Economics at your fingertips  

Understanding use of health services in conditional cash transfer programs: Insights from qualitative research in Latin America and Turkey

Michelle Adato, Terry Roopnaraine and Elisabeth Becker

Social Science & Medicine, 2011, vol. 72, issue 12, 1921-1929

Abstract: Conditional cash transfer programs provide cash grants to poor households conditional on their participation in primary health care services. While significant impacts have been demonstrated quantitatively, little attention is paid to why CCTs have these observed impacts, and as importantly-- why impacts are not greater than they are. This article draws on qualitative research from four countries over a ten year period (1999-2009) to provide insights into why expected health and nutrition impacts do and do not occur. In Nicaragua, El Salvador, and Turkey, ethnographic methods were used, involving between 87 and 120 households per country, and in Mexico, focus groups were conducted with 230 people. Key informant interviews were conducted with health care providers in all countries. While CCTs operate primarily on the assumption that a cash incentive will produce behaviour change, we found multiple sociocultural and structural influences on health care decisions that compete with cash. These include beliefs around traditional and modern biomedical practices, sociocultural norms, gender relations, and the quotidian experience of poverty in many dimensions. We conclude that impacts can be increased through a better understanding of multiple contextual influences on health care decisions, and greater attention to the health education components and complementary interventions.

Keywords: Mexico; Nicaragua; El; Salvador; Turkey; Conditional; cash; transfers; Maternal; and; child; health; and; nutrition; Ethnography; Gender (search for similar items in EconPapers)
Date: 2011
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4) Track citations by RSS feed

Downloads: (external link)
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link:

Ordering information: This journal article can be ordered from
http://www.elsevier. ... _01_ooc_1&version=01

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Dana Niculescu ().

Page updated 2019-04-04
Handle: RePEc:eee:socmed:v:72:y:2011:i:12:p:1921-1929