IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0232761.html
   My bibliography  Save this article

How much is enough? Exploring the dose-response relationship between cash transfers and surgical utilization in a resource-poor setting

Author

Listed:
  • Christopher Strader
  • Joanna Ashby
  • Dominique Vervoort
  • Aref Ebrahimi
  • Shoghi Agbortoko
  • Melissa Lee
  • Naomi Reiner
  • Molly Zeme
  • Mark G Shrime

Abstract

Objective: Cash transfers are a common intervention to incentivize salutary behavior in resource-constrained settings. Many cash transfer studies do not, however, account for the effect of the size of the cash transfer in design or analysis. A randomized, controlled trial of a cash-transfer intervention is planned to incentivize appropriate surgical utilization in Guinea. The aim of the current study is to determine the size of that cash transfer so as to maximize compliance while minimizing cost. Methods: Data were collected from nine coastal Guinean hospitals on their surgical capabilities and the cost of receiving surgery. These data were combined with publicly available data about the general Guinean population to create an agent-based model predicting surgical utilization. The model was validated to the available literature on surgical utilization. Cash transfer sizes from 0 to 1,000,000 Guinean francs were evaluated, with surgical compliance as the primary outcome. Results: Compliance with scheduled surgery increases as the size of a cash transfer increases. This increase is asymptotic, with a leveling in utilization occurring when the cash transfer pays for all the costs associated with surgical care. Below that cash transfer size, no other optima are found. Once a cash transfer completely covers the costs of surgery, other barriers to care such as distance and hospital quality dominate Conclusion: Cash transfers to incentivize health-promoting behavior appear to be dose-dependent. Maximal impact is likely only to occur when full patient costs are eliminated. These findings should be incorporated in the design of future cash transfer studies.

Suggested Citation

  • Christopher Strader & Joanna Ashby & Dominique Vervoort & Aref Ebrahimi & Shoghi Agbortoko & Melissa Lee & Naomi Reiner & Molly Zeme & Mark G Shrime, 2020. "How much is enough? Exploring the dose-response relationship between cash transfers and surgical utilization in a resource-poor setting," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-12, May.
    • Handle: RePEc:plo:pone00:0232761
    DOI: 10.1371/journal.pone.0232761
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232761
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0232761&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0232761?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
    ---><---

    References listed on IDEAS

    as
    1. Guanais, F.C., 2013. "The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998-2010," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 2000-2006.
    2. Charles F. Manski, 2001. "Daniel McFadden and the Econometric Analysis of Discrete Choice," Scandinavian Journal of Economics, Wiley Blackwell, vol. 103(2), pages 217-230, June.
    3. Powell-Jackson, Timothy & Pereira, Shreya K. & Dutt, Varun & Tougher, Sarah & Haldar, Kaveri & Kumar, Paresh, 2016. "Cash transfers, maternal depression and emotional well-being: Quasi-experimental evidence from India’s Janani Suraksha Yojana programme," Social Science & Medicine, Elsevier, vol. 162(C), pages 210-218.
    4. Jessica E. Todd & Paul Winters, 2011. "The Effect of Early Interventions in Health and Nutrition on On-Time School Enrollment: Evidence from the Oportunidades Program in Rural Mexico," Economic Development and Cultural Change, University of Chicago Press, vol. 59(3), pages 549-581.
    5. Mark G Shrime & Serufusa Sekidde & Allison Linden & Jessica L Cohen & Milton C Weinstein & Joshua A Salomon, 2016. "Sustainable Development in Surgery: The Health, Poverty, and Equity Impacts of Charitable Surgery in Uganda," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-14, December.
    6. Kusuma, Dian & Cohen, Jessica & McConnell, Margaret & Berman, Peter, 2016. "Can cash transfers improve determinants of maternal mortality? Evidence from the household and community programs in Indonesia," Social Science & Medicine, Elsevier, vol. 163(C), pages 10-20.
    7. Natalie Carvalho & Naveen Thacker & Subodh S Gupta & Joshua A Salomon, 2014. "More Evidence on the Impact of India's Conditional Cash Transfer Program, Janani Suraksha Yojana: Quasi-Experimental Evaluation of the Effects on Childhood Immunization and Other Reproductive and Chil," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-13, October.
    Full references (including those not matched with items on IDEAS)

    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. 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.
    2. 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.
    3. Cooper, Jan E. & Benmarhnia, Tarik & Koski, Alissa & King, Nicholas B., 2020. "Cash transfer programs have differential effects on health: A review of the literature from low and middle-income countries," Social Science & Medicine, Elsevier, vol. 247(C).
    4. Kusuma, Dian & Thabrany, Hasbullah & Hidayat, Budi & McConnell, Margaret & Berman, Peter & Cohen, Jessica, 2017. "New Evidence on the Impact of Large-scale Conditional Cash Transfers on Child Vaccination Rates: The Case of a Clustered-Randomized Trial in Indonesia," World Development, Elsevier, vol. 98(C), pages 497-505.
    5. Lenel, Friederike & Priebe, Jan & Satriawan, Elan & Syamsulhakim, Ekki, 2022. "Can mHealth campaigns improve CCT outcomes? Experimental evidence from sms-nudges in Indonesia," Journal of Health Economics, Elsevier, vol. 86(C).
    6. Yannick Markhof & Isabela Franciscon & Nicolò Bird & Pedro Arruda, 2021. "Social assistance programmes in South Asia: an evaluation of socio-economic impacts," Research Report 62, International Policy Centre for Inclusive Growth.
    7. Haoying Wang & Guohui Wu, 2022. "Modeling discrete choices with large fine-scale spatial data: opportunities and challenges," Journal of Geographical Systems, Springer, vol. 24(3), pages 325-351, July.
    8. Nikita Arora & Matthew Quaife & Kara Hanson & Mylene Lagarde & Dorka Woldesenbet & Abiy Seifu & Romain Crastes dit Sourd, 2022. "Discrete choice analysis of health worker job preferences in Ethiopia: Separating attribute non‐attendance from taste heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 806-819, May.
    9. Alcaraz Carlo & Chiquiar Daniel & Orraca María José & Salcedo Alejandrina, 2012. "The Effect of Publicly Provided Health Insurance on Academic Performance in Mexico," Working Papers 2012-10, Banco de México.
    10. Sudha Narayanan Narayanan & Nicolas Gerber, 2016. "Safety Nets for Food and Nutritional Security in India," FOODSECURE Working papers 37, LEI Wageningen UR.
    11. Evan Borkum & Dana Rotz & Anu Rangarajan & Swetha Sridharan & Sukhmani Sethi & Mercy Manoranjini & Lakshmi Ramakrishnan & Lalit Dandona & Rakhi Dandona & Priyanka S. Kochar & G. Anil Kumar & Priyanka , "undated". "Midline Findings from the Evaluation of the Ananya Program in Bihar," Mathematica Policy Research Reports 74ef56ababd9412b82ef906fc, Mathematica Policy Research.
    12. Figueroa, José Luis, 2014. "Distributional effects of Oportunidades on early child development," Social Science & Medicine, Elsevier, vol. 113(C), pages 42-49.
    13. Alicia Plemmons, 2022. "Occupational licensing's effects on firm location and employment in the United States," British Journal of Industrial Relations, London School of Economics, vol. 60(4), pages 735-760, December.
    14. Sudha Narayanan & Nicolas Gerber, 2015. "Social safety nets for food and nutritional security in India," Indira Gandhi Institute of Development Research, Mumbai Working Papers 2015-031, Indira Gandhi Institute of Development Research, Mumbai, India.
    15. Alexandre Bugelli & Roxane Borgès Da Silva & Ladislau Dowbor & Claude Sicotte, 2021. "The Determinants of Infant Mortality in Brazil, 2010–2020: A Scoping Review," IJERPH, MDPI, vol. 18(12), pages 1-28, June.
    16. Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.
    17. Tulasi Malini Maharatha & Sumirtha Gandhi & Umakant Dash, 2021. "Has the Demand and Supply-side Components of Janani Suraksha Yojana Augmented the Uptake of Maternal Health Care Services among Poor Women in India ? : An Application of Hybrid Matching Technique," BASE University Working Papers 08/2021, BASE University, Bengaluru, India.
    18. Gebreegziabher, Zenebe & van Kooten, G. Cornelis & van Soest, Daan P., 2017. "Technological innovation and dispersion: Environmental benefits and the adoption of improved biomass cookstoves in Tigrai, northern Ethiopia," Energy Economics, Elsevier, vol. 67(C), pages 337-345.
    19. Kekre, Aishwarya & Mahajan, Kanika, 2023. "Maternity support and child health: Unintended gendered effects," Journal of Comparative Economics, Elsevier, vol. 51(3), pages 880-898.
    20. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).

    More about this item

    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:plo:pone00:0232761. 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: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    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.