A simple mobile money transfer could be the difference between life and death for tens of newborns in the rural areas, a study shows.A ground-breaking research has found that unconditional cash payments to pregnant women reduces infant mortality by nearly half. The gold-standard study was done by economists from UC Berkeley and Oxford University.The research shows that regular monthly payments of Sh9,500 to expectant women starting from mid-pregnancy, plus a lump sum of Sh16,900 in the third trimester — with monthly payments continuing through six months after birth — reduces infant mortality by 48 per cent.Alternatively, two lump sums of Sh37,850 at mid-pregnancy and Sh75,710 in the third trimester with no ongoing monthly payments achieve the same results.The peer-reviewed study by researchers from the National Bureau of Economic Research shows unconditional cash transfers reduced infant mortality by 48 per cent and under-five mortality by 45 per cent.The findings come at a critical time. According to the World Health Organization, a woman still dies every two minutes globally from preventable causes related to pregnancy and childbirth. The majority of the deaths occur in low-resource settings.A new Lancet analysis predicts that United States Agency for International Development (USAid) cuts will lead to an estimated five million deaths of children under five years old by 2030.100,000 birthsThe random, controlled trial drew on data from more than 100,000 births. The trial sought to measure the impact of basic cash transfers on child health. Infant mortality in rural Kenya averaged 32 per 1,000 births before the intervention."Between 2014 and 2017, GiveDirectly sent Sh130,000 one-time cash transfers via mobile money to 10,500 households in Siaya County, Kenya," co-author of the study Prof Edward Miguel states. "Researchers found these cash payments cut infant mortality by 48 per cent, from about 40 per 1,000 births to about 21 per 1,000 births. It also cut under-five mortality by 45 per cent, from about 57 to about 32 per 1,000 births."The human stories behind the statistics paint a vivid picture of transformation.Joyce, who hails from Siaya, says: "I was struggling to afford transport and food because of complications during pregnancy. I used the Sh130,000 I received to pay hospital bills during birth, I bought nutritious food to support breastfeeding, and I also started a small potato-frying business for extra income."For Pricilla, the money came in handy. “I had two previous miscarriages due to hard labour and poor nutrition. This time round when I got money, I rested, ate well and renovated my house. This helped me to have a safe delivery because I avoided physically demanding jobs that could endanger my pregnancy."On the other hand, another recipient, Kadzo, used the money she received to care for her twins."I stopped doing strenuous work after delivery. I bought food for my twins, and improved my house. I was able to pay transport when visiting the hospital for appointments. The money lifted a huge burden in our lives,” she says.The research team comprising Michael Walker, Nick Shankar, Grady Killeen and Dennis Egger from the National Bureau of Economic Research conducted a comprehensive analysis in 653 random villages."We collected census data for over 100,000 births, including on mortality and cause of death, and detailed data on household health behaviours," the researchers said.Their findings revealed that unconditional cash transfers lead to 48 per cent fewer infant deaths before age one, and 45 per cent fewer child deaths before age five."Detailed data on cause of death, cash transfer timing relative to birth, and the location of health facilities indicate that unconditional cash transfers and access to delivery care are complements in generating mortality reductions," they observed.Maternal deaths were largely preventable by appropriate obstetric care, particularly among households living close to physician-staffed facilities and those who received transfers around the time of birth. The treatment led to a large increase in hospital deliveries by 45 per cent.The infant and child mortality declines were concentrated among poorer households with below-median assets or predicted consumption.Read: Kenya among 10 African nations to benefit from birth safety fundThe cash transfers resulted in a substantial decline of 51 per cent in female labour supply in the three months before and after birth, alongside improved child nutrition. And children were 44 per cent less likely to go to bed hungry.The research found that cash transfers work best when paired with basic health infrastructure. Autopsies showed that most lives saved were of newborns who could have otherwise died from birth complications rather than infectious diseases. This suggests that the cash helped more mothers to deliver babies safely.Well-timed transfers led to increased hospital births, maternal rest, and better nutrition — the key factors that helped reduce infant mortality rates.However, the researchers noted that infant and child mortality largely reverted to pre-programme levels after cash transfers ended.The researchers said that this demands new thinking, particularly given the recent USAid funding cuts."Foreign aid budgets are shrinking rapidly, with global health funding projected to fall sharply from $39 billion in 2022 to just $22 billion in the coming year, as the world falls behind on SDG 3: Good health and well-being," the researchers said.The study notes that Bill Gates is set to spend his $200 billion fortune within 20 years to "put the world on a path to ending preventable deaths of mothers and babies, and lifting millions of people out of poverty”.The researchers said that targeting cash directly to pregnant women is a scalable, cost-effective strategy to maximise the impact of limited aid, rapidly saving lives, and helping achieve ambitious global health goals without costly delivery infrastructure.Despite not being the main aim of the original programme, unconditional cash transfers in this setting may be a cost-effective way to reduce infant and child mortality.The study's findings have inspired GiveDirectly to partner with Lwala Community Alliance — a Kenyan-founded and led community health organisation — to launch a Sh234 million ($1.8 million) maternal and child health pilot project in rural Kenya to reach 1,500 mothers.Read: Foreign aid cuts could cause more child deaths, warns UN"Pregnant women will receive cash via mobile money. They will also receive continued care from community health workers, information to make decisions, medicine and vitamin supplementation to support their pregnancy, and high-quality care from their local health facility — all leading to healthier pregnancies and deliveries," GiveDirectly said.The pilot enrolment begins in September, with the first payment due in October.GiveDirectly is a non-profit organisation operating in low-income areas. It helps families living in extreme poverty by making unconditional cash transfers via mobile phone. The organisation currently transfers funds to people in Bangladesh, the DRC, Liberia, Kenya, Malawi, Mozambique, Rwanda, Uganda and the USA.llidigu@ke.nationmedia.com
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