The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria

Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA’s advice is often adhered to by their clients, engaging TBA...

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Main Authors:	Chukwuma, Adanna, Mbachu, Chinyere, McConnell, Margaret, Bossert, Thomas J., Cohen, Jessica
Format:	Journal Article
Published:	World Bank, Washington, DC 2021
Subjects:	POSTNATAL BIRTH ATTENDANTS TRADITIONAL BIRTH INCENTIVE MATERNAL HEALTH NEONATAL HEALTH TRADITIONAL BIRTH ATTENDANT
Online Access:	http://hdl.handle.net/10986/35574

id	okr-10986-35574
recordtype	oai_dc
spelling	okr-10986-355742021-07-19T16:33:55Z The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria Chukwuma, Adanna Mbachu, Chinyere McConnell, Margaret Bossert, Thomas J. Cohen, Jessica POSTNATAL BIRTH ATTENDANTS TRADITIONAL BIRTH INCENTIVE MATERNAL HEALTH NEONATAL HEALTH TRADITIONAL BIRTH ATTENDANT Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA’s advice is often adhered to by their clients, engaging TBAs in advocacy among their clients may increase maternal and neonatal postnatal care use. This study estimates the impact of monetary incentives for maternal referrals by TBAs on early maternal and neonatal postnatal care use (within 48 h of delivery) in Nigeria. Overall, 207 TBAs participated in this study: 103 in the treatment group and 104 in the control group. The intervention increased the proportion of maternal clients of TBAs that reported attending postnatal care within 48 h of delivery by 15.4 percentage points [95% confidence interval (CI): 7.9–22.9]. The proportion of neonatal clients of TBAs that reportedly attended postnatal care within 48 h of delivery also increased by 12.6 percentage points [95% CI: 5.9–19.3]. However, providers often did not address the issues that may have led to maternal and newborn postnatal complications during these visits. We show that motivating TBAs using monetary incentives for maternal postnatal care use can increase skilled care use after delivery among their maternal and neonatal clients, who have a higher risk of mortality because of their exposure to unskilled birth attendance. However, improving the quality of care is key to ensuring maternal and neonatal health gains from postnatal care attendance. 2021-05-13T19:52:51Z 2021-05-13T19:52:51Z 2019-05-20 Journal Article BMC Pregnancy and Childbirth 1471-2393 http://hdl.handle.net/10986/35574 CC BY 4.0 http://creativecommons.org/licenses/by/4.0 World Bank World Bank, Washington, DC Publications & Research :: Journal Article Publications & Research Africa Africa Western and Central (AFW) Nigeria
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	POSTNATAL BIRTH ATTENDANTS TRADITIONAL BIRTH INCENTIVE MATERNAL HEALTH NEONATAL HEALTH TRADITIONAL BIRTH ATTENDANT
spellingShingle	POSTNATAL BIRTH ATTENDANTS TRADITIONAL BIRTH INCENTIVE MATERNAL HEALTH NEONATAL HEALTH TRADITIONAL BIRTH ATTENDANT Chukwuma, Adanna Mbachu, Chinyere McConnell, Margaret Bossert, Thomas J. Cohen, Jessica The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
geographic_facet	Africa Africa Western and Central (AFW) Nigeria
description	Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA’s advice is often adhered to by their clients, engaging TBAs in advocacy among their clients may increase maternal and neonatal postnatal care use. This study estimates the impact of monetary incentives for maternal referrals by TBAs on early maternal and neonatal postnatal care use (within 48 h of delivery) in Nigeria. Overall, 207 TBAs participated in this study: 103 in the treatment group and 104 in the control group. The intervention increased the proportion of maternal clients of TBAs that reported attending postnatal care within 48 h of delivery by 15.4 percentage points [95% confidence interval (CI): 7.9–22.9]. The proportion of neonatal clients of TBAs that reportedly attended postnatal care within 48 h of delivery also increased by 12.6 percentage points [95% CI: 5.9–19.3]. However, providers often did not address the issues that may have led to maternal and newborn postnatal complications during these visits. We show that motivating TBAs using monetary incentives for maternal postnatal care use can increase skilled care use after delivery among their maternal and neonatal clients, who have a higher risk of mortality because of their exposure to unskilled birth attendance. However, improving the quality of care is key to ensuring maternal and neonatal health gains from postnatal care attendance.
format	Journal Article
author	Chukwuma, Adanna Mbachu, Chinyere McConnell, Margaret Bossert, Thomas J. Cohen, Jessica
author_facet	Chukwuma, Adanna Mbachu, Chinyere McConnell, Margaret Bossert, Thomas J. Cohen, Jessica
author_sort	Chukwuma, Adanna
title	The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
title_short	The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
title_full	The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
title_fullStr	The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
title_full_unstemmed	The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
title_sort	impact of monetary incentives on referrals by traditional birth attendants for postnatal care in nigeria
publisher	World Bank, Washington, DC
publishDate	2021
url	http://hdl.handle.net/10986/35574
_version_	1764483357443358720

The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria

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