Improving access to maternity services: An overview of cash transfer and voucher schemes in South Asia

Kate Jehan, Kristi Sidney, Helen Smith, Ayesha de Costa

    Research output: Contribution to journalArticlepeer-review

    Abstract

    In Nepal, India, Bangladesh and Pakistan, policy focused on improving access to maternity services has led to measures to reduce cost barriers impeding women's access to care. Specifically, these include cash transfer or voucher schemes designed to stimulate demand for services, including antenatal, delivery and post-partum care. In spite of their popularity, however, little is known about the impact or effectiveness of these schemes. This paper provides an overview of five major interventions: the Aama (Mothers') Programme (cash transfer element) in Nepal; the Janani Suraksha Yojana (Safe Motherhood Scheme) in India; the Chiranjeevi Yojana (Scheme for Long Life) in India; the Maternal Health Voucher Scheme in Bangladesh and the Sehat (Health) Voucher Scheme in Pakistan. It reviews the aims, rationale, implementation challenges, known outcomes, potential and limitations of each scheme based on current available data. Increased use of maternal health services has been reported since the schemes began, though evidence of improvements in maternal health outcomes has not been established due to a lack of controlled studies. Areas for improvement in these schemes, identified in this review, include the need for more efficient operational management, clear guidelines, financial transparency, plans for sustainability, evidence of equity and, above all, proven impact on quality of care and maternal mortality and morbidity. © 2012 Reproductive Health Matters.
    Original languageEnglish
    Pages (from-to)142-154
    Number of pages12
    JournalReproductive Health Matters
    Volume20
    Issue number39
    DOIs
    Publication statusPublished - Jun 2012

    Keywords

    • Cash transfer
    • Demand-side financing
    • Health care financing
    • Maternal health care
    • South Asia
    • Voucher

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