Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia

Health Econ. 2016 Feb;25(2):225-36. doi: 10.1002/hec.3136. Epub 2015 Jan 9.


There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambia's Child Grant Program on a range of maternal health utilization outcomes using a randomized design and difference-in-differences multivariate regression from data collected over 24 months from 2010 to 2012. Results indicate that while there are no measurable program impacts among the main sample, there are heterogeneous impacts on skilled attendance at birth among a sample of women residing in households having better access to maternal health services. The latter result is particularly interesting because of the overall low level of health care availability in program areas suggesting that dedicated program design or matching supply-side interventions may be necessary to leverage unconditional cash transfers in similar settings to impact maternal health.

Keywords: Zambia; cash transfers; maternal health.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child, Preschool
  • Developing Countries
  • Female
  • Financing, Government / economics*
  • Health Services Accessibility / economics*
  • Humans
  • Income*
  • Infant
  • Infant, Newborn
  • Maternal Health Services / economics*
  • Maternal Health Services / statistics & numerical data
  • Maternal Health*
  • Poverty
  • Preventive Health Services / economics
  • Preventive Health Services / statistics & numerical data
  • Regression Analysis
  • Zambia