Effects of cash transfer and incentive programs on service utilization and treatment outcomes related to neglected tropical diseases and their impact on health and nutrition in low and middle-income countries: a protocol for a systematic review

BackgroundAlthough there has been a general decrease in the global burden on Neglected tropical diseases (NTDs), progress is not on track to meet the Sustainable Development Goals 2030. Evidence suggests the positive effect of conditional cash transfer programs on controlling NTDs. However, it is to be evaluated whether other financial incentive programs exert similar effects on NTD-related service utilization and treatment outcomes and, in turn, on health and nutrition in low and middle-income countries (LMICs). This proposed systematic review aims to evaluate the effects of cash transfer and incentive programs on NTD-related service utilization and treatment outcomes in LMICs, to examine how covariates, program design, implementation plan, and incentive program design influence these outcomes, and to examine how NTD-related these outcomes influence nutritional status and health in LMICs. MethodsThis systematic review will follow the PICOS (Population, Interventions, Comparators, Outcomes, Studies) framework. The population of this review will be restricted to the adult population and children of all ages of LMICs. For intervention selection, we will include any program or policies addressing socioeconomic disadvantage through the provision of cash transfers or incentive programs, including but not limited to in-kind transfers, food vouchers, free medicine vouchers, discount coupons, and micro-credit to households or individuals. Eligible comparators will be the population who did not receive any intervention, recipients of interventions from before the intervention, and populations or areas exposed to different levels of intervention coverage. The primary outcomes of interest will be service utilization and treatment outcomes related to any of the 21 NTDs and disease groups prioritized by WHO. Secondary outcomes include variables related to general health and nutrition outcomes. DiscussionTo provide a comprehensive and unbiased assessment of the current state of knowledge on the effects of cash transfer and other financial incentive programs on NTD-related service utilization and treatment outcomes in LMICs, conducting a systematic review is crucial. This systematic review will provide comprehensive, and unbiased evidence considering the strengths and limitations of existing knowledge on NTDs. Additionally, we will also explore how incentive type and program design influence NTD-related service utilization and treatment outcomes in LMICs. Ethics and disseminationThe systematic review protocol has been reviewed and approved by two independent institutional review boards (IRBs): icddr,b (PR-24112) in Bangladesh and Population Council Institute (IORG0011824) in India. The results will be submitted to a peer-reviewed journal and presented at national and international conferences to reach the scientific community. Systematic review registrationThe protocol has been registered in PROSPERO (CRD42024627804).