The quality of evidence on the effect of financial incentives on breastfeeding practice s was low but seems to indicate a potential positive impact on receiving colostrum , early initiation of breastfeeding , exclusive breastfeeding and mean duration of exclusive breastfeeding .
There is no effect of financial incentives on immunization coverage although there was moderate quality evidence of conditional cash transfers leading to a small but non-significant increase in coverage of age-appropriate immunization .
Conclusions Financial incentives may have potential to promote increased coverage of several important child health interventions , but the quality of evidence available is low .
The more pronounced effects seem to be achieved by programs that directly removed user fees for access to health services .
Some indication of effect were also observed for programs that conditioned financial incentives on participation in health education and attendance to health care visits .
This finding suggest that the measured effect may be less a consequence of the financial incentive and more due to conditionalities addressing important informational barriers
Background Financial incentives are widely used strategies to alleviate poverty , foster development , and improve health .
Cash transfer programs , microcredit , user fee removal policies and voucher schemes that provide direct or indirect monetary incentives to households have been used for decades in Latin America , Sub-Saharan Africa , and more recently in Southeast Asia .
Until now , no systematic review of the impact of financial incentives on coverage and uptake of health interventions targeting children under 5 years of age has been conducted .
The objective of this review is to provide estimates on the effect of six types of financial incentive programs : ( i ) Unconditional cash transfers ( CT ) , ( ii ) Conditional cash transfers ( CCT ) , ( iii ) Microcredit ( MC ) , ( iv ) Conditional Microcredit ( CMC ) , ( v ) Voucher schemes ( VS ) and ( vi ) User fee removal ( UFR ) on the uptake and coverage of health interventions targeting children under the age of five years .
Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial
Summary Background Cash-transfer programmes can improve the wellbeing of vulnerable children , but few studies have rigorously assessed their effectiveness in sub-Saharan Africa . We investigated the effects of unconditional cash transfers ( UCTs ) and conditional cash transfers ( CCTs ) on birth registration , vaccination uptake , and school attendance in children in Zimbabwe . Methods We did a matched , cluster-r and omised controlled trial in ten sites in Manical and , Zimbabwe . We divided each study site into three clusters . After a baseline survey between July , and September , 2009 , clusters in each site were r and omly assigned to UCT , CCT , or control , by drawing of lots from a hat . Eligible households contained children younger than 18 years and satisfied at least one other criteria : head of household was younger than 18 years ; household cared for at least one orphan younger than 18 years , a disabled person , or an individual who was chronically ill ; or household was in poorest wealth quintile . Between January , 2010 , and January , 2011 , households in UCT clusters collected payments every 2 months . Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing . Eligible households in all clusters , including control clusters , had access to parenting skills classes and received maize seed and fertiliser in December , 2009 , and August , 2010 . Households and individuals delivering the intervention were not masked , but data analysts were . The primary endpoints were proportion of children younger than 5 years with a birth certificate , proportion younger than 5 years with up-to- date vaccinations , and proportion aged 6–12 years attending school at least 80 % of the time . This trial is registered with Clinical Trials.gov , number NCT00966849 . Findings 1199 eligible households were allocated to the control group , 1525 to the UCT group , and 1319 to the CCT group . Compared with control clusters , the proportion of children aged 0–4 years with birth certificates had increased by 1·5 % ( 95 % CI −7·1 to 10·1 ) in the UCT group and by 16·4 % ( 7·8–25·0 ) in the CCT group by the end of the intervention period . The proportions of children aged 0–4 years with complete vaccination records was 3·1 % ( −3·8 to 9·9 ) greater in the UCT group and 1·8 % ( −5·0 to 8·7 ) greater in the CCT group than in the control group . The proportions of children aged 6–12 years who attended school at least 80 % of the time was 7·2 % ( 0·8–13·7 ) higher in the UCT group and 7·6 % ( 1·2–14·1 ) in the CCT group than in the control group . Interpretation Our results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa , but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region . Funding Wellcome Trust , the World Bank through the Partnership for Child Development , and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children
The quality of evidence on the effect of financial incentives on breastfeeding practice s was low but seems to indicate a potential positive impact on receiving colostrum , early initiation of breastfeeding , exclusive breastfeeding and mean duration of exclusive breastfeeding .
There is no effect of financial incentives on immunization coverage although there was moderate quality evidence of conditional cash transfers leading to a small but non-significant increase in coverage of age-appropriate immunization .
Conclusions Financial incentives may have potential to promote increased coverage of several important child health interventions , but the quality of evidence available is low .
The more pronounced effects seem to be achieved by programs that directly removed user fees for access to health services .
Some indication of effect were also observed for programs that conditioned financial incentives on participation in health education and attendance to health care visits .
This finding suggest that the measured effect may be less a consequence of the financial incentive and more due to conditionalities addressing important informational barriers
Background Financial incentives are widely used strategies to alleviate poverty , foster development , and improve health .
Cash transfer programs , microcredit , user fee removal policies and voucher schemes that provide direct or indirect monetary incentives to households have been used for decades in Latin America , Sub-Saharan Africa , and more recently in Southeast Asia .
Until now , no systematic review of the impact of financial incentives on coverage and uptake of health interventions targeting children under 5 years of age has been conducted .
The objective of this review is to provide estimates on the effect of six types of financial incentive programs : ( i ) Unconditional cash transfers ( CT ) , ( ii ) Conditional cash transfers ( CCT ) , ( iii ) Microcredit ( MC ) , ( iv ) Conditional Microcredit ( CMC ) , ( v ) Voucher schemes ( VS ) and ( vi ) User fee removal ( UFR ) on the uptake and coverage of health interventions targeting children under the age of five years .