Accelerating birth timing to access cash transfers? Evidence from households in extreme poverty
Journal of Health Economics · 2026 · Pedro Carneiro、Lucy Kraftman、Imran Rasul、Francesca Salvati、Molly Scott
中文摘要
面向穷人的现金转移支付项目持续增加,而促进儿童早期发展的干预措施也日益受到关注。我们将这两股趋势结合起来,研究以孕妇为现金转移支付对象的开放注册式干预,是否会无意中促使未怀孕者为开始领取现金而加快生育时点。我们的研究背景是尼日利亚北部农村,那里的家庭对流动性有很高的需求,因为它们依赖波动的农业收入,频繁遭受自然与人为的总量冲击,并且居住在信贷市场不完善的社区。我们的证据来自对一项干预措施的评估,该干预向孕妇提供高额无条件现金转移支付,开放注册期为四年。我们考察了这一干预如何影响基线时尚未怀孕的1700名女性的怀孕时点。我们发现,在四年的开放注册期内,该干预对怀孕时点的扭曲性影响相对较弱。原因在于:女性对现金转移支付的使用保有完全的控制权,她们在自己的经营中拥有生产性投资机会,并且选择投资于这些机会而非将现金转移给丈夫。这一系列因素使女性能够将加快生育时点的边际收益与成本内部化,从而抑制了家庭原本具有的加快生育时点的激励。就外部有效性而言,我们汇集了45项人口与健康调查(DHS),将各国划分为较有可能或较不可能因针对孕妇的开放注册式现金转移支付干预而在生育时点上出现扭曲性效应的类别。
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.