It has been estimated that increasing the use of skilled care during childbirth could prevent up to 1.5 million maternal and newborn deaths and stillbirths by 2025. Conditional cash transfer programs, in which women receive cash payments conditioned on the use of maternal health services, are increasingly being used as a mechanism to increase uptake. In this study, the investigators randomly assign households to receive varying cash amounts conditioned on uptake of recommended pregnancy and delivery care. The investigators crosscut this with an intervention in which pregnant women receive information about their risk type. This randomized trial will provide new evidence about the potential efficacy of targeting cash transfers by pregnancy risk. This study will take place in 288 primary health service areas (HSAs) in Nigeria.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
36,607
Pregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth.
Pregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics.
Aminu Kano Teaching Hospital
Kano, Kano State, Nigeria
Probability of prenatal care
the probability of receiving prenatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
Uptake of prenatal care
the number of prenatal visits completed
Time frame: 3-4 months after anticipated childbirth/delivery date
Uptake of health facility birth
probability of giving birth at a health facility
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - fetal loss
Child mortality - fetal loss
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - stillbirths
Child mortality - stillbirths
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - early infant death
Child mortality - early infant death
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal health
delivery complications
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal mortality
maternal death
Time frame: 3-4 months after anticipated childbirth/delivery date
Child weight
Child weight
Time frame: 3-4 months after anticipated childbirth/delivery date
Child length
Child length
Time frame: 3-4 months after anticipated childbirth/delivery date
Uptake of postnatal care
Probability of using postnatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
Child vaccination
Probability of receiving recommended child immunizations
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal beliefs
Risk perceptions and beliefs assessed using a questionnaire
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - tetanus vaccination
Probability of receiving tetanus vaccination
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - malaria prophylaxis
Probability of receiving malaria prophylaxis
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - blood building products
Probability of receiving blood building products
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - dietary consumption
Probability of consuming nutrient-rich foods assessed using questionnaire
Time frame: 3-4 months after anticipated childbirth/delivery date
Quality of perinatal care
Quality score assessed using a questionnaire
Time frame: 3-4 months after anticipated childbirth/delivery date
Timely initiation of prenatal care
Probability of initiating prenatal care in the first trimester of pregnancy
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal work
Hours worked in the last seven days
Time frame: 3-4 months after enrollment
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