BMJ Open (Mar 2023)

Women and health professionals’ perspectives on a conditional cash transfer programme to improve pregnancy follow-up: a qualitative analysis of the NAITRE randomised controlled study

  • ,
  • Celine Chauleur,
  • Jacob Hannigsberg,
  • Philippe Merviel,
  • Marc Bardou,
  • Franck Perrotin,
  • Thomas Schmitz,
  • Olivier Picone,
  • Jeanne Sibiude,
  • Karine Chemin,
  • Dominique Dallay,
  • Frédéric Coatleven,
  • Loïc Sentilhes,
  • Céline Brochot,
  • Astrid Eckman-Lacroix,
  • Elise Thellier,
  • Frédérique Falchier,
  • Philippe Deruelle,
  • Muriel Doret,
  • Xavier Carcopino-Tusoli,
  • Nicolas Meunier-Beillard,
  • Hervé Fernandez,
  • Vincent Villefranque,
  • Caroline Diguisto,
  • Damien Subtil,
  • Clémence Houssin,
  • Philippe Gillard,
  • Laurent Mandelbrot,
  • Aurelie Godard-Marceau,
  • Nathalie Lesavre,
  • Claude Virtos,
  • Elodie Debras,
  • Aude Bourtembourg,
  • Claire Toubin,
  • Danièle Addes,
  • Véronique Uguen,
  • Cleo Tourbot,
  • Caroline Lelievre,
  • Christophe Tremouilhac,
  • Anne-Hélène Saliou,
  • Aurelie Derrieu,
  • Stephanie Auget,
  • Anne Legourrierec,
  • Anne Leroux,
  • Julie Fort-Jacquier,
  • Marion Serclerat,
  • Nathalie Laurenceau,
  • Audrey Renouleau,
  • Eliane Catteau,
  • Julie Blanc,
  • Candice Ronin,
  • Laurence Piechon,
  • Séverine Puppo,
  • Fanny Greco,
  • Sandrine Pettazzoni,
  • Muriel Athlani,
  • Amina Desvignes,
  • Annie Petiteau,
  • Amina El Yaakoubi,
  • Valérie Bechadergue,
  • Valérie Vaugirard,
  • Marie-Emmanuelle Neveu,
  • Caroline Geyl,
  • Marie-Victoire Senat,
  • Claire Colmant,
  • Marie Houllier,
  • Myriam Virlouet,
  • Marion Mir,
  • Yasmina Bejaoui,
  • Hélène Le Cornu,
  • Lauriane Nikel,
  • Elodie Gustave,
  • Amandine Stadler,
  • Ahmad Mehdi,
  • Tiphaine Barjat,
  • Suzanne Lima,
  • Thomas Corsini,
  • Anne Genod,
  • Charlotte Vermesch,
  • Cécile Fanget,
  • Marianne Perrot,
  • Manuela Munoz,
  • Sylvie Pitaval,
  • Fanny Magand,
  • Françoise Baldi,
  • Stephanie Bret,
  • Anne-Lise Verdier,
  • Christelle Denis,
  • Carine Arlicot,
  • Jérôme Potin,
  • Stéphanie Chretien,
  • Julie Paternotte,
  • Nathalie Trignol,
  • Élisabeth Blin,
  • Camille Mathieu,
  • Anne Dubreuil,
  • Anne Viallon Pelletier,
  • Catherine Guerin,
  • Chloé Arthuis,
  • Christophe Vayssieres,
  • Olivier Parant,
  • Marion Groussolles,
  • Maria Denis,
  • M Mathieu Morin,
  • Marie-Thérèse Bavoux,
  • Juliette Pelloux,
  • Anne-Claire Jambon,
  • Madeleine Santraine,
  • Veronique Lebuffe,
  • Pascale Broux,
  • Thierry Dzukou,
  • Magloire Gnansounou,
  • Didier Hubert,
  • Claire Djazet,
  • Ludivine Destoop,
  • Marine Derue,
  • Pierrick Theret,
  • Dominique Delzenne,
  • Stéphanie Daussin,
  • Alice Fraissinet,
  • Mélanie Vannerum,
  • Cyril Faraguet,
  • Laurence Landais,
  • Mariana Radu,
  • Anne Rouget,
  • Sena Al Sudani,
  • Bernard Guillon,
  • Estelle Wucher,
  • Véronique Selva,
  • Sandrine Reviron,
  • Francis Schwetterlé,
  • Cécile Chassande,
  • Véronique Grandin,
  • Eliane Krtoliza,
  • Patrick Becher,
  • Marie Sarrau,
  • Claire Lecoq,
  • Elsa Lutringer,
  • Denis Roux,
  • Noémie Berge,
  • Clémentine Barbier,
  • Anne Heron,
  • Audrey Farina-Bracquart,
  • Marie-Paule Curtet,
  • Evelyne Lefebure,
  • Marie-Hélène Le Douarin,
  • Hassan Al Rayes,
  • Émilie Magne,
  • Nathalie Destampes,
  • Émilie Ricard,
  • Pascale Ghezzi,
  • Catherine Guillen,
  • Fanny Alazard,
  • Marie-Thé Campanaro,
  • Florence Mojard,
  • Magalie David-Reynard,
  • Patricia Fuma,
  • Remy De Montgolfier,
  • Capucine Neel,
  • Guillaume Legendre,
  • Isabelle Andre,
  • Sylvie Nordstrom,
  • Brigitte Guionnet,
  • Catherine Crenn Hebert,
  • Chloé Dussaux,
  • Karine Achaintre,
  • Anne Wagner,
  • Martine Werveake,
  • Eloïse De Gouville,
  • George Theresin,
  • Marie Pierre Couetoux,
  • Lydia Caillaud,
  • Marie-Pierre Fernandez,
  • Sabrina Bottet,
  • M Alain Almodovar,
  • Elisa Etienne,
  • Véronique Guiteras,
  • Angélique Torres,
  • N. Roche,
  • Myriam Nassef,
  • Christine Abel-Faure,
  • Marie Louvet,
  • Carole Ettori,
  • Guillaume Ducarme,
  • Valérie Bonnenfant-Mezeray,
  • Laurence Szezot-Renaudeau,
  • Marie-Pierre Berte,
  • Elodie Netier-Herault,
  • Stéphanie Manson-Gallone,
  • Franck Mauviel,
  • Nathalie Agostini,
  • Marine Mazeaud,
  • Jean-Claude Dausset,
  • Isabelle De Murcia,
  • Emilie Alliot,
  • Anne-Marie Bes,
  • Magali Biferi Magali,
  • Hélène Heckenroth,
  • Sophie Morange,
  • Gersende Chiuot,
  • Audrey Gnisci,
  • Annie Allegre,
  • Laetitia Lecq,
  • Eva Balenbois,
  • Claire Tourette,
  • Aude Figarella,
  • Dio Andriamanjay,
  • Pauline Vignoles,
  • Catherine Cazelles,
  • Véronique Lejeune Saada,
  • Benafsheh Kashani,
  • Isabelle Chevalier,
  • Muriel Terrieres,
  • Audrey Cointement,
  • Valérie Benhaïm,
  • Najat Lindoune,
  • Anne-Sophie Maisonneuve,
  • M Frédéric Daubercy,
  • Guilia Mencattini,
  • Vanessa Combaud,
  • Isabelle Moya,
  • Xavier-Côme Donato,
  • Raoul Desbriere,
  • Marie Lafon,
  • Véronique Baudet

DOI
https://doi.org/10.1136/bmjopen-2022-067066
Journal volume & issue
Vol. 13, no. 3

Abstract

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Objectives Women of low socioeconomic status have been described as having suboptimal prenatal care, which in turn has been associated with poor pregnancy outcomes. Many types of conditional cash transfer (CCT) programmes have been developed, including programmes to improve prenatal care or smoking cessation during pregnancy, and their effects demonstrated. However, ethical critiques have included paternalism and lack of informed choice. Our objective was to determine if women and healthcare professionals (HPs) shared these concerns.Design Prospective qualitative research.Setting We included economically disadvantaged women, as defined by health insurance data, who participated in the French NAITRE randomised trial assessing a CCT programme during prenatal follow-up to improve pregnancy outcomes. The HP worked in some maternities participating in this trial.Participants 26 women, 14 who received CCT and 12 who did not, mostly unemployed (20/26), and - 7 HPs.Interventions We conducted a multicentre cross-sectional qualitative study among women and HPs who participated in the NAITRE Study to assess their views on CCT. The women were interviewed after childbirth.Results Women did not perceive CCT negatively. They did not mention feeling stigmatised. They described CCT as a significant source of aid for women with limited financial resources. HP described the CCT in less positive terms, for example, expressing concern about discussing cash transfer at their first medical consultation with women. Though they emphasised ethical concerns about the basis of the trial, they recognised the importance of evaluating CCT.Conclusions In France, a high-income country where prenatal follow-up is free, HPs were concerned that the CCT programme would change their relationship with patients and wondered if it was the best use of funding. However, women who received a cash incentive said they did not feel stigmatised and indicated that these payments helped them prepare for their baby’s birth.Trial registration number NCT02402855