@article{fdi:010077192,
  title = {{P}rogram impact pathway analysis reveals implementation challenges that limited the incentive value of conditional cash transfers aimed at improving maternal and child health care use in {M}ali},
  author = {{L}e {P}ort, {A}. and {Z}ongrone, {A}. and {S}avy, {M}athilde and {F}ortin, {S}onia and {K}ameli, {Y}ves and {S}essou, {E}. and {D}iana, {A}. {D}. and {K}oulidiati, {J}. {L}. and {K}odjo, {N}. {E}. and {K}amayera, {F}. and {M}ahamadou, {T}. and {M}artin-{P}r{\'e}vel, {Y}ves and {R}uel, {M}. {T}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he program "{S}ante {N}utritionnelle a {A}ssise {C}ommunautaire a {K}ayes" ({SNACK}) in {M}ali aimed to improve child linear growth through a set of interventions targeted to mothers and children during pregnancy and up to the child's second birthday. {D}istributions of cash to mothers and/or lipid-based nutrient supplement to children 6-23 mo of age were added to {SNACK} to increase attendance at community health centers ({CHC}s). {O}bjectives: {T}he aim of this study, which was embedded in a cluster-randomized impact evaluation of the program, was to assess the incentive value of the cash in relation to {CHC} attendance. {M}ethods: {W}e used a mixed-methods approach. {W}e collected quantitative data on cash receipt and {CHC} attendance in a midline survey of mother-child pairs (n = 3443). {A} program impact pathway analysis guided qualitative data collection and analysis. {T}welve {CHC}s were purposively selected in study groups that received cash. {W}e conducted semistructured continuous observations of cash distributions in 11 {CHC}s (n = 22) and semistructured qualitative interviews with frontline workers ({FLW}s) (n = 71) and mothers (n = 22) who were purposively selected from the midline survey. {R}esults: {FLW}s' knowledge of the objective and implementation plan of the cash program component was limited. {A} challenging physical environment and insufficient cash available for each distribution were identified as causes of irregularities in cash distributions. {M}ost mothers mentioned having to return several times to receive their cash. {C}hild health was identified as the main motivation to attend {CHC}s and cash was described as an additional benefit. {C}onclusion: {I}mplementation constraints related to remoteness and inaccessibility may have undermined the incentive value of the cash transfers in the {SNACK} program. {A}dditional research is needed to identify interventions that not only incentivize mothers to participate but that can be implemented effectively and with high quality in challenging contexts such as rural areas of {M}ali.},
  keywords = {conditional cash transfer ; health service utilization ; children ; nutrition ; process evaluation ; program impact pathway ; {M}ali ; {MALI}},
  booktitle = {},
  journal = {{C}urrent {D}evelopments in {N}utrition},
  volume = {3},
  numero = {9},
  pages = {nzz084 [13 ]},
  ISSN = {2475-2991},
  year = {2019},
  DOI = {10.1093/cdn/nzz084},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077192},
}