Improving Perinatal Outcomes Using Conditional and Targeted Transfers

项目总结 增加出生前后正规护理的使用被视为改善的关键战略 妇幼保健。然而，在世界范围内，每年约有6000万人在国外出生 卫生机构。这些分娩中的大多数是在家里进行的，辅之以非正式分娩。 服务员，亲戚，在某些情况下没有人。在撒哈拉以南非洲和南亚，这两个国家 占孕产妇和新生儿死亡的86%和75%的地区，仅占43%和42% 分别有%的女性在医疗机构分娩，而在欧洲和北方，这一比例为99% 美国。据估计，在分娩期间增加熟练护理的使用可能会 到2025年，最多可防止150万孕产妇和新生儿死亡以及死产。有条件现金 转移方案，其中妇女获得现金支付的条件是使用产妇 卫生服务，正越来越多地被用作增加卫生机构提供服务的机制 在低收入和中等收入国家。在这项随机对照试验中，我们研究了其有效性。 一项针对高风险女性的现金转移计划。通过CCT(和其他需求方) 项目很受欢迎，人们越来越认识到，需要在 供给侧，以充分发挥激励家庭使用的方案的潜力 服务。许多研究记录了供给侧限制的存在，并有证据表明 这些可能构成使用接生保健和改善健康的重要障碍。 结果。在这项研究中，我们随机分配选定的初级卫生保健诊所接受 可自由支配的现金拨款，并研究对服务交付、利用率和健康状况的影响 结果。

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.