Journal of Population Economics

, Volume 29, Issue 2, pp 457–491 | Cite as

The unintended effects of cash transfers on fertility: evidence from the Safe Motherhood Scheme in India

Original Paper

Abstract

India launched the Safe Motherhood Scheme (Janani Suraksha Yojana or JSY) in 2005 in response to persistently high maternal and child mortality rates. JSY provides a cash incentive to socioeconomically disadvantaged women for childbirth at health facilities. This study explores some unintended consequences of JSY. Using data from two large household surveys, we examine a policy variation that exploits the differential incentive structure under JSY across states and population subgroups. We find that JSY may have resulted in a 2.5–3.5 percentage point rise in the probability of childbirth or pregnancy over a 3-year period in states already experiencing high population growth.

Keywords

Janani Suraksha Yojana JSY Conditional cash transfer Fertility India 
JEL Codes J1 I1 O1 

References

  1. Abadie A, Imbens GW (2006) Large sample properties of matching estimators for average treatment effects. Econometrica 74:235–267CrossRefGoogle Scholar
  2. Arroyo CR, Zhang J (1997) Dynamic microeconomic models of fertility choice: a survey. J Popul Econ 10:23–65CrossRefGoogle Scholar
  3. Becker GS, Lewis HG (1973) On the interaction between the quantity and quality of children. J Polit Econ 81:S279–88CrossRefGoogle Scholar
  4. Becker GS, Tomes N (1976) Child endowments and the quantity and quality of children. J Polit Econ 84:S143–S162CrossRefGoogle Scholar
  5. Becker SO, Caliendo M (2007) Sensitivity analysis for average treatment effects. Stata J 7:71–83Google Scholar
  6. Bhalotra S, van Soest A (2008) Birth-spacing, fertility and neonatal mortality in India: dynamics, frailty, and fecundity. J Econ 143:274–290CrossRefGoogle Scholar
  7. Cain M (1981) Risk and insurance: perspectives on fertility and agrarian change in India and Bangladesh. Popul Dev Rev 7:435–474CrossRefGoogle Scholar
  8. Cohen A, Dehejia R, Romanov D (2007) Do Financial Incentives Affect Fertility?Google Scholar
  9. Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC (2006) Birth spacing and risk of adverse perinatal outcomes. J Am Med Assoc 295:1809–1823CrossRefGoogle Scholar
  10. Das A, Rao D, Hagopian A (2011) India’s Janani Suraksha Yojana: further review needed. Lancet 377:295–6CrossRefGoogle Scholar
  11. Dehejia RH, Wahba S (1999) Causal effects in nonexperimental studies: reevaluating the evaluation of training programs. J Am Stat Assoc 94:1053–1062CrossRefGoogle Scholar
  12. Del Boca D (2002) The effect of child care and part time opportunities on participation and fertility decisions in Italy. J Popul Econ 15:549–573CrossRefGoogle Scholar
  13. Dewey KG, Cohen RJ (2007) Does birth spacing affect maternal or child nutritional status? A systematic literature review. Matern Child Nutr 3:151–173CrossRefGoogle Scholar
  14. Filmer D, Pritchett LH (2001) Estimating wealth effects without expenditure data-or-tears: an application to educational enrollments in States of India. Demography 38:115–132Google Scholar
  15. Fiszbein A, Schady N, Ferreira FHG et al (2009) Conditional cash transfers: reducing present and future poverty. The World Bank, Washington DCCrossRefGoogle Scholar
  16. GoI (2006) Report Of The Working Group On Population Stabilization For The Eleventh Five Year Plan (2007–2012). The Planning Commission, Government of IndiaGoogle Scholar
  17. Gopalan SS, Durairaj V (2012) Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India. BMC Heal Serv Res. doi:10.1186/1472-6963-12-319 Google Scholar
  18. Heckman JJ, Ichimura H, Todd PE (1997) Matching as an econometric evaluation estimator: evidence from evaluating a job training programme. Rev Econ Stud 64:605–654CrossRefGoogle Scholar
  19. Heckman JJ, Willis RJ (1976) Estimation of a stochastic model of reproduction an econometric approach. Household Production and Consumption. National Bureau of Economic Research, In, pp 99–146Google Scholar
  20. Hotz VJ, Klerman JA, Willis RJ (1993) The economics of fertility in developed countries. In: Stark O (ed) Rosenzweig MR. Elsevier, Handbook of Population and Family Economics, pp 275–347Google Scholar
  21. Hotz VJ, Miller RA (1984) The Economics of Family Planning. University of Chicago - Population Research CenterGoogle Scholar
  22. IIPS (2014) District Level Household and Facility Survey (DLHS-4), 2012–13. IIPS, International Institute of Population Sciences, Mumbai, IndiaGoogle Scholar
  23. Laroque G, Salanié B (2013) Identifying the response of fertility to financial incentives. J Appl Econ 29:314–332CrossRefGoogle Scholar
  24. Leung SF (1991) A stochastic dynamic analysis of parental sex preferences and fertility. Q J Econ 106:1063–1088CrossRefGoogle Scholar
  25. Lim SS, Dandona L, Hoisington JA et al (2010) India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. Lancet 375:2009–2023CrossRefGoogle Scholar
  26. Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:719–784Google Scholar
  27. Milligan K (2005) Subsidizing the stork: new evidence on tax incentives and fertility. Rev Econ Stat 87:1–39CrossRefGoogle Scholar
  28. MoHFW (2012) Annual Report 2011–12: Ministry of Health and Family Welfare. Government of India, New Delhi, IndiaGoogle Scholar
  29. Moore C (2008) Assessing Honduras? CCT Programme PRAF, Programa de Asignación Familiar: Expected and Unexpected Realities. International Policy Centre for Inclusive Growth, Country Study 01/2008Google Scholar
  30. Mörk E, Sjögren A, Svaleryd H (2013) Childcare costs and the demand for children—evidence from a nationwide reform. J Popul Econ 26:33–65CrossRefGoogle Scholar
  31. Morris SS, Flores R, Olinto P, Medina JM (2004) Monetary incentives in primary health care and effects on use and coverage of preventive health care interventions in rural Honduras: cluster randomised trial. Lancet 364:2030–7. doi:10.1016/S0140-6736(04)17515-6 CrossRefGoogle Scholar
  32. MoSPI (2010) Household Consumer Expenditure in India, 2007–08. Government of India, New Delhi, IndiaGoogle Scholar
  33. Newman JL (1988) Research in Population Economics. In: Schultz TP (ed). JAI Press, London,Google Scholar
  34. Powell-Jackson T, Mazumdar S, Mills A (2015) Financial incentives in health: new evidence from India’s Janani Suraksha Yojana. J Health Econ. doi:10.1016/j.jhealeco.2015.07.001 Google Scholar
  35. Randive B, Diwan V, Costa A (2013) india’s conditional cash transfer programme (the JSY) to promote institutional birth: is there an association between institutional birth proportion and maternal mortality? PLoS One 8:e67452CrossRefGoogle Scholar
  36. Rosenbaum PR (2002) Observational Studies, 2nd edn. Springer, New YorkCrossRefGoogle Scholar
  37. Rosenbaum PR, Rubin DB (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70:41–55CrossRefGoogle Scholar
  38. Rosenzweig MR, Schultz TP (1985) The demand for and supply of births: fertility and its life cycle consequences. Am Econ Rev 75:992–1015Google Scholar
  39. Rutstein SO (2005) Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. Int J Gynecol Obstet 89:S7–S24CrossRefGoogle Scholar
  40. Sangwan N, Maru RM (1999) The target-free approach: an overview. J Health Manag 1:71–96CrossRefGoogle Scholar
  41. Schultz TP (1993) Demand for children in low income countries. Handbook of Population and Family Economics. Elsevier, In, pp 349–430Google Scholar
  42. Sianesi B (2004) An evaluation of the swedish system of active labor market programs in the 1990s. Rev Econ Stat 86:133–155CrossRefGoogle Scholar
  43. Stecklov G, Winters P, Todd J, Regalia F (2007) Unintended effects of poverty programmes on childbearing in less developed countries: experimental evidence from Latin America. Popul Stud 61:125–140CrossRefGoogle Scholar
  44. Todd J, Winters P, Stecklov G (2011) Evaluating the impact of conditional cash transfer programs on fertility: the case of the Red de Proteccion Social in Nicaragua. J Popul Econ 25:267–290CrossRefGoogle Scholar
  45. UNFPA (2012) Trends in Maternal Mortality:1990–2010. United Nations Population Fund (with UNICEF, WHO, World Bank)Google Scholar
  46. Wolpin KI (1984) An estimable dynamic stochastic model of fertility and child mortality. J Polit Econ 92:852–874CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.The Center for Disease Dynamics, Economics and PolicyWashingtonUSA
  2. 2.The Public Health Foundation of IndiaGurgaonIndia
  3. 3.Princeton Environmental InstitutePrinceton UniversityPrincetonUSA

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