Conditional cash transfers, spillovers and informal health care: Evidence from Peru

The use of low-quality informal health-care providers (IHCPs) is still prominent in developing countries despite the efforts of their governments to expand institutional services. The use of conditional cash transfer (CCT) programs have become instrumental in encouraging the use of formal health services, but little is known about their direct effect on the use of IHCPs. We use a large survey of rural households and a regression discontinuity design to estimate the effects of the Peruvian CCT program on the demand for IHCP. We find a sizeable reduction in the use of IHCPs not only in targeted but also in non-targeted members of treated households. This finding indicates the existence of spillover effects within the household. We also provide evidence that beyond the direct increase in income, the availability of better information about institutional services is a potential mechanism that drives these effects. We also find a corresponding improvement in the self-perception of health status. Our results are robust to a number of sensitivity analyses.