Healthcare at the beginning of life and child survival: Evidence from a cash transfer experiment in Nigeria

• Published in: Journal of development economics Vol. 143; p. 102426
• Main Authors: Okeke, Edward N., Abubakar, Isa S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2020
• Subjects: Cash transfers; Child mortality; Developing countries; Maternal health services; Maternal health services; O15; Cash transfers; Developing countries; I10; Child mortality; I12; I15; maternal health services; child mortality; developing countries; cash transfers
• ISSN: 0304-3878; 1872-6089
• DOI: 10.1016/j.jdeveco.2019.102426

Households in poor countries are encouraged (and sometimes coerced) to increase investments in formal health care services during pregnancy and childbirth. Is this good policy? The answer to a large extent depends on its effects on child welfare. We study the effects of a cash transfer program in Nigeria in which households were offered a payment of $14 conditioned on uptake of health services. We show that the transfer led to a large increase in uptake and a substantial increase in child survival driven by a decrease in in-utero child deaths. We present evidence suggesting that the key driver is prenatal health investments. •We examine the effect of cash transfers conditioned on health care utilization during pregnancy on child health.•The cash transfer program was implemented in Nigeria and selection of communities for the program was random.•In intervention areas use of recommended health services more than doubled.•We find significant reductions in child mortality driven by reductions in in-utero child deaths.•The ley mechanism appears to be prenatal health investments.