Impacts of the “Ujana Salama” Cash Plus Program Across Multiple Domains of Well-Being for Adolescents With and Without Disability: Results of a Cluster-Randomized Controlled Trial in Tanzania

Purpose: Youth with disabilities are more likely to live in poverty, have poorer health, be out of school and work, and face other forms of exclusion. Cash plus programs have shown promise for boosting the impacts of cash transfers, yet few studies have assessed their impact among adolescents with disabilities. Methods: The “Ujana Salama” Cash Plus Program targets adolescents living in households already receiving the Productive Social Safety Net (PSSN) Tanzania to provide additional skills training, mentoring, and health service linkages. We conducted a secondary analysis of an 18-month cluster-randomized control trial (n = 2,191) in 2018–2019 to understand how adolescents with disabilities' livelihoods, health, violence, and education changed by participating in the additional adolescent-targeted program compared to PSSN cash transfers alone. Disability was measured post baseline at the second follow-up with Washington Group Questions and analysis of covariance was used to estimate program impacts. Results: Among adolescents with disabilities, Ujana Salama plus PSSN increased farm work by 11 percentage points (p.p) (95% confidence interval (CI), 0.01, 0.22, p < .05) and reduced sexual violence by 26 p.p (95% CI −0.54, 0.02, p < .10) in preferred models. In stratified models (less preferred), we also find evidence suggesting the intervention improved self-rated health by 9 p.p (95% CI −0.01, 0.18, p < .10) and reduced the probability of school attendance or completion by 6 p.p (95% CI −0.13, 0.01, p < .10). Discussion: This program showed some benefits for adolescents with disabilities. Further work is needed to explore how cash-plus programs achieve greater impact and ensure disability-inclusion in these programs.