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Financial Incentives, Targeting, and Utilization of Child Health Services: Experimental Evidence from Zambia

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  • Günther Fink
  • Peter C. Rockers

Abstract

To address untreated infections in children, routine health checkups have increasingly been incentivized as part of conditional cash transfer programs targeted at the poor. We conducted a field experiment in Zambia to assess the elasticity of demand for checkups as well as the associated health benefits. We find that relatively small incentives induce substantial increases in uptake among non‐farming households and households living farther away from clinics, but not among households in the top wealth quintile. These results suggest that small financial incentives may be an efficient way to target poor populations. However, given the weak socioeconomic gradient in infections observed, small incentives will miss a substantial fraction of exposed children. Copyright © 2016 John Wiley & Sons, Ltd.

Suggested Citation

  • Günther Fink & Peter C. Rockers, 2017. "Financial Incentives, Targeting, and Utilization of Child Health Services: Experimental Evidence from Zambia," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1307-1321, October.
  • Handle: RePEc:wly:hlthec:v:26:y:2017:i:10:p:1307-1321
    DOI: 10.1002/hec.3404
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    1. Esther Duflo, 2003. "Grandmothers and Granddaughters: Old-Age Pensions and Intrahousehold Allocation in South Africa," The World Bank Economic Review, World Bank, vol. 17(1), pages 1-25, June.
    2. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    3. Fink, Günther & Jack, Kelsey & Masiye, Felix, 2014. "Seasonal Credit Constraints and Agricultural Labor Supply: Evidence from Zambia," IZA Discussion Papers 8657, Institute of Labor Economics (IZA).
    4. Jorge M. Aguero & Michael R. Carter & Ingrid Woolard, 2006. "The Impact of Unconditional Cash Transfers on Nutrition: The South African Child Support Grant," SALDRU Working Papers 8, Southern Africa Labour and Development Research Unit, University of Cape Town.
    5. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    6. Vivi Alatas & Abhijit Banerjee & Rema Hanna & Benjamin A. Olken & Julia Tobias, 2012. "Targeting the Poor: Evidence from a Field Experiment in Indonesia," American Economic Review, American Economic Association, vol. 102(4), pages 1206-1240, June.
    7. Bhalotra, Sonia R. & Venkataramani, Atheendar, 2013. "Cognitive Development and Infectious Disease: Gender Differences in Investments and Outcomes," IZA Discussion Papers 7833, Institute of Labor Economics (IZA).
    8. Edmonds, Eric V., 2006. "Child labor and schooling responses to anticipated income in South Africa," Journal of Development Economics, Elsevier, vol. 81(2), pages 386-414, December.
    9. Richard Akresh & Damien de Walque & Harounan Kazianga, 2014. "Alternative Cash Transfer Delivery Mechanisms: Impacts on Routine Preventative Health Clinic Visits in Burkina Faso," NBER Chapters, in: African Successes, Volume II: Human Capital, pages 113-135, National Bureau of Economic Research, Inc.
    10. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    11. Asfaw, Abay & Braun, Joachim von & Klasen, Stephan, 2004. "How Big is the Crowding-Out Effect of User Fees in the Rural Areas of Ethiopia? Implications for Equity and Resources Mobilization," World Development, Elsevier, vol. 32(12), pages 2065-2081, December.
    12. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications - Books, The World Bank Group, number 2597.
    13. Sarah Baird & Craig McIntosh & Berk Özler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(4), pages 1709-1753.
    14. repec:esx:essedp:745 is not listed on IDEAS
    15. David E. Sahn & Stephen D. Younger & Garance Genicot, 2003. "The Demand for Health Care Services in Rural Tanzania," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 65(2), pages 241-260, May.
    16. Marie Gaarder & Amanda Glassman & Jessica Todd, 2010. "Conditional cash transfers and health: unpacking the causal chain," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 2(1), pages 6-50.
    17. Venkataramani, Atheendar S., 2012. "Early life exposure to malaria and cognition in adulthood: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 31(5), pages 767-780.
    18. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    19. Christina Paxson & Norbert Schady, 2010. "Does Money Matter? The Effects of Cash Transfers on Child Development in Rural Ecuador," Economic Development and Cultural Change, University of Chicago Press, vol. 59(1), pages 187-229, October.
    20. Paul Gertler, 2004. "Do Conditional Cash Transfers Improve Child Health? Evidence from PROGRESA's Control Randomized Experiment," American Economic Review, American Economic Association, vol. 94(2), pages 336-341, May.
    21. Bhalotra, Sonia R. & Venkataramani, Atheendar, 2013. "Cognitive Development and Infectious Disease: Gender Differences in Investments and Outcomes," IZA Discussion Papers 7833, Institute for the Study of Labor (IZA).
    22. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
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