Measuring The Impact Of Cash Transfers And Behavioral 'Nudges' On Maternity Care In Nairobi, Kenya.
Health Aff (Millwood)
; 36(11): 1956-1964, 2017 11.
Article
en En
| MEDLINE
| ID: mdl-29137506
ABSTRACT
Many patients in low-income countries express preferences for high-quality health care but often end up with low-quality providers. We conducted a randomized controlled trial with pregnant women in Nairobi, Kenya, to analyze whether cash transfers, enhanced with behavioral "nudges," can help women deliver in facilities that are consistent with their preferences and are of higher quality. We tested two interventions. The first was a labeled cash transfer (LCT), which explained that the cash was to help women deliver where they wanted. The second was a cash transfer that combined labeling and a commitment by the recipient to deliver in a prespecified desired facility as a condition of receiving the final payment (L-CCT). The L-CCT improved patient-perceived quality of interpersonal care but not perceived technical quality of care. It also increased women's likelihood of delivering in facilities that met standards for routine and emergency newborn care but not the likelihood of delivering in facilities that met standards for obstetric care. The LCT had fewer measured benefits. Women preferred facilities with high technical and interpersonal care quality, but these quality measures were often negatively correlated within facilities. Even with cash transfers, many women still used poor-quality facilities. A larger study is warranted to determine whether the L-CCT can improve maternal and newborn outcomes.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Gastos en Salud
/
Accesibilidad a los Servicios de Salud
/
Servicios de Salud Materna
Tipo de estudio:
Clinical_trials
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
Health Aff (Millwood)
Año:
2017
Tipo del documento:
Article