Additional cash incentive within a conditional cash transfer scheme: a 'controlled before and during' design
Chandrakant Lahariya1, Ashok Mishra, Deoki Nandan
1Department of Community Medicine, Gajara Raja Medical College and Associated Hospitals, Gwalior, India. c.lahariya@gmail.com
Indian Journal of Public Health
|September 24, 2011
Summary
The Additional Cash Incentive (ACI) scheme in India faced implementation challenges due to poor planning and low public awareness, hindering its effectiveness in increasing institutional deliveries. Successful future schemes require better public engagement and streamlined processes.
Area of Science:
- Public Health
- Health Economics
- Maternal Health
Background:
- Conditional Cash Transfer (CCT) schemes positively influence health-seeking behaviors.
- Evaluation of an Additional Cash Incentive (ACI) scheme integrated within an existing CCT program in India.
Purpose of the Study:
- To assess the process and performance of the ACI scheme.
- To identify implementation challenges and document lessons learned for future CCT and ACI programs.
Main Methods:
- Controlled before-and-during study design in Madhya Pradesh, India (August 2007-March 2008).
- Primary outcome: Increased institutional deliveries.
- Data collection via in-depth interviews, focus group discussions, and household surveys.
Main Results:
- Major challenges included lack of awareness, complex procedures, and insufficient community involvement.
- Institutional delivery rates increased in both target and control groups, but not statistically significantly.
- No definitive cause-and-effect relationship between the ACI scheme and increased institutional deliveries was established.
Conclusions:
- Poor planning, coordination, and public awareness led to low utilization of the ACI scheme.
- Recommendations include improved Information, Education, and Communication (IEC), training, detailed planning, and community participation.
- Lessons learned are applicable to future ACI scheme implementations in developing countries.
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