteristic and unpredictable ways. Families that cannot solve their own challenges outside of court often show high levels of conflict and/or have issues that are extremely complex, including domestic violence allegations, resist-refuse family dynamics, and relocation requests. Evaluators and judges, being human, tend to oversimplify complex issues due to the limitations of the human brain. Evaluators are subject to cognitive biases that result from the use of mental heuristics, leading to shortcuts and errors in their reasoning and judgment. Other biases, such as implicit and explicit cultural biases, often influence evaluators' reasoning and conclusions. This article explores various biases that affect and potentially diminish the quality of an evaluator's work. We conclude by addressing “de-biasing” strategies that can reduce, but not negate, the risks associated with such biases.