缅甸不同孕产妇现金转移支付模式的比较。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Health policy and planning Pub Date : 2024-08-08 DOI:10.1093/heapol/czae048
Elisa M Maffioli, Nicholus Tint Zaw, Erica Field
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引用次数: 0

摘要

作为 2016 年至 2019 年在缅甸开展的随机对照试验的一部分,我们探讨了一项孕产妇现金转移项目在分配给不同交付模式(政府卫生工作者与非政府组织贷款代理)的村庄中的表现,并确定了成功的关键因素。衡量标准包括注册纳入和排除错误、向注册受益人支付款项的失败(受益人是否收到任何转账、收到的福利比例、是否存在延迟和少付福利金额的情况),以及受益人是否在符合条件后仍留在项目中。我们发现,在有政府卫生工作者提供现金转移支付的村庄,妇女平均每月多收到两笔转移支付,按时足额收到支付的可能性提高了 19.7%,超过资格继续参与计划的可能性降低了 14.6%。关于该计划的主要健康目标--儿童营养--我们发现,与母亲通过贷款中介领取现金的儿童相比,母亲通过政府卫生工作者领取现金的儿童患慢性营养不良的可能性较低。总体而言,在缅甸农村地区,由政府卫生工作者向幼儿母亲发放现金的方式优于由贷款代理人发放现金的方式。定性证据表明,成功有两个关键因素:(i) 与目标受益人之间的信任关系和过往互动,以及政府卫生工作者的专业知识与项目之间的互补性;(ii) 基于特定健康目标的绩效激励机制,以及自上而下的监督。我们不能排除其他激励措施或内在动力也发挥了作用。
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A comparison between different models of delivering maternal cash transfers in Myanmar.

As part of a randomized controlled trial conducted in Myanmar between 2016 and 2019, we explore the performance of a maternal cash transfer program across villages assigned to different models of delivery (by government health workers vs loan agents of a non-governmental organization) and identify key factors of success. Measures include enrolment inclusion and exclusion errors, failures in payment delivery to enrolled beneficiaries (whether beneficiaries received any transfer, fraction of benefits received and whether there were delays and underpayment of benefit amounts) and whether beneficiaries remained in the program beyond eligibility. We find that women in villages where government health workers delivered cash transfers received on average two additional monthly transfers, were 19.7% more likely to receive payments on time and in-full and were 14.6% less likely to stay in the program beyond eligibility. With respect to the primary health objective of the program-child nutrition-we find that children whose mother received cash by government health workers were less likely to be chronically malnourished compared to those whose mother received cash by loan agents. Overall, the delivery of cash transfers to mothers of young children by government health workers outperforms the delivery by loan agents in rural Myanmar. Qualitative evidence suggests two key factors of success: (1) trusted presence and past interactions with targeted beneficiaries and complementarities between government health workers' expertise and the program; and (2) performance incentives based on specific health objectives along with top-down monitoring. We cannot exclude that other incentives or intrinsic motivation also played a role.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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