Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review

Murray, Susan F; Hunter, Benjamin M; Bisht, Ramila; Ensor, Tim; Bick, Debra

doi:10.1186/1471-2393-14-30

Table 2 Modes of DSF

From: Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low- and middle-income countries: a systematic review

	Mechanism for promoting maternal health	Administrative structure used	Distribution	Programmes and studies included in the systematic review	Monetary benefit or equivalent to recipient (maternal health component only) - expressed in US dollars and as a proportion of gross domestic product per capita per month. Illustration sourced from the most recently published study.
Unconditional cash transfers	Alleviates deleterious effects of poverty on health during period of pregnancy	Government health system	Directly into a bank account	Dr Muthulakshmi Reddy Memorial Assistance Scheme (India) [14]	USD 68 (58% of GDP per capita per month) paid twice during pregnancy [14]
Conditional cash transfers	Conditionalities improve utilisation of specified maternity services	Social welfare system	Directly into a bank account, community distribution or sent to beneficiaries	Oportunidades (Mexico – previously PROGRESA) [11, 25–32]	Not stated
				Comunidades Solidarias Rurales (El Salvador – previously Red Solidaria) [28, 33]	USD 15 (5%) every month [33]
				Juntos (Peru) [12]	USD 75 (15%) every two months [12]
				Bono Juana Azurduy (Bolivia) [12]	USD 250 (129%) over 33 months [12]
				Programa de Asignacion Familiar (Honduras) [13]	USD 3 (3%) every month [13]
				Social Risk Mitigation Project (Turkey) [28]	Not stated
				Program Keluarga Harapan (Indonesia) [34]	USD 30 (10%) every four months [34]
Short-term payments to offset costs of access	Alleviates deleterious effects of poverty on access to maternity services	Government health system	Retrospective payments at health facilities	Janani Suraksha Yojana (India) [9, 35–60]	USD 13 – 31 (11-26%), depending on location [40]
Short-term payments to offset costs of access		Government health system	Retrospective payments at health facilities	Safe Delivery Incentive Programme (Nepal) [10, 61, 62]	USD 7 – 24 (12-41%), depending on location [10]
Vouchers for maternity services	Removes/reduces cost of specified maternity services at point of use	Parallel voucher management agency	Community-based distribution (if vouchers are used)	Vouchers for Health (Kenya) [6, 63–65]	Four ANC, delivery and two PNC (voucher cost USD 2.50 - 3%) [64]
				HealthyBaby vouchers (Uganda) [6, 66]	Four ANC, delivery and two PNC (voucher cost USD 1.20 - 3%) [66]
				Makerere University Voucher Scheme (Uganda) [67]	Three ANC, delivery, two PNC and transport costs (voucher provided free) [67]
				Obstetric Care State Certificate Program (Armenia) [68]	Aimed to eliminate informal payments [68]
				Pilot voucher scheme (Pakistan) [69, 70]	Three ANC, delivery and one PNC (voucher cost USD 1.20 - 1%) [69]
				Sambhav vouchers (India) [71]	Three ANC, delivery and two PNC (voucher provided free) [71]
				Chiranjeevi scheme (India) [72, 73]	One ANC, delivery, transport and food (no voucher)
				MAMTA scheme (India) [74]	Three ANC, delivery and one PNC (voucher provided free) [73]
				Pilot voucher scheme (Bangladesh) [75]	Three ANC, delivery, one PNC and transport costs (voucher provided free) [75]
				Maternal Health Voucher Scheme (Bangladesh) [8, 76–80]	Three ANC, delivery, one PNC and transport costs (voucher provided free) [80]
				Pilot voucher scheme (Cambodia) [81]	Three ANC, delivery, one PNC and transport costs (voucher provided free) [81]
Vouchers for merit goods	Removes/reduces cost of merit good at point of use	Government health facilities	Distribution at health facilities	Discount voucher scheme (Tanzania) [82, 83]	USD 0.50 (2%) discount on an insecticide-treated net costing USD 3.50 [83]
				Tanzania National Voucher Scheme (Tanzania) [7, 84, 85]	USD 2.70 (6%) discount on an insecticide-treated net costing USD 3.65 [7]
				Volta voucher scheme (Ghana) [86]	USD 4.20 (5%) discount on an insecticide-treated net [86]

Notes. USD refers to US dollars, ANC to antenatal care, PNC to postnatal care. Some DSF programmes fit into more than one mode, such as the Social Risk Mitigation Programme in Turkey and the Maternal Health Voucher Scheme in Bangladesh which both include short-term payments to offset costs of access for maternity services. Other programmes included supply-side components that were not reviewed here, for example removal of user fees in Nepal. Conditions were added to the Dr Muthulakshmi Reddy Memorial Assistance Scheme in 2012. Where studies did not provide a currency conversion into US Dollars, the conversion was made using historical rate tables produced by XE based on the month and year in which the article was published [87]. Value as a proportion of gross domestic product per capita per month was calculated using World Bank data from the year in which the article was published [22].

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ISSN: 1471-2393

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