Health Policy and Planning Advance Access published online on November 20, 2008
Health Policy and Planning, doi:10.1093/heapol/czn039
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Empowering women to obtain high quality care: evidence from an evaluation of Mexico's conditional cash transfer programme
1Institute of Business and Economic Research, F502 Haas School of Business, University of California, Berkeley, CA 94720–1922, USA.
2 Li Ka Shing Distinguished Professor of Economics, Director, Graduate Program in Health Management, Haas School of Business, F543 Haas Building, University of California, Berkeley, CA 94720–1900, USA. Tel: +1 510 642-1418. Fax: +1 510 642-4700. E-mail: gertler{at}haas.berkeley.edu
*Corresponding author. Institute of Business and Economic Research, F502 Haas School of Business, University of California, Berkeley, CA 94720–1922, USA. Tel: +1 510 643 3953. Fax: +1 510 642-5018. E-mail: barber{at}haas.berkeley.edu; barbers{at}wpro.who.int.
Objectives To evaluate the impact of Mexico's conditional cash transfer programme on the quality of health care received by poor women. Quality is measured by maternal reports of prenatal care procedures received that correspond with clinical guidelines.
Methods The data describe retrospective reports of care received from 892 women in poor rural communities in seven Mexican states. The women were participating in an effectiveness study and randomly assigned to incorporation into the programme in 1998 or 1999. Eligible women accepted cash transfers conditional on obtaining health care and nutritional supplements, and participated in health education sessions.
Results Oportunidades beneficiaries received 12.2% more prenatal procedures compared with non-beneficiaries (adjusted mean 78.9, 95% Confidence Interval (CI): 77.5–80.3; P < 0.001).
Conclusion The Oportunidades conditional cash transfer programme is associated with better quality of prenatal care for low-income, rural women in Mexico. This result is probably a manifestation of the programme's empowerment goal, by encouraging beneficiaries to be informed and active health consumers.
Key Words: Economics, quality, Mexico, prenatal care, evaluation
Accepted for publication 5 September 2008.
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