Accelerating birth timing to access cash transfers? Evidence from households in extreme poverty

There has been a sustained rise in cash transfer programs to the poor, and burgeoning interest in interventions promoting early childhood development. We draw together these trends to study whether open enrolment interventions targeting cash transfers to pregnant mothers unintentionally induce those not pregnant to accelerate birth timing in order to start receiving the cash. Our study context is rural Northern Nigeria, where households have high demand for liquidity because they are reliant on volatile earnings from agriculture, are subject to frequent natural and man-made aggregate shocks, and reside in communities with imperfect credit markets. Our evidence comes from an evaluation of an intervention providing high-valued unconditional cash transfers to pregnant mothers, with four years of open enrolment. We examine how this impacts pregnancy timing among 1700 women not pregnant at baseline. We document relatively weak distortionary impacts on pregnancy timing over the four year period of open enrolment. The reasons are women retain full control over the use of cash transfers, they have productive investment opportunities in their own businesses, and they choose to invest in those rather than transfer cash to husbands. This constellation of factors allows women to internalize the marginal benefits and costs of accelerating birth timing, and place a brake on the incentives households otherwise have to accelerate birth timing. On external validity, we draw together 45 DHS surveys to classify countries into those more or less likely to see distortionary effects on birth timing from open enrolment interventions targeting cash transfers to pregnant mothers.

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Publication Details

Journal
Journal of Health Economics
Published
2026-01-03
DOI
https://doi.org/10.1016/j.jhealeco.2025.103098
Primary Topic
Poverty, Education, and Child Welfare
Type
article
Field-Weighted Citation Impact
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article

Accelerating birth timing to access cash transfers? Evidence from households in extreme poverty

Lucy Kraftman, Francesca Salvati, Imran Rasul, Molly Scott et al.
Journal of Health Economics
Poverty, Education, and Child Welfare
article

Accelerating birth timing to access cash transfers? Evidence from households in extreme poverty

Lucy Kraftman, Francesca Salvati, Imran Rasul, Molly Scott, Pedro Carneiro
article en

Abstract

There has been a sustained rise in cash transfer programs to the poor, and burgeoning interest in interventions promoting early childhood development. We draw together these trends to study whether open enrolment interventions targeting cash transfers to pregnant mothers unintentionally induce those not pregnant to accelerate birth timing in order to start receiving the cash. Our study context is rural Northern Nigeria, where households have high demand for liquidity because they are reliant on volatile earnings from agriculture, are subject to frequent natural and man-made aggregate shocks, and reside in communities with imperfect credit markets. Our evidence comes from an evaluation of an intervention providing high-valued unconditional cash transfers to pregnant mothers, with four years of open enrolment. We examine how this impacts pregnancy timing among 1700 women not pregnant at baseline. We document relatively weak distortionary impacts on pregnancy timing over the four year period of open enrolment. The reasons are women retain full control over the use of cash transfers, they have productive investment opportunities in their own businesses, and they choose to invest in those rather than transfer cash to husbands. This constellation of factors allows women to internalize the marginal benefits and costs of accelerating birth timing, and place a brake on the incentives households otherwise have to accelerate birth timing. On external validity, we draw together 45 DHS surveys to classify countries into those more or less likely to see distortionary effects on birth timing from open enrolment interventions targeting cash transfers to pregnant mothers.

Journal of Health EconomicsVol. 106
University of Essex (GB), University of Suffolk (GB), University College of Osteopathy (GB), Nesta (GB), Cabinet Office (JP)
No poverty
Openalex Percentile: Top 98%
Poverty, Education, and Child Welfare
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