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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
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    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. 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.
    3. 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.
    4. 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.
    5. 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.
    6. repec:idb:brikps:78783 is not listed on IDEAS
    7. Hoyt Bleakley & Jeffrey Lin, 2012. "Portage and Path Dependence," The Quarterly Journal of Economics, Oxford University Press, vol. 127(2), pages 587-644.
    8. 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.
    9. 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).
    10. 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.
    11. Wooldridge, Jeffrey M., 2007. "Inverse probability weighted estimation for general missing data problems," Journal of Econometrics, Elsevier, vol. 141(2), pages 1281-1301, December.
    12. 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.
    13. 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.
    14. Stelios Michalopoulos & Elias Papaioannou, 2013. "Pre‐Colonial Ethnic Institutions and Contemporary African Development," Econometrica, Econometric Society, vol. 81(1), pages 113-152, January.
    15. 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.
    16. 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.
    17. 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 - Books, The World Bank Group, number 2597, December.
    18. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    19. 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.
    20. repec:idb:brikps:publication-detail,7101.html?id=66306 is not listed on IDEAS
    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).
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    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.

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