title: Cash transfers, maternal depression and emotional well-being: Quasi-experimental evidence from India's Janani Suraksha Yojana programme.
abstract: Maternal depression is an important public health concern. We investigated whether a national-scale initiative that provides cash transfers to women giving birth in government health facilities, the Janani Suraksha Yojana (JSY), reduced maternal depression in India's largest state, Uttar Pradesh. Using primary data on 1695 women collected in early 2015, our quasi-experimental design exploited the fact that some women did not receive the JSY cash due to administrative problems in its disbursement - reasons that are unlikely to be correlated with determinants of maternal depression. We found that receipt of the cash was associated with an 8.5% reduction in the continuous measure of maternal depression and a 36% reduction in moderate depression. There was no evidence of an association with measures of emotional well-being, namely happiness and worry. The results suggest that the JSY had a clinically meaningful effect in reducing the burden of maternal depression, possibly by lessening the financial strain of delivery care. They contribute to the evidence that financial incentive schemes may have public health benefits beyond improving uptake of targeted health services.
authors.affiliation: Department of Global Health and Development, Faculty of Public Health and Policy, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK. Electronic address: Timothy.Powell-Jackson@lshtm.ac.uk.
authors.forename: Timothy
authors.initials: T
authors.lastname: Powell-Jackson
authors.affiliation: Department of Global Health and Development, Faculty of Public Health and Policy, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
authors.forename: Shreya K
authors.initials: SK
authors.lastname: Pereira
authors.affiliation: Sambodhi Research and Communications Limited, C-162, Sector-2, Noida, Uttar Pradesh, India.
authors.forename: Varun
authors.initials: V
authors.lastname: Dutt
authors.affiliation: Department of Global Health and Development, Faculty of Public Health and Policy, London School Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tougher
authors.affiliation: Sambodhi Research and Communications Limited, C-162, Sector-2, Noida, Uttar Pradesh, India.
authors.forename: Kaveri
authors.initials: K
authors.lastname: Haldar
authors.affiliation: Sambodhi Research and Communications Limited, C-162, Sector-2, Noida, Uttar Pradesh, India.
authors.forename: Paresh
authors.initials: P
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000191:economics; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006078:Government Programs / Q000191:economics / Q000706:statistics & numerical data*; D061889:Healthcare Financing; D006801:Humans; D007194:India / Q000453:epidemiology; D008427:Maternal Health Services / Q000191:economics; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D036801:Parturition / Q000523:psychology
keywords: Cash transfers; India; Janani Suraksha Yojana; Maternal depression; Quasi-experimental