Studies that documented improved care-seeking indicated the importance of adequate programme scope ( in terms of programme eligibility , size and timing of payments and voucher entitlements ) to address the issue of concern , concurrent investments in supply-side capacity to sustain and /or improve quality of care , and awareness generation using community-based workers , leaders and women ’s groups .
Conclusions Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social , geographical and health systems factors as barriers to accessing care .
Background Dem and -side financing ( DSF ) interventions , including cash transfers and vouchers , have been introduced to promote maternal and newborn health in a range of low- and middle-income countries .
These interventions vary in design but have typically been used to increase health service utilisation by off setting some financial costs for users , or increasing household income and incentivising ‘ healthy behaviours ’ .
This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health .
Impact of Financial and Educational Interventions on Maternity Care: Results of Cluster Randomized Trials in Rural China, CHIMACA
To report on the design and basic outcomes of three interventions aim ed at improving the use and quality of maternity care in rural China :  financial interventions , training in clinical skills , and training in health education . Community-based cluster r and omized trials were carried out in one central and two western provinces between 2007 and 2009 : ( 1 ) financial interventions covered part of women ’s costs for prenatal and postnatal care , ( 2 ) training of midwives in clinical skills was given by local maternity care experts in two- or three-group training courses , ( 3 ) health education training for midwives and village doctors were given by local experts in health education in two- or three-group training courses . A survey was conducted in a stratified r and om sample of women who had been pregnant in the study period . 73 % of women ( n = 3,673 ) were interviewed within 1–10 months of giving birth . Outcomes were compared by the different intervention and control groups . Adjusted odds ratios were calculated by logistic regression to adjust for varying maternal characteristics . Most of the differences found between the groups were small and some varied between provinces . The financial intervention did not influence the number of visits , but was associated with increased caesarean sections and a decrease in many ultrasound tests . The clinical intervention influenced some indicators of care content . There was no consistent finding for the health education intervention . Financial and training interventions have the potential to improve maternity care , but better implementation is required . Unintended consequences , including overuse of technology , are possible
Studies that documented improved care-seeking indicated the importance of adequate programme scope ( in terms of programme eligibility , size and timing of payments and voucher entitlements ) to address the issue of concern , concurrent investments in supply-side capacity to sustain and /or improve quality of care , and awareness generation using community-based workers , leaders and women ’s groups .
Conclusions Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social , geographical and health systems factors as barriers to accessing care .
Background Dem and -side financing ( DSF ) interventions , including cash transfers and vouchers , have been introduced to promote maternal and newborn health in a range of low- and middle-income countries .
These interventions vary in design but have typically been used to increase health service utilisation by off setting some financial costs for users , or increasing household income and incentivising ‘ healthy behaviours ’ .
This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health .