On: April 22, 2026

‍Aaron Richterman, a physician and assistant professor at the University of Pennsylvania, and Harsha Thirumurthy, an economist and fellow U Penn professor, have studied cash-transfer programs in 37 countries. “We’ve come to see a consistent logic behind why cash succeeds in some places and falls short in others,” the duo wrote in The Atlantic in February. “Cash transforms health when four particular conditions are met. Most U.S. cash-transfer pilots have lacked them.”

‍ While Richterman and Thirumurthy looked at health outcomes specifically, what they’ve found about the efficacy of cash transfers (or lack thereof) is something all cash transfer programs can benefit from understanding.

‍ First, in order to be effective, cash transfers have to be large enough to make a tangible difference in the costs associated with day-to-day life. Second, they have to be able to remove the barriers recipients face, many of which are linked to poverty. Third, scale influences success. “Successful cash-transfer programs reach large portions of the population. When millions of people receive support, the benefits spread beyond individual households, which helps explain why such programs have reduced mortality across entire countries,” the authors wrote. Finally, cash transfers are most successful when they’re integrated into the infrastructure on which families already rely.

The authors’ findings validate the work we’re doing at Family Health Project to put $400 a month into the hands of first-time moms for the first three years of their babies’ lives.

While we’re nowhere close to reaching millions of mothers, scaling effectively lies at the heart of what we do. By not looking to replicate services that our partners are already offering, we can reach more moms and communities faster than we could if we were reinventing the wheel every time we worked with a new health center or in a new location. Our partnerships with federally qualified health centers not only support our scaling, but also offer critical integration with services our moms already use.

In terms of the amount we offer ($400 a month) and the length of time we offer it (three years), the authors’ findings suggest that we’re on the right path.

The first inklings of what would become the Family Health Project started several years ago when our founder, Joe Knowles, came across a review of the book Invisible Americans: The Tragic Cost of Child Poverty by economist and journalist Jeffrey Madrick. The review noted that Madrick suggests in the book that direct cash transfers can offer a solution to poverty, Joe recalls.

As it happened, Joe was already investigating the creation of a visiting nursing program to address childhood health and poverty. But he was also realizing that a successful initiative would require significant structural change that included creating, training, and accrediting an entire new category of health worker. “We were trying to boil the ocean,” Joe recalled. “What we really needed was a strategy that would scale and have impact faster. Direct cash transfers were it.”

Madrick pointed Joe in the direction of Lisa Gennetain, an applied economist who studies child poverty. Starting in 2019, Gennetain and her co-investigators began a multi-disciplinary study called Baby’s First Years that’s ongoing today.

Gennetain and company’s research looks at the impact that monthly, unconditional cash transfers for the first three years of recipient’s babies’ lives make in the lives of both moms and children. So far, the findings have been astonishing—from reducing poverty to increased spending on child-specific goods, the impact of the $333 per month that the study’s participants receive has already been made clear.

If $333 a month secures these benefits, surely $400 a month would, too. Plus, the math is easier. And that’s how the $400 per month amount we give to first-time moms became our magic number. Then, when Joe reached out to Kiame Mahaniah—then-CEO of Lynn Community Health Center, our first partner—a bit of serendipity affirmed that thought.

“When I told him the amount, $400, he said, ‘You know, that’s really interesting,’” Joe recalls. Mahaniah told Joe that when he was living in Germany and going to university years ago, he had his first son. Despite not being German citizens, the next month a check for $400 from the German government came in the mail. And it kept coming every month after that for the first five years of Mahaniah’s son’s life. If $400 was good enough for Germany, it would be good enough for FHP.

So far, according to the dozens of moms we have served to date, we weren’t wrong to think that $400 a month can make a major difference.

One of our moms was just 17 when she gave birth. She was living with her brother’s family at the time. She used the money she received to contribute to rent so that she could go to her GED classes without feeling like a burden for relying on her brother and his family to babysit while she finished her education.

Another mom was able to get the healthcare she needed to address the cancer she was diagnosed with when she was pregnant. Other moms have used the money to be able to throw their children a birthday party, complete with a cake and a couple of balloons rather than nothing. Yet another shared that the relief she found in knowing that money was coming in every month helped alleviate her postpartum depression.

Some moms share details about their situations with us while others, like those who are undocumented, often prefer not to. And that’s ok. We don’t police or monitor what moms do with the money. What we know about what they spend it on comes from what they’ve chosen to share with us

We don’t have to track their spending because we know that moms know what they need best. We know that there are enough other support programs out there that come with onerous monitoring and reporting, and that moms don’t need another person or organization looking over their shoulder. We know that the research shows that cash transfers don’t lead to working less, quitting work, or the consumption of what are called “temptation goods”. We know, thanks to research like Gennetain’s, that this modest amount of guaranteed monthly income makes major differences in the lives of moms, their kids, and their families.