ARI SHAPIRO, HOST:
One of the major markers of development in any country is the infant and child mortality rate. In low-income countries, medical interventions like antimalarial drugs or vaccines can lower the mortality rate. But new research shows there's another powerful, simple tool. NPR's Jonathan Lambert has more.
JONATHAN LAMBERT, BYLINE: Across some parts of rural Kenya, roughly 40 of every 1,000 babies die before they turn 1.
TED MIGUEL: Infant and child mortality in rural Kenya is an order of magnitude higher than it is in the U.S.
LAMBERT: That's Ted Miguel, an economist at UC Berkeley. He says poverty is a major reason why, and he's studied a newish tool in the fight against poverty - simply giving people money. Cash, no strings attached. He's found that giving people cash can help them do things like start more businesses or save more money. And...
MIGUEL: Beyond, you know, economic benefits, there's the possibility that cash transfers will enable people to improve their health.
LAMBERT: Studying that, though, is tricky, especially for something like infant mortality.
MIGUEL: Even though there are high rates of infant and child mortality in Kenya, it's still a relatively rare event to have a child die.
LAMBERT: That means researchers need to study a lot of births and deaths to see if cash can prevent kids from dying. So Miguel teamed up with a nonprofit, GiveDirectly, to do a massive experiment. From 2014 to 2017, GiveDirectly gave $1,000 to over 10,000 of the most cash-strapped households across western Kenya.
MIGUEL: It was designed as a randomized controlled trial, so some areas got more cash, some got less cash, and we can study the impact of that cash.
LAMBERT: As it turned out, the cash really mattered for the 3,500 families with young children. Infant mortality dropped by nearly half. And 45% more kids reached their fifth birthday. All told, the researchers estimate that 86 deaths were averted.
MIRIAM LAKER: This is huge. This, for me, is an amazing, groundbreaking finding.
LAMBERT: That's Miriam Laker, GiveDirectly's senior research adviser. Part of that finding was figuring out the best way to give that cash. And timing, it turned out, was really key.
LAKER: Households where the women were in their final month of pregnancy or around the time of birth were more likely to have these amazing outcomes.
LAMBERT: In many regions like this, that's a challenge. Health facilities can be hard to get to and expensive. Laker says that means people often have to choose between health care and feeding their family.
LAKER: We've given people the means to access the care that they need.
LAMBERT: Extra cash can't always help, though. If people lived further than 30 minutes away from a health care facility with a doctor, the benefits started to drop. Heath Henderson is an economist at Drake University who is generally skeptical of cash aid. He praised the study, which was published by the National Bureau of Economic Research, but he says it shows it's not all about the cash.
HEATH HENDERSON: It's really adequate access to health care that's making all the difference. It just so happens that in this particular place, the people needed cash to access health care.
LAMBERT: To Miriam Laker, the study underlines the potential of cash but also shows it's not a silver bullet.
LAKER: The answer is not one or the other. It is not we give cash alone or we just focus on improving the health care system.
LAMBERT: Both need to be working together, she says, to give infants born in places like rural Kenya the same chances as those born in the U.S.
Jonathan Lambert, NPR News. Transcript provided by NPR, Copyright NPR.
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