Can Small Incentives Have Large Payoffs? Health Impacts of a Cash Transfer Program in Bolivia

Celhay, Pablo; Johannsen, Julia; Martínez, Sebastián; Vidal, Cecilia

doi:10.1086/703085

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…In these contexts, demand-side interventions such as conditional cash transfers or transportation vouchers could be alternative policy options to boost obstetric care utilisation. Conditional cash transfers, which condition monetary payments on health service utilisation, have been shown to effectively increase the utilisation of health services, including in rural and indigenous contexts 22–25. Transfer amounts could be set in relation to distance, with higher amounts in more distant communities to compensate for the opportunity cost of time and higher transportation costs.…”

Section: Discussionmentioning

confidence: 99%

Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

et al. 2020

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ObjectivesWe assess the relationship between distance to a woman’s assigned health clinic and obstetric care utilisation.DesignWe employ a cross-sectional study design using baseline data from the evaluation of a conditional cash transfer programme to promote greater utilisation of maternal and infant health services. Data were collected between December 2016 and January 2017.SettingThe study is conducted in Ngäbe Buglé, the largest of Panama’s three indigenous territories, where maternal mortality is three times the national average.ParticipantsWe analyse a representative sample of 1336 indigenous women with a birth in the 12 months prior to the survey.Primary and secondary outcome measuresPrimary outcomes include obstetric care utilisation measures for prenatal, childbirth and postpartum events. Secondary outcomes include reasons for not receiving prenatal care, alarming symptoms, child weight at birth and stillbirths or miscarriages.ResultsCompared with women in closest geographic proximity to a health centre (top quintile, Q1), women who lived farthest from a health centre (bottom quintile, Q5) had significantly lower obstetric care utilisation outcomes for critical prenatal, childbirth and postpartum events. Mothers in Q5 were 36 percentage points less likely to have had at least one prenatal care appointment in a hospital, health centre or clinic compared with mothers in Q1 (p<0.01), and 52 percentage points less likely to attend an institutional first appointment (p<0.01). The gap in institutional delivery and postnatal care between mothers in Q1 and Q5 was about 35 percentage points (p<0.01). All utilisation outcomes were negatively correlated with distance, and differences in obstetric care utilisation persisted even when controlling for household wealth, maternal age and maternal education.ConclusionDistance is an important barrier to obstetric care utilisation, with women in more distant locations suffering significantly lower use of prenatal, childbirth and postpartum care compared with women in closer vicinity to a health establishment. Expanding the supply of healthcare and implementing demand side incentives to promote the use of health services in remote communities are relevant policies to reduce disparities in obstetric care utilisation.Trial registration numberAEA Registry (RCT ID AEARCTR-0001751).

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Section: Discussionmentioning

confidence: 99%

Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

et al. 2020

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“…One notable exception is a CCT from Bolivia. Celhay et al (2016) identify a significant reduction in rates of still birth following receipt of a relatively small CCT. In section 5.2 of this paper we benchmark the impacts of a range of early-life health programs such as WIC.…”

Section: Existing Evidence On the Impact Of Early Life Programs On Infant Healthmentioning

confidence: 94%

Growing Together: Assessing Equity and Efficiency in an Early-Life Health Program in Chile

2018

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“…fParker and Todd (2017); supporting information on targeting system, benefit structure, payment frequency and duration is synthesized from the Celhay et al (2017), Dogherty (2014), McGuire (2013), Medellin and Prada (2015), OECD (2016), Parker and Todd (2017), Poirier (2020), TeleSUR (2020) and World Bank Report (2009);…”

Section: Tablementioning

confidence: 99%

“… Sources: Size and scope (Row 2) was constructed by the authors based on the following:aMedellin and Prada (2015);bPoirier (2020);cOECD (2016);dDogherty (2014);ePoirier (2020);fParker and Todd (2017); supporting information on targeting system, benefit structure, payment frequency and duration is synthesized from the Celhay et al (2017), Dogherty (2014), McGuire (2013), Medellin and Prada (2015), OECD (2016), Parker and Todd (2017), Poirier (2020), TeleSUR (2020) and World Bank Report (2009);*Values in US$ are estimated based on exchange rates for local currencies as of December 2021…”

Section: Tablementioning

confidence: 99%

The contribution of the private sector to poverty alleviation programs: exploring business engagement in conditional cash transfers

Ungson

Hudgens²,

González-Pérez³

et al. 2022

MRJIAM

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Purpose This study aims to propose the roles for business, broadly defined, in government-led programs designed to enhance human capital investment. Through conditional cash transfers (CCTs), businesses have opportunities to alleviate poverty, address the United Nations’ 2030 Agenda (SDGs), enhance CCT viability and explore new market opportunities. Design/methodology/approach This multifaceted research approach consists of five case studies of CCTs in Latin America, face-to-face field meetings with CCT administrators, 48 CCT beneficiaries in a pilot study and 31 interviews (verbal and remote) with business managers and companies in five countries. Findings Building on an on-site pilot study, an in-depth appraisal of five CCTs in Latin America over a five-year period, the authors examined six stages of CCT activities to assess possible areas of business engagement. The cases, augmented by field interviews with businesses, present fledgling business engagement in CCTs. In light of anticipated growth in CCTs, this study presents six major ways businesses can further participate in selected stages of CCT operations that contribute to their long-term sustainability, as well as future market opportunities. Originality/value Conducted over a five-year period with participants from government, businesses and CCT beneficiaries, this study deepens our understanding of how businesses can alleviate poverty through engaging in government-led antipoverty programs.

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Can Small Incentives Have Large Payoffs? Health Impacts of a Cash Transfer Program in Bolivia

Cited by 9 publications

References 34 publications

Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

Growing Together: Assessing Equity and Efficiency in an Early-Life Health Program in Chile

The contribution of the private sector to poverty alleviation programs: exploring business engagement in conditional cash transfers

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