IDEAS home Printed from https://ideas.repec.org/p/idb/brikps/8475.html
   My bibliography  Save this paper

Paying Patients for Prenatal Care: The Effect of a Small Cash Transfer on Stillbirths and Survival

Author

Listed:
  • Martinez, Sebastian
  • Celhay, Pablo
  • Vidal, Cecilia
  • Johannsen, Julia

Abstract

We study the effects of conditional cash transfers to pregnant women on stillbirths and child survival in Bolivia. Payments are conditional on compliance with medically recommended prenatal care and skilled birth attendance. At a value equivalent to just 1% of monthly household consumption, the payments are the smallest amongst national cash transfer programs in Latin America. Using multiple data sources and empirical methods, we show that the intervention reduced the average rate of stillbirths by 9.5% to 22.3%, and increased the survival rates of birth cohorts exposed to the program by 3.5% to 16.8%. The causal pathways of these effects are consistent with evidence of increased utilization of recommended health care services, including early initiation of prenatal care (17%), at least four prenatal visits (16%), and skilled birth attendance (15%). Given the modest transfer amounts and considerable effects on health care utilization, we posit that final health outcomes are likely driven by the health care conditionality, rather than an income effect. The intervention is highly cost-effective, at $184.54 per DALY averted, making the program’s pay-per-compliance design a promising policy alternative.

Suggested Citation

  • Martinez, Sebastian & Celhay, Pablo & Vidal, Cecilia & Johannsen, Julia, 2018. "Paying Patients for Prenatal Care: The Effect of a Small Cash Transfer on Stillbirths and Survival," IDB Publications (Working Papers) 8475, Inter-American Development Bank.
  • Handle: RePEc:idb:brikps:8475
    as

    Download full text from publisher

    File URL: https://publications.iadb.org/publications/english/document/Paying-Patients-for-Prenatal-Care-The-Effect-of-a-Small-Cash-Transfer-on-Stillbirths-and-Survival.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. MacKinnon, James G & Magee, Lonnie, 1990. "Transforming the Dependent Variable in Regression Models," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 31(2), pages 315-339, May.
    2. Deon Filmer & Norbert Schady, 2008. "Getting Girls into School: Evidence from a Scholarship Program in Cambodia," Economic Development and Cultural Change, University of Chicago Press, vol. 56(3), pages 581-617, April.
    3. Sandra E. Black & Paul J. Devereux & Katrine V. L�ken & Kjell G. Salvanes, 2014. "Care or Cash? The Effect of Child Care Subsidies on Student Performance," The Review of Economics and Statistics, MIT Press, vol. 96(5), pages 824-837, December.
    4. repec:idb:brikps:78783 is not listed on IDEAS
    5. Hoyt Bleakley & Jeffrey Lin, 2012. "Portage and Path Dependence," The Quarterly Journal of Economics, Oxford University Press, vol. 127(2), pages 587-644.
    6. Orazio P. Attanasio & Veruska Oppedisano & Marcos Vera-Hernández, 2015. "Should Cash Transfers Be Conditional? Conditionality, Preventive Care, and Health Outcomes," American Economic Journal: Applied Economics, American Economic Association, vol. 7(2), pages 35-52, April.
    7. Seema Jayachandran, 2009. "Air Quality and Early-Life Mortality: Evidence from Indonesia’s Wildfires," Journal of Human Resources, University of Wisconsin Press, vol. 44(4).
    8. Charlotta Mellander & José Lobo & Kevin Stolarick & Zara Matheson, 2015. "Night-Time Light Data: A Good Proxy Measure for Economic Activity?," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-18, October.
    9. Stelios Michalopoulos & Elias Papaioannou, 2013. "Pre‐Colonial Ethnic Institutions and Contemporary African Development," Econometrica, Econometric Society, vol. 81(1), pages 113-152, January.
    10. Anna Aizer & Shari Eli & Joseph Ferrie & Adriana Lleras-Muney, 2016. "The Long-Run Impact of Cash Transfers to Poor Families," American Economic Review, American Economic Association, vol. 106(4), pages 935-971, April.
    11. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications, The World Bank, number 2597.
    12. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    13. Sarah Baird & Craig McIntosh & Berk Özler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, Oxford University Press, vol. 126(4), pages 1709-1753.
    14. repec:idb:brikps:publication-detail,7101.html?id=66306 is not listed on IDEAS
    15. Meyer, Bruce D, 1995. "Natural and Quasi-experiments in Economics," Journal of Business & Economic Statistics, American Statistical Association, vol. 13(2), pages 151-161, April.
    16. Gary Solon & Steven J. Haider & Jeffrey M. Wooldridge, 2015. "What Are We Weighting For?," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 301-316.
    17. Wooldridge, Jeffrey M., 2007. "Inverse probability weighted estimation for general missing data problems," Journal of Econometrics, Elsevier, vol. 141(2), pages 1281-1301, December.
    18. J. Vernon Henderson & Adam Storeygard & David N. Weil, 2012. "Measuring Economic Growth from Outer Space," American Economic Review, American Economic Association, vol. 102(2), pages 994-1028, April.
    19. 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.
    20. Evans, William N. & Lien, Diana S., 2005. "The benefits of prenatal care: evidence from the PAT bus strike," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 207-239.
    21. Stampini, Marco & Tornarolli, Leopoldo, 2012. "The Growth of Conditional Cash Transfers in Latin America and the Caribbean: Did They Go Too Far?," IZA Policy Papers 49, Institute of Labor Economics (IZA).
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Diether W. Beuermann & Patricia Garcia & Jose Perez Lu & Rafael Anta & Alessandro Maffioli & Maria Fernanda Rodrigo, 2020. "Information and Communication Technologies, Prenatal Care Services, and Neonatal Health," Journal of Economics, Race, and Policy, Springer, vol. 3(1), pages 41-59, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Guido Neidhöfer & Miguel Niño‐Zarazúa, 2019. "The Long(er)‐Term Impacts of Chile Solidario on Human Capital and Labor Income," Population and Development Review, The Population Council, Inc., vol. 45(S1), pages 209-244, December.
    2. Adriana Kocornik-Mina & Thomas K. J. McDermott & Guy Michaels & Ferdinand Rauch, 2020. "Flooded Cities," American Economic Journal: Applied Economics, American Economic Association, vol. 12(2), pages 35-66, April.
    3. Guido Neidhöfer & Miguel Niño‐Zarazúa, 2019. "The Long(er)‐Term Impacts of Chile Solidario on Human Capital and Labor Income," Population and Development Review, The Population Council, Inc., vol. 45(S1), pages 209-244, December.
    4. Baird, Sarah & McIntosh, Craig & Özler, Berk, 2019. "When the money runs out: Do cash transfers have sustained effects on human capital accumulation?," Journal of Development Economics, Elsevier, vol. 140(C), pages 169-185.
    5. Rozo, Sandra V. & Sviatschi, Micaela, 2021. "Is a refugee crisis a housing crisis? Only if housing supply is unresponsive," Journal of Development Economics, Elsevier, vol. 148(C).
    6. Boslett, Andrew & Hill, Elaine & Ma, Lala & Zhang, Lujia, 2021. "Rural light pollution from shale gas development and associated sleep and subjective well-being," Resource and Energy Economics, Elsevier, vol. 64(C).
    7. Prakash, Nishith & Rockmore, Marc & Uppal, Yogesh, 2019. "Do criminally accused politicians affect economic outcomes? Evidence from India," Journal of Development Economics, Elsevier, vol. 141(C).
    8. Martin Persson, U. & Alpízar, Francisco, 2013. "Conditional Cash Transfers and Payments for Environmental Services—A Conceptual Framework for Explaining and Judging Differences in Outcomes," World Development, Elsevier, vol. 43(C), pages 124-137.
    9. Gabriel Felbermayr & Jasmin Katrin Gröschl & Mark Sanders & Vincent Schippers & Thomas Steinwachs & Gabriel J. Felbermayr, 2018. "Shedding Light on the Spatial Diffusion of Disasters," CESifo Working Paper Series 7146, CESifo.
    10. Verónica Amarante & Martín Brun, 2018. "Cash Transfers in Latin America: Effects on Poverty and Redistribution," Economía Journal, The Latin American and Caribbean Economic Association - LACEA, vol. 0(Fall 2018), pages 1-31, November.
    11. Fiorella Benedetti & Pablo Ibarrarán & Patrick J. McEwan, 2016. "Do Education and Health Conditions Matter in a Large Cash Transfer? Evidence from a Honduran Experiment," Economic Development and Cultural Change, University of Chicago Press, vol. 64(4), pages 759-793.
    12. Filipe Campante & David Yanagizawa-Drott, 2018. "Long-Range Growth: Economic Development in the Global Network of Air Links," The Quarterly Journal of Economics, Oxford University Press, vol. 133(3), pages 1395-1458.
    13. Donna Feir & Rob Gillezeau & Maggie E. C. Jones, 2019. "The Slaughter of the Bison and Reversal of Fortunes on the Great Plains," Center for Indian Country Development series 1-2019, Federal Reserve Bank of Minneapolis.
    14. Corral, Leonardo & Henderson, Heath & Miranda, Juan José, 2016. "Evidence from a Natural Experiment on the Development Impact of Windfall Gains: The Camisea Fund in Peru," IDB Publications (Working Papers) 7520, Inter-American Development Bank.
    15. Richard Akresh & Damien de Walque & Harounan Kazianga, 2013. "Cash Transfers and Child Schooling: Evidence from a Randomized Evaluation of the Role of Conditionality," Economics Working Paper Series 1301, Oklahoma State University, Department of Economics and Legal Studies in Business.
    16. Russ, Jason, 2020. "Water runoff and economic activity: The impact of water supply shocks on growth," Journal of Environmental Economics and Management, Elsevier, vol. 101(C).
    17. Noemi Pace & Silvio Daidone & Benjamin Davis & Luca Pellerano, 2016. "Does “soft conditionality” increase the impact of cash transfers on desired outcomes? Evidence from a randomized control trial in Lesotho," Working Papers 2016:33, Department of Economics, University of Venice "Ca' Foscari".
    18. Gabriel Felbermayr & Jasmin Katrin Gröschl & Mark Sanders & Vincent Schippers & Thomas Steinwachs & Gabriel J. Felbermayr, 2018. "Shedding Light on the Spatial Diffusion of Disasters," CESifo Working Paper Series 7146, CESifo.
    19. Breinlich, Holger & Ottaviano, Gianmarco I.P. & Temple, Jonathan R.W., 2014. "Regional Growth and Regional Decline," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 2, chapter 4, pages 683-779, Elsevier.
    20. Leander Heldring, 2014. "State Capacity and Violence: Evidence from the Rwandan genocide," CSAE Working Paper Series 2014-08, Centre for the Study of African Economies, University of Oxford.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:idb:brikps:8475. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/iadbbus.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Felipe Herrera Library (email available below). General contact details of provider: https://edirc.repec.org/data/iadbbus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.