Cash Transfers and Delivery Care: Evidence from the Safe Delivery Incentive Program in Nepal


This paper examines the effects of the Safe Delivery Incentive Program in Nepal, a cash transfer program that reduced the costs of childbirth in a healthcare facility. Using a difference-in-differences design, I find that low-parity women in high Human Development Index (HDI) districts increased facility delivery by 8.6 percentage points. Despite larger cost reductions, low-parity women in low HDI districts did not increase facility delivery but increased delivery with skilled personnel by 5 percentage points. The impact in low HDI districts was driven by the program’s supply-side incentive, which paid health workers to deliver in facilities or homes. This program had no impact on high-parity women, who become eligible two years later. Pre-existing barriers such as poor infrastructure of roads and facilities, customs, liquidity constraints, and lack of program awareness limited the effectiveness of the program.

Manda Tiwari
Manda Tiwari
PhD Candidate in Economics

I am a PhD candidate in Economics at the University of Iowa.