Conditional cash transfers for maternal health interventions: factors influencing uptake in North-Central Nigeria

Background: Nigeria accounts for a significant proportion of global maternal mortality figures with little progress made in curbing poor health indices. In a bid to reverse this trend, the Government of Nigeria initiated a conditional cash transfer (CCT) programme to encourage pregnant women utilize services at designated health facilities. This study aims to understand experiences of women who register for CCT services and explore reasons behind non-uptake of those women who do not register. Methods: We conducted this study in a rural community in North Central Nigeria. Having identified programme beneficiaries by randomly sampling contact details obtained from the programme database, using snowball sampling method we sourced non-beneficiaries list based on recommendations from beneficiaries and other community members. Thereafter we undertook semi-structured interviews on both beneficiaries and non-beneficiaries and analysed data obtained thematically. Results: Our findings revealed that, while beneficiaries of the programme were influenced by the cash transfers, cash may not be sufficient incentive for uptake by non-beneficiaries of CCT in Nigeria. Factors such as community and spousal influence, availability of free drugs, proximity to health facility are critical factors that affect uptake in our study context. On the other hand, poor programme administration, mistrust for government initiatives as well as poor quality of services could significantly constrain service utilization despite cash transfers. Conclusion: Considering that a number of barriers to uptake of the CCT programme are similar to barriers to maternal health services, it is essential that maternal health services are available, accessible and of acceptable quality to target recipients for CCT programmes to reach their full implementation potential