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

Hunter, B. , Harrison, S., Portela, A. and Bick, D. (2017) The effects of cash transfers and vouchers on the use and quality of maternity care services: a systematic review. PLoS ONE, 12(3), e0173068. (doi: 10.1371/journal.pone.0173068) (PMID:28328940) (PMCID:PMC5362260)

Abstract

Background Cash transfers and vouchers are forms of ‘demand-side financing’ that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. Methods This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Results Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Conclusion Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hunter, Dr Benjamin
• Authors: Hunter, B., Harrison, S., Portela, A., and Bick, D.
• College/School: College of Social Sciences > School of Social and Political Sciences > Economic and Social History
• Journal Name: PLoS ONE
• Publisher: Public Library of Science
• ISSN: 1932-6203
• ISSN (Online): 1932-6203
• Copyright Holders: Copyright: © 2017 World Health Organization
• First Published: First published in PLoS ONE 12, 3: e0173068
• Publisher Policy: Reproduced under a Creative Commons licence