Table 7 Key challenges

1. Irregular and Inconsistent Pay-Out Events: The CCT pay-out events were highly inconsistent and irregular resulting in large crowds which posed a big challenge for crowd control and management. Owing to the large crowds, women were kept for longer than necessary just to receive their cash support. It was gathered that this problem was as a result of delay in releasing funds to the SURE P MCH Programme Implementation Unit.

2. Security for Cash Disbursements: Adequate security was not provided for the CCT pay-out events and this compromised the safety of the cash being disbursed and placed paying staff at high risk.

3. Non-Payment of Cash Incentives: Several of the women interviewed reported not being paid their entitlement and others who received their first instalment were yet to receive their second instalment. It was later confirmed that the SURE-P MCH PIU had recently received funds and was in the process of conducting another round of CCT pay-out events in the states.

4. State Steering Committees: The SSC meetings were not sustainable as a result of unavailability of imprest to fund such meetings and this impacted negatively on the SSC as it never really carried out its assigned role.

5. Monitoring and Evaluation: Monitoring of the CCT Pay-out events were limited due to a lack of an M&E plan which delayed relevant programmatic interventions when needed.

6. Additional  workload: The additional demand for MNCH services generated by the CCT Programme in the facilities created additional workload for the participating facilities, particularly the obligation to complete the CCT reporting tools which had varying levels of capacity to handle the work.

7. Referrals: Initially the CCT Programme was designed to take care of women who had complications and had to be referred to General Hospitals but this strategy was marred with a lot of hitches as beneficiaries lamented their frustrations in assessing that level of care.