Effect of performance-based incentives for traditional birth attendants on access to maternal and newborn health-care facilities in Gombe State, Nigeria: a pilot study

Oyebola, Bolanle C.; Muhammad, Fatima; Otunomeruke, Allen; Galadima, Abare

doi:10.1016/s0140-6736(14)61873-0

Cited by 8 publications

(11 citation statements)

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“…There was a consensus among the three stakeholders that utilization of ANC and health facility deliveries were abysmally low at most health facilities before the commencement of the CCT programme; however, the CCT programme led to an upsurge in the demand and utilization of MNCH services in designated facilities. This corroborates assertions that cash incentives were useful in promoting positive health‐seeking behaviour among women in rural communities as well as a motivator for positive behaviour change for health and education outcomes . Similarly, our assessment found the CCT scheme as a motivating factor that enabled women to attend ANC and deliver at the health facilities, especially in Nigeria's northern regions.…”

Section: Discussionsupporting

confidence: 86%

“…In conclusion, beneficiaries and stakeholders perceived the CCT as a useful strategy to promote positive health-seeking behaviour among pregnant women. 21 Being consistent with previous studies, which identified incentives as an innovative approach to reduce financial barriers to obstetric care in low-income countries, 25 this paper provides evidence that CCT can stimulate demand for MNCH services and just as CCT was found to be successful in HIV prevention efforts. 26 Beyond stimulating positive behaviour change towards the use of health services, 27 the CCT served as a form of financial empowerment for the beneficiaries and their communities 28 as well as empowerment for beneficiaries to confidently access facility-based services without being deterred by other structural factors.…”

Section: Discussionsupporting

confidence: 84%

“…CCT is a motivating factor that propels the women to come. A WDC secretary in the same state answered No.” In conclusion, beneficiaries and stakeholders perceived the CCT as a useful strategy to promote positive health‐seeking behaviour among pregnant women …”

Section: Discussionsupporting

confidence: 83%

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Perspectives of beneficiaries, health service providers, and community members on a maternal and child health conditional cash transfer pilot programme in Nigeria

Oduenyi

Ordu²,

Okoli

2019

Health Planning & Management

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Summary Background Our paper presents experiences and perceptions of beneficiaries, health service providers, and community members about a conditional cash transfer (CCT) programme piloted in Nigeria from April 2013 to May 2015 to boost demand for maternal, newborn, and child health services. Methods We conducted a descriptive cross‐sectional retrospective study using both qualitative and quantitative methods. Personal interviews and focus group discussions (FGDs) were conducted between June and July 2015 for 314 CCT beneficiaries, 72 ward development committee (WDC) members, and 60 service providers (midwives, community health extension workers [CHEWs], and village health workers [VHWs]) including 29 officers‐in‐charge as key informants. Content analysis was applied to qualitative findings and grouped into themes of attitude, practices, CCT operations, payout, and perceived impact. Results Over 97% of beneficiaries affirmed that the cash incentive was very helpful and almost 70% opined that the free supply‐side services were the real benefit. Majority of service providers applauded the programme though, with complaints about the increased workload. Community members applauded the scheme, with mixed feelings over some operational processes. Conclusion Beneficiaries, service providers, and community members expressed deep satisfaction with the CCT programme and opined that antenatal care (ANC) and skilled birth delivery service utilization increased. Insights into some programmatic challenges are provided to enrich future CCT design and implementation.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 84%

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Perspectives of beneficiaries, health service providers, and community members on a maternal and child health conditional cash transfer pilot programme in Nigeria

Oduenyi

Ordu²,

Okoli

2019

Health Planning & Management

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“…Smaller-scale innovations in financing have included examples such as vouchers for pregnant women to visit health facilities, conditional cash transfers for mothers who engage in target behaviors [ 76 ], and even performance-based incentives for traditional birth attendants who bring their clients to facilities for antenatal, delivery, and postnatal care [ 77 ]. All of these efforts have demonstrated improvements in antenatal care attendance, facility delivery, vaccinations, and, in some cases, incidence of low birth weight [ 76 ].…”

Section: Financingmentioning

confidence: 99%

Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years

et al. 2016

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“…Qualitative evaluations in Somaliland and Nigeria suggest that monetary rewards to TBAs for referrals to skilled providers predict increases in the number of women per year that received care in health facilities [9, 10]. However, neither evaluation included comparison facilities or any other counterfactual, so that increases in facility visits cannot be attributed to monetary rewards.…”

Section: Introductionmentioning

confidence: 99%

The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria

Chukwuma

Mbachu

McConnell

et al. 2019

BMC Pregnancy Childbirth

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Background Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA’s advice is often adhered to by their clients, engaging TBAs in advocacy among their clients may increase maternal and neonatal postnatal care use. This study estimates the impact of monetary incentives for maternal referrals by TBAs on early maternal and neonatal postnatal care use (within 48 h of delivery) in Nigeria. Methods We conducted a non-blinded, individually-randomized, controlled study of 207 TBAs in Ebonyi State, Nigeria between August and December 2016. TBAs were randomly assigned with a 50–50 probability to receive $2.00 for every maternal client that attended postnatal care within 48 h of delivery (treatment group) or to receive no monetary incentive (control group). We compared the probabilities of maternal and neonatal postnatal care use within 48 h of delivery in treatment and control groups in an intention-to-treat analysis. We also ascertained if the care received by mothers and newborns during these visits followed World Health Organization guidelines. Results Overall, 207 TBAs participated in this study: 103 in the treatment group and 104 in the control group. The intervention increased the proportion of maternal clients of TBAs that reported attending postnatal care within 48 h of delivery by 15.4 percentage points [95% confidence interval (CI): 7.9–22.9]. The proportion of neonatal clients of TBAs that reportedly attended postnatal care within 48 h of delivery also increased by 12.6 percentage points [95% CI: 5.9–19.3]. However, providers often did not address the issues that may have led to maternal and newborn postnatal complications during these visits. Conclusions We show that motivating TBAs using monetary incentives for maternal postnatal care use can increase skilled care use after delivery among their maternal and neonatal clients, who have a higher risk of mortality because of their exposure to unskilled birth attendance. However, improving the quality of care is key to ensuring maternal and neonatal health gains from postnatal care attendance. Trial registration The trial was retrospectively registered in clinicaltrials.gov ( NCT02936869 ) on October 18, 2016. Electronic supplementary material The online version of this article (10.1186/s12884-019-2313-8) contains supplementary material, which is available to authorized users.

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Effect of performance-based incentives for traditional birth attendants on access to maternal and newborn health-care facilities in Gombe State, Nigeria: a pilot study

Cited by 8 publications

References 0 publications

Perspectives of beneficiaries, health service providers, and community members on a maternal and child health conditional cash transfer pilot programme in Nigeria

Perspectives of beneficiaries, health service providers, and community members on a maternal and child health conditional cash transfer pilot programme in Nigeria

Transformative Innovations in Reproductive, Maternal, Newborn, and Child Health over the Next 20 Years

The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria

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