Can Small Incentives Have Large Payoffs? Health Impacts of a Cash Transfer Program in Bolivia

We study the effects of a conditional cash transfer for health care utilization, equivalent to 1% of monthly household consumption, on child survival in Bolivia. Using census data and an instrument for program take-up, we show that the intervention increased the survival rates of birth cohorts exposed to the program by 3.8% to 14.7%. A pathways analysis shows higher rates of early antenatal care and skilled birth attendance for women and a higher number of growth monitoring checkups and immunization for children. The intervention is highly cost-effective, at $746 per disability-adjusted life year averted, making the program’s design a promising policy alternative.