The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review

Hunter, Benjamin M.; Harrison, Sean; Portela, Anayda; Bick, Debra

doi:10.1371/journal.pone.0173068

Cited by 84 publications

(96 citation statements)

References 63 publications

(154 reference statements)

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“…12 A systematic review done by Hunter BM shows cashless transfer helps the mother utilize maternity services and increase institutional deliveries. 16 A higher percentage of respondents used JSY in our study compared to NFHS 4 and the Rajasthan study. As this was a more recent study, implementation of JSY may have improved.…”

Section: Antenatal Care Utilizationcontrasting

confidence: 52%

Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada

Tellis¹,

Rent²,

Dmello³

2018

Int J Community Med Public Health

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Background: Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Factors like education, economic status and out of pocket (OOP) expenditure can affect utilization of maternal health services. Hence this study aims to assess the utilization pattern of maternal health care and the out of pocket expenditure for delivery services in a public maternity hospital. Methods: A cross sectional study was conducted using primary data from women who delivered in public maternity hospital, Mangaluru during January -February 2018. Study respondents were interviewed using pre-tested, interview schedule. The data was analysed using SPSS 20.0 version. Results: 78.3% of the respondents visited the health care provider during first trimester of pregnancy. 97.3% of the mothers attended ≥4 antenatal visits. The time of the first ANC visit, consumption of Iron folic acid (IFA) tablets, choice of provider for ANC are significantly associated with caste, education of the respondents and their husbands. The mean expenditure for delivery care, including indirect expenditure was ₹2875. Expenditure during delivery was significantly associated with respondent's education and type of delivery. Conclusions: Socio demographic characteristics like caste and education did seem to have an effect on the utilization of ANC especially consumption of IFA. Education and communication campaigns may aid to improve this. Good implementation of government schemes can help to reduce the direct OOP expenditure for delivery care. The indirect cost associated with maternity care may still be a burden for poor families.

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Section: Antenatal Care Utilizationcontrasting

confidence: 52%

Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada

Tellis¹,

Rent²,

Dmello³

2018

Int J Community Med Public Health

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“…Numerous cash transfer schemes in SEAR countries facilitate the maternal and childcare including institutional deliveries as detected in our review. It is tally with Hunter et al in their consolidated systematic review 74 . Contracting nongovernment health providers is an important step in reducing maternal mortality in India.…”

Section: Discussionmentioning

confidence: 64%

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Perera

Gilks

Alemu

2020

Preprint

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Background: Sustainable Development Goal 3 (SDG-3) aims to ensure healthy lives and promote wellbeing for all. Universal Health Coverage (UHC) assures delivering health services to all who need without suffering from financial hardships. This paper aims to identify the successes, challenges and opportunities towards achieving UHC for maternal and childcare in countries in the World Health Organization, South East Asian Region (SEAR). Methods: We conducted a systematic review of the literature. We searched PubMed, Embase, Scopus, CINAHL, PsycINFO, WHO research portal and Google scholar for studies published in English from 2010 to 2020. We included studies conducted in maternal and childcare focusing on challenges, opportunities or successes towards UHC in countries in SEAR. Data was synthesized and presented as a narrative description, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: We identified 62 studies with different study designs from eight SEAR countries , majority were from India. We observed successes or opportunities in access and quality in MCH with government cash transfer schemes and private sector contribution in India, Bangladesh and Indonesia. Politically prioritized MCH care was identified as an opportunity in a state of India. Inadequate healthcare infrastructure including trained human resources, medical products and other supplies were identified as the main challenges in the region. Facilities are overcrowded in Bangladesh and Indonesia. From provider perspective, health care workers’ knowledge and skills as well as attitudes and behaviors were also identified as issues in the region. Lack of health literacy, misconceptions and cultural barriers are identified as challenges from clients’ side. Difficulties in geographical distribution and transport were contributing to poor healthcare access in four countries. Deficiencies in government policies and administration were identified in some fields. Poverty was detected as an overarching barrier.Conclusions: SEAR countries have demonstrated improvements in access, quality and equity on MCH towards UHC. There are, however, challenges related to human and other resources, health care facilities and socio-economic determinants of health. Regional bodies as well as authorities in individual countries should work on these issues to address challenges to achieve UHC.Registration: PROSPERO: CRD42020166404

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“…Ours is one of the few studies to examine the effect of demand side financing on quality of care (Hunter, Harrison, Portela, & Bick, 2017) with only one quasi-experimental study identified reporting improvements on postnatal quality in Kenya (Watt et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Implementation and effectiveness of free health insurance for the poor pregnant women in Tanzania: A mixed methods evaluation

Kuwawenaruwa

Ramsey

Binyaruka

et al. 2019

Social Science & Medicine

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Demand side financing strategies have been a popular means of increasing coverage and availability of effective maternal and child health services in low and middle income countries (LMIC). However, most research to date has focused on the effects of demand side financing on the use and costs of care with less attention being paid to how they work to achieve outcomes. This study used a mixed methods evaluation to determine the effect of a targeted health insurance scheme on access to affordable quality maternal and child care, and assess implementation fidelity and how this affected programme outcomes. Programme effects on service access, affordability and quality were evaluated using difference in difference regression analysis, with outcomes being measured through facility, patient and household surveys and observations of care before the intervention started and eighteen months later. A simultaneous process evaluation was designed as a case study of the implementation experience. A total of 90 in-depth interviews (IDIs) and five focus group discussions were conducted during three rounds of data collection among respondents from management, facility and community. The scheme achieved high coverage among the target population and reduced the amount paid for antenatal and delivery care; however, there was no effect on service coverage and limited effects on quality of care. The lack of programme effects was partly due to the late timing of first ANC visits and registration for the scheme together with limited understanding of entitlements among beneficiaries and providers. Better communication of programme benefits is needed to enhance effects together with integration of such schemes within existing purchasing mechanisms and in financially decentralised health systems.

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The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review

Cited by 84 publications

References 63 publications

Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada

Utilization of antenatal care and out of pocket expenditure on delivery care in Dakshina Kannada

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

Implementation and effectiveness of free health insurance for the poor pregnant women in Tanzania: A mixed methods evaluation

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