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Can conditional cash transfers improve maternal health care? Evidence from El Salvador's Comunidades Solidarias Rurales program

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  • Alan de Brauw
  • Amber Peterman

Abstract

There 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.

Suggested Citation

  • Alan de Brauw & Amber Peterman, 2020. "Can conditional cash transfers improve maternal health care? Evidence from El Salvador's Comunidades Solidarias Rurales program," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 700-715, June.
    • Handle: RePEc:wly:hlthec:v:29:y:2020:i:6:p:700-715
    DOI: 10.1002/hec.4012
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    References listed on IDEAS

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    1. Ambler, Kate & De Brauw,Alan, 2017. "The impacts of cash transfers on women?s empowerment : learning from Pakistan?s BISP program," Policy Research Working Paper Series 113161, The World Bank.
    2. Sarah Baird & Francisco H. G. Ferreira & Berk Özler & Michael Woolcock, 2013. "Relative Effectiveness of Conditional and Unconditional Cash Transfers for Schooling Outcomes in Developing Countries: A Systematic Review," Campbell Systematic Reviews, John Wiley & Sons, vol. 9(1), pages 1-124.
    3. Ann-Beth Moller & Holly Newby & Claudia Hanson & Alison Morgan & Shams El Arifeen & Doris Chou & Theresa Diaz & Lale Say & Ian Askew & Allisyn C Moran, 2018. "Measures matter: A scoping review of maternal and newborn indicators," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-19, October.
    4. Nguyen, Ha T.H. & Hatt, Laurel & Islam, Mursaleena & Sloan, Nancy L. & Chowdhury, Jamil & Schmidt, Jean-Olivier & Hossain, Atia & Wang, Hong, 2012. "Encouraging maternal health service utilization: An evaluation of the Bangladesh voucher program," Social Science & Medicine, Elsevier, vol. 74(7), pages 989-996.
    5. Peterman, Amber & Schwab, Benjamin & Roy, Shalini & Hidrobo, Melissa & Gilligan, Daniel O., 2015. "Measuring women’s decisionmaking: Indicator choice and survey design experiments from cash and food transfer evaluations in Ecuador, Uganda, and Yemen," IFPRI discussion papers 1453, International Food Policy Research Institute (IFPRI).
    6. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    7. Powell-Jackson, Timothy & Hanson, Kara, 2012. "Financial incentives for maternal health: Impact of a national programme in Nepal," Journal of Health Economics, Elsevier, vol. 31(1), pages 271-284.
    8. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    9. Hidrobo, Melissa & Hoddinott, John & Kumar, Neha & Olivier, Meghan, 2018. "Social Protection, Food Security, and Asset Formation," World Development, Elsevier, vol. 101(C), pages 88-103.
    10. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    11. Gilligan, Daniel & de Brauw, Alan, 2011. "Using the regression discontinuity design with implicit partitions: The impacts of comunidades solidarias rurales on schooling in El Salvador," IFPRI discussion papers 1116, International Food Policy Research Institute (IFPRI).
    12. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    13. Hahn, Jinyong & Todd, Petra & Van der Klaauw, Wilbert, 2001. "Identification and Estimation of Treatment Effects with a Regression-Discontinuity Design," Econometrica, Econometric Society, vol. 69(1), pages 201-209, January.
    14. Sudhanshu Handa & Amber Peterman & David Seidenfeld & Gelson Tembo, 2016. "Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia," Health Economics, John Wiley & Sons, Ltd., vol. 25(2), pages 225-236, February.
    15. Guido Imbens & Karthik Kalyanaraman, 2012. "Optimal Bandwidth Choice for the Regression Discontinuity Estimator," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 79(3), pages 933-959.
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    2. Osmani, Ahmad Reshad & Okunade, Albert, 2025. "Impact of supply-side conditional cash transfers on household family planning decisions: Evidence from a field experiment in Afghanistan," Social Science & Medicine, Elsevier, vol. 383(C).
    3. Kekre, Aishwarya & Mahajan, Kanika, 2023. "Maternity support and child health: Unintended gendered effects," Journal of Comparative Economics, Elsevier, vol. 51(3), pages 880-898.
    4. Reader, Mary Patricia, 2021. "The birthweight effects of universal child benefits in pregnancy: quasi-experimental evidence from England and Wales," LSE Research Online Documents on Economics 121528, London School of Economics and Political Science, LSE Library.
    5. Mary Reader, 2021. "The birthweight effects of universal child benefits in pregnancy: quasi-experimental evidence from England and Wales," CASE Papers /222, Centre for Analysis of Social Exclusion, LSE.
    6. Mary Kopriva, 2023. "Universal Cash Transfer Impacts on Maternal and Infant Health," Working Papers 2023-02, University of Alaska Anchorage, Department of Economics.
    7. Aishwarya Kekre & Kanika Mahajan, 2022. "Maternity Support, Child Health and Unintended Gendered Effects," Working Papers 84, Ashoka University, Department of Economics.
    8. Lama Bou-Karroum & Domenico G Iaia & Fadi El-Jardali & Clara Abou Samra & Sabine Salameh & Zeina Sleem & Reem Masri & Aya Harb & Nour Hemadi & Nadeen Hilal & Layal Hneiny & Sahar Nassour & Mehr Gul Sh, 2024. "Financing for equity for women’s, children’s and adolescents’ health in low- and middle-income countries: A scoping review," PLOS Global Public Health, Public Library of Science, vol. 4(9), pages 1-49, September.

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