Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China.
Adult
Child
Child, Preschool
China
Female
Health Facilities
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Maternal-Child Health Services
/ economics
Medical Assistance
/ statistics & numerical data
Mothers
/ statistics & numerical data
Outcome Assessment, Health Care
Patient Acceptance of Health Care
/ statistics & numerical data
Pregnancy
Program Evaluation
Rural Population
/ statistics & numerical data
Surveys and Questionnaires
Conditional cash transfer
Impact evaluation
Maternal and child health
Western rural China
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
05 Jun 2020
05 Jun 2020
Historique:
received:
07
08
2019
accepted:
27
05
2020
entrez:
7
6
2020
pubmed:
7
6
2020
medline:
11
11
2020
Statut:
epublish
Résumé
Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China. We designated two different sets of villages and households that were used as comparisons against which outcomes of the treated households could be assessed. In 2014, we conducted a large-scale survey of 1522 households in 75 villages (including 25 treatment and 50 comparison) from nine nationally designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). Overall, the uptake of MCH services in the sample households were low, especially in terms of postpartum care visits, early breastfeeding, exclusive breastfeeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. The results from both the ITT and ATT analyses showed that the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers of MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes. The CCT program generated modest improvements in the uptake of MCH services and mothers' knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two potential reasons: poor CCT implementation and the low quality of rural health facilities.
Sections du résumé
BACKGROUND
BACKGROUND
Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.
METHODS
METHODS
We designated two different sets of villages and households that were used as comparisons against which outcomes of the treated households could be assessed. In 2014, we conducted a large-scale survey of 1522 households in 75 villages (including 25 treatment and 50 comparison) from nine nationally designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT).
RESULTS
RESULTS
Overall, the uptake of MCH services in the sample households were low, especially in terms of postpartum care visits, early breastfeeding, exclusive breastfeeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. The results from both the ITT and ATT analyses showed that the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers of MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.
CONCLUSIONS
CONCLUSIONS
The CCT program generated modest improvements in the uptake of MCH services and mothers' knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two potential reasons: poor CCT implementation and the low quality of rural health facilities.
Identifiants
pubmed: 32503554
doi: 10.1186/s12889-020-08996-9
pii: 10.1186/s12889-020-08996-9
pmc: PMC7275386
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
870Subventions
Organisme : China Medical Board
ID : 12-118
Organisme : Major International Joint Research Programme
ID : 71861147003
Organisme : West China Hospital, Sichuan University
ID : skqy201537
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