This Project Briefing provides an outline of the key elements to be considered when designing a cash transfer project that aims to improve maternal health outcomes in low-resource settings.

What is clear from a design perspective is that timing is critical to engage a woman before she gives birth, during delivery and after she gives birth. Other forms of cash transfers, while facing implementation challenges, do not have to contend with this nine-month-plus timeframe.

An additional layer of complexity is trying to measure the impacts of different interventions (conditional versus unconditional transfers), which demands intensive communication and coordination among research and implementation partners. The challenge of project design is not, therefore, just one of content but also one of process.

Based on a review of best practice, the authors state:

• Lack of effective maternal health care services can undermine progress on broader human development
• Well-designed cash transfers that aim to be sustainable and have adequate resourcing can improve maternal health
• Complementary awareness-raising activities are critical for changing behaviour and attitudes at individual, household and community levels