IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v383y2025ics0277953625007853.html

Impact of supply-side conditional cash transfers on household family planning decisions: Evidence from a field experiment in Afghanistan

Author

Listed:
  • Osmani, Ahmad Reshad
  • Okunade, Albert

Abstract

This study examines the effects of supply-side conditional cash transfers (SS-CCTs) on contraceptive knowledge and utilization among Afghan women, emphasizing household decision-making in resource-constrained settings. Leveraging data from a randomized controlled trial involving 6,974 households across 143 health facilities, the study explores how financial incentives for healthcare providers influence their family-planning behaviors. The findings reveal that SS-CCTs significantly improve contraceptive knowledge and uptake, particularly among educated women. Factors such as age, household income, urban residence, and proximity to health facilities are pivotal in shaping these outcomes. Women with no formal education increasingly utilized contraceptives but gained limited knowledge. The results highlight the critical role of education in amplifying the effectiveness of health interventions and call for policies that address socioeconomic disparities. By aligning interventions with household needs, these strategies can enhance reproductive health outcomes and promote broader household welfare.

Suggested Citation

  • Osmani, Ahmad Reshad & Okunade, Albert, 2025. "Impact of supply-side conditional cash transfers on household family planning decisions: Evidence from a field experiment in Afghanistan," Social Science & Medicine, Elsevier, vol. 383(C).
  • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625007853
    DOI: 10.1016/j.socscimed.2025.118454

    Download full text from publisher

    As the access to this document is restricted, you may want to for a different version of it.

    References listed on IDEAS

    1. Karp, Celia & Wood, Shannon N. & Galadanci, Hadiza & Sebina Kibira, Simon Peter & Makumbi, Fredrick & Omoluabi, Elizabeth & Shiferaw, Solomon & Seme, Assefa & Tsui, Amy & Moreau, Caroline, 2020. "‘I am the master key that opens and locks’: Presentation and application of a conceptual framework for women's and girls' empowerment in reproductive health," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Small, Sarah F. & van der Meulen Rodgers, Yana, 2023. "The gendered effects of investing in physical and social infrastructure," World Development, Elsevier, vol. 171(C).
    3. Tisamarie B. Sherry & Sebastian Bauhoff & Manoj Mohanan, 2017. "Multitasking and Heterogeneous Treatment Effects in Pay-for-Performance in Health Care: Evidence from Rwanda," American Journal of Health Economics, University of Chicago Press, vol. 3(2), pages 192-226, Spring.
    4. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    5. Finlay, Jocelyn E., 2021. "Women’s reproductive health and economic activity: A narrative review," World Development, Elsevier, vol. 139(C).
    6. Amanda Glassman & Denizhan Duran & Marge Koblinsky, 2013. "Impact of Conditional Cash Transfers on Maternal and Newborn Health," Policy Papers 19, Center for Global Development.
    7. Anbrasi Edward & Binay Kumar & Faizullah Kakar & Ahmad Shah Salehi & Gilbert Burnham & David H Peters, 2011. "Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan," PLOS Medicine, Public Library of Science, vol. 8(7), pages 1-9, July.
    8. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    9. Gabriella Conti & James Heckman & Sergio Urzua, 2010. "The Education-Health Gradient," American Economic Review, American Economic Association, vol. 100(2), pages 234-238, May.
    10. Samarakoon, Shanika & Parinduri, Rasyad A., 2015. "Does Education Empower Women? Evidence from Indonesia," World Development, Elsevier, vol. 66(C), pages 428-442.
    11. Witvorapong, Nopphol & Foshanji, Abo Ismael, 2016. "The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan," Social Science & Medicine, Elsevier, vol. 152(C), pages 87-95.
    12. Martin Emmert & Frank Eijkenaar & Heike Kemter & Adelheid Esslinger & Oliver Schöffski, 2012. "Economic evaluation of pay-for-performance in health care: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 755-767, December.
    13. Olson, Zachary & Clark, Rachel Gardner & Reynolds, Sarah Anne, 2019. "Can a conditional cash transfer reduce teen fertility? The case of Brazil’s Bolsa Familia," Journal of Health Economics, Elsevier, vol. 63(C), pages 128-144.
    14. repec:wly:hlthec:v:33:y:2024:i:2:p:204-228 is not listed on IDEAS
    15. Claudia Goldin & Lawrence F. Katz, 2002. "The Power of the Pill: Oral Contraceptives and Women's Career and Marriage Decisions," Journal of Political Economy, University of Chicago Press, vol. 110(4), pages 730-770, August.
    16. Lutfullah Safi, 2024. "Review of Afghanistan’s development pattern from 2001 to 2021: a relative lack of sustainability, inclusiveness, and prosperity," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 26(1), pages 333-352, April.
    17. Dana Burde & Leigh L. Linden, 2013. "Bringing Education to Afghan Girls: A Randomized Controlled Trial of Village-Based Schools," American Economic Journal: Applied Economics, American Economic Association, vol. 5(3), pages 27-40, July.
    18. Martha J. Bailey & Brad Hershbein & Amalia R. Miller, 2012. "The Opt-In Revolution? Contraception and the Gender Gap in Wages," American Economic Journal: Applied Economics, American Economic Association, vol. 4(3), pages 225-254, July.
    19. Lant Pritchett & Lawrence H. Summers, 1996. "Wealthier is Healthier," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 841-868.
    20. Chowa, Gina A.N. & Masa, Rainier D. & Wretman, Christopher J. & Ansong, David, 2013. "The impact of household possessions on youth's academic achievement in the Ghana Youthsave experiment: A propensity score analysis," Economics of Education Review, Elsevier, vol. 33(C), pages 69-81.
    21. Edward Anbrasi & Binay Kumar & Faizullah Kakar & Ahmed Shah Salehi & Gilbert Burnham & David H Peters, 2011. "Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years’ Evaluation in Afghanistan," Working Papers id:4362, eSocialSciences.
    22. Eide, Eric R. & Showalter, Mark H., 2011. "Estimating the relation between health and education: What do we know and what do we need to know?," Economics of Education Review, Elsevier, vol. 30(5), pages 778-791, October.
    23. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    24. Sonia Laszlo & Muhammad Farhan Majid & Laëtitia Renée, 2024. "Conditional cash transfers and women's reproductive choices," Health Economics, John Wiley & Sons, Ltd., vol. 33(2), February.
    25. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    26. Parmar, Divya & Banerjee, Aneesh, 2019. "How do supply- and demand-side interventions influence equity in healthcare utilisation? Evidence from maternal healthcare in Senegal," Social Science & Medicine, Elsevier, vol. 241(C).
    27. Jasjeet Singh Sekhon & Richard D. Grieve, 2012. "A matching method for improving covariate balance in cost‐effectiveness analyses," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 695-714, June.
    28. Ahmad Reshad Osmani, 2021. "Conditional Cash Incentive and Use of Health Care Services: New Evidence from a Household Experiment," Journal of Family and Economic Issues, Springer, vol. 42(3), pages 518-532, September.
    29. Yao, Jing & Murray, Alan T. & Agadjanian, Victor, 2013. "A geographical perspective on access to sexual and reproductive health care for women in rural Africa," Social Science & Medicine, Elsevier, vol. 96(C), pages 60-68.
    30. Garenne, Michel & Joseph, Veronique, 2002. "The Timing of the Fertility Transition in Sub-Saharan Africa," World Development, Elsevier, vol. 30(10), pages 1835-1843, October.
    31. Alan de Brauw & Amber Peterman, 2020. "Can conditional cash transfers improve maternal health care? Evidence from El Salvador's Comunidades Solidarias Rurales program," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 700-715, June.
    32. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.


    Cited by:

    1. Ahmad Reshad Osmani & Albert Okunade, 2026. "The effect of supply-side conditional cash transfers on healthcare outcomes for women and children: evidence from experimental and observational data," Journal of Population Research, Springer, vol. 43(1), pages 1-42, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    2. Ji, Sisi & Zhu, Zheyi, 2022. "Does higher education matter for health?," Cardiff Economics Working Papers E2022/4, Cardiff University, Cardiff Business School, Economics Section.
    3. Rasyad A. Parinduri, 2017. "Does Education Improve Health? Evidence from Indonesia," Journal of Development Studies, Taylor & Francis Journals, vol. 53(9), pages 1358-1375, September.
    4. Hania Wu & Tony Tam, 2015. "Economic Development and Socioeconomic Inequality of Well-Being: A Cross-Sectional Time-Series Analysis of Urban China, 2003–2011," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 124(2), pages 401-425, November.
    5. Masato Oikawa, 2024. "The role of education in health policy reform outcomes: evidence from Japan," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 49-76, February.
    6. Martha Bailey & Olga Malkova & Zoë M. McLaren, 2017. "Does Parents' Access to Family Planning Increase Children's Opportunities? Evidence from the War on Poverty and the Early Years of Title X," Working Papers 2017-083, Human Capital and Economic Opportunity Working Group.
    7. Carbone, Jared C. & Kverndokk, Snorre, 2014. "Individual investments in education and health," HERO Online Working Paper Series 2014:1, University of Oslo, Health Economics Research Programme.
    8. Mark McGovern, 2012. "Don't Stress: Early Life Conditions, Hypertension, and Selection into Associated Risk Factors," Working Papers 201227, School of Economics, University College Dublin.
    9. Jofre-Bonet, Mireia & Rossello-Roig, Melcior & Serra-Sastre, Victoria, 2024. "Intimate partner violence and children's health outcomes," LSE Research Online Documents on Economics 121995, London School of Economics and Political Science, LSE Library.
    10. David M. Cutler & Adriana Lleras-Muney, 2012. "Education and Health: Insights from International Comparisons," NBER Working Papers 17738, National Bureau of Economic Research, Inc.
    11. Ahmad Reshad Osmani & Albert Okunade, 2026. "The effect of supply-side conditional cash transfers on healthcare outcomes for women and children: evidence from experimental and observational data," Journal of Population Research, Springer, vol. 43(1), pages 1-42, March.
    12. Steingrimsdottir, Herdis, 2016. "Reproductive rights and the career plans of U.S. college freshmen," Labour Economics, Elsevier, vol. 43(C), pages 29-41.
    13. Bergvall, Sanna & Fernström, Clara & Ranehill, Eva & Sandberg, Anna, 2025. "The impact of PhD studies on mental health—a longitudinal population study," Journal of Health Economics, Elsevier, vol. 104(C).
    14. Tansel, Aysit & Karao?lan, Deniz, 2016. "The Causal Effect of Education on Health Behaviors: Evidence from Turkey," IZA Discussion Papers 10020, IZA Network @ LISER.
    15. Chen, Yuanyuan & Wang, Haining & Cheng, Zhiming & Smyth, Russell, 2023. "Education and Migrant Health in China," Economic Modelling, Elsevier, vol. 121(C).
    16. Giorgio Brunello & Dimitris Christelis & Anna Sanz‐de‐Galdeano & Anastasia Terskaya, 2024. "Does college selectivity reduce obesity? A partial identification approach," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2306-2320, October.
    17. Raquel Fonseca Benito & Yuhui Zheng, 2011. "The Effect of Education on Health Cross-Country Evidence," Working Papers WR-864, RAND Corporation.
    18. Michael F. Lovenheim & Randall Reback & Leigh Wedenoja, 2016. "How Does Access to Health Care Affect Teen Fertility and High School Dropout Rates? Evidence from School-based Health Centers," NBER Working Papers 22030, National Bureau of Economic Research, Inc.
    19. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    20. Strulik, Holger, 2018. "The return to education in terms of wealth and health," The Journal of the Economics of Ageing, Elsevier, vol. 12(C), pages 1-14.

    More about this item

    Keywords

    ; ; ; ; ; ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625007853. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.