Trial reportBMC pregnancy and childbirth2019
Conditional cash transfers to improve use of health facilities by mothers and newborns in conflict affected countries, a prospective population based intervention study from Afghanistan.
Trial report in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.
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The trial behind it
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Who cites it
15 citing papers in PubMed, 5 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Effects of women's economic empowerment interventions on antenatal care outcomes: a systematic review.BMJ open · 2023Pooled it
- Pooled it
- A systematic review of newborn health interventions in humanitarian settings.BMJ global health · 2022Pooled it
- Community health workers and health equity in low- and middle-income countries: systematic review and recommendations for policy and practice.International journal for equity in health · 2022Pooled it
- Impact of conditional and unconditional cash transfers on health outcomes and use of health services in humanitarian settings: a mixed-methods systematic review.BMJ global health · 2022Pooled it
- Trial
- Antenatal care interventions in Afghanistan from 2000 to 2024: a rapid realist review.BMJ open · 2025Review
- Quality of antenatal care services in Afghanistan: findings from the national survey 2022-2023.BMC pregnancy and childbirth · 2025Article
- Evaluation of an obstetric and neonatal care upskilling program for community health workers in Papua New Guinea.BMC pregnancy and childbirth · 2024Article
- Sexual and reproductive health implementation research in humanitarian contexts: a scoping review.Reproductive health · 2024Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Association of Conditional Cash Transfers With Maternal Mortality Using the 100 Million Brazilian Cohort.JAMA network open · 2023Article
- Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations.Conflict and health · 2022Review
- Digital and Economic Determinants of Healthcare in the Crisis-Affected Population in Afghanistan: Access to Mobile Phone and Socioeconomic Barriers.Healthcare (Basel, Switzerland) · 2021Article
- Combination of Interventions Needed to Improve Maternal Healthcare Utilization: A Multinomial Analysis of the Inequity in Place of Childbirth in Afghanistan.Frontiers in global women's health · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effects of conditional cash transfer (CCT) programs on maternal and child health (MCH) service use in conflicted affected countries such as Afghanistan are not known.
methodsWe conducted a non-randomised population based intervention study in six Afghanistan districts from December 2016 to December 2017. Six control districts were purposively matched. Women were eligible to be included in the baseline and endline evaluation surveys if they had given birth to one or more children in the last 12 months. The intervention was a CCT program including information, education, communication (IEC) program about CCT to community members and financial incentives to community health workers (CHWs) and families if mothers delivered their child at a health facility. Control districts received standard care. The primary objective was to assess the effect of CCT on use of health facilities for delivery. Secondary objectives were to assess the effect of CCT on antenatal care (ANC), postnatal care (PNC) and CHW motivation to perform home visits. Outcomes were analysed at 12 months using multivariable difference-in-difference linear regression models adjusted for clustering and socio demographic variables.
resultsOverall, facility delivery increased in intervention villages by 14.3% and control villages by 8.4% (adjusted mean difference [AMD] 3.3%; 95% confidence interval [- 0.14 to 0.21], p value 0.685). There was no effect in the poorest quintile (AMD 0.8% [- 0.30 to 0.32], p value 0.953). ANC (AMD 45.0% [0.18 to 0.72] p value 0.004) and PNC (AMD 31.8% [- 0.05 to 0.68] p value 0.080) increased in the intervention compared to the control group. CHW home visiting changed little in intervention villages (- 3.0%) but decreased by - 23.9% in control villages (AMD 12.2% [- 0.27 to 0.51], p value 0.508). CCT exposure was 27.3% (342/1254) overall and 10.2% (17/166) in the poorest quintile.
conclusionsOur study demonstrated that a CCT program provided to women aged 16-49 years can be implemented in a highly conservative conflict affected population. CCT should be scaled up for the poorest women in Afghanistan.
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