The Impact of Conditional Cash Transfers on Maternal Autonomy in Nigeria

Airah Balogun · MS International and Development Economics · University of San Francisco · October 2025

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Overview

This paper evaluates the effect of Nigeria's SURE-P MCH (Subsidy Reinvestment & Empowerment Programme — Maternal and Child Health) conditional cash transfer program on women's household decision-making autonomy. Using a difference-in-differences design with three waves of DHS microdata, the study asks whether a major CCT program targeting maternal health improved women's autonomy in treated states relative to untreated states.

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Key Results

Specification	DiD coefficient	p-value
Short-run (2008 → 2013)	−0.006	0.57
Long-run (2008 → 2018)	−0.007	0.48
National trend 2013 → 2018	+0.029	< 0.01

The SURE-P program had no statistically significant effect on women's autonomy in treated states. The national improvement in autonomy between 2013 and 2018 reflects broader socioeconomic developments — rising female education and greater household participation — rather than the program's direct effects.

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Data and Methods

• Survey data: Nigeria DHS Individual Recode (IR) files — 2008 (pre-program), 2013 (short-run post), 2018 (long-run post)
• Design: Difference-in-differences (DiD) quasi-experiment
• Treatment: SURE-P implementation states — Anambra, Bauchi, Kaduna, Niger, Ondo, Zamfara
• Outcome: Women's autonomy index from three DHS items (healthcare decisions, large purchases, visits to relatives)
• Controls: Age, education, household wealth, urban residence, regional fixed effects
• Estimation: Weighted regressions using DHS sampling weights; standard errors clustered at state level

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Policy Implications

1. Financial incentives alone are insufficient to transform gender relations. The SURE-P cash transfer did not shift women's decision-making power within households.
2. Complementary investments are required. Sustained improvements in autonomy require parallel investments in education, information access, and gender-inclusive community programmes.
3. CCTs need to be paired with social-norm interventions that directly enhance women's capacity to make informed health and economic decisions.

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Citation

Balogun, A. (2025). The Impact of Conditional Cash Transfers (SURE-P MCH Program)
on Maternal Autonomy in Nigeria. IDEC, University of San Francisco.

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Replication

Data Requirements

Source	Files	Access
Nigeria DHS (IR files)	NGIR53FL.DTA (2008), NGIR6AFL.DTA (2013), NGIR7AFL.DTA (2018)	Free account at dhsprogram.com

Raw DHS microdata are not included in this repository. Download the Nigeria Individual Recode files for 2008, 2013, and 2018 and place them in the data/ directory.

Code

File	Description
code/DHS Project.do	Master do-file — runs full analysis
code/DHS do.do	Data cleaning and variable construction

Notes

• The autonomy index is constructed from DHS variables v743a, v743b, and v743d.
• DHS sampling weights (v005) are applied throughout.
• Standard errors are clustered at the state level.