Lessons from Ghana’s LEAP 1000 Programme
Social protection programmes have widely been used to tackle poverty and promote sustainable livelihoods in Global South countries. However, with a transformative social protection agenda and renewed focus on poverty graduation, these interventions are no longer only just about safety nets (maintaining current welfare levels). They are increasingly aimed at empowering poor households to invest, plan for the future, and improve their well-being. In short, interventions are shifting from being protective to being productive.
Some of these programmes follow a ‘cash-plus’ design, which combines traditional cash transfers with additional physical, psychological, or skills-based interventions. Further, they aim to address both psychosocial and capital constraints. In a new working paper, we share insights from Ghana’s LEAP 1000 programme, which includes both cash transfers and health insurance.
What Is LEAP 1000?
Ghana launched the LEAP 1000 cash-plus programme to support pregnant women or children under 15 months who reside in low-income households. In addition to monthly cash transfers, beneficiaries receive free enrollment in the national health insurance scheme. The programme was piloted in 10 districts in northern Ghana—areas with high poverty and malnutrition levels—and aimed to improve both economic and health outcomes in the critical early stages of a child’s life.
From protection to production – investments in livestock and livelihoods
The programme targeted households using a strict proxy means test, which decides who qualifies for the programme based on certain indicators of financial need. Households below the threshold were enrolled, while those above were deemed ineligible. This selection process meant that households were quite similar in terms of observable characteristics before the intervention.
Using data collected over two periods, we found that LEAP 1000 led to a 7.9% increase in livestock ownership, particularly in small animals like goats and poultry. These animals are important in rural economies, serving both as stores of value and sources of income. Interestingly, the increase wasn’t limited to ownership—commercialization (buying and selling of livestock) also rose, though less consistently.
Beyond livestock, the programme also boosted savings and increased participation in wage employment, suggesting that households were not only consuming the cash plus support from the programme, but also using it to strengthen their economic resilience.
The psychological side of poverty – behaviour matters
A standout feature of this study is its exploration of psychosocial pathways—how agency, socio-emotional skills, and future orientation (how people think about the future) influence economic behaviour. LEAP 1000 recipients reported greater happiness, higher expectations for the future, and an increased sense of agency—or a person's sense of control over their own life and decisions. These improvements were not just feel-good stories; they were statistically linked to higher rates of investment in assets and employment activities.
The study also notes a rise in present orientation (a preference for immediate rewards over future gains) and impatience, particularly among those receiving both cash and insurance. We believe this might reflect Ghana’s inflationary environment at the time of data collection, which may have made long-term planning less appealing. As of 2024, both annual headline inflation and food price inflation remain in double digits.
One of the most compelling findings is how time preferences—impatience, present bias, and future orientation—shaped investment behaviour. Impatient individuals were less likely to invest in durable goods or save money, especially if they received only cash. Conversely, those who were more future-oriented were more inclined to invest in assets and savings, particularly when they received both cash and insurance.
Cash + insurance: a better package?
When comparing the full ‘cash plus’ package (cash and health insurance) to cash-only support, we found that the combined treatment had stronger effects on most outcomes. Households that received both benefits were more likely to invest in livestock, save money, and engage in wage labour. However, the effects were nuanced. For instance, the cash-only group showed stronger gains in savings, possibly because they faced fewer transaction costs related to accessing health services.
Implications for policy and practice
This study challenges the common misconception that cash transfers encourage dependency. Instead, it shows that when designed thoughtfully—especially with add-ons like health insurance—cash transfers can stimulate productive investments, enhance well-being, and shift psychological mindsets in ways that support long-term welfare.
The findings highlight several important points. First, integrated support works. Combining financial assistance with health protection leads to better economic and productive outcomes. Second, psychosocial factors matter: happiness, a sense of control, and future expectations are not just by-products but critical to economic behaviour and should be given more attention in programme design. Finally, context is key: inflation and economic uncertainty can affect how people respond to cash transfers, so development policies and research should consider the broader macroeconomic environment when evaluating programme success.
As social protection evolves, programmes like LEAP 1000 show the way forward by empowering the poor not just to survive, but to thrive—with dignity, choice, and hope for the future.
Martin is a multi-awarded Economist (YP) with the World Bank where he supports the Department of Agriculture and Food.
Emmanuel is a Researcher at RWI Essen in the Economic Policy Lab on Climate Change, Development and Migration.
The views expressed in this piece are those of the authors, and do not necessarily reflect the views of the Institute or the United Nations University, nor the programme/project donors.