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The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan


  • Witvorapong, Nopphol
  • Foshanji, Abo Ismael


While existing research suggests that health-related conditional cash transfer (CCT) programs have positive impacts on the utilization of CCT-targeted health services, little is known as to whether they also influence the utilization of non-targeted health services—defined as general health services for which program participants are not financially motivated. Based on a sample of 6649 households in a CCT program that took place in May 2009–June 2011 in Afghanistan, we evaluate the impact of the receipt of CCTs on the utilization of non-targeted health services both by women, who were direct beneficiaries of the program, and by members of their households. We estimate the outcomes of interest through four probit models, accounting for potential endogeneity of the CCT receipt and dealing with lack of credible exclusion restrictions in different ways. In comparison with the control group, the receipt of CCTs is found to be associated with an increase in the probability of utilizing non-targeted services among household members across regression models. The results are mixed, with regard to the utilization by women, suggesting that there exist non-economic barriers to health care, unique to women, that are not captured by the data. The results confirm the importance of accounting for direct as well as indirect effects in policy evaluation and suggest that future studies investigate more deeply the role of community health workers in removing non-economic barriers for Afghan women and the possibility of introducing an incentive structure to motivate them to contribute more actively to population health in Afghanistan.

Suggested Citation

  • Witvorapong, Nopphol & Foshanji, Abo Ismael, 2016. "The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan," Social Science & Medicine, Elsevier, vol. 152(C), pages 87-95.
  • Handle: RePEc:eee:socmed:v:152:y:2016:i:c:p:87-95
    DOI: 10.1016/j.socscimed.2016.01.043

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    References listed on IDEAS

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    1. Natalia Guerrero & Oswaldo Molina & Diego Winkelried, 2020. "Conditional cash transfers, spillovers, and informal health care: Evidence from Peru," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 111-122, February.
    2. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.

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