Maternal Health Services, Outcome Assessment
Conditions
Brief summary
This is a follow-on study to a cluster randomized trial of maternal conditional incentives conducted in Nigeria. This study found that cash transfers, conditional on women obtaining facility-based prenatal, delivery, and postnatal care, resulted in large, significant effects on maternal and child outcomes (NICHD R01HD083444). This study will answer additional key policy questions. First, are the effects on maternal behavior temporary, or do they result in more sustained behavior change? Second, do measured short run (SR) child health effects persist over the long run? Third, did the program generate spillovers?
Detailed description
This study will build on what the study investigators learned from the RCT and extend it in novel directions. Research assistants will return to the study communities approximately 5 years after enrollment in the RCT to collect data on utilization of maternal health care services for births to the trial participants after the intervention, and on long run child health outcomes including child weight and height. The research assistants will also collect data on the birth outcomes of non-incentivized childbearing women in the study clusters. Data will be collected through in-person surveys of study participants. This study will provide valuable new evidence about the indirect and long run effects of demand-side incentives. This is of critical importance because accounting for only the direct effects may severely underestimate the full effect of the program.
Interventions
BEHAVIORALCash transfer in prior study
Women were offered a cash transfer conditional on attending prenatal and postnatal visits and delivering in a facility
Sponsors
RAND
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
13 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
for Households: * Resident in a community included in the RTC
Exclusion criteria
for Households: * None Inclusion Criteria for Women: * Women must have participated in an earlier randomized trial of conditional incentives OR * They did not take part in the earlier trial but are resident in clusters that participated in the earlier trial and have given birth since 2018
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of births that take place in a health facility | 4-5 years after RCT enrollment | Proportion of births that take place in a health facility |
| Proportion of women that attended prenatal care during pregnancy | 4-5 years after RCT enrollment | Proportion of women that attended prenatal care during pregnancy |
| Child survival | 4-5 years after RCT enrollment | Probability that child is alive |
| Child health utilization | 4-5 years after RCT enrollment | Proportion of children taken to a health facility for care when sick |
| Proportion of children receiving recommended immunizations | 4-5 years after RCT enrollment | Proportion of children receiving recommended immunizations |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal health | 4-5 years after RCT enrollment | Self-rated health |
| Child weight | 4-5 years after RCT enrollment | Child weight measured at visit |
| Child height | 4-5 years after RCT enrollment | Child height measured at visit |
| Birth outcome | 4-5 years after RCT enrollment | Probability of a live birth |
Countries
Nigeria
Contacts
PRINCIPAL_INVESTIGATOREdward N Okeke, MD, PhD
RAND
Outcome results
None listed