Table 1 Table of characteristics of included studies

 Barber and Gertler (2008)

Cross-sectional

Rural communities, Mexico

Oportunidades (conditional cash transfers)The programme was launched in 1997 as PROGRESA and later renamed Oportunidades. Monthly cash transfers are paid directly to mothers and are conditional on meeting health and education requirements. These included regular antenatal visits for pregnant women and attendance at health education meetings.

Conditional cash transfers

Perinatal morbidity, ANC

 Barber and Gertler (2009)

Cross-sectional

Rural communities, Mexico

Conditional cash transfers

QoC

 Barber (2010)

Cross-sectional

Rural communities, Mexico

Conditional cash transfers

C/I

 Barham (2011)

Retrospective area study

Rural communities, Mexico

Programme less effective in areas that do not meet minimum level of sanitation

Infant mortality, NM

 Hernandez Prado et al. (2004)

Retrospective area study

Rural, semi-urban and urban areas, Mexico

Conditional cash transfers

MM, infant mortality

 Hernandez Prado et al. (2004)

Repeat cross-sectional

Rural, semi-urban and urban areas, Mexico

Conditional cash transfers

ANC, SBA, C/I, QoC, infant morbidity

 Sosa-Rubai et al. (2011)

Cross-sectional

Rural communities, Mexico

Conditional cash transfers, but need better targeting to marginalised groups

ANC

 Urquieta et al. (2009)

Repeat cross-sectional

Rural communities, Mexico

Conditional cash transfers, but need to include household members who influence decision-making on place of birth

SBA

 Alatas et al. (2011)

Repeat cross-sectional

Rural and urban districts in Indonesia

Program Keluarga Harapan (conditional cash transfers)The programme was introduced in 2007 and was targeted to five provinces. It was piloted in sub-districts that were felt had sufficient supply-side capacity to meet additional demand for services. Eligible households included those with pregnant or lactating women and women were expected to attend ANC, use a SBA and receive PN/PP. A cash transfer is paid quarterly to the women through a nearby post office. Facilitators are expected to verify that conditionalities are met.

Conditional cash transfers, but relax conditionalities in areas with weaker health systems

ANC, SBA, FB, PN, NM, infant mortality

 Febriany et al. (2011)

Qualitative – interviews and focus groups

12 villages (mixed urban and rural) in 2 provinces, Indonesia

Conditional cash transfers, but need to reduce gaps in service provision and overcome social, economic and geographical barriers

Implementation

 Triyana (2012)

Repeat cross-sectional

Rural and urban areas in Indonesia

Conditional cash transfers

MM, NM, infant mortality, SBA, QoC

 Amarante et al. (2011)

Repeat cross-sectional

Uruguay

Plan de Atención Nacional a la Emergencia Social (PANES) (conditional cash transfers)Between April 2005 and December 2007, Plan de Atención Nacional a la Emergencia Social was implemented by the Uruguayan government. Monthly payments were made to eligible households. In homes with a pregnant woman, payments were conditional on her attendance at ANC.

Conditional cash transfers

Perinatal morbidity, maternal morbidity, ANC, SBA

 Bala-subramanian and Ravindran (2012)

Cross-sectional

Tamil Nadu, India

Muthulakshmi Reddy Maternity Benefit Scheme (conditional cash transfers)The programme was launched in Tamil Nadu, India, in 1987 and provided unconditional payments (in two instalments) to pregnant women. Payments were increased in size over time and were made conditional on antenatal care attendance in 2012. The eligibility of women is determined by a village health nurse and includes those who meet criteria for poverty and who had previously had no more than two live births.

Conditional cash transfers, but shorter application process needed

FB

 Public Health Resource Network (2010)

Qualitative – in-depth interviews

2 districts in Tamil Nadu, India

Conditional cash transfers, but with universal eligibility, timely payments, assistance from community-based workers, and supply-side investment so that maternity care services are universally available and are free

Implementation

 De Brauw et al. (2011)

Repeat cross-sectional

Rural communities, El Salvador

Comunidades Solidarias Rurales (conditional cash transfers)The programme was introduced in 2005 and eligible households are identified from census data. Pregnant woman in eligible households must attend ANC and monthly local health education meetings are held. The programme coincided with health system strengthening programmes introduced by the government.

Conditional cash transfers, but should be conditional on ANC during first trimester, SBA and PNC

ANC, FB, SBA, PN

 Guanais (2013)

Retrospective area study

Brazil

Bolsa Familia (conditional cash transfers)Since 2003 Brazil has paid monthly cash transfers to eligible households that meet conditionalities including that pregnant women attend ANC. Payments are made to women and are credited to electronic benefit cards.

Conditional cash transfers, but should be accompanied by supply-side interventions

Post-neonatal mortality

 Shei (2013)

Retrospective area study

Brazil

Conditional cash transfer effective but need to meet increased demand for services and need to target vulnerable groups

NM, post-neonatal mortality, infant mortality

 Gutierrez et al. (2011)

Repeat cross-sectional

Guatemala

Mi Familia Progresa (conditional cash transfers)Introduced by the Guatemalan government in 2008, Mi Familia Progresa payments are made to eligible households with a pregnant woman and are conditional on ANC attendance.

Conditional cash transfers

ANC, FB, PM

 Morris et al. (2004)

Repeat cross-sectional

Rural municipalities, Honduras

Programa de Asignación Familia (conditional cash transfers)Vouchers with a cash value were distributed to eligible households on a regular basis. Distribution to households with a pregnant woman was conditional on her ANC attendance.

Conditional cash transfers

ANC, PN

  Handa et al. (2015)

Repeat cross-sectional

Three rural districts in Zambia

Child Grant Programme (conditional cash transfers)Launched in 2010, the programme operates in three districts with the highest rates of mortality and morbidity. Eligibility is universal within programme areas as long as there is a young child in the household. Payments are made directly to mothers.

Unconditional cash transfers, but need access to maternity services and may need complimentary short-term payments that are conditional on uptake of maternity care services

ANC, QoC, SBA

  Amudhan et al. (2013)

Quasi-experimental pre- and post- comparative with control groups

Rural area in Haryana, India

Janani Suraksha Yojana (payments to offset costs of access)The programme was launched in 2005 as part of the National Rural Health Mission. A cadre of community-based workers (accredited social health activists) were created to promote the programme in communities. Women from low-income households could receive a cash payment if they give birth in a health facility (usually government, although some states also accredited private facilities). Accredited social health activists are salaried and expected to encourage ANC, facility-based births and PN/PP. They are eligible to receive a payment for accompanying a woman to a health facility to give birth.

Short-term payments, but followed by supply-side strengthening

FB

  Carvalho et al. (2014)

Cross-sectional

National sample of districts (mixed urban and rural), India

Short-term payments, but need appropriate systems for payments

PN, PP

  Chaturvedi and Randive (2009)

Qualitative – semi-structured interviews and focus groups

Ahmednagar district in Maharashtra, India

Short-term payments, but ensure that private service providers are monitored and regulated

Implementation

  Chaturvedi and Randive (2011)

Qualitative – semi-structured interviews and focus groups

Ensure sufficient government capacity to design and manage public-private partnerships

Implementation

  Chaturvedi et al. (2015a)

Qualitative – observations and interviews

11 health facilities in Madhya Pradesh

Improve quality of care before introducing short-term payment programmes

Implementation

  Chaturvedi et al. (2015b)

Qualitative – record reviews and interviews

73 health facilities in Madhya Pradesh

Train and support staff to use partographs

Implementation

  Coffey (2014)

Qualitative – interviews and observations

Three villages in a rural district in Uttar Pradesh

Short-term payments, but need to incentivise health outcomes

Implementation

  Dasgupta (2007)

Qualitative – maternal death investigations

7 districts in Uttar Pradesh, India

Invest in supply-side capacity, promote awareness of programme benefits, and develop systems to track each pregnancy

Implementation

  Devadasan et al. (2008)

Qualitative - interviews

One district in each of four states, India

Short-term payments, but need to ensure quality of care, use streamlined processes for distribution of payments and monitor the programme

Implementation

  Gopalan et al. (2012)

Qualitative – interviews and focus groups

Three districts in Orissa

Short-term payments, but with greater protection for families from costs of care

Implementation

  Gupta (2007)

Qualitative – interviews and focus groups

Nalanda and West Champaran (rural) districts in Bihar, India

No recommendations made

Implementation

  Hangmi and Kuki (2009)

Qualitative – interviews and focus groups

Churachandpur (rural) district in Manipur, India

Short-term payments, but need to invest in capacity of service providers, ensure fair selection of community-based workers, and streamline cash payments

Implementation

  Human Rights Watch (2009)

Qualitative – individual and group interviews

Rural areas in Uttar Pradesh, India

Develop monitoring systems

Implementation

  Joshi and Sivaram (2014)

Repeat cross-sectional

National sample of districts (mixed urban and rural), India

Concurrent supply-side strengthening and flexibility in guidelines

ANC, SBA, PN

  Khan et al. (2010)

Qualitative – interviews

24 villages in Uttar Pradesh (rural), India

Short-term payments, but with adequate training and incentives for community-based workers, and inclusion of private service providers

Implementation

  Krishna and Ananthpur (2011)

Qualitative – interviews and focus groups

Gulbarga and Raichur (rural) districts in Karnataka, India

No recommendations made

Implementation

  Kumar et al. (2009)

Qualitative – focus groups

Una (predominantly rural) district in Himachal Pradesh, India

Short-term payments, but with streamlined distribution of cash payments and ensure community-based workers appropriately trained and that posts are filled

Implementation

  Lim et al. (2010)

Repeat cross-sectional

National sample of districts (mixed urban and rural), India

Short-term payments, but need improved targeting and quality of care

ANC, FB, SBA, PM, NM

  Lodh et al. (2009)

Qualitative – interviews and focus groups

Muzaffarpur district (predominantly rural) in Bihar, India

Short-term payments, but with streamlined distribution of cash payments

Implementation

  Mazumdar et al. (2012)

Repeat cross-sectional

National sample of districts (mixed urban and rural), India

Short-term payments, but caution regarding unintended consequences

ANC, FB, SBA, C/I, NM

  Nandan et al. (2008)

Qualitative – semi-structured and in-depth interviews and focus groups

3 districts in Orissa (predominantly rural), India

Short-term payments using streamlined payment systems, inclusion of private service providers, supply-side investment and awareness generation

Implementation

  Nandan et al. (2008)

Qualitative – semi-structured and in-depth interviews and focus groups

3 districts in Orissa, India

Short-term payments using streamlined payment systems, supply-side investment and awareness generation

Implementation

  Purohit et al. (2014)

Cross-sectional

Four districts in Rajasthan, India

Short-term payments

ANC, PN, QoC

  Rai et al. (2012)

Qualitative – in-depth interviews and focus groups

12 villages in Jharkhand, India

Short-term payments alongside investment in supply-side capacity

Implementation

  Randive et al. (2013)

Repeat cross-sectional

284 districts across nine Indian states

Short-term payments, but need to improve quality of care to impact on MM

FB

  Santhya et al. (2011a)

Repeat cross-sectional

Alwar and Jodhpur districts (mixed rural and urban), India

Short-term payments, but improve awareness among communties, quality of services and administrative capacity

ANC, FB, SBA, PP, QoC, oxytocin

  Santhya et al. (2011b)

Qualitative – in-depth interviews

Alwar and Jodhpur districts in Rajasthan, India

Short-term payments with trained community-based workers to raise awareness in communities

Implementation

  Singh and Chaturvedi (2007)

Qualitative – focus groups and interviews

Five districts in Uttar Pradesh and three districts in Uttarakhand, India

Short-term payments using streamlined systems, inclusion of postpartum care and removal of formal and informal user fees

Implementation

  Sri et al. (2012)

Qualitative – maternal death reviews

Barwani district, Uttar Pradesh, India

Investments must be made in supply-side strengthening and ensuring quality of care before short-term payments are considered

Implementation

  Uttekar et al. (2007a)

Qualitative - interviews

3 districts in Himachal Pradesh, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2007b)

Qualitative - interviews

3 districts in West Bengal, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2007c)

Qualitative - interviews

3 districts in Orissa, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2007d)

Qualitative - interviews

3 districts in Rajasthan, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2007e)

Qualitative - interviews

3 districts in Assam, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2008a)

Qualitative - interviews

3 districts in Uttar Pradesh, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Uttekar et al. (2008b)

Qualitative - interviews

3 districts in Bihar, India

Short-term payments, but need to ensure quality of care by investing in supply-side capacity, use streamlined payments and raise awareness among hard-to-reach communities

Implementation

  Vora et al. (2012)

Cross-sectional

Rural areas in Gujarat and Tamil Nadu, India

Short-term payments, but should expand availability of health facilities, develop referral networks, include public and/or private facilities depending on local health system, promote awareness generation, and divide payments across maternity care services to incentivise multiple services.

ANC, FB, C/I

 Hemminki et al. (2013)

Cross-sectional

One county in Anhui province, China

CHIMACA project (payments to offset costs of access)Women could claim a small cash payment from a health centre if they attended ANC between 2007 and 2009. The size of the payment was increased with the number of ANC visits. Village family planning workers distributed leaflets in communities to advertise the programme and midwives distributed the leaflets to women attending ANC.

Short-term payments, but need payments that are appropriately sized and relatively easy to obtain

ANC, C/I, PN, QoC

 Okoli et al. (2014)

Retrospective area study

Nine states, Nigeria

SURE-P (short term payments to offset costs of access)Cash payments were made to women who attended specific maternity care services (ANC, childbirth and PN/PP). Eligibilty was geographic and was based on the selection of health facilities participating in the wider SURE-P health programme. If a woman was referred to a higher level hospital, the hospital received a payment.

Short-term payments, but need to improve retention of programme recipients throughout pregnancy

ANC, SBA

 Powell-Jackson et al. (2009)

Retrospective area study

Makwanpur district (rural), Nepal

Safe Delivery Incentive Programme (payments to offset costs of access)The programme was launched in 2005 and provides a cash payment to women who give birth in a health facility, and to a health worker who attends her birth (either at home or in a health facility). Payments were initially only available to women who have had two or fewer previous live births, but this condition was later removed. The programme was initially limited to government health facilities but later expanded to include the private sector.

Short-term payments, but need to improve quality of care to impact on NM and need to ensure good communication to communities

ANC, FB, SBA, C/I, NM

 Powell-Jackson et al. (2009)

Qualitative – interviews and focus groups

10 districts, Nepal

Attention to implementation challenges in countries with poor capacity to administer programmes and provide services, and careful planning

Implementation

 Powell-Jackson and Hanson (2012)

Cross-sectional

National sample of districts (mixed urban and rural), India

Short-term payments, but need effective implementation

SBA, FB, C/I

  Agha (2011a)

Repeat cross-sectional

Dera Ghazi Khan City (urban), Pakistan

Pilot voucher scheme (vouchers for maternal health services)12 month programme in which vouchers were sold to eligible families and local officials verified eligibility. Vouchers could be exchanged at participating Greenstar facilities for ANC, childbirth (including caesarean section if needed), PP and PN. Providers were reimbursed for each voucher accepted.

Vouchers for maternity care services

ANC, FB, PN

  Agha (2011b)

Repeat cross-sectional

Jhang district (rural), Pakistan

Vouchers for maternity care services

ANC, FB, PN

  Ahmed and Khan (2011)

Cross-sectional

Sarishabari district (predominantly rural), Bangladesh

Maternal Health Voucher Scheme (vouchers for maternal health services) Since 2007 poor pregnant women received vouchers (some districts had universal distribution, some had targeted distribution) entitling them to free maternity care services (ANC, childbirth, PN/PP), transport subsidies, a cash incentive for delivery with a qualified provider (at home or in a designated facility) and a gift box. Providers received incentives to distribute vouchers and provide services that were covered by the vouchers.

Vouchers for maternity care services

ANC, FB, SBA, PN

  Ahmed and Khan (2011)

Qualitative – semi-structured interviews

Sarishabari district (predominantly rural), Bangladesh

Vouchers for maternity care services, but with significant expansion of service delivery capacity of health facilities

Implementation

  Hatt et al. (2010)

Cross-sectional

Early implementation subdistricts (mainly rural), Bangladesh

Vouchers for maternity care services

ANC, FB, C/I, PN

Qualitative – interviews and focus groups

Early implementation subdistricts (mainly rural), Bangladesh

Vouchers for maternity care services

Implementation

  Koehlmoos et al. (2008)

Qualitative – structured and in-depth interviews and focus groups

Vouchers for maternity care services, but with investment in physical infrastructure at government facilities, appropriate human resources, and attention to incentives to conduct caesarean sections

Implementation

  Nguyen et al. (2012)

Cross-sectional

Early implementation subdistricts (mainly rural), Bangladesh

Vouchers for maternity care services as part of a wider initiative that includes supply-side strengthening

ANC, FB, SBA, C/I, PN

  Reproductive Health Vouchers Evaluation Team (2011)

Qualitative - interviews

22 sub-districts, Bangladesh

Vouchers for maternity care services

Implementation

  Rob et al. (2009)

Repeat cross-sectional

Habiganj district (rural), Bangladesh

Pilot voucher scheme (vouchers for maternal health services)12 month programme in which fieldworkers identified a total of eligible women who were then validated as “poor” by a community support group Women could use vouchers for ANC, childbirth, PN and PP. Providers were reimbursed for vouchers accepted. Service providers and fieldworkers were trained and strengthened health facilities for providing ANC, delivery, and PNC services.

Vouchers for maternity care services

ANC, FB, SBA, PN

Qualitative – semi-structured interviews

Habiganj district (rural), Bangladesh

Vouchers for maternity care services

Implementation

  Alfonso et al. (2015)

Retrospective area study

Kamuli and Pallisa districts, Uganda

Makerere University Voucher Scheme (vouchers for maternal health services)Between June 2010 and May 2011, vouchers were distributed to women in two selected areas of two Ugandan districts during ANC visits. Vouchers could be exchanged at public facilities or participating private facilities for intrapartum care, transport to and from the hospital, and for PN/PP in case of complications. Transport vouchers’ reimbursement covered the cost of the average distance in the treatment areas, and health facilities were reimbursed for services provided.

Vouchers for maternity care services

FB

  Pariyo et al. (2011)

Qualitative – focus groups

Kamuli district, Uganda

Vouchers for maternity care services, but with inclusion of transport providers

Implementation

  Okal et al. (2013)

Qualitative - interviews

7 districts, Uganda

HealthyBaby vouchers (vouchers for maternal health services)Since 2008 vouchers for maternity care services have been sold to eligible women in 20 districts. Vouchers can be exchanged at accredited private providers for ANC, childbirth, PN. Community-based voucher distributors are responsible for targeting poor pregnant women using district-customized poverty grading tool.

Vouchers for maternity care services, but with public facilities included, greater awareness raising in communities and support for policy champions

Implementation

  Reproductive Health Vouchers Evaluation Team (2012)

Repeat cross-sectional

6 districts, Uganda

Vouchers for maternity care services

ANC, FB, PN

Qualitative - interviews

30 health facilities, Uganda

Vouchers for maternity care services

Implementation

  Abuya et al. (2012)

Qualitative – in-depth interviews

Three districts and two urban slums

Vouchers for Health (vouchers for maternal health services)Since 2006 vouchers have been sold to eligible women in three districts and two informal settlements in Kenya. Vouchers can be exchanged for ANC, childbirth (including caesarean section if needed) and PN. A facility was accredited if it met criteria set by the public authorities in terms of staffing and quality of care.

Vouchers for maternity care services, with strong partnerships between public and private sectors and leading role for government

Implementation

  Amendah et al. (2013)

Repeat cross-sectional

Two urban slums in Nairobi, Kenya

Vouchers for maternity care services

FB for subsequent pregnancy

  Arur et al. (2009)

Qualitative – semi-structured interviews

Kenya

Vouchers for maternity care services if financial issues are the main barrier to care-seeking

Implementation

  Bellows et al. (2012)

Repeat cross-sectional

Informal settlements in Nairobi (urban), Kenya

Vouchers for maternity care services

ANC, FB, SBA

  Njuki et al. (2013)

Qualitative – structured interviews and focus groups

Three districts in Kenya

Vouchers for maternity care services, but with adequate information and availability of voucher distributors

Implementation

  Njuki et al. (2015)

Qualitative – in-depth interviews

Three districts in Kenya

Vouchers for maternity care services, but greater awareness of eligibility criteria and entitlements, and greater flexibility for public facilities to use income from vouchers

Implementation

  Obare et al. (2012)

Cross-sectional

Six districts (all mixed urban and rural), Kenya

Vouchers for maternity care services

ANC, FB, SBA, PN

  Obare et al. (2014)

Repeat cross-sectional

Six districts (all mixed urban and rural), Kenya

Vouchers for maternity care services, but transport costs should be included

FB

  Reproductive Health Vouchers Evaluation Team (2011)

Qualitative - interviews

6 rural districts and 2 informal settlements, Kenya

Vouchers for maternity care services with awareness generation, monitoring of quality of care, and adequate provisions to overcome geographical (transports) issues

Implementation

  Watt et al. (2015)

Repeat cross-sectional

Six districts (all mixed urban and rural), Kenya

Vouchers for maternity care services, and need to include PP before discharge from hospital within hospital agreements

QoC

  Bhat et al. (2009)

Cross-sectional

Dahod district (mixed urban and rural), India

Chiranjeevi Scheme (vouchers for maternal health services)The programme was introduced in five districts in Gujarat, India, in 2005. Women with documentation that indicate eligibility can receive free maternity care services at participating private facilities. Facilities are reimbursed for every 100 women who they provide care to.

Vouchers for maternity care services

PN

  De Costa et al. (2014)

Retrospective area study

Gujarat, India

Further research needed

FB

  Ganguly et al. (2014)

Qualitative – interviews

Two districts in Gujarat, India

Vouchers for maternity care services, but with greater attention to developing trust between service providers and communities

Implementation

  Jega (2007)

Qualitative – interviews

2 districts in Gujarat (mixed urban and rural), India

Vouchers for maternity care services, but with antenatal and postnatal care included, supply-side investment (to establish blood banks) and formal monitoring systems

Implementation

  Mohanan et al. (2014)

Cross-sectional

Gujarat, India

Further research needed

ANC, FB, PN

  Ir et al. (2010)

Qualitative – in-depth interviews and focus groups

3 districts in Kampong province, Cambodia

Voucher programme (vouchers for maternal health services)The programme was implemented in 22 districts between 2007 and 2010. Voucher distribution was universal in 14 districts and targeted in 8 districts. Eligible women were identified local volunteers and could use vouchers for free ANC, childbirth and PN/PP at public health facilities. Health centres were reimbursed for vouchers.

Vouchers for maternity care services alongside interventions to promote quality of care and to overcome non-financial barriers to demand

Implementation

  Van de Poel et al. (2014)

Cross-sectional

Nationally representative sample, Cambodia

Vouchers for maternity care services, but universal distribution may be more effective than targeting

ANC, FB, C/I, PN

  Hanson et al. (2009)

Repeat cross-sectional

21 districts (mixed urban and rural), Tanzania

Tanzanian National Voucher Scheme (vouchers for merit goods)Women attending ANC were given a voucher that entitled them to a discounted insecticide-treated net (of any size) from an approved supplier. The programme began in 2004 and expanded globally over subsequent years.

Vouchers for merit goods

Ownership and use of insecticide-treated net

  Koenker et al. (2013)

Qualitative – meetings, site visits and mathematical modelling

Five areas in Tanzania

Vouchers for merit goods, with voucher distribution in schools and at health clinics

Implementation

  Mubyazi et al. (2010)

Qualitative – interviews and focus groups

Mkuranga and Mufindi districts (rural), Tanzania

No recommendation made

Implementation