Improving Perinatal Outcomes Using Conditional and Targeted Transfers

Not Applicable

Active, not recruiting

• Conditions: Utilization, Health Care; Birth Outcomes
• Interventions: Behavioral: Conditional cash transfer; Behavioral: Risk information provision

• Registration Number: NCT04090762
• Lead Sponsor: RAND

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2019-06-28
• Study Start: 2019-07-08
• Study First Submitted QC: 2019-09-12
• Study First Posted: 2019-09-16
• Primary Completion: 2021-06-30
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-14
• Last Update Posted: 2024-08-15
• Study Completion: 2025-04-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Female
• Target Recruitment: 36607

Inclusion Criteria

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

Exclusion Criteria

• none

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Conditional Cash Transfer only	Conditional cash transfer	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.
Conditional Cash Transfer and risk information	Conditional cash transfer	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.
Conditional Cash Transfer and risk information	Risk information provision	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.
Risk information only	Risk information provision	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).

Primary Outcome Measures

Name	Time	Method
Uptake of prenatal care	3-4 months after anticipated childbirth/delivery date	the number of prenatal visits completed
Child mortality - early infant death	3-4 months after anticipated childbirth/delivery date	Child mortality - early infant death
Child mortality - stillbirths	3-4 months after anticipated childbirth/delivery date	Child mortality - stillbirths
Probability of prenatal care	3-4 months after anticipated childbirth/delivery date	the probability of receiving prenatal care
Uptake of health facility birth	3-4 months after anticipated childbirth/delivery date	probability of giving birth at a health facility
Child mortality - fetal loss	3-4 months after anticipated childbirth/delivery date	Child mortality - fetal loss

Secondary Outcome Measures

Name	Time	Method
Maternal mortality	3-4 months after anticipated childbirth/delivery date	maternal death
Child weight	3-4 months after anticipated childbirth/delivery date	Child weight
Maternal beliefs	3-4 months after anticipated childbirth/delivery date	Risk perceptions and beliefs assessed using a questionnaire
Pregnancy behavior - dietary consumption	3-4 months after anticipated childbirth/delivery date	Probability of consuming nutrient-rich foods assessed using questionnaire
Maternal work	3-4 months after enrollment	Hours worked in the last seven days
Pregnancy behavior - tetanus vaccination	3-4 months after anticipated childbirth/delivery date	Probability of receiving tetanus vaccination
Timely initiation of prenatal care	3-4 months after anticipated childbirth/delivery date	Probability of initiating prenatal care in the first trimester of pregnancy
Uptake of postnatal care	3-4 months after anticipated childbirth/delivery date	Probability of using postnatal care
Maternal health	3-4 months after anticipated childbirth/delivery date	delivery complications
Child vaccination	3-4 months after anticipated childbirth/delivery date	Probability of receiving recommended child immunizations
Pregnancy behavior - malaria prophylaxis	3-4 months after anticipated childbirth/delivery date	Probability of receiving malaria prophylaxis
Pregnancy behavior - blood building products	3-4 months after anticipated childbirth/delivery date	Probability of receiving blood building products
Child length	3-4 months after anticipated childbirth/delivery date	Child length
Quality of perinatal care	3-4 months after anticipated childbirth/delivery date	Quality score assessed using a questionnaire

Trial Locations

Locations (1)

Aminu Kano Teaching Hospital; 🇳🇬 Kano, Nigeria