Improving Perinatal Outcomes Using Conditional and Targeted Transfers (IMPACTT)

January 12, 2026 updated by: Edward Okeke, RAND
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 uptake. In this study, the investigators randomly assign households to receive varying cash amounts conditioned on uptake of recommended pregnancy and delivery care. The investigators crosscut this with an intervention in which pregnant women receive information about their risk type. This randomized trial will provide new evidence about the potential efficacy of targeting cash transfers by pregnancy risk. This study will take place in 288 primary health service areas (HSAs) in Nigeria.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
36607

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Nigeria
    • Kano State
      • Kano, Kano State, Nigeria
        • Aminu Kano Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

15 years to 49 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Pregnant women ages 15-49 who reside in the participating health service areas

Exclusion Criteria:

  • none

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: Control
Women in the control arm will complete the baseline and follow up surveys but will not receive any intervention.
Active Comparator: Risk information only
Women in the risk only arm who exhibit characteristics associated with a greater risk of a poor birth outcome will be informed that they possess these characteristics. Risk characteristics (identified from the medical and epidemiological literature) include age, prior pregnancy and birth history (e.g., previous stillbirth).
Behavioral: Risk information provision
Pregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics.
Active Comparator: Conditional Cash Transfer only
Women in this arm will be eligible to receive conditional cash transfers. To receive the transfer, pregnant women must attend prenatal care and give birth in a health facility.
Behavioral: Conditional cash transfer
Pregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth.
Active Comparator: Conditional Cash Transfer and risk information
Women in this arm will be provided with risk information at the time of baseline survey administration AND be eligible to receive conditional cash transfers, pending attendance at prenatal care and delivery at a health facility.
Behavioral: Risk information provision
Pregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics.
Behavioral: Conditional cash transfer
Pregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Probability of prenatal care
Time Frame: 3-4 months after anticipated childbirth/delivery date
the probability of receiving prenatal care
3-4 months after anticipated childbirth/delivery date
Uptake of prenatal care
Time Frame: 3-4 months after anticipated childbirth/delivery date
the number of prenatal visits completed
3-4 months after anticipated childbirth/delivery date
Uptake of health facility birth
Time Frame: 3-4 months after anticipated childbirth/delivery date
probability of giving birth at a health facility
3-4 months after anticipated childbirth/delivery date
Child mortality - fetal loss
Time Frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - fetal loss
3-4 months after anticipated childbirth/delivery date
Child mortality - stillbirths
Time Frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - stillbirths
3-4 months after anticipated childbirth/delivery date
Child mortality - early infant death
Time Frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - early infant death
3-4 months after anticipated childbirth/delivery date

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Maternal health
Time Frame: 3-4 months after anticipated childbirth/delivery date
delivery complications
3-4 months after anticipated childbirth/delivery date
Maternal mortality
Time Frame: 3-4 months after anticipated childbirth/delivery date
maternal death
3-4 months after anticipated childbirth/delivery date
Child weight
Time Frame: 3-4 months after anticipated childbirth/delivery date
Child weight
3-4 months after anticipated childbirth/delivery date
Child length
Time Frame: 3-4 months after anticipated childbirth/delivery date
Child length
3-4 months after anticipated childbirth/delivery date
Uptake of postnatal care
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of using postnatal care
3-4 months after anticipated childbirth/delivery date
Child vaccination
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of receiving recommended child immunizations
3-4 months after anticipated childbirth/delivery date
Maternal beliefs
Time Frame: 3-4 months after anticipated childbirth/delivery date
Risk perceptions and beliefs assessed using a questionnaire
3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - tetanus vaccination
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of receiving tetanus vaccination
3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - malaria prophylaxis
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of receiving malaria prophylaxis
3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - blood building products
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of receiving blood building products
3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - dietary consumption
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of consuming nutrient-rich foods assessed using questionnaire
3-4 months after anticipated childbirth/delivery date
Quality of perinatal care
Time Frame: 3-4 months after anticipated childbirth/delivery date
Quality score assessed using a questionnaire
3-4 months after anticipated childbirth/delivery date
Timely initiation of prenatal care
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of initiating prenatal care in the first trimester of pregnancy
3-4 months after anticipated childbirth/delivery date
Maternal work
Time Frame: 3-4 months after enrollment
Hours worked in the last seven days
3-4 months after enrollment

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Maternal depression
Time Frame: 3-4 months after anticipated childbirth/delivery date
Depression assessed using the Edinburgh Postnatal Depression Scale
3-4 months after anticipated childbirth/delivery date
Health facility choice
Time Frame: 3-4 months after anticipated childbirth/delivery date
Probability of receiving care at a government or private hospital
3-4 months after anticipated childbirth/delivery date

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
RAND

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 8, 2019

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 30, 2021

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 30, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 28, 2019

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 12, 2019

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
September 16, 2019

Study Record Updates

Last Update Posted (Estimated)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 13, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 12, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • R01HD090231 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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