Improving Perinatal Outcomes Using Conditional and Targeted Transfers

利用有条件和有针对性的转移改善围产期结局

• 批准号: 9383519
• 负责人: Edward N Okeke
• 金额: $ 56.23万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-11 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9383519
• 关键词: Address; Africa South of the Sahara; Asia; Back; Birth; Budgets; Caring; Catchment Area; Cessation of life; Characteristics; Child; Childbirth; Clinic; Clinical; Control Groups; Country; Developing Countries; Discipline of obstetrics; Eclampsia; Effectiveness; Electricity; Eligibility Determination; Europe; Funding; Geography; Government; Grant; Health; Health Personnel; Health care facility; High Risk Woman; High-Risk Pregnancy; Home environment; Household; Incentives; Income; India; Institution; Intervention; Investments; Literature; Magnesium Sulfate; Malawi; Maternal Health; Maternal Health Services; Maternal and Child Health; Midwifery; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Neonatal Mortality; Newborn Infant; Nigeria; North America; Outcome; Oxytocin; Pharmaceutical Preparations; Policies; Population; Postpartum Hemorrhage; Primary Health Care; Randomized; Randomized Controlled Trials; Reporting; Research; Research Design; Risk; Scheme; Services; Side; Surveys; Time; Traditional Birth Attendants; Woman; base; care delivery; compare effectiveness; cost effectiveness; design; early experience; efficacy study; high risk; improved; low and middle-income countries; mortality; neonatal death; payment; perinatal outcomes; prevent; programs; randomized trial; relative effectiveness; stillbirth

PROJECT SUMMARY Increasing the use of formal care around the time of birth is seen as a key strategy for improving maternal and child health. Yet, worldwide, about 60 million births annually take place outside of health institutions. The majority of these births take place at home, assisted by informal birth attendants, relatives, and in some cases no one. In sub-Saharan Africa and South Asia, the two regions that account for 86% and 75% of maternal and newborn deaths, only 43 percent and 42 percent of women, respectively, deliver in a health facility compared to 99% in Europe and North America. 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 deliveries in health facilities in low and middle-income countries. In this randomized controlled trial, we study the effectiveness of a cash transfer scheme that targets higher-risk women. Though CCT (and other demand-side) programs are popular, there is growing recognition that investments will need to be made on the supply-side in order to realize the full potential of programs that incentivize households to use services. Many studies document the existence of supply-side constraints and there is evidence that these may constitute important barriers to use of delivery care and improvement in health outcomes. In this study, we randomly assign selected primary health care clinics to receive discretionary cash grants and study the impact on service delivery, utilization, and health outcomes.

项目总结