Impact of Conditional Cash Transfers on Maternal and Newborn Health

Maternal and newborn health is a high priority for global health and is included among the Millennium Development Goals (MDGs). However, the slow decline in maternal and newborn mortality jeopardizes MDG achievements; according to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50 percent. Further, skilled birth attendance, use of antenatal care, and satisfaction with family planning are the most inequitably distributed of maternal and newborn health interventions in low- and middle-income countries. Conditional cash transfers (CCTs) have been shown to increase health service utilization among the poorest, but little is written on the effects of such programs on maternal and newborn health. We carry out a systematic review of studies on CCTs that report maternal and newborn health outcomes, including studies from eight countries. We find that CCTs have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers, and reduced the incidence of low birth weight. The programs have not had a significant impact on fertility or Caesarean sections while impact on maternal and newborn mortality has not been well documented thus far. Given these positive effects, we discuss priorities for future investment in CCT programs for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programs. We recommend more rigorous impact evaluations that document impact pathways, look into outcomes, and take factors such as cost-effectiveness into account.