How to reduce the number of female deaths? Give away cash.

Why it matters: Poverty is a big killer.

In 2019, more than 8 percent of the world’s population lived in extreme poverty, living on less than $2.15 a day, and about half the world living on less than $6.85 a day. Poverty has insidious consequences for housing stability, education, health and life expectancy.

The pandemic pushed an additional 97 million people into extreme poverty in 2020, according to one estimate by the World Bank, leading more countries to launch remittance programs. Of the 962 such programs worldwide, 672 were introduced during the pandemic.

Direct remittances have been shown to improve school attendance, nutrition and use of health services. A few studies in one country have linked the payments to reduced mortality rates. But it was unclear whether those trends applied on a global scale.

“There are some concerns about whether these programs are sustainable, whether governments can and should pay for them,” said Harsha Thirumurthy, an economist at the University of Pennsylvania and a co-author of the analysis.

Background: Small payments, big impact.

More than 100 low- and middle-income countries have introduced money transfer programs to reduce poverty, although they vary widely in how much they pay, how often and to whom.

The new study is the first to examine the effect of cash transfers on death rates worldwide, the researchers said. Between 2000 and 2019, they collected information about these programs in 29 countries in sub-Saharan Africa, one in North Africa, four in the Asia-Pacific region, and three in Latin America and the Caribbean.

The data includes information on more than 4 million adults and nearly 3 million children. About 300,000 deaths were recorded during the study. Recipients received between 6 percent and 13 percent of a country’s per capita income, often much less than $100.

“These are not amounts anywhere near what we are talking about in the US when it comes to guaranteed income programs,” said Dr. Thirumurthy.

Still, the findings are relevant even to high-income countries, said Audrey Pettifor, a social epidemiologist at the University of North Carolina at Chapel Hill who studies remittances for HIV prevention and women’s health.

Donors often worry that beneficiaries could misuse the money to buy alcohol, junk food or other non-essential items, but “the data just doesn’t support that,” she said.

What’s Next: The benefits could extend to entire communities.

The researchers couldn’t identify the beneficiaries, so they analyzed the mortality rates at the population level. The findings suggest that remittances can benefit not only women, but also families and entire communities.

“These social protection programs actually account for the vast majority of income” in households in places like South Africa, said Dr. Pettifor. “You would expect these spillover effects.”

Berk Özler, a development economist at the World Bank’s research division, offered an alternative explanation. Cash transfers are common accompanied by improvements to health care services or other infrastructure that helps communities, he noted.

“Maybe it’s not the direct effect of people carrying more money,” he said.

The study did not look at adults over age 60 or specific features of the programs, such as the length or frequency of payments, whether the beneficiaries are men or women, how the money is provided, and whether it is bundled with counseling or education.

“I think it’s helpful to look at that in future work,” said Dr. Thirumurthy.