Long Term Effects Of a Maternal Cash Transfer Experiment

Study Overview
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Brief Summary
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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
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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.

Official Title
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Long Term Effects of an Intervention on Maternal Behavior, Child Health, and Community Influence

Conditions
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Maternal Health Services, Outcome Assessment

Intervention / Treatment
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* Behavioral: Cash transfer in prior study


Participation Criteria
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Eligibility Criteria
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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 Exclusion Criteria for Women: -

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: RCT Participants<br>Women and children who participated in the earlier study. | Behavioral: Cash transfer in prior study<br>* Women were offered a cash transfer conditional on attending prenatal and postnatal visits and delivering in a facility<br>|
| No Intervention: Non-RCT participants<br>Women and children in the same communities included in the earlier study who did not participate in that study. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of births that take place in a health facility | Proportion of births that take place in a health facility | 4-5 years after RCT enrollment | 
| Proportion of women that attended prenatal care during pregnancy | Proportion of women that attended prenatal care during pregnancy | 4-5 years after RCT enrollment | 
| Child survival | Probability that child is alive | 4-5 years after RCT enrollment | 
| Child health utilization | Proportion of children taken to a health facility for care when sick | 4-5 years after RCT enrollment | 
| Proportion of children receiving recommended immunizations | Proportion of children receiving recommended immunizations | 4-5 years after RCT enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maternal health | Self-rated health | 4-5 years after RCT enrollment | 
| Child weight | Child weight measured at visit | 4-5 years after RCT enrollment | 
| Child height | Child height measured at visit | 4-5 years after RCT enrollment | 
| Birth outcome | Probability of a live birth | 4-5 years after RCT enrollment |