Table 2 Summary of key findings from quantitative studies on short-term cash payments and cash transfers
Programme | Effect on care-seeking outcomesa | Key findings from synthesis of factors influencing implementation | |
|---|---|---|---|
Enablers | Barriers | ||
Conditional cash transfers | |||
Comunidades Solidarias Rurales, El Salvador | Increased skilled birth attendance and facility births. No effect on antenatal care and postnatal care | -Awareness generation during monthly meetings [19] -Concurrent investments in health facility infrastructure and recruitment of health workers [19] -Payments made to women (not their husbands) [19] | None stated |
Mi Familia Progresa, Guatemala | Increased antenatal care. No effect on facility births | -Concurrent investments in health facility infrastructure and recruitment of health workers [20] | None stated |
Programa de Asignación Familia, Honduras | Increased antenatal care. No effect on postnatal care | -Conditionalities to submit paperwork at health facilities [21] | -Poor awareness among women of programme conditionalities [21] |
Muthulakshmi Reddy Maternity Benefit Scheme, India | Associated with use of public facilities for antenatal care and childbirth | -Increased total amount of payments [22] | -Delays in receipt of money for women [22] -Overly bureaucratic process for determining eligibility [22] -Eligibility criteria that restrict payments to women for her first or second live birth [22] |
Program Keluarga Harapan, Indonesia | Increased antenatal and postnatal care. Mixed picture of positive and no effect on skilled birth attendance. No effect on facility births | -Awareness generation by community-based workers [24] | -Poor awareness of the programme among target groups [24] -Delays in receipt of money for women [24] -Failure to implement verification systems to penalise households that do not meet conditionalities [24] -Poor availability of midwives [26] -High start-up costs [24] |
Oportunidades, Mexico | Mixed picture of positive and no effect on skilled birth attendance. No effect on antenatal care | -Perceived poor behaviour of staff at participating hospitals [33] -Attitudes towards formal maternity care services of family members who do not attend monthly meetings [34] -Distance to participating facilities [33] -Cost of travel to health facilities [33] -Lack of concurrent investment in health facilities [28, 29] | |
Plan de Atención Nacional a la Emergencia Social (PANES), Uruguay | Increased antenatal care. No effect on skilled attendance at birth. | -Conditionalities for antenatal care were not enforced [35] | -Conditionalities for antenatal care were not enforced [35] |
Unconditional cash transfers | |||
Child Grant Programme, Zambia | No effect on skilled birth attendance or antenatal care | None stated | -Lack of concurrent investment in health facilities [36] |
Short-term cash payments | |||
CHIMACA programme, China | No effect on antenatal care or postnatal care | None stated | -Payment too small [37] -Overly difficult process for claiming money [37] |
Janani Suraksha Yojana, India | Increased skilled birth attendance and facility births. Mixed picture of positive, negative and no effect on antenatal care and postnatal care | -Awareness generation by community-based workers [38, 39] -Round-the-clock opening of health facilities [38, 60] -Emergency transport programmes [62] -Accreditation of remote health facilities to reduce travel distances [55] -Active involvement of state and district officials [55] -Detailed implementation plans [38] | -Poor awareness of the programme among target groups [63] -Distance and lack of transport to participating facilities [55, 60] -Payments not made until after childbirth, thereby reducing incentive for antenatal care [55, 62] -Delays in receipt of money for women [39, 51, 55, 60, 63] -Demands for additional or informal payments [39, 60, 63] -Perceived poor quality of care at participating facilities [39] -Overly bureaucratic process for determining eligibility [55] -Inappropriate proxy measures of poverty, such as caste [38] -Women who travel to another area to give birth [51] -Delays in recruitment of community-based workers [39] -Poor awareness of the existence of community-based workers [63] -Delays in payments for community-based workers [55] -Increased workloads and reduced quality of care at participating health facilities [55, 62, 63] -Lack of trained midwives [62] -Existence of a similar programme – the National Maternity Benefit Scheme [55] |
Safe Delivery Incentive Programme, Nepal | Increased antenatal care. Mixed picture of positive or no effect on skilled birth attendance and facility births | -Awareness generation by women’s groups in communities [77] -Lack of geographical barriers in the study district [77] -Universal eligibility [77] -Output-based reimbursements for providers [77] | -Poor awareness of the programme among target groups [77] -Delays in receipt of money for women [77] -Payments not sufficient to cover treatment costs [77] -Demands for additional or informal payments [77] -Overly difficult process for claiming money [77] -Confusion amongst health workers and officials regarding eligibility criteria, sharing of health worker incentives and payment mechanisms for women [77] |
SURE-P programme, Nigeria | No effect on skilled birth attendance or antenatal care | -Prompt payments to pregnant women [78] -Defined roles and contracts for local banks and for organisations that will develop information systems [78] -Concurrent programmes to expand availability of maternity care services [78] | -Increased workload at participating health facilities [78] -High start-up costs including research, advocacy, development of information systems, recruitment of workers for data collection and the logistics and security of payments to pregnant women [78] |