Long Term Effects Of a Maternal Cash Transfer Experiment

Long Term Effects of an Intervention on Maternal Behavior, Child Health, and Community Influence

This is a follow-on study to a cluster randomized trial of maternal conditional incentives conducted in Nigeria. This study found that cash transfers, conditional on women obtaining facility-based prenatal, delivery, and postnatal care, resulted in large, significant effects on maternal and child outcomes (NICHD R01HD083444). This study will answer additional key policy questions. First, are the effects on maternal behavior temporary, or do they result in more sustained behavior change? Second, do measured short run (SR) child health effects persist over the long run? Third, did the program generate spillovers?

Study Overview

• Status: Active, not recruiting
• Conditions: Outcome Assessment; Maternal Health Services
• Intervention / Treatment: Behavioral: Cash transfer in prior study

Detailed Description

This study will build on what the study investigators learned from the RCT and extend it in novel directions. Research assistants will return to the study communities approximately 5 years after enrollment in the RCT to collect data on utilization of maternal health care services for births to the trial participants after the intervention, and on long run child health outcomes including child weight and height. The research assistants will also collect data on the birth outcomes of non-incentivized childbearing women in the study clusters. Data will be collected through in-person surveys of study participants.

This study will provide valuable new evidence about the indirect and long run effects of demand-side incentives. This is of critical importance because accounting for only the direct effects may severely underestimate the full effect of the program.

• Study Type: Interventional
• Enrollment (Estimated): 21000
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Nigeria
  • Kano, Nigeria
    • Amino Kano Teaching Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria for Households:

• Resident in a community included in the RTC

Exclusion Criteria for Households:

• None

Inclusion Criteria for Women:

• Women must have participated in an earlier randomized trial of conditional incentives OR
• They did not take part in the earlier trial but are resident in clusters that participated in the earlier trial and have given birth since 2018

Exclusion Criteria for Women:

-

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: RCT Participants; Women and children who participated in the earlier study.	Behavioral: Cash transfer in prior study; Women were offered a cash transfer conditional on attending prenatal and postnatal visits and delivering in a facility
No Intervention: Non-RCT participants; Women and children in the same communities included in the earlier study who did not participate in that study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of births that take place in a health facility	Proportion of births that take place in a health facility	4-5 years after RCT enrollment
Proportion of women that attended prenatal care during pregnancy	Proportion of women that attended prenatal care during pregnancy	4-5 years after RCT enrollment
Child survival	Probability that child is alive	4-5 years after RCT enrollment
Child health utilization	Proportion of children taken to a health facility for care when sick	4-5 years after RCT enrollment
Proportion of children receiving recommended immunizations	Proportion of children receiving recommended immunizations	4-5 years after RCT enrollment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maternal health	Self-rated health	4-5 years after RCT enrollment
Child weight	Child weight measured at visit	4-5 years after RCT enrollment
Child height	Child height measured at visit	4-5 years after RCT enrollment
Birth outcome	Probability of a live birth	4-5 years after RCT enrollment

Collaborators and Investigators

• Sponsor: RAND
• Investigators: Principal Investigator: Edward N Okeke, MD, PhD, RAND

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2021
• Primary Completion (Actual): July 31, 2023
• Study Completion (Estimated): April 30, 2026

Study Registration Dates

• First Submitted: October 19, 2022
• First Submitted That Met QC Criteria: January 23, 2023
• First Posted (Actual): February 2, 2023

Study Record Updates

• Last Update Posted (Actual): January 21, 2026
• Last Update Submitted That Met QC Criteria: January 20, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: R01HD102412 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified data will be shared after results are published.
• IPD Sharing Supporting Information Type: ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No