What difference do cash transfers make? Understanding impacts and mechanisms from cash transfer recipients and communities in Malawi and Lesotho.

Cash transfers are a common poverty alleviation intervention, yet qualitative reports of recipients’ lived experiences are limited. To address this gap, we analyzed 77 in-depth interviews with cash transfer recipients and their household members in rural Malawi and Lesotho. Using reflexive thematic analysis, we created four themes: 1) cash transfers help address basic needs but are not enough for structural change, 2) grandmothers share cash transfers within intergenerational networks of care, 3) cash transfers bring psychological relief and restore dignity, but difficulty and uncertainty in obtaining them create stress, and 4) stigma and jealousy arise from community perceptions about the deservingness of ‘sky-falling’ and ‘satanic’ money. Recipients consistently noted improvement in food security, while effects on mental health and social relationships were more mixed. We argue that recipient-centered reports complement and strengthen quantitative evidence about the impacts and mechanisms of cash transfers. We discuss specific policy recommendations, such as larger and more predictable payments, better communication, and sensitive disbursement options, gender-sensitive support, and more active monitoring of psychosocial and community effects in order to mitigate potential negative impacts. Finally, we argue there is a need for a more ambitious focus on development as the key path to poverty eradication.