Not just money: What mothers value in conditional cash transfer programs in India

Introduction: Conditional cash transfers (CCTs) have become an important policy tool for increasing demand for key maternal and child health services in low/middle-income countries. Yet, these programs have had variable success in increasing service use. Understanding beneficiary preferences for des...

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Main Authors: Rao, Krishna D., Kachwaha, Shivani, Kaplan, Avril, Bishai, David
Format: Journal Article
Language:Inglés
Published: BMJ 2020
Subjects:
Online Access:https://hdl.handle.net/10568/142384
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author Rao, Krishna D.
Kachwaha, Shivani
Kaplan, Avril
Bishai, David
author_browse Bishai, David
Kachwaha, Shivani
Kaplan, Avril
Rao, Krishna D.
author_facet Rao, Krishna D.
Kachwaha, Shivani
Kaplan, Avril
Bishai, David
author_sort Rao, Krishna D.
collection Repository of Agricultural Research Outputs (CGSpace)
description Introduction: Conditional cash transfers (CCTs) have become an important policy tool for increasing demand for key maternal and child health services in low/middle-income countries. Yet, these programs have had variable success in increasing service use. Understanding beneficiary preferences for design features of CCTs can increase program effectiveness. Methods: We conducted a Discrete choice experiment in two districts of Uttar Pradesh, India in 2018 with 405 mothers with young children (<3 years). Respondents were asked to choose between hypothetical CCT programme profiles described in terms of five attribute levels (cash, antenatal care visits, growth-monitoring and immunisation visits, visit duration and health benefit received) and responses were analysed using mixed logit regression. Results: Mothers most valued the cash transfer amount, followed by the health benefit received from services. Mothers did not have a strong preference for conditionalities related to the number of health centre visits or for time spent seeking care; however, service delivery points were in close proximity to households. Mothers were willing to accept lower cash rewards for better perceived health benefits—they were willing to accept 2854 Indian rupees ($41) less for a programme that produced good health, which is about half the amount currently offered by India’s Maternal Benefits Program. Mothers who had low utilisation of health services, and those from poor households, valued the cash transfer and the health benefit significantly more than others. Conclusion: Both cash transfers and the perceived health benefit from services are highly valued, particularly by infrequent service users. In CCTs, this highlights the importance of communicating value of services to beneficiaries by informing about health benefits of services and providing quality care. Conditionalities requiring frequent health centre visits or time taken for seeking care may not have large negative effects on CCT participation in contexts of good service coverage.
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spelling CGSpace1423842025-04-08T18:34:19Z Not just money: What mothers value in conditional cash transfer programs in India Rao, Krishna D. Kachwaha, Shivani Kaplan, Avril Bishai, David maternal and child health health social protection mothers cash transfers Introduction: Conditional cash transfers (CCTs) have become an important policy tool for increasing demand for key maternal and child health services in low/middle-income countries. Yet, these programs have had variable success in increasing service use. Understanding beneficiary preferences for design features of CCTs can increase program effectiveness. Methods: We conducted a Discrete choice experiment in two districts of Uttar Pradesh, India in 2018 with 405 mothers with young children (<3 years). Respondents were asked to choose between hypothetical CCT programme profiles described in terms of five attribute levels (cash, antenatal care visits, growth-monitoring and immunisation visits, visit duration and health benefit received) and responses were analysed using mixed logit regression. Results: Mothers most valued the cash transfer amount, followed by the health benefit received from services. Mothers did not have a strong preference for conditionalities related to the number of health centre visits or for time spent seeking care; however, service delivery points were in close proximity to households. Mothers were willing to accept lower cash rewards for better perceived health benefits—they were willing to accept 2854 Indian rupees ($41) less for a programme that produced good health, which is about half the amount currently offered by India’s Maternal Benefits Program. Mothers who had low utilisation of health services, and those from poor households, valued the cash transfer and the health benefit significantly more than others. Conclusion: Both cash transfers and the perceived health benefit from services are highly valued, particularly by infrequent service users. In CCTs, this highlights the importance of communicating value of services to beneficiaries by informing about health benefits of services and providing quality care. Conditionalities requiring frequent health centre visits or time taken for seeking care may not have large negative effects on CCT participation in contexts of good service coverage. 2020-10-01 2024-05-22T12:10:24Z 2024-05-22T12:10:24Z Journal Article https://hdl.handle.net/10568/142384 en Open Access BMJ Rao, Krishna D.; Kachwaha, Shivani; Kaplan, Avril; and Bishai, David. 2020. Not just money: What mothers value in conditional cash transfer programs in India. BMJ Global Health 5: e003033. https://doi.org/10.1136/bmjgh-2020-003033
spellingShingle maternal and child health
health
social protection
mothers
cash transfers
Rao, Krishna D.
Kachwaha, Shivani
Kaplan, Avril
Bishai, David
Not just money: What mothers value in conditional cash transfer programs in India
title Not just money: What mothers value in conditional cash transfer programs in India
title_full Not just money: What mothers value in conditional cash transfer programs in India
title_fullStr Not just money: What mothers value in conditional cash transfer programs in India
title_full_unstemmed Not just money: What mothers value in conditional cash transfer programs in India
title_short Not just money: What mothers value in conditional cash transfer programs in India
title_sort not just money what mothers value in conditional cash transfer programs in india
topic maternal and child health
health
social protection
mothers
cash transfers
url https://hdl.handle.net/10568/142384
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