Beyond Healthcare Utilisation: Evaluating the Conditionality and Income Pathways of a CCT Scheme in Improving Maternal and Child Health

Maternity benefit programmes increasingly combine healthcare conditionalities with income support, yet it remains unclear whether improvements in maternal and child wellbeing arise through increased healthcare utilisation, additional household resources, or both. This study evaluates the Mukhyamantri Shramik Seva Prasuti Sahayata Yojana (MMSSPSY), a maternity benefit programme for women in the informal sector in Madhya Pradesh, India. Using primary survey data from 1,246 mothers and propensity score matching to compare beneficiaries with eligible non-beneficiaries, we estimate programme impacts across the maternal and child health continuum. The programme substantially increased antenatal care utilisation, institutional delivery, iron-folic acid supplementation, and child immunisation, while also reducing low birth weight and improving maternal body mass index. However, it had limited measurable effect on maternal anaemia or child undernutrition. Household expenditure patterns suggest that while the transfer improved engagement with healthcare services and supported some nutritional investment during pregnancy, it was insufficient to sustain the investments needed to improve longer-term child nutrition. The findings highlight the importance of integrating maternity cash transfers with sustained nutrition support and quality maternal healthcare. These findings also have implications for the growing use of unconditional cash transfers especially targeted towards women, which seek to strengthen household resource availability and could potentially improve broader nutritional outcomes among women and children. Length: 46 pages