IDEAS home Printed from https://ideas.repec.org/a/eee/deveco/v143y2020ics0304387819307011.html
   My bibliography  Save this article

Healthcare at the beginning of life and child survival: Evidence from a cash transfer experiment in Nigeria

Author

Listed:
  • Okeke, Edward N.
  • Abubakar, Isa S.

Abstract

Households in poor countries are encouraged (and sometimes coerced) to increase investments in formal health care services during pregnancy and childbirth. Is this good policy? The answer to a large extent depends on its effects on child welfare. We study the effects of a cash transfer program in Nigeria in which households were offered a payment of $14 conditioned on uptake of health services. We show that the transfer led to a large increase in uptake and a substantial increase in child survival driven by a decrease in in-utero child deaths. We present evidence suggesting that the key driver is prenatal health investments.

Suggested Citation

  • Okeke, Edward N. & Abubakar, Isa S., 2020. "Healthcare at the beginning of life and child survival: Evidence from a cash transfer experiment in Nigeria," Journal of Development Economics, Elsevier, vol. 143(C).
    • Handle: RePEc:eee:deveco:v:143:y:2020:i:c:s0304387819307011
    DOI: 10.1016/j.jdeveco.2019.102426
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0304387819307011
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jdeveco.2019.102426?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. N. Meltem Daysal & Mircea Trandafir & Reyn van Ewijk, 2015. "Saving Lives at Birth: The Impact of Home Births on Infant Outcomes," American Economic Journal: Applied Economics, American Economic Association, vol. 7(3), pages 28-50, July.
    2. Powell-Jackson, Timothy & Mazumdar, Sumit & Mills, Anne, 2015. "Financial incentives in health: New evidence from India's Janani Suraksha Yojana," Journal of Health Economics, Elsevier, vol. 43(C), pages 154-169.
    3. Federico A. Bugni & Ivan A. Canay & Azeem M. Shaikh, 2018. "Inference Under Covariate-Adaptive Randomization," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 113(524), pages 1784-1796, October.
    4. Theodore Joyce, 1994. "Self-Selection, Prenatal Care, and Birthweight among Blacks, Whites, and Hispanics in New York City," Journal of Human Resources, University of Wisconsin Press, vol. 29(3), pages 762-794.
    5. Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," The World Bank Economic Review, World Bank, vol. 26(2), pages 165-190.
    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. Vivi Alatas & Abhijit Banerjee & Rema Hanna & Benjamin A. Olken & Julia Tobias, 2012. "Targeting the Poor: Evidence from a Field Experiment in Indonesia," American Economic Review, American Economic Association, vol. 102(4), pages 1206-1240, June.
    8. Rachel Meacock & Søren Rud Kristensen & Matt Sutton, 2014. "The Cost‐Effectiveness Of Using Financial Incentives To Improve Provider Quality: A Framework And Application," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 1-13, January.
    9. Maluccio, John A. & Flores, Rafael, 2005. "Impact evaluation of a conditional cash transfer program: the Nicaraguan Red de Protección Social," Research reports 141, International Food Policy Research Institute (IFPRI).
    10. Gustavo J. Bobonis, 2011. "The Impact of Conditional Cash Transfers on Marriage and Divorce," Economic Development and Cultural Change, University of Chicago Press, vol. 59(2), pages 281-312.
    11. Edward N. Okeke & Amalavoyal V. Chari, 2015. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda," Working Papers 1072, RAND Corporation.
    12. Yoshito Takasaki & Ryoko Sato, 2017. "Short-run Incentive and Information in Sequential Adoptions: An Antenatal Care Experiment in Rural Nigeria," CIRJE F-Series CIRJE-F-1070, CIRJE, Faculty of Economics, University of Tokyo.
    13. Teodora Boneva & Christopher Rauh, 2018. "Parental Beliefs about Returns to Educational Investments—The Later the Better?," Journal of the European Economic Association, European Economic Association, vol. 16(6), pages 1669-1711.
    14. Biroli, Pietro & Boneva, Teodora & Raja, Akash & Rauh, Christopher, 2022. "Parental beliefs about returns to child health investments," Journal of Econometrics, Elsevier, vol. 231(1), pages 33-57.
    15. Liu, Haiyong & Mroz, Thomas & Adair, Linda, 2009. "Parental compensatory behaviors and early child health outcomes in Cebu, Philippines," Journal of Development Economics, Elsevier, vol. 90(2), pages 209-230, November.
    16. Manuela Angelucci & Giacomo De Giorgi, 2009. "Indirect Effects of an Aid Program: How Do Cash Transfers Affect Ineligibles' Consumption?," American Economic Review, American Economic Association, vol. 99(1), pages 486-508, March.
    17. Chari, A.V. & Glick, Peter & Okeke, Edward & Srinivasan, Sinduja V., 2019. "Workfare and infant health: Evidence from India's public works program," Journal of Development Economics, Elsevier, vol. 138(C), pages 116-134.
    18. Sarah Barber & Paul Gertler, 2010. "Empowering women: how Mexico's conditional cash transfer programme raised prenatal care quality and birth weight," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 2(1), pages 51-73.
    19. Simon Heß, 2017. "Randomization inference with Stata: A guide and software," Stata Journal, StataCorp LP, vol. 17(3), pages 630-651, September.
    20. James G. MacKinnon & Matthew D. Webb, 2017. "Wild Bootstrap Inference for Wildly Different Cluster Sizes," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 32(2), pages 233-254, March.
    21. Orazio Attanasio & Teodora Boneva & Christopher Rauh, 2022. "Parental Beliefs about Returns to Different Types of Investments in School Children," Journal of Human Resources, University of Wisconsin Press, vol. 57(6), pages 1789-1825.
    22. Godlonton, Susan & Okeke, Edward N., 2016. "Does a ban on informal health providers save lives? Evidence from Malawi," Journal of Development Economics, Elsevier, vol. 118(C), pages 112-132.
    23. Gissele Gajate-Garrido, 2013. "The Impact of Adequate Prenatal Care on Urban Birth Outcomes: An Analysis in a Developing Country Context," Economic Development and Cultural Change, University of Chicago Press, vol. 62(1), pages 95-130.
    24. Barham, Tania, 2011. "A healthier start: The effect of conditional cash transfers on neonatal and infant mortality in rural Mexico," Journal of Development Economics, Elsevier, vol. 94(1), pages 74-85, January.
    25. Marie Gaarder & Amanda Glassman & Jessica Todd, 2010. "Conditional cash transfers and health: unpacking the causal chain," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 2(1), pages 6-50.
    26. Okeke, Edward N. & Chari, A.V., 2018. "Health care at birth and infant mortality: Evidence from nighttime deliveries in Nigeria," Social Science & Medicine, Elsevier, vol. 196(C), pages 86-95.
    27. Susan Horton & Hellen Gelband & Dean Jamison & Carol Levin & Rachel Nugent & David Watkins, 2017. "Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-12, August.
    28. 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.
    29. Jishnu Das & Jeffrey Hammer, 2014. "Quality of Primary Care in Low-Income Countries: Facts and Economics," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 525-553, August.
    30. Gopalan, Saji S. & Mutasa, Ronald & Friedman, Jed & Das, Ashis, 2014. "Health sector demand-side financial incentives in low- and middle-income countries: A systematic review on demand- and supply-side effects," Social Science & Medicine, Elsevier, vol. 100(C), pages 72-83.
    31. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    32. de Walque, Damien & Dow, William H & Nathan, Rose & Abdul, Ramadhani & Abilahi, Faraji & Gong, Erick & Isdahl, Zachary & Jamison, Julian & Jullu, Boniphace & Krishnan, Suneeta & Majura, Albert & Migue, 2012. "Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania," Department of Economics, Working Paper Series qt4vw984q0, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    33. Paul Gertler, 2004. "Do Conditional Cash Transfers Improve Child Health? Evidence from PROGRESA's Control Randomized Experiment," American Economic Review, American Economic Association, vol. 94(2), pages 336-341, May.
    34. Achyuta Adhvaryu & Anant Nyshadham, 2015. "Return to Treatment in the Formal Health Care Sector: Evidence from Tanzania," American Economic Journal: Economic Policy, American Economic Association, vol. 7(3), pages 29-57, August.
    35. Jose Urquieta & Gustavo Angeles & Thomas Mroz & Hector Lamadrid-Figueroa & Bernardo Hernández, 2009. "Impact of Oportunidades on Skilled Attendance at Delivery in Rural Areas," Economic Development and Cultural Change, University of Chicago Press, vol. 57(3), pages 539-558, April.
    36. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
    37. Sudhanshu Handa & Amber Peterman & David Seidenfeld & Gelson Tembo, 2016. "Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia," Health Economics, John Wiley & Sons, Ltd., vol. 25(2), pages 225-236, February.
    38. Robert Jensen, 2010. "The (Perceived) Returns to Education and the Demand for Schooling," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 515-548.
    39. Douglas Almond & Bhashkar Mazumder, 2011. "Health Capital and the Prenatal Environment: The Effect of Ramadan Observance during Pregnancy," American Economic Journal: Applied Economics, American Economic Association, vol. 3(4), pages 56-85, October.
    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. Nguyen, Cuong Viet & Nguyen, Minh Khanh Hoang & Phung, Tung Duc & Tran, Oanh Ngoc, 2023. "The effect of income shocks on health behaviors: Evidence from a low-income country," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 257-276.
    2. Raveh, Ohad & Zhang, Yan, 2022. "The Long-Term Health Effects of Oil Discoveries: Evidence from China," MPRA Paper 114059, University Library of Munich, Germany.
    3. Christian Posso & Jorge Tamayo & Arlen Guarin & Estefania Saravia, 2024. "Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes," Borradores de Economia 1269, Banco de la Republica de Colombia.
    4. Bauhoff,Sebastian Peter Alexander & Kandpal,Eeshani, 2021. "Information, Loss Framing, and Spillovers in Pay-for-Performance Contracts," Policy Research Working Paper Series 9687, The World Bank.
    5. Lagarde, Mylène & Riumallo Herl, Carlos, 2025. "Better together? Group incentives and the demand for prevention," LSE Research Online Documents on Economics 125349, London School of Economics and Political Science, LSE Library.
    6. Raveh, Ohad & Zhang, Yan, . "Giant Oil Discoveries and Long-Term Health Effects: Evidence from China," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, vol. 49(2).
    7. Edward N. Okeke, 2021. "Money and my mind: Maternal cash transfers and mental health," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2879-2904, November.
    8. Mensah,Justice Tei & Hirfrfot,Kibrom Tafere & Abay,Kibrom A., 2022. "Saving Lives through Technology : Mobile Phones and Infant Mortality," Policy Research Working Paper Series 9978, The World Bank.
    9. Mylène Lagarde & Carlos Riumallo Herl, 2023. "Stronger together: Group incentives and the demand for prevention," Tinbergen Institute Discussion Papers 23-0010/V, Tinbergen Institute.
    10. Rosenberg, Molly & Beidelman, Erika & Chen, Xiwei & Canning, David & Kobayashi, Lindsay & Kahn, Kathleen & Pettifor, Audrey & Kabudula, Chodziwadziwa Whiteson, 2023. "The impact of a randomized cash transfer intervention on mortality of adult household members in rural South Africa, 2011–2022," Social Science & Medicine, Elsevier, vol. 324(C).

    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. Edward N. Okeke, 2021. "Money and my mind: Maternal cash transfers and mental health," Health Economics, John Wiley & Sons, Ltd., vol. 30(11), pages 2879-2904, November.
    2. Friedman, Willa & Keats, Anthony & Mutua, Martin Kavao, 2022. "Disruptions to healthcare quality and early child health outcomes: Evidence from health-worker strikes in Kenya," Journal of Health Economics, Elsevier, vol. 86(C).
    3. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    4. Falch, Ranveig, 2021. "How Do People Trade Off Resources Between Quick and Slow Learners?," Discussion Paper Series in Economics 5/2021, Norwegian School of Economics, Department of Economics.
    5. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    6. Suzane Bellue, 2023. "Why Don’t Poor Families Move? A Spatial Equilibirum Analysis of Parental Decisions with Social Learning," CRC TR 224 Discussion Paper Series crctr224_2023_472, University of Bonn and University of Mannheim, Germany.
    7. Bancalari, Antonella & Berlinski, Samuel & Buitrago, Giancarlo & García, María Fernanda & Mata, Dolores de la & Vera-Hernández, Marcos, 2023. "Health Inequalities in Latin American and the Caribbean: Child, Adolescent, Reproductive, Metabolic Syndrome and Mental Health," IDB Publications (Working Papers) 13158, Inter-American Development Bank.
    8. von Haaren, Paula & Klonner, Stefan, 2020. "Maternal cash for better child health? The impacts of India’s IGMSY/PMMVY maternity benefit scheme," Working Papers 0689, University of Heidelberg, Department of Economics.
    9. Hoyong Jung, 2023. "Can Universal Cash Transfer Save Newborns’ Birth Weight During the Pandemic?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(1), pages 1-22, February.
    10. Packel, Laura J. & de Walque, Damien & Feeney, Kevin C. & Balampama, Marianna P. & Cooper, Jan E. & Kalolella, Admirabilis & Wechsberg, Wendee M. & Dow, William H., 2021. "A randomized trial of cash incentives for sexual behavior change among female sex workers in Dar es Salaam," Social Science & Medicine, Elsevier, vol. 272(C).
    11. Wang, Haining & Cheng, Zhiming & Smyth, Russell, 2022. "Parental misbeliefs and household investment in children's education," Economics of Education Review, Elsevier, vol. 89(C).
    12. de Walque, Damien, 2020. "The use of financial incentives to prevent unhealthy behaviors: A review," Social Science & Medicine, Elsevier, vol. 261(C).
    13. Juan‐José Díaz & Victor Saldarriaga, 2019. "Encouraging use of prenatal care through conditional cash transfers: Evidence from JUNTOS in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1099-1113, September.
    14. repec:fpr:export:1342 is not listed on IDEAS
    15. Aggarwal, Shilpa, 2021. "The long road to health: Healthcare utilization impacts of a road pavement policy in rural India," Journal of Development Economics, Elsevier, vol. 151(C).
    16. Grépin, Karen A. & Habyarimana, James & Jack, William, 2019. "Cash on delivery: Results of a randomized experiment to promote maternal health care in Kenya," Journal of Health Economics, Elsevier, vol. 65(C), pages 15-30.
    17. Karol Mazur, 2021. "A note on pessimism in education and its economic consequences," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 19(4), pages 773-783, December.
    18. Lekfuangfu, Warn N. & Odermatt, Reto, 2022. "All I have to do is dream? The role of aspirations in intergenerational mobility and well-being," European Economic Review, Elsevier, vol. 148(C).
    19. Aizawa, T.;, 2019. "Reviewing the Existing Evidence of the Conditional Cash Transfer in India through the Partial Identification Approach," Health, Econometrics and Data Group (HEDG) Working Papers 19/24, HEDG, c/o Department of Economics, University of York.
    20. Avitabile, Ciro & de Hoyos, Rafael, 2018. "The heterogeneous effect of information on student performance: Evidence from a randomized control trial in Mexico," Journal of Development Economics, Elsevier, vol. 135(C), pages 318-348.
    21. Ersoy, Fulya, 2023. "Effects of perceived productivity on study effort: Evidence from a field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 207(C), pages 376-391.

    More about this item

    Keywords

    Cash transfers; Maternal health services; Child mortality; Developing countries;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

    Statistics

    Access and download statistics

    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:eee:deveco:v:143:y:2020:i:c:s0304387819307011. See general information about how to correct material in RePEc.

    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: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/devec .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.