Evaluating the Impact of a Conditional Cash Transfer Programme on Facility-Based Deliveries Among Adolescent Mothers in Zambezia Province, Mozambique: A 2020 Analysis

Maternal mortality remains a critical public health challenge in Mozambique, with adolescent mothers facing heightened risks. Low rates of facility-based deliveries contribute to poor maternal outcomes. Conditional cash transfer programmes have been implemented in various settings to incentivise health-seeking behaviours, but their specific impact on adolescent mothers in rural Mozambican contexts is not well documented. This working paper aims to quantify the effect of a conditional cash transfer programme on the utilisation of facility-based delivery services among adolescent mothers in Zambezia Province, Mozambique. It seeks to determine whether the financial incentive increased institutional delivery rates within this subgroup. A quasi-experimental design was employed, comparing adolescent mothers enrolled in the cash transfer programme with a matched control group of non-enrolled adolescents from similar communities. Secondary data from programme administrative records and health facility registries were analysed using multivariate logistic regression to isolate the programme's effect, controlling for key socio-economic and geographic confounders. Analysis indicates a positive association between the cash transfer programme and increased facility-based deliveries. Adolescent mothers receiving the transfer were significantly more likely to deliver in a health facility compared to the control group, with a measured increase of approximately 22 percentage points. Insights suggest the cash mitigated transport costs and other financial barriers. The conditional cash transfer programme appears to be an effective intervention for increasing institutional delivery rates among adolescent mothers in this setting. This suggests that addressing financial obstacles can improve health service utilisation in this demographic. Programme implementers should consider expanding the cash transfer scheme for adolescent mothers, ensuring timely payments and integration with adolescent-friendly sexual and reproductive health services. Further research is needed to assess the programme's cost-effectiveness and its impact on broader maternal and neonatal health outcomes. conditional cash transfers, maternal health, adolescent mothers, facility-based delivery, Mozambique, health systems This analysis provides specific evidence on the effect of a conditional cash transfer programme on facility-based delivery among a high-risk demographic in a rural African setting, informing policy and programme design for adolescent maternal health.