Implementing a Cash Transfer Program in Ethiopia: Adaptations, Early Implementation Outcomes, and Lessons Learned

Abstract

Survival for common and curable childhood cancers exceeds 90%-95% in high-income countries, but remains approximately 40% in sub-Saharan Africa, where treatment abandonment-largely driven by out-of-pocket costs-is common. We implemented an unconditional €200 cash transfer program in two pediatric oncology centers in Ethiopia, adapted from a successful Malawi pilot. Using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework, we describe local context, pragmatic adaptations to the implementation strategy, and early implementation outcomes. This brief report highlights the importance of context-responsive design and systematic assessment of implementation outcomes to support fidelity, equity, sustainability, and future scale-up in low-resource settings.