Which strings attached: ethical considerations for selecting appropriate conditionalities in conditional cash transfer programmes

Krubiner, Carleigh; Merritt, Maria W.

doi:10.1136/medethics-2016-103386

Cited by 23 publications

(19 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They rather requested the government to explore other forms of incentives as they believed that memories of the N5000 (USD30) cash incentive would not last as much as the benefits of a proper economic empowerment programme such as skills acquisition/vocational trainings. The CCT programme had a high degree of receptivity by beneficiaries as consistent with conditionalities for consideration, and all stakeholders were appreciative of the scheme. However, all three stakeholders were disappointed that beneficiaries who had complications during their care could not access free referral services at the general hospitals during emergencies as earlier promised by the intervention following programmatic challenges.…”

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…Other economic-based interventions should be assessed similarly from an ethics perspective, and choose carefully the conditionality. 43 , 44 …”

Section: Discussionmentioning

confidence: 99%

TheEmpower Nudgelottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africa

Galárraga

Harries

Maughan-Brown

et al. 2018

Reproductive Health Matters

View full text Add to dashboard Cite

The objective of this study is to measure the preliminary efficacy of a pilot intervention, grounded in behavioural economics, increasing adherence of dual protection (simultaneous use of effective modern contraception and a barrier method, such as a condom) to protect against HIV, other sexually transmitted infections, and unintended pregnancy. Between 2015 and 2016, 100 women aged 18–40 years, seeking post-abortion care in Cape Town, South Africa were recruited to Empower Nudge, a randomised controlled trial to test a lottery incentive intervention designed to increase dual protection. At baseline, the mean age of participants was 27 years; 82% of them were from South Africa; 58% self-identified as Black African; average education completed was 11.7 years. At three months, assignment to the lottery intervention was associated with higher odds of returning for study visits (OR: 6.0; 95%CI: 2.45 to 14.7, p < 0.01), higher condom use (OR: 4.5; 95%CI: 1.43 to 14.1; p < 0.05), and higher use of dual protection (OR: 3.16; 95%CI: 1.01 to 9.9; p < 0.05). Only 60% of the study population returned after three months and only 38% returned after six months. Women who receive post-abortion care represent a neglected population with an urgent need for HIV and pregnancy prevention. Dual protection is a critically important strategy for this population. Lottery-based behavioural economics strategies may offer possible ways to increase dual protection use in this population. Further research with larger samples, longer exposure time, and more sites is needed to establish fully powered efficacy of lottery incentives for dual protection; using objective verification for monitoring.

show abstract

“…As one participant wrote, “It started out that the money was the reason I got involved. Then the programs instruction and leaders were the reason I continued to come back.” This comment highlights the ethical importance of matching the incentive to participation in a program that (a) participants value, (b) has been demonstrated to improve health outcomes in the target population (i.e., low-income families, families of color), (c) is open to all parents in the grade, thereby limiting any stigma associated with participation, and (d) is linked to long-term benefits to families and society (Krubiner and Merritt 2017).…”

Section: Discussionmentioning

confidence: 99%

Financial Incentives for Promoting Participation in a School-Based Parenting Program in Low-Income Communities

Gross

Bettencourt²

2019

Prev Sci

View full text Add to dashboard Cite

Although financial incentives are a well-accepted strategy for raising parent participation rates in prevention studies, they are rarely employed in practice due to concerns about their ethics, sustainability, and public acceptability. We sought to address these common concerns in the context of a larger prevention study using financial incentives to boost parent participation in a group-based parenting program implemented in an urban school district. We examined the extent to which the financial incentives delivered via bank debit cards ($15 for attending weekly group sessions, $5 for completing weekly practice assignments) motivated parents to enroll in the program and were associated with higher attendance and practice completion but poorer participation quality in group sessions, and how parents used the extra cash. Over 3 years, 67.4% ( n = 372) of eligible families enrolled in a parenting program called the Chicago Parent Program. Most parents were African American (68%) or Latinx (24%); 67% reported annual household incomes < $20,000. Although 71.2% of parents reported that the financial incentives motivated their enrollment, the most important motivators pertained to wanting to be a better parent. Parents citing incentives as motivating their enrollment had higher attendance than those who did not ( p = .01). Quality of parent participation was high and unrelated to whether financial incentives motivated enrollment. Parents reported using the extra cash to purchase items for their children (92%) and groceries (56%). Results suggest that financial incentives targeting low-income families of young children may improve parent participation rates without diminishing their intrinsic motivation to improve their parenting.

show abstract

Which strings attached: ethical considerations for selecting appropriate conditionalities in conditional cash transfer programmes

Cited by 23 publications

References 38 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

TheEmpower Nudgelottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africa

Financial Incentives for Promoting Participation in a School-Based Parenting Program in Low-Income Communities

Contact Info

Product

Resources

About