Utilization, Health CareIMPACTTNCT04090762
Improving Perinatal Outcomes Using Conditional and Targeted Transfers
A study testing Conditional cash transfer and Risk information provision in people with Utilization, Health Care and Birth Outcomes, run by RAND at 1 site in Nigeria.
Trial summary
It has been estimated that increasing the use of skilled care during childbirth could prevent up to 1.5 million maternal and newborn deaths and stillbirths by 2025. Conditional cash transfer programs, in which women receive cash payments conditioned on the use of maternal health services, are increasingly being used… Read more about this study
- Who is it for?
- Ages 15 to 49 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Utilization, Health Care, Birth Outcomes
- What is being tested?
- Conditional cash transfer and Risk information provision
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36,607 participants
- Where
- 1 siteNigeria
- Study dates
- 8 Jul 2019to 30 Apr 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 to 49 years
- Women only
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Pregnant women ages 15-49 who reside in the participating health service areas
Who cannot join
- none
Trial locations and contacts
1 site in 1 country.
About this study
It has been estimated that increasing the use of skilled care during childbirth could prevent up to 1.5 million maternal and newborn deaths and stillbirths by 2025. Conditional cash transfer programs, in which women receive cash payments conditioned on the use of maternal health services, are increasingly being used as a mechanism to increase uptake. In this study, the investigators randomly assign households to receive varying cash amounts conditioned on uptake of recommended pregnancy and delivery care. The investigators crosscut this with an intervention in which pregnant women receive information about their risk type. This randomized trial will provide new evidence about the potential efficacy of targeting cash transfers by pregnancy risk. This study will take place in 288 primary health service areas (HSAs) in Nigeria.
- Conditions
- Utilization, Health Care, Birth Outcomes
- Being tested
- Conditional cash transfer, Risk information provision
- Medical subject headings
- Patient Acceptance of Health Care
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conditional cash transferBehavioural
Pregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth.
Risk information provisionBehavioural
Pregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics.
| Study group | Role | What they receive |
|---|---|---|
| Control | No intervention | Women in the control arm will complete the baseline and follow up surveys but will not receive any intervention. |
| Risk information only | Active comparator | Women in the risk only arm who exhibit characteristics associated with a greater risk of a poor birth outcome will be informed that they possess these characteristics. Risk characteristics (identified from the medical and epidemiological literature) include age, prior pregnancy and birth history (e.g., previous stillbirth). Receives: Behavioral: Risk information provision |
| Conditional Cash Transfer only | Active comparator | Women in this arm will be eligible to receive conditional cash transfers. To receive the transfer, pregnant women must attend prenatal care and give birth in a health facility. Receives: Behavioral: Conditional cash transfer |
| Conditional Cash Transfer and risk information | Active comparator | Women in this arm will be provided with risk information at the time of baseline survey administration AND be eligible to receive conditional cash transfers, pending attendance at prenatal care and delivery at a health facility. Receives: Behavioral: Conditional cash transfer; Behavioral: Risk information provision |
What is being measured
The primary outcome is the main question the study is designed to answer.
Probability of prenatal care
the probability of receiving prenatal care
Measured: 3-4 months after anticipated childbirth/delivery date
Uptake of prenatal care
the number of prenatal visits completed
Measured: 3-4 months after anticipated childbirth/delivery date
Uptake of health facility birth
probability of giving birth at a health facility
Measured: 3-4 months after anticipated childbirth/delivery date
Child mortality - fetal loss
Child mortality - fetal loss
Measured: 3-4 months after anticipated childbirth/delivery date
Child mortality - stillbirths
Child mortality - stillbirths
Measured: 3-4 months after anticipated childbirth/delivery date
Child mortality - early infant death
Child mortality - early infant death
Measured: 3-4 months after anticipated childbirth/delivery date
Secondary outcomes (14)
Maternal health
delivery complications
Measured: 3-4 months after anticipated childbirth/delivery date
Maternal mortality
maternal death
Measured: 3-4 months after anticipated childbirth/delivery date
Child weight
Child weight
Measured: 3-4 months after anticipated childbirth/delivery date
Child length
Child length
Measured: 3-4 months after anticipated childbirth/delivery date
Uptake of postnatal care
Probability of using postnatal care
Measured: 3-4 months after anticipated childbirth/delivery date
Child vaccination
Probability of receiving recommended child immunizations
Measured: 3-4 months after anticipated childbirth/delivery date
Maternal beliefs
Risk perceptions and beliefs assessed using a questionnaire
Measured: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - tetanus vaccination
Probability of receiving tetanus vaccination
Measured: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - malaria prophylaxis
Probability of receiving malaria prophylaxis
Measured: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - blood building products
Probability of receiving blood building products
Measured: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - dietary consumption
Probability of consuming nutrient-rich foods assessed using questionnaire
Measured: 3-4 months after anticipated childbirth/delivery date
Quality of perinatal care
Quality score assessed using a questionnaire
Measured: 3-4 months after anticipated childbirth/delivery date
Timely initiation of prenatal care
Probability of initiating prenatal care in the first trimester of pregnancy
Measured: 3-4 months after anticipated childbirth/delivery date
Maternal work
Hours worked in the last seven days
Measured: 3-4 months after enrollment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Sep 2019
- Study start8 Jul 2019
- Primary completion30 Jun 2021
- Study completion30 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Utilization, Health CareStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 36,607 participants (actual)
Sponsor and investigators
- Lead sponsor
- RAND
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Edward Okeke, RAND
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04090762
- Sponsor's protocol ID
- R01HD090231
- Acronym
- IMPACTT
- Status last verified
- Jan 2026
- First submitted
- 28 Jun 2019
- Last updated
- 13 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Okeke EN, Abubakar IS, De Guttry R. In Nigeria, Stillbirths And Newborn Deaths Increased During The COVID-19 Pandemic. Health Aff (Millwood). 2021 Nov;40(11):1797-1805. doi: 10.1377/hlthaff.2021.00659. Epub 2021 Oct 20.
PubMed 34669501Okeke EN. Playing defense? Health care in the era of Covid. J Health Econ. 2022 Sep;85:102665. doi: 10.1016/j.jhealeco.2022.102665. Epub 2022 Jul 25.
PubMed 35952443
Study at a glance
From the registry record, last updated by the sponsor on 13 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Improving Perinatal Outcomes Using Conditional and Targeted Transfers
- ClinicalTrials.gov ID
- NCT04090762
- Acronym / sponsor ID
- IMPACTT / R01HD090231
- Conditions
- Utilization, Health Care, Birth Outcomes
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36,607 participants (actual)
- Lead sponsor
- RANDUniversity, hospital or other
- Study start
- 8 Jul 2019 (actual)
- Primary completion
- 30 Jun 2021 (actual)
- Study completion
- 30 Apr 2025 (actual)
- First posted
- 16 Sep 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
It has been estimated that increasing the use of skilled care during childbirth could prevent up to 1.5 million maternal and newborn deaths and stillbirths by 2025. Conditional cash transfer programs, in which women receive cash payments conditioned on the use of maternal health services, are increasingly being used as a mechanism to increase uptake. In this study, the investigators randomly assign households to receive varying cash amounts conditioned on uptake of recommended pregnancy and delivery care. The investigators crosscut this with an intervention in which pregnant women receive information about their risk type. This randomized trial will provide new evidence about the potential efficacy of targeting cash transfers by pregnancy risk. This study will take place in 288 primary health service areas (HSAs) in Nigeria.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Control | No intervention | –Women in the control arm will complete the baseline and follow up surveys but will not receive any intervention. |
| Risk information only | Active comparator | Behavioral: Risk information provisionWomen in the risk only arm who exhibit characteristics associated with a greater risk of a poor birth outcome will be informed that they possess these characteristics. Risk characteristics (identified from the medical and epidemiological literature) include age, prior pregnancy and birth history (e.g., previous stillbirth). |
| Conditional Cash Transfer only | Active comparator | Behavioral: Conditional cash transferWomen in this arm will be eligible to receive conditional cash transfers. To receive the transfer, pregnant women must attend prenatal care and give birth in a health facility. |
| Conditional Cash Transfer and risk information | Active comparator | Behavioral: Conditional cash transfer, Behavioral: Risk information provisionWomen in this arm will be provided with risk information at the time of baseline survey administration AND be eligible to receive conditional cash transfers, pending attendance at prenatal care and delivery at a health facility. |
Who may qualify
- Ages
- 15 to 49 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (1 listed)
- Pregnant women ages 15-49 who reside in the participating health service areas
Key exclusion criteria (1 listed)
- none
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conditional cash transferPregnant women receive cash payments conditioned on their use of prenatal services and use of a health facility for child birth. | Behavioural | Conditional Cash Transfer and risk information, Conditional Cash Transfer only |
| Risk information provisionPregnant women who exhibit characteristics associated with a greater risk of a poor birth outcome - these will be identified from the medical and epidemiological literature - will be informed that they possess these characteristics. | Behavioural | Conditional Cash Transfer and risk information, Risk information only |
Primary outcome
Probability of prenatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
the probability of receiving prenatal care
Uptake of prenatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
the number of prenatal visits completed
Uptake of health facility birth
Time frame: 3-4 months after anticipated childbirth/delivery date
probability of giving birth at a health facility
Child mortality - fetal loss
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - fetal loss
Child mortality - stillbirths
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - stillbirths
Child mortality - early infant death
Time frame: 3-4 months after anticipated childbirth/delivery date
Child mortality - early infant death
14 secondary outcomes
Maternal health
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal mortality
Time frame: 3-4 months after anticipated childbirth/delivery date
Child weight
Time frame: 3-4 months after anticipated childbirth/delivery date
Child length
Time frame: 3-4 months after anticipated childbirth/delivery date
Uptake of postnatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
Child vaccination
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal beliefs
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - tetanus vaccination
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - malaria prophylaxis
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - blood building products
Time frame: 3-4 months after anticipated childbirth/delivery date
Pregnancy behavior - dietary consumption
Time frame: 3-4 months after anticipated childbirth/delivery date
Quality of perinatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
Timely initiation of prenatal care
Time frame: 3-4 months after anticipated childbirth/delivery date
Maternal work
Time frame: 3-4 months after enrollment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jan 2026.
- Background: PubMed 34669501Okeke EN, Abubakar IS, De Guttry R. In Nigeria, Stillbirths And Newborn Deaths Increased During The COVID-19 Pandemic. Health Aff (Millwood). 2021 Nov;40(11):1797-1805. doi: 10.1377/hlthaff.2021.00659. Epub 2021 Oct 20.
- Background: PubMed 35952443Okeke EN. Playing defense? Health care in the era of Covid. J Health Econ. 2022 Sep;85:102665. doi: 10.1016/j.jhealeco.2022.102665. Epub 2022 Jul 25.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conditional cash transfer and Risk information provision in people with Utilization, Health Care and Birth Outcomes, run by RAND at 1 site in Nigeria.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Nigeria. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Probability of prenatal care (time frame: 3-4 months after anticipated childbirth/delivery date). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04090762, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2026.