Results Data from 51 studies ( 15 more than previous review s ) 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 .
There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes .
Background Cash transfers and vouchers are forms of ‘ dem and -side financing ’ that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years .
Paying the price: the cost and consequences of emergency obstetric care in Burkina Faso.
Substantial healthcare expenses can impoverish households or push them further into poverty . In this paper , we examine the cost of obstetric care  and the social and economic consequences associated with exposure to economic shocks up to a year following the end of pregnancy in Burkina Faso . Burkina Faso is a low-income country with poor health outcomes and a poorly functioning health system . We present an inter-disciplinary analysis of an ethnographic study of 82 women nested in a prospect i ve cohort study of 1013 women . We compare the experiences of women who survived life-threatening obstetric complications ( ' near-miss ' events ) with women who delivered without complications in hospitals . The cost of emergency obstetric care  was significantly higher than the cost of care for uncomplicated delivery . Compared with women who had uncomplicated deliveries , women who survived near-miss events experienced substantial difficulties meeting the costs of care , reflecting the high cost of emergency obstetric care and the low socioeconomic status of their households . They reported more frequent sale of assets , borrowing and slower repayment of debt in the year following the expenditure . Healthcare costs consumed a large part of households ' re sources and women who survived near-miss events continued to spend significantly more on healthcare in the year following the event , while at the same time experiencing continued cost barriers to accessing healthcare . In-depth interviews confirm that the economic burden of emergency obstetric care  contributed to severe and long-lasting consequences for women and their households . The necessity of meeting unexpectedly high costs challenged social expectations and patterns of reciprocity between husb and s , wives and wider social networks , placed enormous strain on everyday survival and shaped physical , social and economic well-being in the year that followed the event . In conclusion , we consider the implication s of our findings for financing mechanisms for maternity care in low-income setting
Results Data from 51 studies ( 15 more than previous review s ) 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 .
There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes .
Background Cash transfers and vouchers are forms of ‘ dem and -side financing ’ that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years .