Small Cash Transfers Encourage Mothers To Participate In AIDS Prevention Program

MedicalResearch.com Interview with:

Dr Marcel Yotebieng, PhD Department of Epidemiology Ohio State University, 304 Cunz Hall Columbus, OH

Dr. Marcel Yotenbieng

Dr Marcel Yotebieng, PhD
Department of Epidemiology
Ohio State University, 304 Cunz Hall
Columbus, OH

Medical Research: What is the background for this study? What are the main findings?

Response: With the current World Health Organization recommended treatment for the prevention of mother-to-child HIV transmission (PMTCT), the risk of transmission of HIV from an infected mother to her baby can be cut from 35-45% to less than 5% in breastfeeding population and <1% in non-breastfeeding population. But in sub-Saharan Africa where over 90% of HIV-infected pregnant women worldwide live, transportation costs and opportunity costs to attend regular clinic visits (to collect drugs) have been identified as important barriers to PMTCT. The provision of economic incentives has the potential to help women overcome these economic barriers. In addition, by creating immediate rewards that “nudge” individuals towards positive health behaviors, financial incentives can also address psychological barriers to health-seeking behavior of HIV-infected pregnant and breastfeeding women. This is the first study to use small cash incentives to encourage women to attend clinic visit and received available PMTCT care. We found that, among newly diagnosed HIV-infected women, small, incremental cash incentives resulted in increased retention along the  prevention of mother-to-child HIV transmission cascade and uptake of available services.

Medical Research: What should clinicians and patients take away from your report?

Response: Given the growing recognition that factors such as low retention in care, linkage to care, and failure to deliver in a healthcare facility are limiting the effectiveness of available  prevention of mother-to-child HIV transmission interventions, the findings from this study suggest a promising, feasible approach that can help further the goal of reducing vertical transmission.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Larger and Longer duration trials are needed to determine the cost-effectiveness trial of cash incentive intervention and their effect on HIV-free survival. Additionally, more in-depth examinations, including qualitative analyses, of the mechanisms by which cash incentive interventions increase desired  prevention of mother-to-child HIV transmission outcomes would enhance  our understanding how  these interventions work and improve our ability to design and scale up similar interventions for PMTCT and other health and social issues 

Medical Research: Is there anything else you would like to add?

Response: The human and economic cost of an infected child is simply not affordable, particularly at a time when we have the medical treatment to prevent such unfortunate event. In addition, the benefit of keeping mothers and infant in care during the critical 1000 days around birth goes beyond HIV prevention and treatment. Key stakeholders in high burden countries and globally, including funding agencies, in light of these compelling findings, should be taking immediate steps to explore the scale-up of these relatively inexpensive intervention to improve retention in maternal and child health care.

Citation:

Conditional cash transfers and uptake of and retention in prevention of mother-to-child HIV transmission care: a randomised controlled trial

Yotebieng, Marcel et al.

The Lancet HIV , Volume 3 , Issue 2 , e85 – e93

DOI: http://dx.doi.org/10.1016/S2352-3018(15)00247-7

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Dr Marcel Yotebieng, PhD (2016). Small Cash Transfers Encourage Mothers To Participate In AIDS Prevention Program 

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