Abstract
SummaryThere is growing evidence on positive human capital impacts of large, poverty‐focused cash transfer programs. However, evidence is inconclusive on whether cash transfer programs affect maternal health outcomes, and if so, through which pathways. We use a regression discontinuity design with an implicit threshold to evaluate the impact of Comunidades Solidarias Rurales in El Salvador on four maternal health service utilization outcomes: (a) prenatal care; (b) skilled attendance at birth; (c) birth in health facilities; and (d) postnatal care. We find robust impacts on outcomes at the time of birth but not on prenatal and postnatal care. In addition to income effects, supply‐side health service improvements and gains in women's agency may have played a role in realizing these gains. With growing inequalities in maternal health outcomes globally, results contribute to an understanding of how financial incentives can address health systems and financial barriers that prevent poor women from seeking and receiving care at critical periods for both maternal and infant health.
Highlights
Large-scale cash transfer programs have become a mainstay in social protection and poverty reduction strategies in lowand middle-income countries globally, reaching over 780 million beneficiaries (Honorati et al, 2015)
The typical national conditional cash transfer (CCT) in Latin America and the Caribbean (LAC) requires beneficiaries to comply with co-responsibilities related to child health and/or education to remain eligible for transfers
We initially describe the proportion of mothers receiving adequate prenatal care, skilled attendance at birth, birth in a health facility, and postnatal care by entry group and by whether or not the care occurred pre- or posttreatment for the treatment group (Table 2)
Summary
Large-scale cash transfer programs have become a mainstay in social protection and poverty reduction strategies in lowand middle-income countries globally, reaching over 780 million beneficiaries (Honorati et al, 2015). The typical national conditional cash transfer (CCT) in LAC requires beneficiaries to comply with co-responsibilities related to child health and/or education to remain eligible for transfers. Beneficiaries may be required to attend periodic trainings focused on health and nutrition information and behavior change. A large literature explores the impact of cash transfers on children's education, health, nutrition, and household-level poverty-related outcomes As cash transfer programs continue to expand, there is growing interest in examining maternal health impacts, defined as the health of women during pregnancy, childbirth, and postpartum periods. In a desk review of CCTs and health, Morris wileyonlinelibrary.com/journal/hec
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