Conditional and Unconditional Cash Transfers to Improve Use of Contraception in Low and Middle Income Countries: A Systematic Review

Abstract

This systematic review synthesizes evidence on the impact of conditional and unconditional cash transfers (CCT and UCT) on contraception in low‐ and middle‐income countries. Scientific and gray literature databases were searched from 1994 to 2016 and 11 papers from ten studies were included. Most of the studies had low risk of bias. Cash transfers were used for increasing school attendance or improving health and nutrition, but not directly for contraception. Three studies showed positive impact on contraceptive use and four showed a decrease in fertility outcomes. An increase in childbearing was observed in two studies, and three studies demonstrated no impact on fertility indicators. All studies treated contraceptive use or fertility only as unintended and indirect outcomes. The available evidence on impact of CCT and UCT on contraception is inconclusive due to the limited number of studies, varying outcome measures, and lack of intervention specifically for contraception.

Systematic Reviews of Mechanisms for Financing Family Planning: Findings, Implications, and Future Agenda

“…), which included interventions for family planning that focus on the role of the community in mobilizing, pooling, and allocating reproductive health resources through various health financing instruments, including micro‐insurance, microfinance and microcredit, mutual health organizations, and community‐managed user fees; (ii) introduction of conditional and unconditional cash transfers (Khan et al. ); (iii) introducing, removing, or changing out‐of‐pocket payments or user fees (Korachais et al. ); (iv) results‐based financing (Blacklock et al.…”

“…Five intervention groups were identified, and for each a specific systematic review was carried out. The specific interventions groups were: (i) introduction of community financing and community-based health insurance (Karra et al 2016), which included interventions for family planning that focus on the role of the community in mobilizing, pooling, and allocating reproductive health resources through various health financing instruments, including micro-insurance, microfinance and microcredit, mutual health organizations, and community-managed user fees; (ii) introduction of conditional and unconditional cash transfers (Khan et al 2016); (iii) introducing, removing, or changing out-of-pocket payments or user fees (Korachais et al 2016); (iv) results-based financing (Blacklock et al 2016), including all interventions involving payment for performance that have a supply-side component; and (v) social protection programs that provided a voucher (Bellows et al 2016) subsidy to disadvantaged clients and reimbursed healthcare workers for providing contraceptive services at a pre-defined quality standard, including referral vouchers. Social marketing and franchising were not included as these were examined by other recent systematic reviews (Sweat et al 2012;Westley and Shochet 2013).…”

Education Equity in Special Education Transfer Payments to Low-income Groups

“…The state of education in China has obviously improved, but the level of education per capita is still relatively low. There is also a big gap between the educational equity of our country and the developed countries (Goldrick-Rab, et al, 2016;Cahalan et al, 2018;Khan et al, 2016). In general, the per capita educational years and Gini coeffi cient of education in the eastern provinces with relatively developed economies are better than those in the central and western provinces are.…”

Health financing and family planning in the context of Universal Health Care: Connecting the discourse

“…• This has included systematic reviews of specific financing models (and their effective inclusion of FP), such as community financing and community-based health insurance (Karra et al, 2016), conditional and unconditional cash transfers (Khan et al, 2016), introducing, removing, or changing OOP or user fees (Korachais et al, 2016), results-based financing (Blacklock et al, 2016), performance-based incentives (Bellows et al, 2014), and social protection programs that provide a voucher subsidy (Bellows et al, 2016). A summary of the systematic reviews concluded that there is 'limited scientific evidence on the effectiveness of the various financing mechanisms for contraception' and that more robust studies are required (Lissner and Ali, 2016).…”